Efficacy of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder: A Systematic Review of Randomized Controlled Trials
,
Abstract
Objective: Borderline personality disorder (BPD) is a serious public health problem. Dialectical Behavior Therapy (DBT) is a program that has provided encouraging results for its treatment. However, scientific evidence about its efficacy is scarce. Therefore, we aimed to describe the scientific production on the components of the DBT program and its therapeutic efficacy in the treatment of people with BPD.
Method: A systematic review with relevant keywords was conducted based on studies available in Scopus, Web of Science, and PubMed until June 2023, including studies in English, research on therapeutic intervention, studies with a randomized controlled trial (RCT) design that included people with the diagnosis of BPD.
Results: We found 18 RCTs, most of which supported the effectiveness of DBT for BPD. There were a total of 1,755 participants in these studies, most of whom were women. These studies looked for treating self-injurious behaviors, suicidal thoughts or ideations, number of visits to emergency services, and frequency of hospital admissions. Most studies revealed that both short-term DBT and standard DBT improved suicidality in BPD patients with small or moderate effect sizes, lasting up to 24 months after the treatment period. Furthermore, these studies showed that DBT can significantly improve general psychopathology and depressive symptoms in patients with BPD. Improvement of compliance, impulsivity, mood instability, as well as reduction in hospitalization rate are other findings observed in the trials following DBT.
Conclusion: Although DBT shows efficacy in the treatment of BPD, heterogeneity in the methodologies employed is highlighted. Therefore, it is necessary to design studies from a homogeneous theoretical and methodological framework.
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2. Akbari V, Rahmatinejad P, Mohammadi SD. Comparing Neurocognitive Profile of Patients with Borderline Personality and Bipolar-II Disorders. Iran J Psychiatry. 2019;14(2):113-9.
3. Reichl C, Kaess M. Self-harm in the context of borderline personality disorder. Curr Opin Psychol. 2021;37:139-44.
4. Mohammadi MR, Shamohammadi M, Salmanian M. The prevalence of borderline personality symptoms in adolescents. Iran J Psychiatry. 2014;9(3):147-51.
5. Ellison WD, Rosenstein LK, Morgan TA, Zimmerman M. Community and Clinical Epidemiology of Borderline Personality Disorder. Psychiatr Clin North Am. 2018;41(4):561-73.
6. Gratz KL, Kiel EJ, Mann AJD, Tull MT. The prospective relation between borderline personality disorder symptoms and suicide risk: The mediating roles of emotion regulation difficulties and perceived burdensomeness. J Affect Disord. 2022;313:186-95.
7. Zashchirinskaia O, Isagulova E. Childhood Trauma as a Risk Factor for High Risk Behaviors in Adolescents with Borderline Personality Disorder. Iran J Psychiatry. 2023;18(1):65-71.
8. Husain SF, Tang TB, Tam WW, Tran BX, Ho CS, Ho RC. Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study. BMC Psychiatry. 2021;21(1):201.
9. Ruocco AC, Rodrigo AH, McMain SF, Page-Gould E, Ayaz H, Links PS. Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study. Front Hum Neurosci. 2016;10:220.
10. Lieslehto J, Tiihonen J, Lähteenvuo M, Mittendorfer-Rutz E, Tanskanen A, Taipale H. Comparative Effectiveness of Pharmacotherapies for the Risk of Attempted or Completed Suicide Among Persons With Borderline Personality Disorder. JAMA Netw Open. 2023;6(6):e2317130.
11. Bailey RC, Grenyer BF. Burden and support needs of carers of persons with borderline personality disorder: a systematic review. Harv Rev Psychiatry. 2013;21(5):248-58.
12. McLenan J, Lazzari C, McMillan G, Mackie R. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals. Iran J Psychiatry. 2016;11(4):201-5.
13. Rabiee N, Nazari AM, Keramat A, Khosravi A, Bolbol-Haghighi N. The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial. Iran J Psychiatry. 2022;17(2):118-26.
14. Linehan MM, Wilks CR. The Course and Evolution of Dialectical Behavior Therapy. Am J Psychother. 2015;69(2):97-110.
15. Gillespie C, Murphy M, Joyce M. Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder: A Systematic Review of Outcomes After One Year of Follow-Up. J Pers Disord. 2022;36(4):431-54.
16. Barnicot K, Redknap C, Coath F, Hommel J, Couldrey L, Crawford M. Patient experiences of therapy for borderline personality disorder: Commonalities and differences between dialectical behaviour therapy and mentalization-based therapy and relation to outcomes. Psychol Psychother. 2022;95(1):212-33.
17. Lakeman R, Crighton J. The Impact of Social Distancing on People with Borderline Personality Disorder: The Views of Dialectical Behavioural Therapists. Issues Ment Health Nurs. 2021;42(5):410-6.
18. Kliem S, Kröger C, Kosfelder J. Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling. J Consult Clin Psychol. 2010;78(6):936-51.
19. Panos PT, Jackson JW, Hasan O, Panos A. Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT). Res Soc Work Pract. 2014;24(2):213-23.
20. Oud M, Arntz A, Hermens ML, Verhoef R, Kendall T. Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis. Aust N Z J Psychiatry. 2018;52(10):949-61.
21. Chen SY, Cheng Y, Zhao WW, Zhang YH. Effects of dialectical behaviour therapy on reducing self-harming behaviours and negative emotions in patients with borderline personality disorder: A meta-analysis. J Psychiatr Ment Health Nurs. 2021;28(6):1128-39.
22. Khaleghi A, Zarafshan H, Vand SR, Mohammadi MR. Effects of Non-invasive Neurostimulation on Autism Spectrum Disorder: A Systematic Review. Clin Psychopharmacol Neurosci. 2020;18(4):527-52.
23. Mostafavi SA, Khaleghi A, Mohammadi MR, Akhondzadeh S. Is transcranial direct current stimulation an effective modality in reducing food craving? A systematic review and meta-analysis. Nutr Neurosci. 2020;23(1):55-67.
24. Mostafavi SA, Khaleghi A, Mohammadi MR. Noninvasive brain stimulation in alcohol craving: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2020;101:109938.
25. Khaleghi A, Pirzad Jahromi G, Zarafshan H, Mostafavi SA, Mohammadi MR. Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior. Psychiatry Clin Neurosci. 2020;74(9):455-65.
26. Clarkin JF, Levy KN, Lenzenweger MF, Kernberg OF. Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychiatry. 2007;164(6):922-8.
27. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, et al. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry. 2006;63(7):757-66.
28. Koons CR, Robins CJ, Tweed JL, Lynch TR, Gonzalez AM, Morse JQ, et al. Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behav Ther. 2001;32(2):371-90.
29. Linehan MM, Dimeff LA, Reynolds SK, Comtois KA, Welch SS, Heagerty P, Kivlahan DR. Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend. 2002;67(1):13-26.
30. McMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry. 2009;166(12):1365-74.
31. van den Bosch LM, Koeter MW, Stijnen T, Verheul R, van den Brink W. Sustained efficacy of dialectical behaviour therapy for borderline personality disorder. Behav Res Ther. 2005;43(9):1231-41.
32. Linehan MM, Korslund KE, Harned MS, Gallop RJ, Lungu A, Neacsiu AD, et al. Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry. 2015;72(5):475-82.
33. Pistorello J, Fruzzetti AE, Maclane C, Gallop R, Iverson KM. Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial. J Consult Clin Psychol. 2012;80(6):982-94.
34. McMain SF, Chapman AL, Kuo JR, Dixon-Gordon KL, Guimond TH, Labrish C, et al. The Effectiveness of 6 versus 12 Months of Dialectical Behavior Therapy for Borderline Personality Disorder: A Noninferiority Randomized Clinical Trial. Psychother Psychosom. 2022;91(6):382-97.
35. Keefe JR, Kim TT, DeRubeis RJ, Streiner DL, Links PS, McMain SF. Treatment selection in borderline personality disorder between dialectical behavior therapy and psychodynamic psychiatric management. Psychol Med. 2021;51(11):1829-37.
36. Bohus M, Kleindienst N, Hahn C, Müller-Engelmann M, Ludäscher P, Steil R, et al. Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(12):1235-45.
37. Euler S, Stalujanis E, Allenbach G, Kolly S, de Roten Y, Despland JN, Kramer U. Dialectical behavior therapy skills training affects defense mechanisms in borderline personality disorder: An integrative approach of mechanisms in psychotherapy. Psychother Res. 2019;29(8):1074-85.
38. Walton CJ, Bendit N, Baker AL, Carter GL, Lewin TJ. A randomised trial of dialectical behaviour therapy and the conversational model for the treatment of borderline personality disorder with recent suicidal and/or non-suicidal self-injury: An effectiveness study in an Australian public mental health service. Aust N Z J Psychiatry. 2020;54(10):1020-34.
39. Lin TJ, Ko HC, Wu JY, Oei TP, Lane HY, Chen CH. The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan. Arch Suicide Res. 2019;23(1):82-99.
40. Carter GL, Willcox CH, Lewin TJ, Conrad AM, Bendit N. Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Aust N Z J Psychiatry. 2010;44(2):162-73.
41. Andreasson K, Krogh J, Wenneberg C, Jessen HK, Krakauer K, Gluud C, et al. EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF-HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER-A RANDOMIZED OBSERVER-BLINDED CLINICAL TRIAL. Depress Anxiety. 2016;33(6):520-30.
42. Soler J, Pascual JC, Tiana T, Cebrià A, Barrachina J, Campins MJ, et al. Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behav Res Ther. 2009;47(5):353-8.
43. Kramer U, Pascual-Leone A, Berthoud L, de Roten Y, Marquet P, Kolly S, et al. Assertive Anger Mediates Effects of Dialectical Behaviour-informed Skills Training for Borderline Personality Disorder: A Randomized Controlled Trial. Clin Psychol Psychother. 2016;23(3):189-202.
44. Uliaszek AA, Hamdullahpur K, Chugani CD, Tayyab R. Mechanisms of change in group therapy for treatment-seeking university students. Behav Res Ther. 2018;109:10-7.
45. Krantz LH, McMain S, Kuo JR. The unique contribution of acceptance without judgment in predicting nonsuicidal self-injury after 20-weeks of dialectical behaviour therapy group skills training. Behav Res Ther. 2018;104:44-50.
46. Mehlum L. Mechanisms of change in dialectical behaviour therapy for people with borderline personality disorder. Curr Opin Psychol. 2021;37:89-93.
47. Creswell JD. Mindfulness Interventions. Annu Rev Psychol. 2017;68:491-516.
48. Goodman M, Carpenter D, Tang CY, Goldstein KE, Avedon J, Fernandez N, et al. Dialectical behavior therapy alters emotion regulation and amygdala activity in patients with borderline personality disorder. J Psychiatr Res. 2014;57:108-16.
49. Schmitt R, Winter D, Niedtfeld I, Herpertz SC, Schmahl C. Effects of Psychotherapy on Neuronal Correlates of Reappraisal in Female Patients With Borderline Personality Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging. 2016;1(6):548-57.
2. Akbari V, Rahmatinejad P, Mohammadi SD. Comparing Neurocognitive Profile of Patients with Borderline Personality and Bipolar-II Disorders. Iran J Psychiatry. 2019;14(2):113-9.
3. Reichl C, Kaess M. Self-harm in the context of borderline personality disorder. Curr Opin Psychol. 2021;37:139-44.
4. Mohammadi MR, Shamohammadi M, Salmanian M. The prevalence of borderline personality symptoms in adolescents. Iran J Psychiatry. 2014;9(3):147-51.
5. Ellison WD, Rosenstein LK, Morgan TA, Zimmerman M. Community and Clinical Epidemiology of Borderline Personality Disorder. Psychiatr Clin North Am. 2018;41(4):561-73.
6. Gratz KL, Kiel EJ, Mann AJD, Tull MT. The prospective relation between borderline personality disorder symptoms and suicide risk: The mediating roles of emotion regulation difficulties and perceived burdensomeness. J Affect Disord. 2022;313:186-95.
7. Zashchirinskaia O, Isagulova E. Childhood Trauma as a Risk Factor for High Risk Behaviors in Adolescents with Borderline Personality Disorder. Iran J Psychiatry. 2023;18(1):65-71.
8. Husain SF, Tang TB, Tam WW, Tran BX, Ho CS, Ho RC. Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study. BMC Psychiatry. 2021;21(1):201.
9. Ruocco AC, Rodrigo AH, McMain SF, Page-Gould E, Ayaz H, Links PS. Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study. Front Hum Neurosci. 2016;10:220.
10. Lieslehto J, Tiihonen J, Lähteenvuo M, Mittendorfer-Rutz E, Tanskanen A, Taipale H. Comparative Effectiveness of Pharmacotherapies for the Risk of Attempted or Completed Suicide Among Persons With Borderline Personality Disorder. JAMA Netw Open. 2023;6(6):e2317130.
11. Bailey RC, Grenyer BF. Burden and support needs of carers of persons with borderline personality disorder: a systematic review. Harv Rev Psychiatry. 2013;21(5):248-58.
12. McLenan J, Lazzari C, McMillan G, Mackie R. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals. Iran J Psychiatry. 2016;11(4):201-5.
13. Rabiee N, Nazari AM, Keramat A, Khosravi A, Bolbol-Haghighi N. The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial. Iran J Psychiatry. 2022;17(2):118-26.
14. Linehan MM, Wilks CR. The Course and Evolution of Dialectical Behavior Therapy. Am J Psychother. 2015;69(2):97-110.
15. Gillespie C, Murphy M, Joyce M. Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder: A Systematic Review of Outcomes After One Year of Follow-Up. J Pers Disord. 2022;36(4):431-54.
16. Barnicot K, Redknap C, Coath F, Hommel J, Couldrey L, Crawford M. Patient experiences of therapy for borderline personality disorder: Commonalities and differences between dialectical behaviour therapy and mentalization-based therapy and relation to outcomes. Psychol Psychother. 2022;95(1):212-33.
17. Lakeman R, Crighton J. The Impact of Social Distancing on People with Borderline Personality Disorder: The Views of Dialectical Behavioural Therapists. Issues Ment Health Nurs. 2021;42(5):410-6.
18. Kliem S, Kröger C, Kosfelder J. Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling. J Consult Clin Psychol. 2010;78(6):936-51.
19. Panos PT, Jackson JW, Hasan O, Panos A. Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT). Res Soc Work Pract. 2014;24(2):213-23.
20. Oud M, Arntz A, Hermens ML, Verhoef R, Kendall T. Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis. Aust N Z J Psychiatry. 2018;52(10):949-61.
21. Chen SY, Cheng Y, Zhao WW, Zhang YH. Effects of dialectical behaviour therapy on reducing self-harming behaviours and negative emotions in patients with borderline personality disorder: A meta-analysis. J Psychiatr Ment Health Nurs. 2021;28(6):1128-39.
22. Khaleghi A, Zarafshan H, Vand SR, Mohammadi MR. Effects of Non-invasive Neurostimulation on Autism Spectrum Disorder: A Systematic Review. Clin Psychopharmacol Neurosci. 2020;18(4):527-52.
23. Mostafavi SA, Khaleghi A, Mohammadi MR, Akhondzadeh S. Is transcranial direct current stimulation an effective modality in reducing food craving? A systematic review and meta-analysis. Nutr Neurosci. 2020;23(1):55-67.
24. Mostafavi SA, Khaleghi A, Mohammadi MR. Noninvasive brain stimulation in alcohol craving: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2020;101:109938.
25. Khaleghi A, Pirzad Jahromi G, Zarafshan H, Mostafavi SA, Mohammadi MR. Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior. Psychiatry Clin Neurosci. 2020;74(9):455-65.
26. Clarkin JF, Levy KN, Lenzenweger MF, Kernberg OF. Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychiatry. 2007;164(6):922-8.
27. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, et al. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry. 2006;63(7):757-66.
28. Koons CR, Robins CJ, Tweed JL, Lynch TR, Gonzalez AM, Morse JQ, et al. Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behav Ther. 2001;32(2):371-90.
29. Linehan MM, Dimeff LA, Reynolds SK, Comtois KA, Welch SS, Heagerty P, Kivlahan DR. Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend. 2002;67(1):13-26.
30. McMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry. 2009;166(12):1365-74.
31. van den Bosch LM, Koeter MW, Stijnen T, Verheul R, van den Brink W. Sustained efficacy of dialectical behaviour therapy for borderline personality disorder. Behav Res Ther. 2005;43(9):1231-41.
32. Linehan MM, Korslund KE, Harned MS, Gallop RJ, Lungu A, Neacsiu AD, et al. Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry. 2015;72(5):475-82.
33. Pistorello J, Fruzzetti AE, Maclane C, Gallop R, Iverson KM. Dialectical behavior therapy (DBT) applied to college students: a randomized clinical trial. J Consult Clin Psychol. 2012;80(6):982-94.
34. McMain SF, Chapman AL, Kuo JR, Dixon-Gordon KL, Guimond TH, Labrish C, et al. The Effectiveness of 6 versus 12 Months of Dialectical Behavior Therapy for Borderline Personality Disorder: A Noninferiority Randomized Clinical Trial. Psychother Psychosom. 2022;91(6):382-97.
35. Keefe JR, Kim TT, DeRubeis RJ, Streiner DL, Links PS, McMain SF. Treatment selection in borderline personality disorder between dialectical behavior therapy and psychodynamic psychiatric management. Psychol Med. 2021;51(11):1829-37.
36. Bohus M, Kleindienst N, Hahn C, Müller-Engelmann M, Ludäscher P, Steil R, et al. Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(12):1235-45.
37. Euler S, Stalujanis E, Allenbach G, Kolly S, de Roten Y, Despland JN, Kramer U. Dialectical behavior therapy skills training affects defense mechanisms in borderline personality disorder: An integrative approach of mechanisms in psychotherapy. Psychother Res. 2019;29(8):1074-85.
38. Walton CJ, Bendit N, Baker AL, Carter GL, Lewin TJ. A randomised trial of dialectical behaviour therapy and the conversational model for the treatment of borderline personality disorder with recent suicidal and/or non-suicidal self-injury: An effectiveness study in an Australian public mental health service. Aust N Z J Psychiatry. 2020;54(10):1020-34.
39. Lin TJ, Ko HC, Wu JY, Oei TP, Lane HY, Chen CH. The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan. Arch Suicide Res. 2019;23(1):82-99.
40. Carter GL, Willcox CH, Lewin TJ, Conrad AM, Bendit N. Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Aust N Z J Psychiatry. 2010;44(2):162-73.
41. Andreasson K, Krogh J, Wenneberg C, Jessen HK, Krakauer K, Gluud C, et al. EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF-HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER-A RANDOMIZED OBSERVER-BLINDED CLINICAL TRIAL. Depress Anxiety. 2016;33(6):520-30.
42. Soler J, Pascual JC, Tiana T, Cebrià A, Barrachina J, Campins MJ, et al. Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behav Res Ther. 2009;47(5):353-8.
43. Kramer U, Pascual-Leone A, Berthoud L, de Roten Y, Marquet P, Kolly S, et al. Assertive Anger Mediates Effects of Dialectical Behaviour-informed Skills Training for Borderline Personality Disorder: A Randomized Controlled Trial. Clin Psychol Psychother. 2016;23(3):189-202.
44. Uliaszek AA, Hamdullahpur K, Chugani CD, Tayyab R. Mechanisms of change in group therapy for treatment-seeking university students. Behav Res Ther. 2018;109:10-7.
45. Krantz LH, McMain S, Kuo JR. The unique contribution of acceptance without judgment in predicting nonsuicidal self-injury after 20-weeks of dialectical behaviour therapy group skills training. Behav Res Ther. 2018;104:44-50.
46. Mehlum L. Mechanisms of change in dialectical behaviour therapy for people with borderline personality disorder. Curr Opin Psychol. 2021;37:89-93.
47. Creswell JD. Mindfulness Interventions. Annu Rev Psychol. 2017;68:491-516.
48. Goodman M, Carpenter D, Tang CY, Goldstein KE, Avedon J, Fernandez N, et al. Dialectical behavior therapy alters emotion regulation and amygdala activity in patients with borderline personality disorder. J Psychiatr Res. 2014;57:108-16.
49. Schmitt R, Winter D, Niedtfeld I, Herpertz SC, Schmahl C. Effects of Psychotherapy on Neuronal Correlates of Reappraisal in Female Patients With Borderline Personality Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging. 2016;1(6):548-57.
| Files | ||
| Issue | Vol 19 No 1 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v19i1.14347 | |
| Keywords | ||
| Borderline Personality Disorder Dialectical Behavior Therapy Randomized Controlled Trial Suicidal Ideation Systematic Review | ||
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How to Cite
1.
Hernandez-Bustamante M, Cjuno J, M .Hernández R, C. Ponce-Meza J. Efficacy of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder: A Systematic Review of Randomized Controlled Trials. Iran J Psychiatry. 2023;19(1):119-129.
