Abstract
Treatment of borderline personality disorder (BPD) with comorbid substance use disorder can be challenging due to symptom overlap and limited assessment methods. Preliminary evidence has shown promising effectiveness of dialectical behavioral therapy (DBT) for BPD with comorbid substance use disorders. The current study compared the benefits of a 28-day transitional DBT treatment program for individuals with BPD with and without substance use disorders through evaluating the changes in coping skills, generalized anxiety, and depression symptom scales at admission and discharge. A total of 76 patients were split into two groups: Group 1 consisted of individuals with BPD without substance use disorders (n = 41), and Group 2 involved individuals with BPD and a substance use disorder (SUD) (n = 35). A univariate general linear model showed significant differences between the two groups in improvement of coping skills and depressive symptoms. After a 28-day transitional DBT treatment program there were significant decreases from severe to moderate depression scores in both groups. Our findings support the effectiveness of DBT treatment in patients with comorbid BPD and SUD.
Highlights
Substance use disorders (SUD) are highly prevalent among individuals with borderline personality disorder (BPD) with 78% of individuals meeting diagnostic criteria (American Psychiatric Association, 2013)
There is, only preliminary evidence on the efficacy of Dialectical Behavior Therapy (DBT) for substance use disorder (SUD) (Stotts and Northrup, 2015) and even fewer trials of DBT for BPD and SUD (Lee et al, 2015). The purpose of this pilot study was to examine the benefits of a 28-day, transitional, DBT treatment program for individuals with BPD and SUD compared to those with BPD and no SUD through evaluating the changes in DBT-Ways of Coping Checklist (DBTWCCL) skill use and anxiety and depression symptom scales at admission and discharge
Group 1 consisted of individuals with BPD without SUD (BPD; n = 41), and Group 2 was composed of individuals with BPD and SUD (BPD and SUD; n = 35)
Summary
Substance use disorders (SUD) are highly prevalent among individuals with borderline personality disorder (BPD) with 78% of individuals meeting diagnostic criteria (American Psychiatric Association, 2013). Lee et al (2015) concluded that, despite the absence of a strong evidence base, DBT, and dynamic deconstructive psychotherapy (DDP) showed benefit in reducing symptoms, naming DBT “the first choice” of treatment for individuals with comorbid BPD and SUD. There is, only preliminary evidence on the efficacy of DBT for SUD (Stotts and Northrup, 2015) and even fewer trials of DBT for BPD and SUD (Lee et al, 2015) The purpose of this pilot study was to examine the benefits of a 28-day, transitional, DBT treatment program for individuals with BPD and SUD compared to those with BPD and no SUD through evaluating the changes in DBT-Ways of Coping Checklist (DBTWCCL) skill use and anxiety and depression symptom scales at admission and discharge
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