Efficacy of Dialectical Behavior and Prolonged Exposure Therapy in Treating Suicidal Behavior among Adolescents with Posttraumatic Stress and Depressive Disorders in Nairobi, Kenya

Abstract

Suicide is a leading cause of death among adolescents thus, necessitating effective interventional measures for those at risk. The effectiveness of DBT PE in the Kenyan population had not been ascertained before this study. This study sought to evaluate the efficacy of Dialectical Behavior Therapy and Prolonged Exposure (DBT PE) in treating Suicidal Behavior (SB) among adolescents with SB, Depressive Disorders (DD), and Posttraumatic Stress Disorders (PTSD) in Nairobi County. The study objectives were to establish the prevalence of SB, DD, and PTSD; determine the severity of SB; examine the risk factors for SB; assess the relationship between PTSD and DD; and evaluate the efficacy of DBT PE in treating SB. Both cognitive-behavioral and biosocial theories were used to inform the development and intervention for the disorders. The quasi-experimental design was used. Data was collected using a sociodemographic questionnaire, Suicide Behaviors Questionnaire-Revised, PTSD Checklist for DSM-5, and Beck's Depression Inventory. From the 1,040 students who were assessed at baseline, a study sample of 104 students was purposively selected. The experimental group received DBT PE treatment but the control group did not. Both groups were evaluated from baseline, midline to end-line. Data was keyed into statistical package for social sciences (SPSS) version 24 and analyzed. The study established SB prevalence (21.5%) and that of comorbid DD, PTSD and SB (15.0%). SB, DD, and PTSD had a significant moderate positive correlation (r = 0.48 to 0.653, p <0.001). The efficacy of DBT PE was established in treatment of SB, DD and PTSD. The study recommends early assessment of the disorders in schools and inclusion of DBT PE in life skills lessons and in the Kenya national suicide prevention plan for the treatment of adolescents and young adults.