The Impact of Perceived Parental Invalidation and Self-Invalidation on Suicidality in an Adolescent DBT Partial Hospitalization Program

Background Dialectical Behavior Therapy’s (DBT) original biosocial theory and subsequent iterations as a transactional model suggest that invalidating social and family environments can contribute to emotion dysregulation and patterns of self-invalidation that may lead to suicidal and non-suicidal self-injurious behaviors over time. To our knowledge, no studies have examined the relationship between parental and self-invalidation on suicidality in a treatment setting or longitudinally over the course of treatment from pre-to post-treatment. This study examined the relationship between youth-reported parental invalidation, self-invalidation, and suicidality over the course of treatment in a comprehensive DBT partial hospitalization program (PHP). Methods Two hundred sixty-four adolescents and young adults admitted to a four-week comprehensive DBT PHP that incorporated family, individual, and skills group therapy components. All patients completed surveys evaluating perceived parental-invalidation, self-invalidation, and suicidality pre- and post-treatment. Results Patients reported significant decreases on all outcome measures: perceived mother and father invalidation, self-invalidation, and suicidality after 4 weeks. Changes (reductions) in both self-invalidation and mother invalidation were significant predictors of reduced suicidality. Conclusion Comprehensive DBT is a viable treatment option for decreasing invalidation and suicidality in four weeks. These findings emphasize the importance of parent involvement in improving treatment outcomes for adolescents and young adults.