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Dialectical Behavioral Therapy in Adolescents With Suicidal Behaviors

Not Applicable
Completed
Conditions
Suicidal Behaviors
Interventions
Behavioral: Behavioral Therapy
Registration Number
NCT02406625
Lead Sponsor
Fundacion Clinic per a la Recerca Biomédica
Brief Summary

Suicidal behaviors among adolescents represents a public health problem due to its high prevalence and its low predictability. It is also known that brain development continues during adolescence, therefore, a therapeutic intervention during this period might propitiate neural changes that might favor the emotional regulation involved in suicidal behaviors. Dialectical Behavioral Therapy has proved to be effective regarding this problem.

For this reason, the investigators aimed to study the clinical, neuropsychological and neural effects of Dialectical Behavioral Therapy in adolescents with suicidal behaviors.

Detailed Description

Suicidal behaviors represent a public health problem due to its high prevalence and its low predictability. At a neurological level, higher vulnerability for suicidal behavior has been related to a frontostriatal-cingulum tract dysfunction as well as attention, memory and executive deficits. It is also known that brain development continues during adolescence, therefore, a therapeutic intervention during this period might propitiate neural changes that could favor the emotional regulation involved in suicidal behaviors. Specifically, Dialectical Behavioral Therapy has proved to be effective regarding this problem.

The investigators hypothesis is that DBT (Dialectical Behavioral Therapy) will improve clinical symptoms associated with suicidal behaviors, as well as the neural interconnections, which will result not only in structural and functional connectivity changes, but also in a better cognitive functioning. The investigators aimed to investigate the clinical, neuropsychological, and neural effects of Dialectical Behavioral Therapy in adolescents with suicidal behaviors.

The investigators method is a randomized, controlled study that includes 30 patients with suicidal behaviors and 15 healthy controls between the ages of 12 and 18 years. Patients were assigned to one of two groups (randomized): DBT and Regular Support Therapy. Clinical and neuropsychological evaluations were performed before and after the treatment for both patient groups. Additionally, Structural MRI data sets, diffusion-tensor imaging (DTI) and Functional Connectivity (Resting State fmri) were acquired for all patients and controls at baseline and after treatment. Initial characteristics will be compared between the three groups, and the investigators will also compared clinical, neuropsychological and imaging measures before and after the treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
52
Inclusion Criteria
  • Age between 12 and 18 years,

  • Intellectual level over 70 (IQ>70)

  • For the experimental groups:

    • Patients with suicidal behavior:

      • Real attempt,
      • Interrupted attempt,
      • Aborted attempt or behaviors, or
      • Preparation actions (based on the Columbia Suicide Severity Rating Scale -C-SSRS criteria) present during the last 12 months and that persist in the actual moment.
Exclusion Criteria
  • Presence of Acute Psychosis,
  • Eating Disorder with an BMI < 18.5;
  • Substance abuse in the current moment or during the last 6 months;
  • Any neurological condition that curses with cognitive alterations; and
  • Pregnancy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Diaclectical Behavioral TherapyBehavioral Therapy15 adolescents with history of suicidal behaviors receiving Dialectical Behavioral Therapy.
Support TherapyBehavioral Therapy15 adolescents with history of suicidal behaviors receiving Support Therapy.
Primary Outcome Measures
NameTimeMethod
Neural changes after 16 sessions of Dialectical Behavioral Therapy.4 months

Magnetic Resonance Imaging and functional Magnetic Resonance Imaging data sets will be acquired at baseline and then after the treatment, in order to determine anatomical or functional brain connectivity changes in relation to the applied therapy.

Clinical changes after 16 sessions of Dialectical Behavioral Therapy.4 months

Clinical evaluations will be performed before and after the treatment in order to determine clinical improvement in relation to the applied therapy.

Neuropsychological changes after 16 sessions of Dialectical Behavioral Therapy.4 months

Neuropsychological evaluations will be administrated before and after the treatment in order to determine changes in memory, attention or executive functioning in relation to the applied therapy.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Hospital Clínic

🇪🇸

Barcelona, Spain

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