A Pilot Evaluation of Dialectical Behavioural Therapy in Adolescent Long-Term Inpatient Care.

BACKGROUND: There is a paucity of research investigating psychosocial treatments for youth receiving long-term residential care. OBJECTIVE: This study describes the implementation and impact of dialectical behavioural therapy (DBT) in a long-term psychiatric hospital located in the United States of America. METHOD: Changes in overall functioning, number of psychotropic medications prescribed, non-suicidal self-injurious behaviour (NSIB), and locked seclusions were investigated in 106 consecutive unique adolescent patients who received DBT. In addition, a comparison group of historical controls was used to examine the effect of DBT in youth with the highest rates of NSIB. RESULTS: A statistically significant increase in overall functioning, as well as a decrease in number of psychotropic medications and non-suicidal self-injurious behaviour (NSIB) was observed within the DBT group. A decrease in locked seclusions was not observed. Accounting for the effects of age, gender, length of stay, and time, youth who received DBT were less likely to engage in NSIB relative to historical controls. CONCLUSIONS: These preliminary data suggest that DBT is beneficial for youth with NSIB in long term inpatient psychiatric care.

Trajectories of maternal depressive symptoms, maternal sensitivity, and children's functioning at school entry.

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, the authors modeled trajectories of maternal depressive symptoms from infant age 1 month to 7 years. The authors identified 6 trajectories of maternal depressive symptoms: high-chronic, moderate-increasing, high-decreasing, intermittent, moderate-stable, and low-stable. Women on these depression trajectories varied in sociodemographic risk and in changes in observed maternal sensitivity over time. Maternal sensitivity was generally higher and increased when depressive symptoms were low; sensitivity was lower and decreased when depressive symptoms were either high or increasing. Child outcomes at 1st grade were examined by trajectory group. The authors discuss the complexity of disentangling maternal symptoms from maternal sensitivity and sociodemographic risk when predicting children's functioning.