A randomized controlled trial of an Internet delivered dialectical behavior therapy skills training for suicidal and heavy episodic drinkers
Open accessAbstract
Background Given that alcohol misuse elevates risk of suicide death among ideators, the paucity of treatment outcome research for individuals presenting with both suicide ideation and problem drinking is particularly troubling. Dialectical behavior therapy (DBT) skills training, which effectively targets behaviors associated with emotion dysregulation including addictive and suicidal behaviors, provides a fitting model amenable to computerization. As stigma and scarcity stand as potential barriers to treatment, online dissemination platforms provide means for efficient treatment delivery that can augment the utility of suitable interventions. This pilot RCT sought to evaluate the feasibility, acceptability, and preliminary efficacy of an Internet-delivered DBT skills training intervention (iDBT-ST) for suicidal individuals who engage in heavy episodic drinking METHODS: Participants (N = 59) were randomized to receive iDBT-ST immediately or after an 8-week waiting period. Clinical outcomes were suicide ideation, alcohol use, and emotion dysregulation.Results Participants on average saw a significant reduction in all outcomes over the four-month study period. Compared to waitlist controls, individuals who received iDBT-ST immediately showed faster reductions in alcohol consumption.Conclusions Preliminary results suggest that iDBT-ST may be a viable resource for the high-risk and underserved group represented in this study, and pathways for future development are suggested.Limitations There was difficulty retaining and engaging participants due to technological barriers.
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Internet-based interventions have not been shown to prevent suicidal behavior, and only 3 of 10 studies reported benefit for suicidal ideation.
“Internet-based interventions have not been shown to prevent suicidal behavior (Table S5) but are highly scalable. Only 3/10 studies reported benefit for suicidal ideation(117–123) (Table S5).”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [117]
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- Lungu A 2015 Computerized Trans-Diagnostic Dialectical Behavior Therapy Skills Training for Emotion Dysregulation Doctoral dissertation
- Whiteside U 2011 A brief motivational intervention incorporating DBT skills for depressed and anxious young drinkers PhD dissertation Seattle, WA University of Washington
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- Authors
- Wilks, C. R., Lungu, A., Ang, S. Y., Matsumiya, B., Yin, Q., & Linehan, M. M.
- Affiliations
- University of Washington (US)
- University of Central Florida (US)
- Corresponding author
- Wilks, Chelsey R.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2018-05
- Volume
- 232
- Pages
- 219-228
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC5859943
- OpenAlex
- W2793982463
- Cited by
- 114
- References
- 70
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 7 · 2023: 12 · 2022: 17 · 2021: 19 · 2020: 19 · 2019: 17 · 2018: 3
- FWCI
- 18.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Journal of International Crisis and Risk Communication Research (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (F31 AA 24658-01)
- Alcohol and Drug Abuse Institute (ADAI-0315-2)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- dialectical behavior therapy, skills training, online intervention, suicidal ideation, binge drinking, alcohol abuse, emotional dysregulation, feasibility and acceptability, treatment retention, technology barriers
- MeSH terms
- Suicide Prevention, Adult, Alcoholic Intoxication, Behavior Therapy, Female, Humans, Male, Surveys and Questionnaires, Treatment Outcome, Internet, Suicidal Ideation
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