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31-10-2020 | Original Article | Uitgave 3/2021

Cognitive Therapy and Research 3/2021

Dialectical Behavior Therapy in the Treatment of Comorbid Borderline Personality Disorder and Eating Disorder in a Naturalistic Setting: A Six-Year Follow-up Study

Cognitive Therapy and Research > Uitgave 3/2021
María V. Navarro-Haro, Verónica Guillén Botella, Laura Badenes-Ribera, Luis Borao, Azucena García-Palacios
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Dialectical Behavior Therapy (DBT) has shown evidence of its effectiveness in the treatment of borderline personality disorder (BPD) and eating disorders (EDs) separately, and there is preliminary evidence for co-occurrent BPD and EDs. However, the long-term effectiveness of DBT for this specific population is still unknown. The main goal of this study was to assess long-term treatment effectiveness in people diagnosed with BPD and ED.


Participants (N = 109) had previously received a 6-month treatment during a clinical trial (DBT = 64 vs. Treatment as Usual, Cognitive Behavior Therapy; TAU CBT = 45). Outcome measures (emotional eating, depressive symptoms, anger, emotion regulation, impulsiveness, and resilience) were evaluated prospectively at 4- and 6-year follow-ups.


There was a statistically significant improvement in most study outcomes from pre-treatment to the follow-ups in the DBT condition, and in depression, resilience and trait anger in the TAU CBT. No statistically significant between-group differences were found. Nonetheless, a high percentage of participants showed a clinically significant improvement over time in the DBT condition.


Findings of this study contribute to determinate the long-term treatment effectiveness of DBT for people with BPD and ED in routine psychotherapeutic practice. Longitudinal studies with larger sample sizes are needed to confirm these results.

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