Dialectical Behavior Therapy in the Management of Emotion Dysregulation in a Sample of Egyptian Female Adolescents\Mothers Dyad: An Interventional Study
Authors: Abdel-Hameed Zolfa Salah , Omar Abdel Nasser Mahmoud , El Deen Azzam Hanan Mohamed Ezz , Sultan Marwa AbdelRahman , ElGhamry Reem Hassan , Khamis Marwa Esameldin 
Published: November 2024

Abstract

Background
Emotion dysregulation can have significant implications for overall well-being and developmental outcomes. Adolescents exhibit greater difficulties in emotion regulation when compared to adults and children. Emotion dysregulation may be indicative of psychiatric disorders and can be also typical for adolescents’ turmoil with no specified psychiatric diagnosis. Dialectical Behavior Therapy (DBT) targets improving emotion regulation as a primary mechanism of change. The current study aimed to evaluate the outcome of Dialectical Behavior Therapy for Adolescents “DBT-A” in Egyptian adolescent girls with emotion dysregulation recruited from adolescents’ outpatient clinics, Ain Shams University. This study also aimed to evaluate the impact of DBT-A on parenting stress of the mothers through multifamily skills training group.

Methods
Twenty two female adolescents and their mothers, (22 daughter/mother dyads) (n = 44 participants) enrolled to the study intervention (DBT-A) for 6 months, Assessments for outcome measures (Emotion regulation, Interpersonal difficulties inventory, Distress Tolerance Scale, Mindfulness Inventory) were made for adolescents and mothers at baseline and after 6 months at end of treatment, Additional assessments for the adolescents (Suicidal and Non-Suicidal Behavior Severity Index, Borderline symptomatology, quality of life, Global Assessment of functioning, Frequency of hospitalization and Emergency department visit over the trial period were recorded). Assessment for mothers’ parental stress was done at baseline and after 6 months at the end of treatment intervention.

Results
Treatment Retention for DBT-A intervention was good with low drop-out rate (4.5%), Effect sizes were medium for the treatment outcomes. Results showed marked improvement as regards emotion regulation, Interpersonal effectiveness, Distress Tolerance, Mindfulness skills in the studied adolescents and their mothers after receiving comprehensive DBT-A program, For the participating adolescents results showed that borderline symptoms and behavior severity were significantly decreased after DBT-A, suicidal severity index significantly improved (severity of suicidal ideations, actual lethality subscale, frequency of true suicide attempts and non-suicidal self-injury and risk stratification) all decreased after DBT-A with decreased frequency of hospitalization and utilization of emergency department services. The adolescents showed an improved quality of life and global functioning after DBT-A. For the participating mothers, parental stress level was significantly decreased after DBT-A.

Conclusion
DBT-A may be an effective intervention for treatment and prevention of emotion dysregulation in adolescents, as well as may be an effective intervention reduce self-harm, suicidal ideations and suicidal behavior in adolescents with repetitive self-harming behavior
Key words: Adolescents, Self-harm, Emotion regulation, Suicide, DBT-A.