The Claim
Dialectical Behavior Therapy is ineffective for adolescents with nonsuicidal self-injury driven by anhedonia due to its failure to address underactivity in the reward system.
What the research says
Not yet evaluated
We are still looking at what the research says.
These are independent scores, not a percentage. Higher-grade studies count more, so a single strong opposing study can outweigh several weaker ones.
For adolescents who engage in self-harm because they feel no pleasure or reward in life, Dialectical Behavior Therapy does not reduce self-harm because it does not target the underlying lack of reward system activity.
See the scientific wording
The clinical approach of distress tolerance, such as Dialectical Behavior Therapy, may be ineffective for adolescents whose nonsuicidal self-injury is driven by anhedonia rather than emotional hyperarousal, because it fails to address the core deficit of reward system underactivity.
The brain's reward center doesn't respond to normal pleasures, so the person feels empty. When they hurt themselves, the pain stopping triggers a strong burst of feel-good chemicals that briefly fill that emptiness. This makes hurting themselves the only reliable way to feel anything positive.
What the research says
1 studyThis study says some teens hurt themselves not to feel less pain, but to feel anything at all because they can’t feel pleasure—and therapies that just teach them to handle pain won’t help. It suggests we need new therapies that help them feel good again.
Score breakdown, mechanism chain, raw evidence, ideal studies needed & 1 supporting studies
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.