Abstract
Although nonsuicidal self-injury (NSSI) is a clinically significant behavior, evidence-based, specific, time-, and cost-effective treatment approaches are lacking. The aim of this study was to compare the efficacies of a brief cognitive-behavioral psychotherapy manual, the Cutting Down Programme (CDP), and treatment as usual (TAU) in the treatment of adolescent NSSI. We conducted a single-centre randomised controlled trial (RCT). Eligible participants were aged 12–17 years engaging in repetitive NSSI (at least 5 times within the past 6 months). We randomly allocated 74 participants to CDP (n = 37) or TAU (n = 37; in a 1:1 ratio). Outcome measures were administered before treatment (T0), directly after CDP or 4 months after baseline evaluation in the TAU group (T1), and another 6 months later (T2; primary endpoint). Primary outcome was a 50% reduction in NSSI frequency within the past 6 months at 10-month follow-up (T2). Regarding the primary outcome, there were no significant differences between the CDP (n = 26; 70.3%) and TAU group [n = 27; 73.0%; χ2(1) = 0.07; p = 0.797]; NSSI frequency within the past 6 months was significantly reduced at T2 [χ2(1) = 12.45; p < 0.001] with no between-group difference [χ2(1) = 0.14; p = 0.704]. However, we found a significant group x point of measurement interaction [χ2(2) = 7.78; p = 0.021] regarding NSSI within the last month indicating at T1. CDP was equally effective and achieved faster recovery compared to a significantly more intensive TAU in treating adolescent NSSI. The CDP could provide a brief and pragmatic first treatment within a stepped-care model for NSSI in routine clinical care.Clinical Trial Registration The trial was prospectively registered in the German Registry of Clinical Trials (https://www.drks.de; DRKS00003605) and is now complete.
Highlights
Nonsuicidal self-injury (NSSI) is defined “as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned” (International Society for the Study of Self-Injury, ISSS).1 3 Vol.:(0123456789)European Child & Adolescent Psychiatry (2020) 29:881–891According to a large systematic review, approximately 17–18% of adolescents worldwide report at least a single episode of NSSI during lifetime [1]
We expected the Cutting Down Programme (CDP) to result in greater reductions in NSSI incidents with a response rate difference of 35%
At T2, there was no evidence for the superiority of CDP compared with a significantly more intensive treatment as usual (TAU) for adolescents with repetitive NSSI
Summary
Nonsuicidal self-injury (NSSI) is defined “as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned” (International Society for the Study of Self-Injury, ISSS).1 3 Vol.:(0123456789)European Child & Adolescent Psychiatry (2020) 29:881–891According to a large systematic review, approximately 17–18% of adolescents worldwide report at least a single episode of NSSI during lifetime [1]. A recent systematic review revealed that there are effective treatments, which include or can be expanded to include the treatment of NSSI. These approaches were mostly neither developed for nor do they focus on NSSI [4]. In the context of (emerging) borderline personality disorder (BPD), NSSI is often treated with dialectical behavior therapy for adolescents (DBT-A), which was found to be effective within a randomised controlled trial (RCT) [5]. These treatment effects remained stable within an 1-year follow-up [6]. Other treatments that seem effective are mentalization-based treatment for adolescents (MBT-A) and cognitive-behavioral therapy (CBT) [3, 7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
