ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Adolescent and Young Adult Psychiatry
Comprehensive Intervention for Reducing Suicidal Ideation and Depressive Symptoms in Adolescents with Non-Suicidal Self-Injury: A Study of Internet-Delivered and Offline Dialectical Behavior Therapy
Yanping Zhang
Jixuan Hou
Meiqi Guo
Yue Zhou
Xue Zhang
Chuansheng Wang
Fang Yan
Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
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Abstract
Abstract Objective: Evaluate the efficacy of the comprehensive intervention— internet-integrated and offline dialectical behavior therapy (DBT)—in reducing suicidal ideation and depressive symptoms, and improving cognitive emotion regulation among adolescent non-suicidal self-injury (NSSI). Methods: Adolescent patients with NSSI(n=120) who were discharged from the follow-up system of the The Second Affiliated Hospital of Xinxiang Medical University were enrolled in this study (from September 2022 to October 2024).The control group received internet-delivered DBT training, while the experimental group received internet-delivered and offline-DBT sessions. The intervention lasted one-year. All participants completed the following questionnaires: Self-rating idea of suicide scale (SIOSS), cognitive emotion regulation questionnaire (CERQ-C) and Montgomery–Asberg depression rating scale (MADRS) to evaluate suicidal ideation, cognitive-emotional regulation, and depressive symptoms. Assessments were conducted at baseline, 6 months, and 12 months. Repeated measures ANOVA was employed to compare the health status of the two groups at different time points. Results: The control group (n=55) and the experimental group (n=53) were found the main effects of the SIOSS optimistic and concealing factor, total score, CERQ-C dimension scores, and MADRS scores among the groups were significant (P < 0.05). Additionally, the main effects of time on SIOSS factors and total score, CERQ-C dimension scores and MADRS scores were significant (P < 0.05). Furthermore, there was an interactive effect between groups and time on the SIOSS sleep and concealing factor scores, CERQ-C self-blame, contemplation, active refocus, refocus plans, and active reappraisal scores (P < 0.05). Conclusions: Comprehensive intervention effectively mitigate suicidal ideation, alleviate depressive symptoms, enhances cognitive emotion regulation ability, improve quality of life in adolescents with NSSI.
Summary
Keywords
adolescents, Comprehensive intervention, dialectical behavior therapy, Internet-delivered, Non-suicidal self-injury, offline-DBT, Rehabilitation
Received
29 December 2025
Accepted
20 February 2026
Copyright
© 2026 Zhang, Hou, Guo, Zhou, Zhang, Wang and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Chuansheng Wang; Fang Yan
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