# Comprehensive intervention for reducing suicidal ideation and depressive symptoms in adolescents with non-suicidal self-injury: a study of Internet-delivered and offline dialectical behavior therapy

## TL;DR

This study tests a combined online and in-person therapy to reduce suicidal thoughts and depression in teens who self-harm but aren't suicidal.

## Contribution

The novel approach combines internet and offline dialectical behavior therapy for adolescents with non-suicidal self-injury.

## Key findings

- The intervention significantly reduced suicidal ideation and depressive symptoms.
- Cognitive emotion regulation improved over time in participants.
- Combined therapy showed better outcomes than online-only therapy.

## Abstract

This study aims to evaluate the efficacy of a comprehensive intervention—Internet-integrated and offline dialectical behavior therapy (DBT)—in reducing suicidal ideation and depressive symptoms and improving cognitive emotion regulation among adolescent non-suicidal self-injury (NSSI).

Adolescent patients with NSSI (n = 120) who were discharged from the follow-up system of The Second Affiliated Hospital of Xinxiang Medical University were enrolled in this study (from September 2022 to October 2024).The control group received Internet-delivered DBT training, while the experimental group received Internet-delivered and offline-DBT sessions. The intervention lasted for 1 year. All participants completed the following questionnaires: Self-Rating Idea of Suicide Scale (SIOSS), Cognitive Emotion Regulation Questionnaire (CERQ-C), and Montgomery–Asberg Depression Rating Scale (MADRS) to evaluate suicidal ideation, cognitive–emotional regulation, and depressive symptoms. Assessments were conducted at baseline, 6 months, and 12 months. Repeated-measures ANOVA was employed to compare the health status of the two groups at different time points.

In the control group (n = 55) and the experimental group (n = 53), the main effects of the SIOSS optimistic and concealing factor, total score, CERQ-C dimension scores, and MADRS scores were found to be significant (P < 0.05). Additionally, the main effects of time on SIOSS factors and total score, CERQ-C dimension scores, and MADRS scores were significant (P < 0.05). Furthermore, there was an interactive effect between groups and time on the SIOSS sleep and concealing factor scores, CERQ-C self-blame, contemplation, active refocus, refocus plans, and active reappraisal scores (P < 0.05).

Comprehensive intervention effectively mitigates suicidal ideation, alleviates depressive symptoms, enhances cognitive emotion regulation ability, and improves the quality of life in adolescents with NSSI.