Academic Journal
The Effectiveness of Dialectical Behavior Therapy in Reducing Self-Directed Violence and Suicidality in Usual Care Settings: A Meta-Analysis.
| Τίτλος: | The Effectiveness of Dialectical Behavior Therapy in Reducing Self-Directed Violence and Suicidality in Usual Care Settings: A Meta-Analysis. |
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| Συγγραφείς: | Maxwell CA; Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA.; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Holland KE; Icahn School of Medicine at Mount Sinai, Center of Excellence in Eating and Weight Disorders, New York, New York, USA.; Department of Behavioral Health, Trinitas Regional Medical Center - Rober Wood Johnson - Barnabus Health, Elizabeth, New Jersey, USA., Young L; Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA.; College of Graduate Studies and Research, Immaculata University, Immaculata, Pennsylvania, USA., Chen EY; Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA., Olino T; Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA., Kendall PC; Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA. |
| Πηγή: | Journal of clinical psychology [J Clin Psychol] 2026 Nov; Vol. 82 (11), pp. 1699-1743. Date of Electronic Publication: 2026 Aug 01. |
| Τύπος έκδοσης: | Journal Article; Meta-Analysis; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley Country of Publication: United States NLM ID: 0217132 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-4679 (Electronic) Linking ISSN: 00219762 NLM ISO Abbreviation: J Clin Psychol Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2005-> : Hoboken, N.J. : Wiley Original Publication: Brandon, Vt. [etc.] Clinical Psychology Pub. Co. |
| Ιατρικοί όροι (MeSH): | Dialectical Behavior Therapy*/methods , Violence*/prevention & control , Outcome Assessment, Health Care*/statistics & numerical data , Suicidal Ideation* , Suicide Prevention*, Humans |
| Περίληψη: | Dialectical behavior therapy (DBT) has shown efficacy in reducing suicidality, though less is known about its effectiveness when delivered in usual care (UC) settings, where the resource-intensive nature of the program often results in modifications during implementation. This systematic meta-analysis examined the effectiveness of DBT in reducing suicidality-related outcomes when delivered in usual care settings. A systematic search was conducted and studies were identified for inclusion if they evaluated a DBT-based intervention with original, quantitative data reflecting pre- and post-treatment measurement of at least one of the three suicidality-related outcomes: (i) self-directed violence (SDV), (ii) crisis service use (CSU), and (iii) suicidal ideation (SI). Random effects models were used to estimate pooled effects. Meta-regression analyses were used to compare pooled effects across usual care and non-usual care settings and to examine the differential effects of theoretical predictors often involved in treatment modification. The final sample included 83 studies. In uncontrolled studies, DBT was associated with a large reduction in SDV and medium reductions in CSU and SI. In controlled studies, DBT demonstrated a significant effect for SDV but not for CSU or SI. Adjustment for publication bias attenuated the CSU findings. No differences were observed between usual care and non-usual care settings. Substantial heterogeneity was observed across models. In uncontrolled studies, positive associations emerged between therapist training and SDV reduction, adherence reporting and CSU reduction, and outpatient setting and SI reduction. Results provide the strongest support for the effectiveness of DBT in reducing SDV, with more limited and variable evidence for CSU and SI. Results should be interpreted with caution given heterogeneity and evidence of publication bias. (© 2026 The Author(s). Journal of Clinical Psychology published by Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: crisis service use; dialectical behavior therapy; effectiveness research; meta‐analysis; self‐directed violence; suicidality |
| Entry Date(s): | Date Created: 20260801 Date Completed: 20261001 Latest Revision: 20261009 |
| Update Code: | 20261009 |
| PubMed Central ID: | PMC13630350 |
| DOI: | 10.1002/jclp.70195 |
| PMID: | 42541715 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1097-4679 |
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| DOI: | 10.1002/jclp.70195 |