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

Anna J. Yeo, Miguelina Germán, Lorey A. Wheeler, Kathleen Camacho, Emily Hirsch, Alec Miller

Research output: Contribution to journalArticle


Background: Difficulties in coping with stress and regulating emotions are transdiagnostic risk factors for self-harming behavior. Due to sociocultural stressors, ethnic minority adolescents may be at greater risk for self-regulation difficulties and self-harm. Dialectical behavior therapy for adolescents (DBT-A) frames adaptive skill acquisition as a mechanism of change, but few studies have investigated its impact on ethnic minority adolescents’ self-regulation (i.e. coping, emotion regulation). Therefore, this pilot study examined relations between self-regulation and self-harm among ethnic minority adolescents and investigated changes in their self-regulation upon completing DBT-A. Methods: A clinically referred sample of 101 ethnic minority adolescents (Mage = 14.77; female = 69.3%) completed questionnaires about a history of self-harm, coping (DBT Ways of Coping Checklist), and emotion regulation (Difficulties in Emotion Regulation Scale). Of the initial sample, 51 adolescents (Mage = 14.73; female = 80.4%) entered a 20-week DBT-A program due to self-harm and/or Borderline Personality features. Results: In a pretreatment sample, the frequency of dysfunctional coping, but not of adaptive coping, differentiated self-injurers from non-self-injurers. Full information maximum likelihood estimation was used to address high attrition (60.8%) from DBT-A. Those who completed DBT-A (n = 20) reported significantly improved emotion regulation. Adaptive coping at pretreatment predicted increased DBT skills use at post-treatment. Conclusions: This non-randomized pilot study highlights dysfunctional coping and emotion dysregulation as risk factors for self-harm and suggests that 20-week DBT-A may help improve emotion regulation. Future research should employ a randomized design to further examine the effect of DBT-A on these transdiagnostic processes of psychopathology.

Original languageEnglish (US)
JournalChild and Adolescent Mental Health
StateAccepted/In press - Jan 1 2020


  • coping
  • dialectical behavior therapy
  • emotion regulation
  • ethnic minority adolescents
  • Self-harm

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

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