Abstract
BackgroundDialectical behavior therapy (DBT) is a first‐line treatment for the prevention of suicide. Zhong‐Yong thinking could be viewed as a Chinese way of dialectical thinking, has long been a culturally dictating thinking style in China. To enhance cultural adaptability, we integrated Zhong‐Yong thinking into DBT group skills training and examined its efficacy in suicidal prevention compared with a supportive group therapy and a wait‐list group in high‐risk suicidal Chinese college students.MethodsA total of 97 suicidal participants were randomized to either Zhong‐Yong thinking based DBT group skills training (DBTZYT, n = 33), or supportive group therapy (SGT; n = 32), or wait‐list group (WL; n = 32). DBTZYT was a 12‐week program based on Zhong‐Yong thinking instead of dialectical thinking, coaching participants mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Supportive group therapy was a 12‐week program aiming at improving interpersonal effectiveness and emotion regulation skills. Outcome measures were assessed at pre‐ and post‐treatment and 6‐month follow‐up.ResultsAt post‐treatment measures, the levels of suicidal ideation, hopelessness, psychache symptoms, and general psychopathology had significantly decreased in both intervention groups; at the 6‐month follow‐up measures, the intervention effects were better maintained in the DBTZYT group rather than in the SGT group. Specifically, DBTZYT was more effective in relieving participants’ long‐term obsessive‐compulsive, anxiety, hostility, phobic, psychotic, and additional symptoms.ConclusionsZhong‐Yong thinking not only could integrate with DBT skills training in Chinese young adult population, but also has special strength in enhancing DBT’s efficacy.
Highlights
Suicide is the second leading cause of death in young adults aged 15–29 years (WHO, 2017)
The purposes of the present study were to explore whether Dialectical behavior therapy (DBT) could integrate with Zhong-Yong thinking in Chinese young adults with high-suicidal risks, and to test whether Zhong-Yong thinking based DBT would demonstrate superior or equivalent or inferior efficacy compared with supportive group therapy and wait-list group
We found that the two intervention groups evidenced more reductions in suicidal risks at post-treatment measures compared with the wait-list group
Summary
Suicide is the second leading cause of death in young adults aged 15–29 years (WHO, 2017). It has a profound influence on shaping Chinese people’ perception and cognition (Chang & Yang, 2014; Chiu, 2000; Guo, Li, Huang, & Chen, 2017; Kim, Yang, & Hwang, 2006; Wu & Lin, 2005) Both dialectical and Zhong-Yong thinking advocate tolerance of contradiction, avoiding going to extremes, and overcoming dichotomous, rigid patterns of thinking. We combined DBT group skills training with Zhong-Yong thinking as the underlying philosophy to improve its cultural adaptability Making such modification to the well-established DBT practice among an eastern population whose thinking style is different from their western counterparts (Xinyue, Lingnan, Qing, Junpeng, & Baumeister, 2012) would further enhance the understanding of whether and how a psychological intervention could apply to individuals in different cultural contexts. The purposes of the present study were to explore whether DBT could integrate with Zhong-Yong thinking in Chinese young adults with high-suicidal risks, and to test whether Zhong-Yong thinking based DBT would demonstrate superior or equivalent or inferior efficacy compared with supportive group therapy and wait-list group
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