The effect of mindfulness-based cognitive therapy on non-suicidal self-injury in hospitalized adolescents with depressive disorders: a randomized controlled trial
Jingjing Xie, Li Li, Xuehua Liu, WeiHua Yue, Jing Guo
Psychological Medicine 2026 DOI: 10.1017/s0033291726104735 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 94 |
| Population | Hospitalized adolescents diagnosed with depressive disorder and engaging in nonsuicidal self-injury |
| Interventions | Mindfulness-based cognitive therapy for adolescents (MBCT-A) Treatment-as-usual (TAU) |
| Duration | 4-week intervention, 1-month follow-up |
| Measures | Adolescent Self-Harm Scale (ASHS) |
| Topics | Depression Meditation |
| Keywords | Randomized controlled trial Rumination Impulsivity Depressive symptoms Cognitive behavioral therapy Cognitive therapy Cognition Clinical psychology Coping psychology Intervention counseling Poison control Psychological intervention |
| Key findings | MBCT-A plus TAU significantly reduced NSSI severity compared to TAU alone at 4 weeks and at 1-month follow-up (interaction effect F = 9.454, P < 0.001). The intervention also improved mindfulness, emotion regulation, and depressive symptoms. |
Abstract
Abstract Background Nonsuicidal self-injury (NSSI) in adolescents with depressive disorder is characterized by recurrent impulsivity and is a predictor of future suicidal behavior, necessitating effective and feasible interventions. Mindfulness-based cognitive therapy for adolescents (MBCT-A), a first-line treatment for depression, was evaluated in this trial for its efficacy in reducing NSSI in this population.
Methods: In this randomized, single-blind, controlled trial, 94 hospitalized adolescents diagnosed with depressive disorder and engaging in NSSI were allocated to either MBCT-A plus treatment-as-usual (TAU) or TAU alone. The primary outcome was the severity of NSSI, measured by the Adolescent Self-Harm Scale (ASHS) at baseline, post treatment (4 weeks), and at 1-month follow-up. Secondary outcomes encompassed symptoms of anxiety, depression, emotion regulation, risk behaviors, life satisfaction, resilience, rumination, coping styles, and mindfulness. Both intention-to-treat (ITT) and per-protocol (PP) analyses were conducted.
Results: Both ITT and PP analyses revealed significant between-group differences in NSSI severity at 4 weeks. Compared to the control group, the MBCT-A group showed significant improvements in mindfulness awareness, nonreactivity, emotional awareness, depressive symptoms, emotion regulation, and rumination (all P < 0.05). At the 1-month follow-up, the intervention group maintained a significant reduction in NSSI severity (interaction effect: F = 9.454, P < 0.001).
Conclusions: MBCT-A is effective in reducing NSSI behavior and improving mindfulness, emotion regulation, and depressive symptoms among adolescents with depressive disorder and NSSI. These findings support the clinical application of MBCT-A for this high-risk population.