Electronic Theses and Dissertations



Document Type


Degree Name

Doctor of Philosophy


Counseling Psychology

Committee Chair

Douglas C. Strohmer

Committee Member

Gary S. Del Conte

Committee Member

Laura Marks

Committee Member

Owen Lightsey


The primary purpose of this investigation was to examine the added benefit of directly targeting self-critical thoughts in the treatment of non-suicidal self-injury (NSSI) in youth undergoing Dialectical Behavior Therapy for Adolescents (DBT-A). This was a randomized study of 40 adolescents with recent engagement in NSSI at a partial hospitalization program using DBT-A. This study utilized an additive component treatment design with randomization to either DBT-A or DBT-A Plus. All study participants received the full DBT-A protocol, and those randomized to the DBT-A Plus condition received a brief cognitive intervention developed to decrease self-critical thoughts in adolescents. Of the 40 adolescents that enrolled in the study, 37 completed treatment. The sample included 30 females and 10 males with an average age of 14.92. Overall, study participants experienced mean level decreases in NSSI from baseline to posttreatment, -0.06, p = .019. Moreover, there was a significant interaction between assignment to treatment condition and changes in self-criticism, -0.24, p = .026. This indicated that the effect of changes in self-criticism on NSSI at posttreatment varied as a function of assignment to treatment condition. For the DBT-A Plus group, a 1-unit decrease in self-criticism led to 0.79 times fewer acts of NSSI at posttreatment, controlling for baseline NSSI. The results of this investigation provide additional support for the efficacy of DBT-A in reducing NSSI for our youth and underscore the import of directly targeting self-criticism in the treatment of NSSI. Researchers are encouraged to implement advances in statistical modeling procedures to more accurately analyze NSSI in order to advance psychological science and our understanding of how to treat this pernicious class of behaviors in adolescents.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest