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Citation
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Diamond GS, Kobak RR, Krauthamer Ewing ES, Levy SA, Herres JL, Russon JM, Gallop RJ. J. Am. Acad. Child Adolesc. Psychiatry 2019; 58(7): 721-731. |
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Abstract
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OBJECTIVE: To evaluate the efficacy of Attachment-based Family Therapy (ABFT) compared to a Family Enhanced Non-Directive Supportive Therapy (FE-NST) for reducing adolescents' suicide ideation and depressive symptoms.
METHOD: A randomized controlled trial of 129 suicidal adolescents, between the ages of 12 to 18 (49% were African-American) were randomized to ABFT (n = 66) or FE-NST (n = 63) for 16 weeks of treatment. Assessments occurred at baseline, 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms.
RESULTS: There was no significant between group difference in the rate of change in self-reported ideation Suicidal Ideation Questionnaire-Jr (SIQ-JR) (F(1,127) = 181, p=0.18). Similar results were found for depressive symptoms. However, adolescents receiving ABFT showed significant reduction in suicide ideation (t (127) = 12.61, p <.0001; effect size: d = 2.24). Adolescents receiving FE-NST experienced a similar significant reduction (t (127) = 10.88, p <.0001; effect size: d = 1.93). Response rates (i.e. 50% or more reduction in suicide ideation symptoms from baseline) at post-treatment were 69.1% for ABFT versus 62.3% for FE-NST.
CONCLUSION: Contrary to expectations, ABFT did not perform better than FE-NST. Both treatments produced substantial reductions in suicidal ideation and depressive symptoms that were comparable to or better than those reported in other more intensive, multicomponent treatments. The equivalent outcomes may be attributed to common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up, secondary outcomes, and potential moderators and mediators.
Copyright © 2018. Published by Elsevier Inc.
Language: en |