Dialectical Behavior Therapy Group Research Articles

Trajectories of Treatment Response and Nonresponse in Youth at High Risk for Suicide.

To examine trajectories of treatment response in suicidal youth who participated in a randomized controlled trial comparing dialectical behavior therapy (DBT) and individual and group supportive therapy. Using latent class analysis across both treatment conditions, secondary analyses were conducted of data from a multisite randomized controlled trial comprising 173 youths ages 12-18 with repetitive self-harm (SH) (including≥1 lifetime suicide attempts) and elevated suicidal ideation (SI). The sample was 95% female, 56.4% White, and 27.49% Latina. Participants received 6 months of DBT or individual and group supportive therapy and 6 months of follow-up. Primary outcomes were SH and SI. Of the sample, 63% and 74% were members of latent classes that showed improvement in SI and SH, respectively; 13% were total nonresponders, with no improvement in SI or SH. SH nonresponse emerged at the midpoint of treatment (3 months), with nonresponders showing a sharp increase in SH over the remainder of treatment and follow-up. Youth receiving DBT were significantly more likely to be an SH responder vs nonresponder than youths in individual and group supportive therapy (ꭓ21= 6.53, p= .01). An optimal threshold cut point using multivariate predictors of total nonresponse (White, externalizing symptoms, total SH, and SI) predicted total nonresponders to DBT with 100% accuracy. This is the first study to identify trajectories of both SI and SH response to treatment in a sample of adolescents at risk of suicide. Results may inform personalized treatment approaches. Collaborative Adolescent Research on Emotions and Suicide (CARES); https://www. gov/; NCT01528020.

Adult ADHD Treatment Based on Combination of Dialectical Behavior Therapy (DBT) and Transcranial Direct Current Stimulation (tDCS) as Measured by Subjective and Objective Scales

Almost 30% of ADHD adults do not respond to standard pharmaceuticals. Transcranial direct current stimulation (tDCS) is a method for modulation of cortical excitability. On the other hand, dialectical behavioral therapy (DBT) is a cognitive-behavioral approach that might be utilized for adults with ADHD. The effects of integration of these interventions are only beginning to be explored. In the present work, we used both subjective and objective measures to investigate the effects of tDCS, DBT, and the integration of the two in treating adult ADHD symptoms. A total of 80 adults with ADHD (63 females, 17 males) participated in the study and were grouped into control, DBT, tDCS, and combined groups. Based on the observed results, the combination of DBT and tDCS was significantly effective in improving the mentioned variables compared to administration of each method in isolation. The results are discussed in terms of neurophysiological and psychological aspects of treatment methods.

Comparison of the effect of two interventions of group dialectical behavior therapy and structured matrix treatment on pathological narcissism and craving for drugs among drug abusers

Background and aims: Pathological narcissism is one of the personality disorders in drug abusers, and its main characteristic is self-conceit and lack of empathy and solidarity with others. The present study aimed to compare the effects of group dialectical behavior therapy (DBT) and structured matrix treatment on pathological narcissism and craving for drugs among drug abusers in Ahvaz. Methods: This was a quasi-experimental study based on a pretest-posttest design with control and test groups. The study population consisted of all drug abusers visiting the addiction rehabilitation centers affiliated with the Department of Social Welfare, Ahvaz, Iran, in 2021. Of them, 75 individuals were selected as the sample through the cluster random sampling method and were randomly assigned to two experimental groups and a control group. Participants in all three groups completed the Pathological Narcissism Inventory (PNI) and the Desires for Drug Questionnaire (DDQ) as the pre-test. The first experimental group participated in eight 90-minute sessions of group DBT. Moreover, the second experimental group underwent fourteen 90-minute sessions of structured matrix treatment. Finally, all participants took a post-test, and data were statistically analyzed by multivariate analysis of covariance (MANCOVA). Results: The results showed that both group DBT and structured matrix treatment reduced pathological narcissism and craving for drugs in experimental groups (P<0.001). However, there was no significant difference between the two experimental groups in the mean scores of pathological narcissism and craving for drugs. Conclusion: As our findings demonstrated the effectiveness of group DBT and structured matrix treatment in reducing pathological narcissism and craving for drug among drug abusers, these two interventions, along with other therapies, are recommended to improve the mental state and reduce craving for drugs among drug abusers.

Effectiveness of Mindfulness-Based Stress Reduction and Dialectical Behavior Therapy on Pathological Worry and Difficulty in Emotion Regulation in Students With Depression Symptoms

Background: High school students may experience stress, worry, anxiety, educational problems, and psychological damage because of high workload, expansive cognitive assignments, and being in a competitive space regarding their assignments and the university entrance exam. The present study aims to investigate the effectiveness of mindfulness-based stress reduction (MBSR) and dialectical behavior therapy (DBT) on pathological worry and difficulty in emotion regulation in students with depression symptoms in Dehloran City, Iran. Methods: This was a quasi-experimental study based on a pretest-posttest design with a control group. The statistical population comprised all 12-grade female students studying for the university entrance exam in the academic year of 2020-2021 in Dehloran City, Iran. A total of 45 students were selected through convenience sampling and randomly divided into MBSR, DBT, and control groups. The research instruments included the difficulties in emotion regulation scale, Penn State worry questionnaire, and Beck depression inventory-II. The data were analyzed via descriptive statistics and multivariate analysis of covariance. Results: The Mean±SD of the pathological worry for MBSR, DBT, and control groups in the posttest phase were 33.67±3.69, 31.00±3.87, and 37.78±3.96, respectively. Moreover, the Mean±SD of the difficulty in emotion regulation in the posttest phase for MBSR, DBT, and control groups were 62.00±6.18, 61.60±6.95, and 72.20±6.84, respectively. The results indicated that the differences between MBSR and DBT groups with the control group were significant in terms of the scores for pathological worry and difficulty in emotion regulation of the university entrance exam applicants with depression symptoms in the posttest stage (P<0.001). Conclusion: MBSR and DBT can be recommended to school counselors as effective interventions to improve emotion regulation and pathological worry in university entrance exam applicants with depression symptoms.

A clinical follow-up study of dialectical behavior therapy skills groups among female adolescents diagnosed with depressive disorder.

Our aim was to evaluate longitudinal data for adolescents who were treated with Dialectical Behavior therapy (DBT) skills groups having been previously diagnosed with depressive disorder. Intervention with an observational cross-sectional design was implemented to evaluate the treatment outcome of a 10-week DBT skills groups with female adolescents with depression. After the patients were identified for enrollment, parents and adolescents were evaluated with psychometric measurements pre-, post-intervention, and at one-year follow-up. Repeated measures analysis was undertaken with the Child Depression Inventory (CDI), Pediatric Quality of Life Inventory (PedsQL) and Strengths and Difficulties Questionnaire (SDQ) for participants. Statistical significance was detected for self-report CDI scores and both self-report and parent SDQ and PedsQL scores. This study is the first DBT intervention in Turkish children, shows that a group DBT skills groups training can be adapted and put into practice successfully with depressed Turkish adolescents.

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Effectiveness of a brief dialectical behavior therapy intensive-outpatient community health program.

Standard dialectical behavior therapy (DBT), with its 12-month format, has a documented record of efficacy. While emerging evidence is supportive of DBT adaptations in community mental health settings and brief, intensive formats, many of these studies are limited by sample size of its DBT group, by omission of program completion rates and specific data from program noncompleters, and by focusing solely on symptom-focused measures-which inadvertently omits observing gains associated with well-being. We used a nonexperimental design to assess client outcomes on pathology-focused and positive-psychology measures in a brief DBT intensive-outpatient Community Mental Health Center in the midwestern United States for program graduates and program dropouts who completed at least two surveys (n = 77). This is the shortest average program length (M = 19.01 days) known for a DBT program. Scores on measures of depression (d = 0.41), anxiety (d = 0.5), stress (d = 0.5), and difficulties in emotion regulation (d = 0.51) all decreased from entrance to exit. Scores on measures of mindfulness (d = 0.43), Snyder's hope (d = 0.51), and integrative hope (d = 0.41) increased from entrance to exit. These results provide evidence that pathology decreases and measures associated with well-being increase in this brief, intensive-outpatient community health DBT program. This study provides support for future investigations of brief, intensive community health programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Dialectical Behavior Therapy for Emotional and Mindless Eating After Bariatric Surgery: a Prospective Exploratory Cohort Study.

To assess the effect of dialectical behavior therapy (DBT) on emotional and mindless eating and, consequently, body mass index (BMI) loss, in patients who have undergone bariatric surgery. A prospective exploratory cohort study was conducted with two groups of patients who had undergone bariatric surgery: the DBT group received DBT group skills training sessions, while the control group received no intervention. Outcome measurements included BMI and scores of the Emotional Eating Scale (EES) and Mindful Eating Questionnaire (MEQ). The study included 36 women: 18 in each group. In the DBT group, the interval from surgery was 11.17 ± 7.12months, and in the control group 10.89 ± 5.74. Laparoscopic sleeve gastrectomy was done in 88.9% and 83.3% of patients in the DBT and control groups respectively. The rest underwent Roux-en-Y gastric bypass. The DBT group showed significant changes in overall and subscale scores of the EES and MEQ and BMI in kg/m2 after 6months of follow-up. BMI in kg/m2 changed from mean ± SD 35.45 ± 6.17 to 28.47 ± 4.28 in the DBT group, in control 35.88 ± 5.07 to 31.56 ± 3.71. The excess weight loss percentage (EWL%) in the DBT was mean ± SD 75.3 ± 17.9 and in the control was 63.6 ± 14.5. In the DBT group, the EES score and MEQ score changed from mean ± SD 45.06 ± 20.19 to 20.50 ± 13.40 and 11.52 ± 2.02 to 15.87 ± 1.92, respectively. The control group showed no significant change in scores. DBT skills training can reduce emotional eating, increase mindful eating, and facilitate weight loss after bariatric surgery.

Dialectical behavior therapy skills training for individuals with multiple sclerosis and their support partners: A pilot randomized controlled trial

BackgroundSymptoms of anxiety, depression, and emotion dysregulation are common among individuals with MS and their support partners. Dialectical behavior therapy (DBT) – a type of cognitive behavioral intervention – may be a promising treatment for individuals affected by MS. This pilot randomized controlled trial (RCT) assessed the effects and feasibility of remotely delivered DBT skills on anxiety and depression symptoms and emotion dysregulation in individuals with MS and their support partners. MethodsThis study featured a single-masked, two-arm, parallel group design. Twenty pairs of individuals with MS and their support partners (n = 40) were randomized to 12 weeks of DBT or facilitated peer support (FPS). Masked assessments were completed at weeks 0 (baseline), 13 (post-intervention), and 26 (follow-up). ResultsAt post-intervention (primary endpoint), participants randomized to DBT exhibited significantly greater reductions in anxiety and depression symptoms compared to FPS (B = 4.45, p = .04, Cohen's d = 0.57). Secondary outcomes of emotion dysregulation and well-being favored the DBT group but did not reach statistical significance (ds = 0.51, ps = 0.07). Effects were not maintained at follow-up. Most (86%) individuals screened were eligible for the trial, and retention (70%) did not differ between study arms. ConclusionsThis pilot RCT provides encouraging evidence that DBT skills is feasible and may improve depression, anxiety, and emotion dysregulation for individuals with MS and their support partners. Future research is needed to optimize maintenance of DBT skills, investigate mechanisms for these improvements, and replicate these promising effects in a fully powered trial.

Comparison of the Effectiveness of group Dialectical Behavior Therapy with group Schema Therapy on Psychological Distress in Women with Coronary Heart Disease

Aim: This study aimed to compare the effectiveness of group dialectical behavior therapy with group schema therapy on psychological distress in women with coronary heart disease. Method: This was a quasi-experimental study using a pre-test-post-test design with a control group. The statistical population included women suffering from coronary heart disease referred to Azadi Hospital in Tehran in 2018-2019, 45 people were selected as a statistical sample by available sampling method and divided into two experimental groups, and one control group (15 people for each group) were replaced. The research measurement tools included psychological distress (Kessler et al., 2002). After completing eight sessions of dialectical behavioral therapy (two sessions per week for 4 weeks) and eight sessions of group schema therapy (two sessions per week for 4 weeks) in the experimental groups, the questionnaires were repeated immediately and after three months. The sequence was completed as a post-test and follow-up in groups. The results were analyzed using descriptive statistics and inferential (repeated measures analysis of variance) in SPSS.23 software. Results: The results of repeated measures analysis of variance showed that both treatments were effective on psychological distress in women with coronary heart disease from pre-test to post-test and follow-up (p=0.001). The Bonferroni post hoc test results also showed that group dialectical behavior therapy has a more significant effect on reducing psychological distress in women with coronary heart disease than group schema therapy from pre-test to post-test and follow-up (p=0.001). Conclusion: Therefore, group dialectical behavior therapy training is recommended as an effective intervention method for reducing psychological distress in women with coronary heart disease.

The Effect of Dialectical Behavioral Therapy on Emotion Dysregulation in Couples.

Background:Divorce rates have increased during the last decade, leading to a greater focus of marital scholars on the importance of understanding couple-maintaining strategies within marital life. Distresses in couples are attributable to difficulties controlling felt, experienced, and expressed emotions; thus, emotion dysregulation is a core stressor in couples with maladaptive responses.Objective:The aim of the study was to evaluate the effect of Dialectical Behaviour Therapy (DBT) on outpatient couples to treat emotion dysregulation.Methods:We recruited 20 couples with marital distress in which partners presented emotion dysregulation. We offered the couples the opportunity to join a couple DBT group at their convenience and based on the immediate availability of treatment slots. We measured the treatment efficacy using psychometric tools (the Difficulties in Emotion Regulation Scale (DERS) and the Dyadic Adjustment Ccale (DAS) at baseline and after DBT therapy.Results:Both male and female partners presented significant improvements in marital adjustment DAS and emotion regulation scores. Female partners showed significantly greater amplitude changes in both scales. Female partners showed significant improvement in most DERS subscales (except the GOALS subscale); on the other hand, male partners showed significant improvements in impulse, awareness, strategies, and clarity subscales. We found significant improvements in most DAS subscales in both sexes; only affectional expression remained unchanged before and after therapy.Conclusion:DBT for couples is an effective approach to treat emotion dysregulation.

The Effect of Dialectical Behavior Therapy on Negative Automatic Thoughts, Suicidal Ideation and Life Expectancy in Female Students of Yasooj University of Medical Sciences

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

اثربخشی مهارت آموزی مبتنی بر رفتار درمانی دیالکتیکی بر ترس از ارزیابی منفی و مهارت های ارتباطی نوجوانان مبتلا به اختلال اضطراب اجتماعی

اثربخشی مهارت آموزی مبتنی بر رفتار درمانی دیالکتیکی بر ترس از ارزیابی منفی و مهارت های ارتباطی نوجوانان مبتلا به اختلال اضطراب اجتماعی

Efficacy of Dialectical Behavioral Therapy for Emotion Dysregulation in Patients with Dual Diagnosis of Borderline Personality Disorder and Substance Use Disorder

Background: The published evidence supports the efficacy of dialectical behavioral therapy (DBT) to treat patients with borderline personality disorder and particular emphasis on emotion dysregulation as a psychopathological construct. Aim: To assess the efficacy of DBT for improving emotion dysregulation among patients with dual diagnosis of borderline personality disorder and substance use disorder. Methods: We recruited 40 patients meeting DSM-5 criteria for borderline personality disorder and substance use disorder and assigned them to one of two groups of 20 participants each. One group underwent DBT therapy and the other group followed a treatment-as-usual (TAU) protocol over one year. We used the scores of the difficulties in emotion regulation scale (DERS) at baseline, immediately after therapy, and 4 months after therapy to assess emotion dysregulation. Results: We found significant improvements (p<0.05) in the DBT group after therapy that were maintained at least for 4 months afterwards based on the DERS scores (including subscale scores). More patients dropped out of the treatment in the TAU group than in the DBT group. Conclusion: DBT is a potentially efficacious psychological intervention to treat emotion dysregulation in patients with borderline personality disorder and substance use disorder.

Effectiveness of a brief form of group dialectical behavior therapy for binge‐eating disorder: Case series in a routine clinical setting

While there is evidence to support the use of group dialectical behavior therapy (DBT) in the treatment of binge-eating disorder (BED), treatment is relatively long compared with other evidence-based treatments. This study explored the effectiveness of brief DBT groups for BED, delivered in a routine community setting. Eighty-four adults with BED entered 10-week DBT group treatment in a community eating disorders service. In total, 12 groups were conducted. Patients completed measures of eating disorder pathology, anxiety, depression, and emotional eating at the start and end of treatment, and at 1-month follow-up. Frequency of weekly binges was recorded. Outcomes were similar to those of longer versions of DBT, with an attrition rate of 26%, and significant reductions in eating disorder psychopathology and emotional eating by the end of treatment and at follow-up. Over 50% of patients were abstinent from binge eating by Session 4. Group DBT delivered in a 10-session format is clinically equivalent to longer versions of the same treatment. Future research is required to explore patterns of change and to demonstrate replicability under controlled conditions, but these findings are promising for the efficient delivery of effective treatment and reducing waiting times.

A pilot randomized controlled trial of dialectical behavior therapy (DBT) for reducing craving and achieving cessation in patients with marijuana use disorder: feasibility, acceptability, and appropriateness.

ObjectiveTo conduct a pilot RCT investigating the feasibility, acceptability, and preliminary efficacy of dialectical behavioral therapy (DBT) for marijuana cessation and craving reduction.MethodsSixty-one patients with marijuana use disorder diagnoses were randomly assigned to a DBT group or a control group (psycho-education). Patients completed measures at pre-intervention, post-intervention, and at two-month follow-up. The Marijuana Craving Questionnaire (MCQ) and marijuana urine test kits were used to assess craving and abstinence respectively.ResultsThe feasibility of DBT was significantly higher than control group feasibility. In the DBT 29/30 participants completed all sessions (96% retention) and 24/31 control group participants completed all sessions (77% retention) (χ2 = 4.95, p = 0.02). Moreover, 29/30 (96%) participants in the DBT group completed the two-month follow-up and 20/31 (64.5%) control group members completed the two-month follow-up (χ2 = 9.97, p = 0.002). The results showed that patients in the DBT group had significantly higher intervention acceptability rates (16.57 vs. 9.6) than those in the control group. This pattern was repeated for appropriateness rates (p < 0.05). The overall results for craving showed that there was no significant difference between the groups (F = 3.52, p > 0.05), although DBT showed a significant reduction in the “emotionality” subscale compared to the control group (F = 19.94, p < 0.05). To analyze cessation rates, DBT was compared to the control group at the posttest (46% vs. 16%) and follow-up (40% vs. 9.5%) and the results confirmed higher effectiveness in the DBT group for cessation (p < 0.05). Furthermore, among those who had lapsed, participants in the DBT group had fewer consumption days than those in the control group (p < 0.05).ConclusionsDBT showed feasibility, acceptability, and promising efficacy in terms of the marijuana cessation rate.Clinical trial registrationThailand Registry of Clinical Trials, TCTR20200319007.

Compare the Effectiveness of Acceptance and Commitment Based Group Therapy and Dialectical Behavior Therapy on Cognitive Strategies of Emotional Regulation in Addicts with Antisocial Personality Disorder

Compare the Effectiveness of Acceptance and Commitment Based Group Therapy and Dialectical Behavior Therapy on Cognitive Strategies of Emotional Regulation in Addicts with Antisocial Personality Disorder

The effectiveness of dialectical behaviour therapy for treating women with obesity suffering from BED: A feasibility and pilot study

ObjectiveThis study aimed to examine the effects of dialectical behaviour therapy skills training intervention on emotional eating, body image, and weight management in women with obesity suffering from binge eating disorder.MethodForty women with obesity were selected based on inclusion and exclusion criteria from three outpatient nutrition clinics in Tehran, Iran, and were assigned into the dialectical behaviour therapy (n = 20) or control groups (n = 20) randomly. The dialectical behaviour therapy group participated in 20 group therapy sessions, while there was no intervention for the control group. All participants completed the Multidimensional Body Self‐Relations Questionnaire‐Appearance Scale, Emotional Eating Scale, and body mass index at the baseline and post‐treatment.ResultsCurrent results indicated that dialectical behaviour therapy has significant effects on the reduction of body mass index and emotional eating subscales (except for depression; F [1, 35] = 0.05, p = .94). Moreover, dialectical behaviour therapy resulted in an improvement in the body image of women with obesity at the end of the treatment.ConclusionsThis study suggests that dialectical behaviour therapy‐based skills training is efficacious not only in reducing weight and emotional eating but also in improving the body image of females with binge eating disorder.

El síndrome de Burnout en supervisados en Terapia Dialéctica Conductual: Una revisión de literatura

This literature review examined the findings about the Dialectical Behavioral Therapy (DBT) supervisor’s role on the supervisees’ burnout with the goal of guiding future research about clinical supervision methods. This article evaluates protective factors of DBT individual and group supervision as a tool for managing the burnout of different types of mental health providers. The individual modality trains the therapists on how to manage clients categorized as challenging. On the other hand, group modality propitiates a balancing environment between the personal (validation and success perception) and the professional (less stigma and apathy). Finally, we suggest future areas to research as we found a very limited availability of Iberoamerican research conducted about this topic; with this, we urge researchers from Spain and Latinoamerica to provider their research contribution.

Study of Dialectical Behavior Therapy Versus Cognitive Behavior Therapy on Emotion Regulation and Mindfulness in Patients with Generalized Anxiety Disorder

Although the effectiveness of dialectical behavior therapy (DBT) in the treatment of generalized anxiety disorder (GAD) has not been addressed to date, cognitive behavior therapy (CBT) is the gold-standard psychotherapy for GAD patients. The present study investigated effects of DBT versus CBT on emotion regulation and mindfulness in GAD patients. Conducted in Iran, 68 GAD patients were randomly assigned to one of two groups: CBT or DBT. Assessment was performed at pre-treatment, post-treatment, and at 3 months follow-up. Evaluation included the Generalized Anxiety Disorder scale (GAD-7), Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Five Facet Mindfulness Questionnaire (FFMQ), and Difficulties in Emotion Regulation Scale (DERS). Results of the present study showed that both groups had lower scores in depression, anxiety, and emotion dysregulation and higher scores in mindfulness after the interventions, and at follow-up. During the study period, the CBT group experienced greater reductions than the DBT group in symptoms of depression and anxiety, while the DBT group experienced greater improvements than the CBT group in emotion regulation and mindfulness. Findings seem to warrant the conclusion that, although CBT reduced symptoms of depression and anxiety more than DBT, DBT was more effective in improving emotion regulation and mindfulness than CBT. Findings of the study are of significance for psychotherapy and future studies of these treatments.