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Effectiveness of a 5-Week Inpatient Dialectical Behavior Therapy for Borderline Personality Disorder

PROBST, THOMAS, PhD; O’ROURKE, TERESA; DECKER, VERENA, MSc; KIEßLING, EVA; MEYER, SASCHA, DiplPsych; BOFINGER, CHRISTINE, MD; NIKLEWSKI, GÜNTER, MD, PhD; MÜHLBERGER, ANDREAS, PhD; PIEH, CHRISTOPH, MD

Journal of Psychiatric Practice®: May 2019 - Volume 25 - Issue 3 - p 192–198
doi: 10.1097/PRA.0000000000000383
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Objective: The goal of this study was to evaluate whether symptoms are reduced and emotion regulation improves when patients with borderline personality disorder (BPD) receive a 5-week course of inpatient dialectical behavioral therapy (DBT) and if changes in emotion regulation are associated with changes in symptoms.

Methods: Forty-four patients with BPD receiving a 5-week course of DBT in a German psychiatry clinic participated. The short version of the “Borderline Symptom List” (BSL-23) was the patient-reported outcome. To measure emotion regulation, the “Self-Report Measure for the Assessment of Emotion Regulation Skills” (SEK-27) was administered. Wilcoxon tests were performed to evaluate whether pre-post changes in the BSL-23 and SEK-27 reached statistical significance. Effect sizes (d) were calculated and correlations between the pre-post differences for both measures were computed to test associations between changes in emotion regulation and changes in symptoms. Completer (n=33) and intention-to-treat (n=43) analyses were performed.

Results: Symptoms (BSL-23) were reduced and emotion regulation (SEK-27) improved during the 5-week inpatient DBT treatment (completer and intention-to-treat analysis: P<0.001). Effect sizes reached d=0.47 for the BSL-23 and d=0.84 for the SEK-27 in the completer analysis, and d=0.38 for the BSL-23 and d=0.68 for the SEK-27 in the intention-to-treat analysis. Improvements in emotion regulation (SEK-27) were correlated with reductions in symptoms (BSL-23) in both the completer (r=0.54; P=0.001) and the intention-to-treat (r=0.59; P<0.001) analyses.

Conclusions: These findings indicate that a 5-week course of inpatient DBT can effectively reduce symptoms in patients with BPD and that the more patients’ emotion regulation improves, the more the patients benefit from the therapy.

PROBST, O’ROURKE, and PIEH: Department for Psychotherapy and Biopsychosocial Health, Danube University, Krems, Austria

DECKER, KIEßLING, MÜHLBERGER: Clinical Psychology & Psychotherapy, Institute for Psychology, Regensburg University, Regensburg, Germany

MEYER, BOFINGER, NIKLEWSKI: University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany

The authors declare no conflicts of interest.

Please send correspondence to: Thomas Probst, PhD, Danube University Krems, Dr Karl Dorrek Street 30, Krems A-3500, Austria (e-mail: thomas.probst@donau-uni.ac.at).

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