Many persons with autism spectrum disorder (ASD) are treated in long-term specialised care. In this population, suicidal behaviour troubles patients, families, and specialists in the field because it is difficult to treat. At present, there is no documented effective therapy for suicidal behaviour in ASD (Autism Research 7:507-521, 2014; Crisis 35:301-309, 2014). Dialectical Behaviour Therapy (DBT) is an efficacious treatment programme for chronically suicidal and/or self-harm behaviour in patients with Borderline Personality Disorder (J Psychiatry 166:1365-1374, 2014; Linehan MM. Cognitive behavioural therapy of borderline personality disorder. 1993). This study will evaluate the efficacy of DBT in persons with ASD and suicidal/ self- destructive behaviour in a multicentre randomised controlled clinical trial. One hundred twenty-eight persons with autism and suicidal and/or self-harming behaviour will be recruited from specialised mental healthcare services and randomised into two conditions: 1) the DBT condition in which the participants have weekly individual cognitive behavioural therapy sessions and a 2.5 h skills training group session twice per week during 6 months, and 2) the treatment as usual condition which consists of weekly individual therapy sessions of 30–45 min with a psychotherapist or social worker. Assessments will take place at baseline, at post-treatment (6 months), and after a follow-up period of 12 months. The mediators will also be assessed at 3 months. The primary outcome is the level of suicidal ideation and behaviour. The secondary outcomes are anxiety and social performance, depression, core symptoms of ASD, quality of life, and cost-utility. Emotion regulation and therapeutic alliance are hypothesised to mediate the effects on the primary outcome. The results from this study will provide an evaluation of the efficacy of DBT treatment in persons with ASD on suicidal and self-harming behaviour. The study is conducted in routine mental health services which enhances the generalisability of the study results to clinical practice. ISRCTN96632579. Registered 1 May 2019. Retrospectively registered.

中文翻译：

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辩证行为疗法对有自杀倾向和/或自毁行为的自闭症谱系患者（DIASS）的影响：多中心随机对照试验的研究方案。


许多自闭症谱系障碍 (ASD) 患者接受长期专门护理治疗。在这一人群中，自杀行为给患者、家属和该领域的专家带来困扰，因为自杀行为很难治疗。目前，尚无针对 ASD 自杀行为的有效疗法记录（Autism Research 7:507-521, 2014；Crisis 35:301-309, 2014）。辩证行为疗法（DBT）是针对边缘性人格障碍患者的慢性自杀和/或自残行为的有效治疗方案（J Psychiatry 166:1365-1374, 2014；Linehan MM.边缘性人格障碍的认知行为治疗。1993 ）。本研究将在多中心随机对照临床试验中评估 DBT 对自闭症谱系障碍和自杀/自毁行为患者的疗效。将从专门的心理保健服务中招募 128 名患有自闭症和自杀和/或自残行为的人，并随机分为两种情况：1）DBT 情况，其中参与者每周进行个人认知行为治疗课程和 2.5 h 技能培训小组课程，在 6 个月内每周两次，以及 2) 照常治疗，包括每周与心理治疗师或社会工作者进行 30-45 分钟的个人治疗课程。评估将在基线、治疗后（6 个月）以及 12 个月的随访期后进行。调解员也将在 3 个月后接受评估。主要结果是自杀意念和行为的水平。次要结果是焦虑和社交表现、抑郁、自闭症谱系障碍的核心症状、生活质量和成本效用。 假设情绪调节和治疗联盟可以调节对主要结果的影响。这项研究的结果将评估 DBT 治疗 ASD 患者自杀和自残行为的效果。该研究是在常规心理健康服务中进行的，这增强了研究结果对临床实践的普遍性。 ISRCTN96632579。 2019 年 5 月 1 日注册。追溯注册。