Effects of family-integrated emotion regulation group therapy on non-suicidal self-injury among adolescents with depressive disorders: A randomized controlled follow-up study
N. Du, X.-B. He, X.-J. Nie, Z.-S. Huan, Y. XiaoIntroduction
In recent years, the prevalence of Non-suicidal self-injury (NSSI) among adolescents has been increasing sharply. Although NSSI may appear less severe than suicidal behavior, it significantly increases the likelihood of future suicide attempts. However, available treatment methods for NSSI are limited. Emotion Regulation Group Therapy (ERGT) has proven effective in teaching adolescents adaptive emotional strategies and reducing NSSI behaviors. However, the role of family relationships in improving outcomes for adolescents with NSSI is also essential.
Objectives
Therefore, we designed the present randomized controlled trial with the following objectives: (1) to evaluate the efficacy of a therapist-delivered, family-integrated ERGT program developed by our team for adolescents with depressive disorders and NSSI; (2) to determine whether this integrated model yields superior and more sustained outcomes compared to traditional ERGT approaches; and (3) to explore potential cognitive and autonomic nervous system changes associated with the intervention.
Methods
This study enrolled adolescents (aged 12–18 years) diagnosed with depression and recurrent episodes of NSSI (n=73). They were randomly assigned to two groups: the trial group (n=36) which received family-integrated ERGT; and the control group (n=37) which received ERGT alone. Data on NSSI behavior, depressive symptoms, and impulsivity were collected using questionnaires, including the Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSSIQ), the Self-Rating Depression Scale (SDS), and Barratt’s Impulsivity Scale (BIS). All questionnaires were administered at five time points: baseline, immediately post-intervention, and at the 1-month, 3-month, and 6-month follow-ups. The values of heart rate variability (HRV) and event-related potential (ERP) were also collected before and after the intervention.
Results
Immediately post-intervention, no significant differences were observed between the two groups in ANSSIQ, BIS, and SDS scores (P>0.05). However, at all follow-ups, the trial group demonstrated significantly greater reductions in all three measures (P<0.05), with a more pronounced decline over time (see image 1,2,3 for details). Results showed lower N2, P3a, and P3b amplitudes and higher HRV in the trial group post-intervention, with no significant changes in the control group.
Image 1: Long description.