Collaborative Adolescent Research on Emotions and Suicide

Suicide is the third leading cause of death among adolescents in the US yet there is a
paucity of research on effective treatments for this population. The primary aim of the
research described in this application is to evaluate the efficacy of dialectical behavior
therapy (DBT) for suicidal adolescents. DBT has an empirical track record with suicidal
adults of reducing the incidence, frequency and medical risk of suicide attempts and
non-suicidal self-injuries among individuals meeting criteria for borderline personality
disorder (BPD). While DBT is widely used in the community with suicidal adolescents,
particularly those with difficulties characteristic of BPD such as poor emotion regulation
and impulse control, no randomized trial of DBT with suicidal adolescents has ever been
conducted. And, while non-randomized trials indicate that the intervention is both safe and
effective, without a randomized trial the investigators simply do not know whether DBT for
suicidal adolescents is efficacious or not. Given the severity of the problem and the lack
of alternative treatments for high risk adolescents, addressing this question is of great
importance. The second aim of the research is to analyze mediators of reduced suicidal and
self-injurious behaviors in adolescents. 170 adolescents at two sites (Seattle and Los
Angeles) will be randomized to DBT or Individual and Supportive Group Therapy (IGST). Both
treatments include 6 months of individual and group treatment and adolescents and a parent
complete 5 assessments over a 1-year period.