Mapping Aspects of Psychotherapy in Dialectical Behavior Therapy
Condition: Borderline Personality Disorder
MeSH terms: Personality Disorders; Borderline Personality Disorder
Study type: Interventional

Summary: 
      Although dialectical behavior therapy (DBT) skills training is effective in the treatment of
      borderline personality disorder, it contains four skills modules and there is little research
      to guide their modular application. This study compares the unique effects of two distinct
      DBT skills training modules, relative to a non-DBT therapy group for adults with borderline
      personality disorder. Using innovative laboratory-based assessment methods, the proposed
      study will examine the effects of these conditions on emotional responding and interpersonal
      functioning, as well as clinical outcomes.
    

Detailed description: 
      Borderline personality disorder (BPD) is a severe mental health condition with high morbidity
      and mortality. Although dialectical behavior therapy (DBT) is an efficacious treatment for
      BPD, it is resource-intensive and lengthy in its full form, involving one year of weekly
      individual therapy and group skills training in mindfulness, emotion regulation,
      interpersonal effectiveness, and distress tolerance. As a result, few patients have access to
      the full treatment. A better understanding of how the distinct components of DBT affect
      different sets of symptoms could help to streamline this treatment and personalize its use
      with specific patients.

      Improvements in both interpersonal and emotional functioning are theorized to underlie
      improvements in BPD. Thus, emotion regulation and interpersonal effectiveness skills training
      may be particularly important components of DBT. Therefore, this study examines the unique
      effects of two distinct DBT skills training modules.

      Participants are adults with BPD and recent, recurrent self-injurious behaviors (planned N =
      81) who are randomly assigned to six weeks of DBT emotion regulation skills training
      (DBT-ER), DBT interpersonal effectiveness skills training (DBT-IE), or a non-skills control
      group. Using innovative laboratory-based multimethod assessments, this study examines the
      effects of these conditions on emotional responding and interpersonal functioning, as well as
      BPD related outcomes. Aim 1 examines the unique effects of DBT-ER and DBT-IE on their
      respective emotion-related (subjective and biological emotional reactivity, behavioral
      emotion regulation, skills use) and interpersonal (subjective and behavioral) targets,
      compared to the non-DBT treatment. Aim 2 examines whether improved emotional functioning
      predicts reductions in BPD symptoms and self-injury. Aim 3 examines whether baseline emotion
      dysregulation interacts with treatment condition to predict treatment response.

      The proposed research is innovative in its experimental examination of the effects of DBT
      components on specific targets in BPD. Given the high societal costs of BPD, this work has
      important public health significance. Findings will inform larger studies evaluating the
      potential modular use of DBT components to result in briefer and more efficient
      individualized treatments for patients.
    

Intervention name(s): Dialectical behavior therapy - emotion regulation skills training; Dialectical behavior therapy - interpersonal effectiveness skills training; Interpersonal psychotherapy
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Arm 1. Dialectical behavior therapy - emotion regulation skills training follows the emotion regulation skills DBT Skills Training Manual Second Edition and the DBT Skills Training Handouts and Worksheets Second Edition. This group involves 6 weekly sessions.
Arm 2. Dialectical behavior therapy - interpersonal effectiveness skills training follows the interpersonal effectiveness skills DBT Skills Training Manual Second Edition and the DBT Skills Training Handouts and Worksheets Second Edition. This group involves 6 weekly sessions.; Arm 2. Dialectical behavior therapy - interpersonal effectiveness skills training follows the interpersonal effectiveness skills DBT Skills Training Manual Second Edition and the DBT Skills Training Handouts and Worksheets Second Edition. This group involves 6 weekly sessions.; Arm 3. Non-skills-oriented interpersonal psychotherapy group follows evidence-based principles on common factors in a group therapy context. This group involves 6 weekly sessions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: Dialectical behavior therapy; Emotions; Behavior and Behavior mechanisms; Randomized Controlled Trials