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On the potential for iatrogenic effects of psychiatric crisis services: The example of dialectical behavior therapy for adult women with borderline personality disorder.
Author(s) -
Trevor N. Coyle,
Jennifer A. Shaver,
Marsha M. Linehan
Publication year - 2018
Publication title -
journal of consulting and clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.582
H-Index - 240
eISSN - 1939-2117
pISSN - 0022-006X
DOI - 10.1037/ccp0000275
Subject(s) - borderline personality disorder , dialectical behavior therapy , psychiatry , suicidal ideation , suicide attempt , psychology , suicide prevention , randomized controlled trial , clinical psychology , poison control , medicine , medical emergency , surgery
Although previous research has suggested that people with a history of using psychiatric crisis services are at higher risk for suicide, it is unclear whether this link is attributable to individual risk factors or iatrogenic effects of service utilization. We examined this question by analyzing data from a randomized controlled trial of dialectical behavior therapy (DBT), a treatment for highly suicidal individuals in which patients took advantage of crisis services less than those in the comparison condition. We hypothesized that crisis-service utilization during a treatment year, rather than pretreatment indicators of suicide risk, would be associated with higher suicide risk after treatment, and that DBT's treatment effects would be partially attributable to this association.

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