Self-injurious behaviour and suicidal ideation during dialectical behaviour

Objective: The purpose of this study was to investigate the effect of dialectical behaviour therapy (DBT) and specific DBT modules on the longitudinal evolution of parasuicide of borderline patients (BPD). It was expected that a decrease in parasuicide would occur, in particular during therapy module ‘crisis coping skills’. Method: Hypotheses were tested using a sequential and replicated single-case experimental phase-design. Thirteen BPD patients made daily recordings of the frequency, urge, and severity of their self-injury and of their suicidal thoughts and behaviour. Results: Parasuicidal behaviours showed a highly variable course but, overall, decreased during DBT, albeit that the change could not be specifically attributed to the module ‘crisis coping skills’. Conclusions: Results suggest that both the integral approach of DBT (using all DBT modules) and its long-term application may be responsible for the abiding reduction in parasuicide