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Background <p>Non-suicidal self-injury (NSSI) is highly prevalent among adolescents. Although dialectical behavior therapy for adolescents (DBT-A) is effective, its standard format can be lengthy (often &gt; 19 weeks) and may insufficiently address deeper family dynamics, limiting accessibility and impact. This study evaluated the efficacy of a more time-contained DBT protocol, augmented with a structured parental support (PS) program, in reducing NSSI frequency and suicidal ideation (primary outcomes), as well as emotion dysregulation and depressive symptoms (secondary outcomes) in adolescents.</p> Methods <p>This study included 100 adolescents with depressive disorders who exhibited NSSI behavior and randomly assigned them to an intervention group (DBT + PS, <i>n</i> = 50) or a control group (DBT only, <i>n</i> = 50). The control group received 13 weeks of DBT (6 weeks face-to-face, 7 weeks online). The intervention group received the same DBT plus a 10-week parallel PS program. Outcomes were assessed using the Self-rating Idea of Suicide Scale, Adolescent Non-Suicidal Self-injury Assessment Questionnaire, Difficulties in Emotion Regulation Scale, Patient Health Questionnaire-9, and Montgomery–Asberg Depression Rating Scale at baseline, 6-week (mid-intervention), and 13-week (post-intervention). Data were analyzed using repeated-measures ANOVA.</p> Results <p>This study was completed by 91 participants (intervention: <i>n</i> = 44; control: <i>n</i> = 47). Significant group-by-time interactions were observed for all outcomes (<i>p</i> &lt; 0.05). Compared to the Control group, the Intervention group exhibited significantly greater reductions in NSSI frequency at 6 weeks (<i>p</i> = 0.027) and in all measured outcomes at 13 weeks, including suicidal ideation, NSSI frequency and function, emotion dysregulation, and depressive symptoms (all <i>p</i> &lt; 0.01).</p> Conclusions <p>Supplementing DBT with a structured PS program is more effective than DBT alone in improving clinical outcomes for adolescents with NSSI. Hospitals with relevant resources should consider implementing such combined interventions to improve patient recovery.</p> Clinical trial registry <p>Offline and online dialectical behavioral therapy combined with offline parental support in adolescents with non-suicidal self-injury: a randomized controlled trial (<a href="https://www.chictr.org.cn/">https://www.chictr.org.cn/</a>) (ChiCTR2500107404).</p>

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Dialectical behavior therapy combined with parental support in adolescents with non-suicidal self-injury: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月30日

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  • Yanping Zhang,
  • Yue Zhou,
  • Bingyi Du,
  • Jixuan Hou,
  • Runing Hou,
  • Binyuan Zhang,
  • Shouxun He,
  • Chuansheng Wang,
  • Fang Yan

摘要

Background

Non-suicidal self-injury (NSSI) is highly prevalent among adolescents. Although dialectical behavior therapy for adolescents (DBT-A) is effective, its standard format can be lengthy (often > 19 weeks) and may insufficiently address deeper family dynamics, limiting accessibility and impact. This study evaluated the efficacy of a more time-contained DBT protocol, augmented with a structured parental support (PS) program, in reducing NSSI frequency and suicidal ideation (primary outcomes), as well as emotion dysregulation and depressive symptoms (secondary outcomes) in adolescents.

Methods

This study included 100 adolescents with depressive disorders who exhibited NSSI behavior and randomly assigned them to an intervention group (DBT + PS, n = 50) or a control group (DBT only, n = 50). The control group received 13 weeks of DBT (6 weeks face-to-face, 7 weeks online). The intervention group received the same DBT plus a 10-week parallel PS program. Outcomes were assessed using the Self-rating Idea of Suicide Scale, Adolescent Non-Suicidal Self-injury Assessment Questionnaire, Difficulties in Emotion Regulation Scale, Patient Health Questionnaire-9, and Montgomery–Asberg Depression Rating Scale at baseline, 6-week (mid-intervention), and 13-week (post-intervention). Data were analyzed using repeated-measures ANOVA.

Results

This study was completed by 91 participants (intervention: n = 44; control: n = 47). Significant group-by-time interactions were observed for all outcomes (p < 0.05). Compared to the Control group, the Intervention group exhibited significantly greater reductions in NSSI frequency at 6 weeks (p = 0.027) and in all measured outcomes at 13 weeks, including suicidal ideation, NSSI frequency and function, emotion dysregulation, and depressive symptoms (all p < 0.01).

Conclusions

Supplementing DBT with a structured PS program is more effective than DBT alone in improving clinical outcomes for adolescents with NSSI. Hospitals with relevant resources should consider implementing such combined interventions to improve patient recovery.

Clinical trial registry

Offline and online dialectical behavioral therapy combined with offline parental support in adolescents with non-suicidal self-injury: a randomized controlled trial (https://www.chictr.org.cn/) (ChiCTR2500107404).