Self-harm and self-regulation in urban ethnic minority youth: a pilot application of dialectical behavior therapy for adolescents.

Due to cultural and environmental stressors, ethnic minority adolescents may be at greater risk for developing self-regulatory difficulties - transdiagnostic mechanisms known to underly self-harming behaviors; however, we know little about whether empirically supported treatments for self-harm will improve youth's coping and emotion regulation. In a clinically referred, pretreatment sample of ethnic minority youth, levels of BPD symptomatology, emotion dysregulation, and dysfunctional coping, but not of adaptive coping, differentiated teens who self-harmed from those who did not. Self-harming ethnic minority youth who participated in an uncontrolled, pilot trial of dialectical behavior therapy for adolescents (DBT-A) at an urban mental health clinic reported improved emotion regulation at post-treatment. Baseline emotion regulation skills were not predictive of treatment-related changes, suggesting that other factors, such as DBT-A, may have played a decisive role in improving teens' emotion regulation. In contrast, adaptive coping skills at pretreatment were linked to increased DBT skills use at post-treatment, indicating that patients' baseline coping skills may play a predictive role in psychotherapy outcomes. Future research should employ a randomized control trial to examine the effect of DBT-A on vulnerable ethnic minority youth's development of self-regulation. It should also investigate the hypothesized mediating role of self-regulation in effecting lasting clinical gains.