A Longitudinal Study on the Effectiveness of Dialectical Behavior Therapy Based on "Internet Plus" for Adolescent Non-Suicidal Self-Injury Intervention.

Background:Sexual desires are one of the natural needs of each person being, which, if not used in the right direction, may become problematic and lead to various sexual disorders, including hypersexuality. This study aimed to compare the effects of dialectical behavior therapy (DBT) and aripiprazole on emotional divorce in hypersexual patients.Materials and Methods:This study was quasi-experimental, with two experimental groups, a control group, a pretest, a posttest, and a follow-up phase. For this purpose, 54 men and women with hypersexuality were purposely selected from four hospitals and psychiatric centers in Isfahan, Iran. After matching in terms of age and gender, they were randomly assigned to two experimental groups (18 patients in each group) and a control group (18 patients). The three groups were pretested by the Emotional Divorce Questionnaire. The first experimental group underwent DBT intervention for eight 2-hour sessions (once a week), and the second was prescribed aripiprazole for 2 months. Afterward, the three groups were posttested and followed up, and the data were analyzed by multivariate analysis of covariance (MANCOVA) using Statistical Package for the Social Sciences (SPSS) version 24.Results:The findings demonstrated that DBT and aripiprazole significantly affected and reduced emotional divorce (P < 0.01). Also, there was a difference between DBT and aripiprazole interventions, with the more significant effect of DBT on emotional divorce (P < 0.01).Conclusion:It can be concluded that DBT and aripiprazole interventions influenced emotional divorce and these methods can be used in a complementary way; however, DBT was more influential.

زمینه و هدف: یکی از مشکلات عمده ای که تأثیر بازدارنده ای بر کارآمدی و پویایی افراد دارد و از شکوفایی استعدادها و قوای فکری و عاطفی آنان جلوگیری می کند، مشکل اضطراب اجتماعی و ناتوانی در برقراری ارتباطات اجتماعی است. هدف این پژوهش تعیین اثربخشی مهارت آموزی مبتنی بر رفتار درمانی دیالکتیکی بر ترس از ارزیابی منفی و مهارت های ارتباطی نوجوانان مبتلا به اختلال اضطراب اجتماعی بود. روش و مواد: روش پژوهش حاضر از نوع نیمه آزمایشی با طرح پیش‌آزمون، پس‌آزمون با گروه شاهد بود. جامعه‌آماری این پژوهش را نوجوانان 12 تا 18 سال مبتلا به اختلال اضطراب اجتماعی تشکیل دادند که در سال 1398 به مراکز مشاوره منطقه شش شهر تهران مراجعه کردند. تعداد60 نفر با روش نمونه‌گیری در دسترس انتخاب و به صورت تصادفی در دو گروه 30 نفری آزمایش و شاهد قرار گرفتند. گروه آزمایش مهارت آموزی مبتنی بر رفتار درمانی دیالکتیکی را طی 12 جلسه 120 دقیقه­ای به صورت هفتگی دریافت نمود، قبل و بعد از مداخله، مقیاس ترس از ارزیابی منفی و مقیاس مهارت هاي ارتباطي در هر دو گروه اجرا شد. داده‌ها از طریق آزمون کوواریانس و با استفاده از نرم‌افزار SPSS-22 مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین (انحراف معیار) ترس از ارزیابی منفی گروه آزمایش در پیش آزمون (2/5) 9/19 بود که در پس آزمون به (9/3) 9/16 کاهش یافت (001/0>P) اما میانگین (انحراف معیار) گروه شاهد در پیش آزمون (9/4) 7/20 بود که در پس آزمون به (7/4) 1/20 رسید که این تفاوت از نظر آماری معنادار نبود. میانگین (انحراف معیار) مهارت های ارتباطی گروه آزمایش در پیش آزمون (3/20) 1/88 بود که در پس آزمون به (3/20) 1/115 افزایش یافت (001/0>P). اما میانگین (انحراف معیار) گروه شاهد در پیش آزمون (5/19) 1/93 بود که در پس آزمون به (5/20) 2/88 رسید که این تفاوت از نظر آماری معنادار نبود. نتیجه‌گیری: مطالعه نشان داد که مهارت آموزی مبتنی بر رفتار درمانی دیالکتیکی موجب کاهش ترس از ارزیابی منفی و افزایش مهارت های ارتباطی نوجوانان مبتلا به اختلال اضطراب اجتماعی شد.

Trichotillomania is a mental disorder characterized by recurrent and irresistible urges to pull out hair from the body. The present study aimed to elucidate the effectiveness of dialectical behavior therapy on impulsivity, emotion regulation, rumination, and self-criticism in individuals with trichotillomania. From an objective standpoint, this study is considered applied research and, methodologically, a quasi-experimental study with a pre-test, post-test, and follow-up test design, including a control group with a 2-month follow-up period. The population of this research included all individuals with trichotillomania in districts 2 and 4 of Tehran, from whom 18 persons for each group were selected through purposive non-random sampling and were randomly assigned to either the experimental or control group. The instruments used in this research included the Massachusetts Hair Pulling Questionnaire, Williams and colleagues' (1997) Emotion Regulation Scale, Barratt and colleagues' (1990) Impulsivity Scale, Gilbert and colleagues' (2004) Self-Criticism Scale, and Nolen-Hoeksema and colleagues' (1991) Rumination Scale. The dialectical behavior therapy intervention was conducted over 8 one-hour sessions; however, the control group did not receive any intervention. The research was analyzed through mixed ANOVA (with repeated measures) and Bonferroni follow-up tests using SPSS version 22. The results of the present study indicated that dialectical behavior therapy has a significant effect on impulsivity (P&lt;0.01), emotion regulation (P&lt;0.01), rumination (P&lt;0.01), and self-criticism (P&lt;0.01), and these effects continue in the follow-up phase. It can be concluded that dialectical behavior therapy is effective in reducing impulsivity, improving emotion regulation, decreasing rumination, and reducing self-criticism, and can therefore be beneficial for individuals with trichotillomania.

BACKGROUNDThe aim of this study was to investigate the effectiveness of dialectical behavior therapy (DBT) on adherence to treatment and self-caring behavior in patients with coronary heart disease (CHD).METHODSThis was an experimental study based on control and experimental groups with pre-test and post-test. 32 male and female patients with CHD having at least high school diploma, referring to Isfahan cardiovascular research institute, Isfahan, Iran, were selected and placed randomly in two groups of control and experimental. Pre-test stage was done for both two groups by 8-item Morisky Medication Adherence Scale (MMAS-8) and Self-Care of Coronary Heart Disease Inventory (SC-CHDI). The experimental group was placed under the intervention of DBT for 8 sessions of 2 hours (once a week). Afterwards, the post-test was done for both groups.RESULTSIt was shown by analyzing results from t-test that adherence to treatment and self-care behavior significantly increased in experimental group comparing to control group [(1.81 ± 0.75 vs. 5.19 ± 1.22, P < 0.001) and (72.50 ± 4.38 vs. 55.50 ± 7.42, P < 0.001), respectively]. Also results showed that self-caring and adherence to treatment significantly increased after being adjusted for baseline measurement (P < 0.001). The findings showed that DBT had effect on adherence to treatment and self-caring behavior of patients with CHD.CONCLUSIONOn the basis of results, it could be said that DBT intervention can have positive impact on adherence to treatment and self-caring behavior of patients with CHD.

Background and Aim: Various researches have been conducted in this regard, but the present study compares two methods of Adlerian group counseling and dialectical behavior therapy in the academic life of male students who failed the entrance exam, which is rare in its kind. The present study was conducted by comparing the effectiveness of Adlerian group counseling and dialectical behavior therapy in the academic vitality of male students who failed the Zanjan entrance exam. Methods: The current research design is applied and its method is semi-experimental. The statistical population of this research includes 587 male high school students who failed in the 2019 entrance exam. 45 of these students were voluntarily selected and randomly divided into three groups of 15 (one control group and two experimental groups). In the first group, the intervention was based on the Adlerian group counseling protocol of Alizadeh and Hashemi (2007), and in the second group, the intervention was based on the dialectical behavior therapy protocol of Miller et al. (2007), and the third group, as a control group, did not receive any intervention. The required data were collected in three periods: pre-test, post-test and follow-up. The tools of this research were used in all three stages of the academic vitality questionnaire (Dehghanizadeh and Chari, 2013) based on the academic vitality scale (Martin and Marsh, 2006). Data analysis was done using repeated measure analysis of variance by SPSS-24 software. Results: The effect of dialectical behavior therapy method on students' academic vitality (F=99.52, P&lt;0.001) was more than Adlerian group counseling method. Conclusion: Based on the findings of this research, it can be concluded that dialectical behavior therapy can be used to restore academic vitality in students who have experienced academic failure.

Aim: This study is aimed to determine the comparison of the effectiveness of dialectical behavior therapy with integrated psychotherapy in defensive styles and Internet addiction. Method: The research method was quasi-experimental with a pretest-posttest design and one-month follow-up with the control group. And the statistical population consisted of all high school students in district one of Tehran province 2017-2018. In this population, 60 students with high scores in Internet addiction were purposefully selected and were placed randomly in two study groups and one control group (20 people in each group). The research tools included the Internet Addiction Test (Young, 1999) and the defense styles of Andrews, Singh, and Bond (2014). The first study group received eight sessions of 90 minutes and one session per week of integrated psychotherapy package of Lotfi, Kashani, and Vaziri (2015), and the second study group received dialectical behavioral therapy package of Linehan (1987). The data were analyzed using repeated measures analysis. Results: The results showed that dialectical behavior therapy intervention is effective on Internet addiction score (F = 61.21, P = 0.001), developed component (F = 4.28, P = 0.046), underdeveloped component (34 F = 6.6, P = 0.017) and neurotic component (F = 4.51, P = 0.041). And integrated psychotherapy intervention is effective on Internet addiction score (F = 54.07, P = 0.001), developed component (F = 10.09, P = 0.003), underdeveloped component (F = 6.80, P = 0.041) and neurotic component (F = 13.44, P = 0.001).This effect has been stable in the follow-up stage. Conclusion: According to the results, it can be concluded that both dialectical therapy and integrated psychotherapy were effective in defense styles and reducing Internet addiction of the participants of the research compared to the control group. But there is no significant difference between the two therapies.

The effects of dialectical behavior therapy on generalized anxiety disorder have not been examined to date, whereas cognitive behavioral therapy is a well-known psychotherapy for generalized anxiety disorder. This study investigated the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder. In the present study, 72 generalized anxiety disorder patients were randomly assigned to one of two groups: dialectical behavior therapy or cognitive behavioral therapy. Evaluations were performed at baseline, post-test, and three months after interventions as a follow-up. Measures included the Structured Clinical Interview for DSM-IV Axis I disorders, the Generalized Anxiety Disorder scale, the Beck Anxiety Inventory, the Beck Depression Inventory, the Tower of London Task, and the Wisconsin Card Sorting Task.Results: The results of the present study showed that both groups had reduced scores for depression and anxiety and increased scores for executive function after the psychotherapies. These changes were maintained at follow-up. Although depression and anxiety symptoms were significantly reduced by cognitive behavioral therapy, dialectical behavior therapy was more effective for improving executive function.

Dialectical behavior therapy (DBT) is a therapeutic approach that can align a balance in a person's acceptance strategies withcognitive and behavioral change strategies. Therefore, it is of interest to evaluate the effectiveness of a 12-week Dialectical BehaviorTherapy (DBT) program in reducing depression and anxiety among elderly individuals aged 65 years and above. Hence, a total of 40participants were randomly assigned to either a DBT intervention group or a waitlist control group. Depression and anxiety levels wereassessed before and after the intervention using the Geriatric Depression Scale (GDS) and the Hamilton Anxiety Rating Scale (HAM-A),respectively. Participants in the DBT group demonstrated significant reductions in both depression and anxiety scores compared to thecontrol group (p < .05), with moderate to large effect sizes (Cohen's d = 0.72 for depression; d = 0.69 for anxiety). Thus, datashows that DBT is an effective intervention for alleviating emotional distress in elderly populations and may be beneficial forintegration into community-based mental health services for aging individuals.

Many autistic people in mental health are suicidal. This study evaluated the effectiveness of dialectical behavior therapy (DBT) v. treatment as usual (TAU) in reducing suicidal ideation and suicide attempts. At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (n = 63) or TAU control group (n = 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes. At end-of-treatment, DBT significantly reduced both suicidal ideation (z = -2.24; p = 0.025; b = -4.41; s.e. = 197.0) and suicide attempts (z = -3.15; p = 0.002; IRR = 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (z = -1.99; p = 0.046: b = -2.74; s.e. = 1.37) remaining so at 12 months (z = -2.46; p = 0.014; b = -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition. DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.

The objective of this study was to evaluate the effectiveness of Dialectical Behavior Therapy (DBT) in reducing emotional exhaustion and enhancing empathy among participants. This randomized controlled trial included 30 participants, randomly assigned to either the DBT intervention group or a control group, with 15 participants in each group. The intervention group underwent eight 75-minute DBT sessions over three months, while the control group received no intervention. Emotional exhaustion and empathy were measured at baseline, post-intervention, and at a three-month follow-up using the Maslach Burnout Inventory (MBI) and the Interpersonal Reactivity Index (IRI), respectively. Data analysis was conducted using analysis of variance (ANOVA) with repeated measurements and the Bonferroni post-hoc test, with statistical analyses performed using SPSS-27. The intervention group showed a significant reduction in emotional exhaustion from a baseline mean of 45.23 (SD = 8.21) to 32.56 (SD = 7.45) post-intervention and 34.12 (SD = 7.89) at follow-up. In contrast, the control group's emotional exhaustion remained relatively stable (baseline: 44.87, SD = 7.98; post-intervention: 44.12, SD = 7.89; follow-up: 45.23, SD = 8.12). Empathy scores in the intervention group increased significantly from 52.34 (SD = 9.12) at baseline to 60.23 (SD = 8.45) post-intervention, with a slight decrease to 58.56 (SD = 8.76) at follow-up. The control group showed minimal changes in empathy (baseline: 51.67, SD = 8.89; post-intervention: 52.34, SD = 8.56; follow-up: 51.23, SD = 8.67). ANOVA results confirmed the significance of these changes (F = 31.15, p &lt; 0.001), with Bonferroni post-hoc tests indicating significant differences between baseline and subsequent time points in the intervention group (p &lt; 0.001). The study demonstrates that DBT is significantly effective in reducing emotional exhaustion and enhancing empathy among participants. These findings suggest that DBT can be a valuable intervention for improving psychological resilience and interpersonal effectiveness, particularly in populations at risk for burnout and empathic distress.

Migraine is a debilitating disease in the world today. Depression, stress and anxiety could be mentioned as the most important psychological correlates of migraine. The present study was to investigate the effectiveness of dialectical behavior therapy on depression, stress, anxiety and migraine's symptoms. This quasi-experimental intervention was conducted as a pretest-posttest design with experimental and control groups. The population consisted of all the migraine patients in 5 neurological clinics of the Iran Medical Sciences University. Then, 30 patients from the population agreed to collaborate in the treatment and randomly assigned into two groups (n = 15 per group). The instruments applied in this study was Ahvaz migraine headache questionnaire (Najarian, 1998), and the short version of the Depression Anxiety Stress (DASS-21) Scale (Lovibond & Lovibond, 1995). The dialectical behavior therapy program was conducted for interventional group within 12 sessions. Data was compared through covariance analysis. The results showed a significant difference between the two groups, and we observed reduction of depression, stress, anxiety and migraine's symptoms of DBT group compared with the control group. The implicit inference of this study showed the effectiveness of dialectical behavior therapy on decreasing the level of migraine's symptoms and this effect along with the reduction of depression, anxiety and also stress.

Substance use disorder is a major public health problem, and its treatment is one of the most challenging issues facing clinical professionals. This clinical trial study investigated the effects of the dialectical behavior therapy (DBT) on cognitive and executive functions in patients under methadone maintenance treatment (MMT). Participants included 50 people under MMT who referred to addiction treatment clinics in Kashan in 2018. They were randomly assigned to intervention (DBT + MMT) and control (MMT) groups. Participants in the intervention group received twelve 90-minute sessions of the DBT skills. The used assessments included Structured Clinical Interview for DSM-5 Axis I Disorders, Iowa Gambling Task, Wisconsin Card Sorting Task, and Tower of London Task. The results showed that DBT improved cognitive and executive function. Risky decision making (F = 4.1, p = 0.04), attention (F = 18.2, p = 0.001), cognitive flexibility (F = 18.5, p = 0.001), problem-solving (F = 18.5, p = 0.001), and planning (F = 14.10, p = 0.003) showed improvement in the intervention group following DBT. Therefore, it can be said that DBT alongside the MMT can be useful for patients under MMT.

Objective: Traumatic childbirth may expose mothers to physical and psychological postpartum disorders. The reduced rate of exclusive breast feeding is an essential consequence of this problem. The goal of this study was to see if dialectical behavioral therapy could help with the onset and duration of exclusive breast feeding after a traumatic delivery. Method: This clinical trial study included, 210 primiparous women with traumatic vaginal births were admitted to Bahar hospital in Shahroud. A standard protocol was designed and administered. The group allocation imbalance happened by chance and was averted by utilizing block randomization with a size of four and sequentially numbering the intervention or control groups with a sealed concealed envelope Participants in the intervention group had one individual session and four group counseling sessions by the researcher, while the control group participants obtained a routine care. Breast feeding self-efficacy was measured using a related questionnaire before the intervention, six and 12 weeks postpartum. Exclusive breast feeding was determined using a related form at the end of each month until the fourth month.Results: The outcome of repeated measure ANOVA Before the intervention, based on the greenhouse geisser test indicated no statistically significant difference in breast feeding self-efficacy (P = 0.07) or infant weight between the two groups. (P = 0.98). Nevertheless, a statistically significant difference between the mean score of breast feeding self-efficacy and infant's weight was discovered by a post hoc test utilizing the Bonferroni correction, (P = 0.001) between the two groups after the intervention. Therefore, in the intervention group, the level of exclusive breast feeding was higher than in the control group, and four months after birth, more infants in the intervention group were exclusively breastfed (58% vs 32%) (P < 0.001). The analysis of data using the GEE model showed that the odds of adherence to exclusive breast feeding in the intervention group were 3.4 (0.95 CI: 2.04-5.7). Conclusion: Dialectical behavior therapy is a powerful tool for minimizing the negative features of traumatic childbirth and increase the success of breast feeding mothers. Therefore, it can be used as a supportive method for mothers.

Background : Suicide has occurred in all cultures and eras is a disaster for the individual, family, and society. Dialectical behavior therapy is a practical treatment for major depressive disorder. The main aim of the present study was to investigate the effect of dialectical behavior therapy on negative automatic thoughts, suicidal ideation, and life expectancy in female students of Yasooj University of Medical Sciences. Methods: The research method is quasi-experimental and the statistical population of the study included female students of Yasooj University of Medical Sciences in the age range of 18 to 25 years. The sample size was 40 people who were selected by a convenience sampling method and were randomly divided into two groups of dialectical behavior therapy and control group. To collect data, Snyder Hope Scale, Negative Automatic Thought Scale, and Beck Suicidal ideation Questionnaire in pre-test and post-test stages were used. In the intervention phase, the experimental group underwent dialectical behavior therapy for ten sessions of 120 minutes while the control group did not receive any intervention during this period. Data analysis was performed using SPSS software. Results : The findings indicate that dialectical behavior therapy was effective in increasing life expectancy and reducing negative automatic thoughts (Pvalue=0.001) and was not significantly effective in reducing suicidal ideation. Conclusions : Considering the effectiveness of dialectical behavior therapy on reducing negative thoughts and increasing the level of hope, therefore dialectical behavior therapy training is recommended to increase knowledge and empower students against depression and its components. Keywords: Dialectical behavior therapy, Suicidal ideations, Negative automatic thoughts, Life expectancy

Bipolar disorder (BD) is a debilitating psychiatric disorder characterized by recurrent depression, manic, and hypomanic episodes. Patients with BD are also likely to experience difficulties with executive functions and emotion regulation. The literature review states that little research has been done on dialectical behavior therapy (DBT) for BD, and there has not been an examination of this therapy on BD patients’ executive functions and emotion regulation. The present study addresses this absence of research with a pilot study on 60 BD patients. Participants in the intervention group received twelve 90-min sessions adapted from a standard DBT protocol for BD and the control group was on a wait-list for treatment. Participants completed measures of mental wellbeing and executive functioning at baseline, immediately after the intervention, and 3 months later as a follow-up. Results showed that the intervention group improved over time, having lower scores in mania, depression, and emotion disregulation than the control group post-treatment. Further, the intervention group had higher scores in mindfulness, planning, problem-solving, and cognitive flexibility than the control group. The findings highlight that DBT, alongside prescription medication, can be an effective therapy for BD as well as leading to reduced manic and depression symptoms and improved executive functions, emotion regulation, and mindfulness.