Special Series: Behavior Therapy Perspectives On The American Psychiatric Association Practice Guidelines
Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder*

https://doi.org/10.1016/S0005-7894(01)80009-5Get rights and content

Twenty women veterans who met criteria for borderline personality disorder (BPD) were randomly assigned to Dialectical Behavior Therapy (DBT) or to treatment as usual (TAU) for 6 months. Compared with patients in TAU, those in DBT reported significantly greater decreases in suicidal ideation, hopelessness, depression, and anger expression. In addition, only patients in DBT demonstrated significant decreases in number of parasuicidal acts, anger experienced but not expressed, and dissociation, and a strong trend on number of hospitalizations, although treatment group differences were not statistically significant on these variables. Patients in both conditions reported significant decreases in depressive symptoms and in number of BPD criterion behavior patterns, but no decrease in anxiety. Results of this pilot study suggest that DBT can be provided effectively independent of the treatment's developer, and that larger efficacy and effectiveness studies are warranted.

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      Sixteen of the included studies were RCTs, five were nRCTs, and the remaining 13 studies were within-subjects trials. Of the 34 studies included in the meta-analysis, 27 (n = 1563) included anger outcome measures (Bohus et al., 2004; Burckhardt et al., 2017; Evershed et al., 2003; Feigenbaum et al., 2012; Fitzpatrick et al., 2020; Flynn et al., 2019; Flynn et al., 2020; Görg et al., 2019; Guillen-Botella et al., 2021; Gutteling et al., 2012; Jones et al., 2021; Koons et al., 2001; Koons et al., 2006; Linehan et al., 1994; McMain et al., 2009; McMain et al., 2017; Moulden et al., 2020; Navarro-Haro et al., 2021; Neacsiu et al., 2014, 2018; Pozzi et al., 2008; Prada et al., 2015; Prendergast & McCausland, 2007; Rosenfeld et al., 2019; Simpson et al., 2004; Soler et al., 2009; Woodberry & Popenoe, 2008). Anger measures included the State-Trait Anger Inventory (STAXI; k = 17), Novaco Anger Scale (NAS; k = 2), Buss Perry Aggression Questionnaire (BPAQ)-Trait Anger subscale (k = 2), Positive and Negative Affective States-Anger/Hostility subscale (PANAS-X; k = 1), visual analogue scale of trauma-related anger (k = 1), Trauma Symptoms Checklist-Children (TSCC) anger subscale (k = 1), and Clinical Global Impression-Borderline Personality Disorder-Anger subscale (CGI-BPD; k = 1, for which scores were determined by psychiatrists blind to experimental condition).

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    *

    Support for this study was provided by a VA Research Advisory Group grant to the first author. The authors would also like to acknowledge the significant contributions of the following individuals: Theresa Yuschok and Lawrence Dunn, VA staff psychiatrists providing medication management, Haleh Ghanizadeh and Danuta Jagla-Schudel, skills training group coleaders, and Jean Beckham, VA staff psychologist and consultant.

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