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Citation
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Berk MS, Gallop R, Asarnow JR, Adrian M, Avina C, Hughes JL, Korslund KE, McCauley E. J. Am. Acad. Child Adolesc. Psychiatry 2022; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To examine trajectories of treatment response in suicidal youth who participated in a randomized controlled trial (RCT) comparing dialectical behavior therapy (DBT) and individual and group supportive therapy (IGST).
METHOD: Using latent class analysis across both treatment conditions, we conducted secondary analyses of data from a multisite RCT with N = 173 youth, ages 12-18, with repetitive self-harm (SH, including > 1 lifetime suicide attempt) and elevated suicidal ideation (SI). The sample was 95% female, 56.4% White and 27.49% Latina. Participants received 6 months of DBT or IGST and 6 months of follow-up. Primary outcomes were SH and SI.
RESULTS: 63% of the sample were members of latent classes that showed improvement in SI and 74% showed improvement in SH. 13% were "total non-responders," with no improvement in SI or SH. SH non-response emerged at the mid-point of treatment (3 months), with non-responders showing a sharp increase in SH over the remainder of treatment and follow-up. Youth in DBT were significantly more likely to be an SH responder v. non-responder than those in IGST (ꭓ(2) [1] =6.53, p=0.01). An optimal threshold cut point using multivariate predictors of total non-response (White, externalizing symptoms, total SH, and SI) predicted total non-responders to DBT with 100% accuracy.
CONCLUSION: This is the first study to identify trajectories of both SI and SH response to treatment in a sample of adolescents at risk of suicide.
RESULTS may inform personalized treatment approaches.
Language: en |