Dialectical behavior therapy skills use and emotion dysregulation in personality disorders and psychopathy: a community self-report study.

Andrada D Neacsiu,Mathew A Tkachuck

doi:10.1186/s40479-016-0041-5

Abstract

BackgroundEmotion dysregulation is a critical transdiagnostic mental health problem that needs to be further examined in personality disorders (PDs). The current study examined dialectical behavior therapy (DBT) skills use, emotion dysregulation, and dysfunctional coping among adults who endorsed symptoms of cluster B PDs and psychopathy. We hypothesized that skills taught in DBT and emotion dysregulation are useful for adults with PDs other than borderline personality disorder (BPD).MethodsUsing a self-report questionnaire, we examined these constructs in three groups of community adults: those who reported symptoms consistent with borderline personality disorder (BPD; N = 29), those who reported symptoms consistent with any other cluster B PD (N = 22), and those with no reported cluster B PD symptoms (N = 77) as measured by the Personality Diagnostic Questionnaire-4 + .ResultsBoth PD groups reported higher emotion dysregulation and dysfunctional coping when compared to the no PD group. Only the BPD group had significantly lower DBT skills use. DBT skills use was found to be a significant predictor of cluster B psychopathology but only before accounting for emotion dysregulation. When added to the regression model, emotion dysregulation was found to be a significant predictor of cluster B psychopathology but DBT skills use no longer had a significant effect. Across all groups, DBT skills use deficits and maladaptive coping, but not emotion dysregulation, predicted different facets of psychopathy.ConclusionEmotion dysregulation and use of maladaptive coping are problems in cluster B PDs, outside of BPD, but not in psychopathy. Inability to use DBT skills may be unique to BPD. Because this study relied exclusively on self-report, this data is preliminary and warrants further investigation.

Highlights

Emotion dysregulation is a critical transdiagnostic mental health problem that needs to be further examined in personality disorders (PDs)
Using the information collected on the PDQ-4+ we first assessed the validity of our sample’s responses, in accordance with the PDQ+ scoring instructions, and excluded 83 participants for underreporting, lying, or answering randomly
Using the PDQ-4+ subscales, we identified 29 participants who reported symptoms consistent with borderline personality disorder (BPD) (i.e., > 4 BPD symptoms; the BPD group); 22 that reported symptoms consistent with either narcissistic PD (NPD) (i.e., > 4 NPD symptoms), antisocial PD (ASPD) (i.e., > 3 symptoms of conduct disorder and > 3 ASPD symptoms since age 15), or histrionic PD (HPD) (i.e., > 4 HPD symptoms; the otherPD group); and 77 who did not report symptoms consistent with any of the cluster B PDs

Summary

Introduction

Emotion dysregulation is a critical transdiagnostic mental health problem that needs to be further examined in personality disorders (PDs). One influential contemporary model defines emotion dysregulation as a multidimensional set of difficulties with: (1) emotional awareness, (2) clarity, (3) acceptance, (4) impulsivity, (5) achieving goals, and (6) use of emotion regulation strategies when upset [31]. Such difficulties with regulating emotions occur across psychopathology (e.g., [1, 50]), mediate [27, 83] and moderate [2, 16] development and course of mental illness. The definition of PDs slightly changed in the recently released DSM-5 [4]; these changes are not likely to affect the prevalence of PDs

Methods

Results

Discussion

Conclusion