Search

Existing descriptions of the treatment of avoidant/restrictive food intake disorder (ARFID) at higher levels of care (HLOC) for eating disorders are limited, despite HLOC settings frequently serving patients with ARFID. The purpose of this commentary is to expand on the preliminary literature that describes pediatric ARFID treatment at HLOC by describing two specific components of our approach to treating pediatric ARFID that may not yet have traction in the current literature. Specifically, we highlight the utility of (1) treatment accommodations that appropriately account for patients neurodevelopmental needs (e.g., executive functioning, sensory processing) and (2) the adjunctive use of Dialectical Behavior Therapy (DBT) elements within family-based pediatric ARFID treatment. We also describe necessary future directions for research in these domains to clarify if incorporating these considerations and approaches into pediatric ARFID treatment at HLOC does indeed improve treatment outcomes.

Since Stern first started his work in 1938, the field has recognized several empirically supported models of the etiology of borderline personality disorder (BPD). Two such models are the Tripartite Model of the Development of BPD and the Biosocial Development Model of BPD. The Tripartite Model of the Development of BPD suggests that it is a combination of a hyperbolic temperament, traumatic childhood experiences, and an event or series of events that trigger the onset of BPD. Whereas the Biosocial Development Model of BPD elaborates on the work of Linehan's Biosocial Theory. This model suggests a combination of an emotionally vulnerable temperament and an invalidating environment cause BPD. Over 70 years of research support these models. This article covers a detailed description of each of these models, the decades of research supporting these models, similarities, differences, treatment implications, the latest research, and future directions. [ABSTRACT FROM AUTHOR]

ABSTRACT This article presents a case study of a 31‐year‐old woman with a dual diagnosis of Borderline Personality Disorder (BPD) and Eating Disorder Not Otherwise Specified (EDNOS). Paula received a 12‐month Dialectical Behavior Therapy (DBT) outpatient treatment. DBT is considered a transdiagnostic treatment approach to address emotion dysregulation, which shifts the therapy focus traditionally placed only on behavioral change toward including also validation and acceptance and dialectical strategies. DBT addresses eating symptomatology as a dysfunctional form of emotional regulation and has shown promising results regarding its efficacy for the treatment of BPD and EDNOS comorbidity. Given the growing evidence, a standard DBT treatment plan was developed for this case. Specifically, pretreatment and phase 1 of the DBT program are described. During pretreatment and phase 1, individual therapy aims to improve and maintain client's motivation to change and engage in treatment, as well as to establish and prioritize treatment goals. As for group therapy, the main goal of the skills training in DBT is to enhance individual's capability by increasing skillful behavior (mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills). Paula received 24 weekly skills training sessions over a year. The results after a 12‐month standard DBT treatment showed that Paula no longer met criteria for BPD, she had a significant decrease in difficulties in emotional regulation and impulsiveness and in EDNOS symptomatology. This case study may enhance learning about how to apply a transdiagnostic treatment to address BPD and EDNOS together in clinical practice. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionsThe purpose of this systematic review and meta-analysis is to provide an updated examination of the adolescent Dialectical Behavioral Therapy (DBT) literature and synthesize study findings across treatment settings (e.g. inpatient, outpatient, school), and treatment levels (e.g. clinical intervention, targeted, universal prevention). We also provide meta-analytic findings of the impact of DBT across key problem behaviors: depression, emotion dysregulation, suicidal and self-harm behaviors, externalizing problems, and eating disorders.A reference database search was used to identify studies conducted on adolescent DBT interventions from 2000 through 2023 (N = 72). In addition to ensuring that the review process conformed to the PRISMA statement, we independently verified that each study met inclusion criteria before triple coding each article to examine variables of interest and extracted outcome data needed to conduct meta-analyses.DBT appears to demonstrate effectiveness in improving mental health outcomes in adolescents across a range of psychiatric problems. To meet these treatment needs, DBT interventions have been appropriately adapted based on care setting, suggesting empirical support in inpatient, residential, partial hospitalization, and intensive outpatient programs, as well as in outpatient settings, juvenile correctional facilities, and schools.The growing evidence base for adolescent DBT appears to reflect its promise and versatile clinical utility. Clinical implications and recommendations for future directions are discussed, including the need for more randomized controls and representation of diverse communities. [ABSTRACT FROM AUTHOR]

Background: Despite the increasing use of dialectical behaviour therapy (DBT) as a treatment for eating disorders (EDs), there is little published evidence of its effectiveness for treating restrictive eating disorders. DBT for EDs may be particularly helpful for those who live with severe and enduring eating disorders (SE-EDs) given that it targets those for whom first-line treatments have not been effective, its focus on factors thought to maintain symptoms and its focus on improving quality of life. This study sought to evaluate the experiences of participants in a comprehensive DBT programme for people with SE-EDs. Methods: Semistructured interviews were conducted with seven participants who were treated in the 'DBT for Multidiagnostic Eating Disorders (MED-DBT)' programme at a regional eating disorders service in New Zealand. The interviews were transcribed verbatim and analysed via thematic analysis. Results: The findings indicate that the MED-DBT programme was perceived as effective by participants. The skills learned provided participants with valuable tools that could be used to better manage emotions, crises, and tasks of daily life, which improved their quality of life and improved their management of their eating disorder symptoms. Several participants reported that the programme saved their lives. A key component of the MED-DBT programme was having access to phone coaching that supported participants with the acquisition and consolidation of skills to reduce crises and generalise learning of the skills. These skills have continued to be used by participants more than five years posttreatment. Conclusions: The qualitative findings of the present study suggest that the MED-DBT programme is an effective and valuable treatment for participants. All participants endorsed the MED-DBT programme for ED treatment. The treatment programme was seen as a highly beneficial and feasible treatment that could provide greater options for treating complex clients with severe and enduring eating symptomology with confidence. Plain English summary: People who are living with a long-term eating disorder often experience problems managing their emotions which can negatively impact their quality of life. Treatment options that focus on the eating disorder and don't address the difficulties with managing emotions have had less success for these people. Dialectical behaviour therapy (DBT) is an emerging treatment option that focuses on how to better manage emotions and behaviours that impact quality of life, including eating disorders. This study interviewed seven people who attended a DBT programme developed to treat eating disorders (MED-DBT), develop emotion management skills, and help areas of life that may be impacted by these problems. We found that people thought the MED-DBT programme was life-saving and that it helped them to develop skills and improve their quality of life beyond what other treatments had offered. This resulted in a decreased impact of eating disorder symptoms and some people reported being eating disorder symptom-free due to the MED-DBT programme. [ABSTRACT FROM AUTHOR]

Background: The lack of training for professionals on how to manage suicide risk is an important barrier to effective intervention. Dialectical Behavior Therapy Intensive Training™ (DBT-IT) includes specific training for suicide and has shown promising results to enhance implementation of DBT. To our knowledge, no published studies have evaluated the effect of DBT-IT on therapists' attitudes towards treating suicide risk and among Spanish-speaking mental health professionals. The main aim of this study was to evaluate the effect of DBT-IT on therapists' attitudes regarding treating suicide risk and its relationship with the implementation of DBT before and after receiving DBT-IT. Methods: A total of 242 mental health workers (76.4% women, mean age 35.38, SD = 9.17; 77.7% from Latin America; 22.3% from Spain) who had received a DBT-IT participated in the study. Self-efficacy (Efficacy in Assessing and Managing Suicide Risk Scale) and concerns (Concerns about Treating Suicidal Clients Scale) in treating suicide, perceived burnout (Copenhagen Burnout Inventory), confidence in applying DBT (Behavioral Anticipation and Confidence Questionnaire), barriers to implementation (Barriers to Implementation Inventory), implementation of DBT and reach were measured via online survey at parts 1 (pre-training) and 2 (post-training, after 9 months of implementation) of the DBT-IT. Results: Differences between pre-training and post-training (n = 61) indicated statistically significant improvements in self-efficacy, concerns about the lack of training and competence in treating suicide, and confidence in applying DBT. Statistically significant increases in the rates of DBT treatment modes implementation (except for individual therapy) and mindfulness practice, as well as the number of team members and consultation team hours, were also found. Findings also indicated statistically significant positive correlations between burnout and concerns about treating suicidal clients, as well as with structural and administrative implementation barriers, and between self-efficacy in managing suicide, confidence in applying DBT and implementation of DBT treatment modes. Participants with more implementation barriers reported lower rates of consultation team meetings and phone coaching implementation. Conclusions: DBT-IT could be an adequate training model to increase self-efficacy and confidence in treating suicide risk as well as to facilitate implementation of DBT treatment modes by Spanish-speaking mental health professionals. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: The inclusion of family therapy in residential treatment centers (RTCs) has increased over time. However, there is little data on whether empirically-supported family therapies (ESFTs) are being adopted and if they contribute to treatment effectiveness. This study aimed to test whether Attachment-Based Family Therapy (ABFT), an ESFT integrated into a large residential psychiatric system, would improve perceived attachment insecurity (anxiety and avoidance) and contribute to decreases in depression for adolescents. Method: ABFT was integrated into the clinical program of a large, residential psychiatric system. All family therapists were trained to a level of certification. Improvement was measured by changes in adolescent's perceived attachment to caregivers and reduction in depressive symptoms. The sample included 4786 patients. Attachment insecurity and depressive symptoms were measured at intake, week 3, and week 5. A random-intercept, cross-lagged panel model was used to examine the relationships between attachment and depression over time. Results: The results generally supported hypotheses. Attachment insecurity and depressive symptoms improved over the five weeks of treatment. Improvements in attachment avoidance preceded improvements in depressive symptoms within subjects, over time. Simultaneously, improvements in depressive symptoms preceded those in both dimensions of attachment. Thus, improvement in perceived attachment was associated with a reduction in depressive symptoms. Conclusion: RTCs that can generate improvements in attachment insecurity and depressive symptoms, via ABFT or other ESFTs, might improve treatment outcomes, and ideally, adolescents' successful transition back home to families. More research is needed to disentangle the contribution of ABFT and other treatment elements in a multimodal, residential treatment program. The study supports the call for increased incorporation of families into the RTC treatment process. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depressive disorders, characterized by high incidence and functional impairments, are emotional disorders with shared etiological and maintenance mechanisms. Dialectical behavior therapy (DBT) is a promising approach for the transdiagnostic treatment of emotional disorders. Developing a brief DBT intervention can facilitate the adoption of evidence-based therapy. Methods: This protocol is for a 3-year single-blinded, two-arm randomized controlled trial. Individuals with depressive or anxiety disorder will be randomly allocated to a modified DBT–informed transdiagnostic psychotherapy group or a treatment-as-usual group. The intervention group will receive DBT individual therapy for 15 weeks. Power analyses revealed that the cohort should include a minimum of 250 participants. Preintervention, postintervention, and follow-up (after 3 months) assessments will be conducted. Primary outcomes will be severities of depression and anxiety rated by blind assessors. Intent-to-treat and per-protocol analyses will be conducted using the hierarchical linear model. Effect sizes will be estimated using Cohen's d. Result: To the best of our knowledge, the proposed study will be the first randomized controlled trial to evaluate the efficacy of a modified DBT intervention in managing transdiagnostic emotional disorders in Chinese individuals. Conclusion: This intervention is expected to improve clinical outcomes, daily functioning, and quality of life. The trial will enrich the empirical evidence for transdiagnostic interventions, facilitating the implementation of evidence-based therapy and reducing the high prevalence and challenges (e.g., disability) of emotional disorders in the Chinese population. Trial registration number: NCT05989451 [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to comprehensively review existing treatments for impulsivity and compulsivity in non-substance addictions, driven by the importance of these factors in addictive disorder development and treatment efficacy. Methods: A systematic review carried out following PRISMA guidelines identified 14 articles from a total of 764 studies, highlighting the limited literature that is available on psychological treatments for non-substance addictions, in particular studies focusing on impulsivity and compulsivity. The studies were categorized by behavioral addiction type. Results: For compulsive sexual behavior and problematic pornography use, cognitive-behavioral therapy (CBT) has shown significant improvements in compulsivity. In gambling disorder, interventions like cognitive bias modification and motivational interviewing combined with CBT have been effective in reducing impulsivity. Cognitive-behavioral therapy was advocated for compulsive shopping, although results varied. For problematic internet use, dialectical behavior therapy and acceptance and commitment therapy have been effective in addressing impulsivity. Despite literature supporting CBT for most behavioral addictions, the review noted that some articles indicate that dialectical behavior therapy and acceptance and commitment therapy were also effective for problematic internet use, suggesting different underlying mechanisms for this type of addiction. Discussion: It also highlighted limitations, including the small number of studies and the lack of standardized assessment measures. Further research is needed to understand underlying mechanisms and develop tailored treatments for impulsivity and compulsivity in non-substance addictions. These findings offer new directions for research and intervention guidelines in behavioral addictions. [ABSTRACT FROM AUTHOR]

Objective: Dialectical behavior therapy (DBT) is an evidence‐based treatment for disorders characterized by recurrent binge eating. Yet, access to specialized treatment like DBT remains limited. To increase the accessibility of DBT, we developed a DBT skills training app (Resilience: eDBT) for the management of eating disorder (ED) symptoms. This paper delineates the developmental process of Resilience and tests its usability. Methods: Descriptive information on the development and features of Resilience is provided, including its framework, content structure and delivery formats, functionality, data storage procedure, and privacy protocols. Usability was assessed via a mixed methods approach in 10 symptomatic individuals. Qualitative data were organized based on an existing framework, which included six themes: usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance. Results: Resilience demonstrated good usability via a Systems Usability Scale score of 85.5, which exceeded the recommended cutoff of 68. Positive aspects of the app, according to interview data, were the ease of use and the visual design, while the addition of peer support was suggested as an opportunity for improvement. Discussion: A novel DBT‐based app may serve as an acceptable, low‐intensity option or adjunct to traditional treatment for targeting ED symptoms that emerge in daily life. However, notable limitations include the small sample size and the single time point at which the usability assessment was conducted. [ABSTRACT FROM AUTHOR]

This paper presents a pioneering pilot implementation of group dialectical behaviour therapy (DBT) for adolescents with maladaptive coping in Qatar's child and adolescent mental health services. The project highlights the positive effect on patient satisfaction and the potential for early intervention with adolescents displaying emotional dysregulation. This pioneering initiative was consistent with local cultural values, stressing the importance of interconnectedness in mental health interventions. The impact of the initiative stresses its significance in diverse cultural contexts, urging further adoption regionally for improved mental health outcomes, particularly among adolescents displaying features of an emerging emotionally unstable personality disorder. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including the creation and pilot evaluation of a dissonance-based intervention (DBI) designed to change variables that previously have not been the focus of DBI research and prevention programming, adaptation and implementation of the Body Project, and ecological perspective in designing policies and programs.

Background: Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait‐like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within‐person processes of elevated risk in clinically meaningful time periods. Methods: The present study used clinical data from 689 adolescents aged 12–19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self‐report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. Results: Overall, two‐thirds of variance in weekly irritable mood was accounted for by between‐person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. Conclusions: Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression. [ABSTRACT FROM AUTHOR]

• Describes the paradigms that inform the delivery of dialectical behavior therapy. • Provides overview of critical research on dialectical behavior therapy. • Suggests avenues for future research on dialectical behavior therapy. The first randomized clinical trial of dialectical behavior therapy (DBT) for women with borderline personality disorder was published in 1991. Over the past 30 years, research on DBT has proliferated along with interest by clinicians and the public. In this State of the Science review, we provide a brief description of the treatment paradigm and its conceptual and theoretical underpinnings. We also briefly review the research conducted to date on DBT across populations and settings, the vast majority of which demonstrates that it is effective at treating the behaviors that it targets. We also argue that, although DBT has been established as a "gold-standard" treatment for certain populations and behaviors, there is much more research needed to answer critical questions and improve its efficacy. [ABSTRACT FROM AUTHOR]

Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment, originally developed as a variant of dialectical behaviour therapy (DBT), that emerged as a novel treatment approach for those presenting with excessive or maladaptive overcontrol. Despite RO DBT's growing popularity among clinicians as a treatment for chronic depression, personality disorders and eating disorders, to date, no systematic review has been conducted to summarise the evidence on this therapy. Therefore, the aim of this study was to systematically review the literature to provide a current and comprehensive summary of the available evidence on the clinical applications and efficacy of RO DBT. Articles were included if they were original research studies that described the use of RO DBT in the treatment of any psychological disorder, condition or symptom, published in the English language in a peer‐reviewed journal. Four electronic databases were searched, and screening, selection, risk of bias assessment and data extraction were all conducted by two independent reviewers. Fourteen articles were included in this review, including two qualitative articles, one case study, five case series studies, four quasi‐experimental studies, and two articles describing one randomized control trial. Findings indicated there is emerging evidence for the use of RO DBT in both adolescents and adults, for disorders characterized by excessive self‐control, such as anorexia nervosa and autism, as well as for treatment‐resistant depression. While RO DBT shows promise as a treatment for disorders of overcontrol, further research is needed. This review outlines current gaps and identifies areas for future research. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is a severe mental illness, with high rates of co-morbid depression and suicidality. Despite the importance of optimizing treatment in BPD, little is known about how neural processes relate to individual treatment response. This study examines how baseline regional brain blood oxygen level dependent (BOLD) activation during a functional magnetic resonance imaging (fMRI) task of emotion regulation is related to treatment response following a six-month randomized clinical trial of Dialectical Behavior Therapy (DBT) or Selective Serotonin Reuptake Inhibitor (SSRI) treatment. Unmedicated females with BPD (N = 37), with recent suicidal behavior or self-injury, underwent an fMRI task in which negative personal memories were presented and they were asked to distance (i.e., downregulate their emotional response) or immerse (i.e., experience emotions freely). Patients were then randomized to DBT (N = 16) or SSRI (N = 21) treatment, with baseline and post-treatment depression and BPD severity assessed. BOLD activity in prefrontal cortex, anterior cingulate, and insula was associated with distancing. Baseline BOLD during distancing in dorsolateral, ventrolateral, and orbital prefrontal cortex (dlPFC, vlPFC, OFC) differentially predicted depression response across treatment groups, with higher activity predicting better response in the SSRI group, and lower activity predicting better response in the DBT group. All female samples. Findings indicate that greater prefrontal engagement during emotion regulation may predict more antidepressant benefit from SSRIs, whereas lower engagement may predict better response to DBT. These results suggest different mechanisms of action for SSRI and DBT treatment, and this may allow fMRI to guide individualized treatment selection. • Borderline personality disorder (BPD) is associated with high rates of depression. • Neural processes may offer insight into predicting antidepressant response. • Prefrontal engagement differentially predicted response to SSRI and DBT treatment. • Examining prefrontal activity may allow for more individualized treatment in BPD. [ABSTRACT FROM AUTHOR]

• Clients with Borderline Personality Disorder exhibit a complex array of presenting problems. • Identifying a client's "core problem" brings precision and clarity to Dialectical Behavior Therapy case formulation. • Treating the core problem leads to reductions in high-priority target behaviors and increases in quality of life. In her later years of teaching and training, Linehan (personal communication) spoke of an assessment construct that she referred to as a client's "core problem." In this paper, we trace the historical roots of this concept, review and clarify its current operationalization, anticipate common therapist questions and challenges to identifying a client's core problem, and provide a case example to illustrate its utility for Dialectical Behavior Therapy (DBT) case formulation and treatment planning. We propose that conceptualizing a client's core problem holds great promise for enhancing the therapist's effective and efficient delivery of DBT. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the efficacy of online Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) in reducing eating psychopathology and investigate the factors that influence the severity and frequency of binge eating. Seventy-three individuals seeking treatment for BED participated in 20 two-hour group sessions. Participants completed the Emotional Eating Scale (EES), Binge Eating Scale (BES), and Eating Disorder Examination Questionnaire (EDE-Q) before and after the treatment and at three- and six-month follow-ups. Results from 58 participants were analyzed. The study results indicated a significant decrease in objective binge eating (OBE) days, as well as in all EES, BES, and EDE-Q subscales (except the Restraint subscale), and global EDE-Q score at the end of treatment and follow-ups. Moreover, the Body Mass Index (BMI) reduced at the end of treatment and during the follow-up period. Except for the Restraint subscale, more OBE days were linked with higher EES, BES, and EDE-Q scores. Overall, the study suggests that online DBT-BED is an effective approach to treating Binge Eating Disorder (BED) for individuals who cannot receive in-person therapy. Further research is necessary to compare the efficacy of online DBT-BED with other interventions. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionThe purpose of this study was to assess the implementation of suicide-focused treatments delivered via a hybrid telemental health (TMH) and in-person format.This study was conducted at four university counseling centers (UCCs) across the United States. Treatment-seeking clients were recruited from their local UCCs and participated in adaptive treatment strategies (ATSs) involving Treatment as Usual (TAU), Collaborative Assessment and Management of Suicidality (CAMS), and Dialectical Behavior Therapy (DBT). Implementation outcomes, including appropriateness, acceptability, feasibility, fidelity, safety, and client satisfaction, were assessed. UCC clinicians participated in qualitative interviews focused on implementation of TMH for clients presenting with suicidal ideation (SI).Overall, treatments delivered via hybrid format were reported to be appropriate, acceptable, feasible, and satisfactory by clinicians and clients. Implementation of TMH was reported to be equivalent to in-person treatment across multiple measurement methods.Results from this study demonstrate that TMH is an implementable treatment modality for addressing suicidality, particularly for college students presenting to UCCs with SI. This study has implications for real-world clinical settings planning to offer hybrid treatment modalities to address SI.Trial registration: ClinicalTrials.gov identifier: NCT04728815. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The study aims to investigate the efficacy of sertraline medication plus dialectical behavior therapy (DBT) in reducing nonsuicidal self‐injury (NSSI) behavior and depression among adolescents.Participants were 100 adolescents with depression and NSSI behaviors, 50 of whom received sertraline medication plus DBT and 50 of whom received sertraline medication plus cognitive behavioral therapy (CBT) for 12 weeks.During 6 months post intervention, 26 (57.8%) participants did not report having engaged in any form of NSSI in the sertraline + DBT group and 15 (32.6%) in the sertraline + CBT group, showing significant difference. The sertraline + DBT group and the sertraline + CBT group exhibited significant difference regarding the proportions of cutting skin and biting self. The scores of anxiety, depression, aggression against self in four modified overt aggression scale categories, and Personal and Social Performance were notably lower in the sertraline + DBT group than those in the sertraline + CBT group at 6 months post intervention.Sertraline medication plus DBT could decrease NSSI episodes and improve symptoms of anxiety and depression for adolescents, and these changes were comparable to those of CBT. More importantly, DBT was demonstrated better clinical improvements at 6‐month follow‐up. [ABSTRACT FROM AUTHOR]

Objectives: Dialectical behavior therapy (DBT) is an evidence‐based treatment for people with emerging borderline personality disorder (BPD). In "real world" clinical settings, standard DBT is resource intensive. Emerging evidence suggests that group‐based DBT skills training alone can lead to promising outcomes. This hybrid type 1 effectiveness‐implementation trial directly compared the effectiveness of an 8‐week group DBT‐skills training program and a 16‐week DBT‐informed program including individual treatment and group‐based skills training. Methods: This pragmatic trial employed a staggered, parallel‐groups design. We recruited 104 participants, aged 16–25 years, with emotion dysregulation or emerging BPD symptoms. Participants were randomized to receive either program at a youth mental health service located in the Gold Coast, Australia. Data was collected via online surveys at baseline, 8‐week, 16‐week, and 24‐week follow‐up. Mixed effect linear models compared groups on the primary outcomes of emotion dysregulation and BPD symptoms, and secondary outcomes of suicidal ideation, coping skills, depression, anxiety, and stress. Results: Across groups there were significant and sustained improvements relating to emotion dysregulation, BPD symptoms, stress, depression, and emotion‐focused coping; but not suicide risk, anxiety, or task‐focused coping. There was no significant time by group differences between the 8‐week and 16‐week interventions on any primary or secondary outcome. Conclusion: The more intensive mode of delivering DBT was not more effective than the brief group‐based skills training. Both interventions resulted in significant improvements across both primary and most secondary outcomes. These results have implications for clinical practice regarding length and intensity of DBT treatment in young people. [ABSTRACT FROM AUTHOR]

This study investigates the efficacy of a short-term integrative psychotherapeutic intervention designed to reduce suicidal behavior and ideation in depressed patients admitted to a psychiatric ward. Suicidal risk, influenced by mental health disorders, personal crises, social isolation, substance abuse, and trauma, is typically treated with pharmacotherapy and psychotherapy. The study focuses on combining various psychotherapeutic techniques including Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT) into a cohesive intervention program. The intervention, delivered over four weeks, included six modules encompassing psychoeducation, behavioral activation, cognitive restructuring, mindfulness practices, and personal development strategies. Participants were divided into an experimental group receiving both the psychotherapeutic intervention and medication and a control group receiving only medication. The study measured changes in hopelessness and depression using the Beck Hopelessness Scale (BHS), Montgomery-Åsberg Depression Rating Scale (MADRS), and the DASS-21R depression scale. The study concludes that integrative psychotherapeutic intervention significantly improves psychological outcomes for depressed patients at risk of suicide, offering a viable complement to pharmacological treatments. These findings support the potential of combining cognitive-behavioral and mindfulness techniques for the holistic management of depression and suicidal ideation in clinical settings. Results indicated significant reductions in hopelessness and depression among the experimental group. Specifically, the BHS and MADRS scores showed substantial decreases post-intervention, highlighting the immediate efficacy of the integrated psychotherapeutic approach. However, the DASS-21R results did not demonstrate statistically significant differences. [ABSTRACT FROM AUTHOR]

Youth mental health is a major public health concern. Adolescents experiencing mental health crises are increasingly presenting to high-intensity settings such as inpatient and partial hospitalization programs. These services offer a multimodal approach involving medication management, cognitive-behavioral therapy (CBT), and dialectical behavior therapy (DBT).1 Treating these distressed youth in intense settings is challenging due to their high acuity, limited lengths of stay, and frequent lack of resources. However, CBT/DBT are typically evaluated in outpatient settings, leaving clinicians in high-intensity programs to adapt models with limited guidance.2 While traditional CBT/DBT interventions are not new or unfamiliar, and various literature reviews report their effectiveness, few reports offer specific guidance and practical tips for implementing these procedures.1-6 This Clinical Perspectives article highlights the necessary adaptations of traditional CBT/DBT for these intense settings in which high acuity, shorter stays, limited resource allocation, and a lack of staff involvement/training are limiting factors. [ABSTRACT FROM AUTHOR]

Background: Binge-eating disorder (BED) is a serious mental health condition characterized by recurrent episodes of consuming large quantities of food in a short period, accompanied by feelings of loss of control. Individuals with BED often experience negative emotional states such as selfblame and mental rumination, which can exacerbate their binge-eating behaviors. Dialectical Behavior Therapy (DBT) is an evidence-based treatment approach that focuses on developing skills to manage emotions, improve interpersonal relationships, and regulate behaviors and in this population has not been studied. Aims: The aim of the present study was investigate of the effectiveness of dialectical behavior therapy on self-blame and mental rumination of patients with binge-eating disorder. Methods: The current research was a semi-experimental with a pretest, posttest, and 3-month followup design and a control group. The statistical population include all obese and overweight women aged 18 to 45 suffering from overeating in Karaj, who had regular visits to Overeaters Anonymous Association in Karaj between July 2022 and May 2023. A convenience method was used to select the sample (n=40) from among the statistical population, who volunteered to participate in the intervention and met the inclustion criteria. The subjects were assigned equally in two experimental (20 patients) and one wait-list control (20 patients). After the pretest, the subjects of the experimental group received the dialectical behavior therapy intevention in 2-hour weekly sessions for 9 sessions. Then the posttest stage and three months later follow-up was carried out. The tools used in this research were the levels of self-criticism scale (Thompson & Zuroff, 2004), the mental rumination (Nolen-Hoeksema and Maro, 1991) and the overeating questionnaire (Gormali et al., 1982). The data obtained from this research were analyzed using SPSS-27 software using mixed ANOVA. Results: The results showed that dialectical behavior therapy has a significant effect in reducing selfblame and mental rumination in binge eating patients and this effect has been stable after three months. Conclusion: In conclusion, this study adds to the evidence supporting Dialectical Behavior Therapy (DBT) for treating binge-eating disorder. It shows that DBT reduces self-blame and mental rumination, and these improvements last at least three months. DBT's focus on addressing cognitive distortions and improving emotion regulation skills offers hope for long-term recovery. [ABSTRACT FROM AUTHOR]

Dialectical behavior therapy (DBT) and its adaptation for adolescents (DBT‐A) provide evidence‐based tools for individuals with chronic emotion dysregulation and their families (Linehan, 2015; Miller et al., 2007). Teens with emotion dysregulation struggle to understand, label, and accept their emotions; they are frequently unable to modulate the intensity of their emotions to match the goals of the present context. No matter how much emotionally‐dysregulated teens and their families may wish it were so, emotion regulation does not include getting rid of emotions. Why not? We need emotions for survival, as emotions serve essential functions: to motivate us for action and to communicate to ourselves and others. Rather than eliminating emotions, emotion regulation aims to help individuals understand their own emotions, decrease emotional vulnerability and suffering, and change unwanted emotions. This article presents "Check the Facts," a DBT skill for helping individuals with emotion dysregulation effectively change unwanted emotions. We share a handout that we adapted from DBT with step‐by‐step tips based on our experience treating adolescents with chronic emotion dysregulation co‐occurring with obsessive‐compulsive disorder (OCD)/anxiety disorders. [ABSTRACT FROM AUTHOR]

In 'The Making of Pragma-Dialectics: A Synopsis' the authors give an overview of the pragma-dialectical argumentation theory. First they characterize the five components of the research program: critical rationalistic philosophy, pragma-dialectical theory, qualitative and quantitative empirical research, resolution-oriented reconstructive analysis, reflection-minded practical intervention. Then they explain the four metatheoretical principles underlying the pragma-dialectical research: functionalization, socialization, externalization, and dialectification. Next the various phases in the systematic development of pragma-dialectics in the past 50 years are described: (1) conceptualization of the theoretical framework, (2) validation of the theoretical proposals, (3) empiricalization of the research efforts, (4) instrumentalization of the reconstructive analysis, (5) extension of the standard theory, (6) contextualization of the extended theory. In conclusion, a further explanation is given of the pragmadialectical approach of the crucial relationship between dialectical reasonableness and rhetorical effectiveness. [ABSTRACT FROM AUTHOR]

The editorial "Introduction: Philosophical Discussions with Pragma-Dialectics" published in the journal "Topoi: An International Review of Philosophy" commemorates the anniversaries of two seminal works in argumentation theory. The special issue explores the philosophy of argument underlying pragma-dialectical theory, emphasizing the pragmatic perspective on argumentation. The pragma-dialectical approach defines argumentation as a speech act, focusing on actions in context and normative standards of rationality. The editorial highlights the significant role pragma-dialectics has played in contemporary argumentation studies and its ongoing impact on philosophical inquiry. [Extracted from the article]

Objective: The aim of this study was to examine the effectiveness of dialectical behavior therapy-based skills training on distress tolerance, cognitive emotion regulation, and marital quality of life in women with recurrent miscarriages. Methods: The statistical population consisted of all women who visited infertility clinics in Tehran in 2019-2020. A sample of 30 women was selected using convenience and purposive sampling methods, based on inclusion and exclusion criteria, and was randomly assigned to experimental and control groups (15 women in each group). The questionnaires used in this study were the Distress Tolerance Questionnaire by Simons and Gaher (2005), the Cognitive Emotion Regulation Questionnaire by Garnefski, Kraaij, and Spinhoven (2006), and the Marital Quality of Life Questionnaire by Fletcher, Simpson, and Thomas (2000). The statistical method used was repeated measures, with a significance level of 0.05. Findings: According to the results, the differences in means between the two groups in the pre-test, post-test, and follow-up stages were significant. There were significant differences in distress tolerance, cognitive emotion regulation, and marital quality of life between the two groups. The dialectical behavior therapy-based skills training had an impact on the variables of distress tolerance, cognitive emotion regulation, and marital quality of life, with effect sizes of 0.885, 0.910, and 0.983, respectively. Conclusion: Given the confirmed effectiveness of this therapy, it is recommended that these women receive appropriate psychological treatments alongside medical treatments. [ABSTRACT FROM AUTHOR]

Objective: Borderline Personality Disorder (BPD) begins in adolescence or early adulthood and can lead to difficulties in conflict resolution and emotion regulation. The aim of this study was to compare the effectiveness of Mentalization-Based Therapy (MBT) and Dialectical Behavior Therapy (DBT) on emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder. Methods and Materials: This study employed an applied research design and a quasi-experimental pretest-posttest and follow-up design with a control group. The statistical population included all individuals with Borderline Personality Disorder in Tehran. The sample comprised 45 individuals with Borderline Personality Disorder selected through convenience sampling. Data were collected using the Jackson and Claridge Borderline Personality Inventory (1991), the Garnefski et al. Emotion Regulation Questionnaire (2001), the Dickman Impulsivity Inventory (1990), and the Rosenberg Self-Esteem Scale (1965). Data were analyzed using repeated measures ANOVA and SPSS-26 software. Findings: The results indicated a significant difference between the two therapy groups (MBT and DBT) on emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder. Dialectical Behavior Therapy had a greater impact on improving emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder (P<0.001). Conclusion: It can be concluded that both Dialectical Behavior Therapy and Mentalization-Based Therapy can be effective intervention methods for improving emotion regulation, impulsivity, and self-esteem in individuals with Borderline Personality Disorder. [ABSTRACT FROM AUTHOR]

Abstract Background The lack of training for professionals on how to manage suicide risk is an important barrier to effective intervention. Dialectical Behavior Therapy Intensive Training™ (DBT-IT) includes specific training for suicide and has shown promising results to enhance implementation of DBT. To our knowledge, no published studies have evaluated the effect of DBT-IT on therapists’ attitudes towards treating suicide risk and among Spanish-speaking mental health professionals. The main aim of this study was to evaluate the effect of DBT-IT on therapists’ attitudes regarding treating suicide risk and its relationship with the implementation of DBT before and after receiving DBT-IT. Methods A total of 242 mental health workers (76.4% women, mean age 35.38, SD = 9.17; 77.7% from Latin America; 22.3% from Spain) who had received a DBT-IT participated in the study. Self-efficacy (Efficacy in Assessing and Managing Suicide Risk Scale) and concerns (Concerns about Treating Suicidal Clients Scale) in treating suicide, perceived burnout (Copenhagen Burnout Inventory), confidence in applying DBT (Behavioral Anticipation and Confidence Questionnaire), barriers to implementation (Barriers to Implementation Inventory), implementation of DBT and reach were measured via online survey at parts 1 (pre-training) and 2 (post-training, after 9 months of implementation) of the DBT-IT. Results Differences between pre-training and post-training (n = 61) indicated statistically significant improvements in self-efficacy, concerns about the lack of training and competence in treating suicide, and confidence in applying DBT. Statistically significant increases in the rates of DBT treatment modes implementation (except for individual therapy) and mindfulness practice, as well as the number of team members and consultation team hours, were also found. Findings also indicated statistically significant positive correlations between burnout and concerns about treating suicidal clients, as well as with structural and administrative implementation barriers, and between self-efficacy in managing suicide, confidence in applying DBT and implementation of DBT treatment modes. Participants with more implementation barriers reported lower rates of consultation team meetings and phone coaching implementation. Conclusions DBT-IT could be an adequate training model to increase self-efficacy and confidence in treating suicide risk as well as to facilitate implementation of DBT treatment modes by Spanish-speaking mental health professionals. Clinical trial number Not applicable.

Abstract Background Anxiety and depressive disorders, characterized by high incidence and functional impairments, are emotional disorders with shared etiological and maintenance mechanisms. Dialectical behavior therapy (DBT) is a promising approach for the transdiagnostic treatment of emotional disorders. Developing a brief DBT intervention can facilitate the adoption of evidence-based therapy. Methods This protocol is for a 3-year single-blinded, two-arm randomized controlled trial. Individuals with depressive or anxiety disorder will be randomly allocated to a modified DBT–informed transdiagnostic psychotherapy group or a treatment-as-usual group. The intervention group will receive DBT individual therapy for 15 weeks. Power analyses revealed that the cohort should include a minimum of 250 participants. Preintervention, postintervention, and follow-up (after 3 months) assessments will be conducted. Primary outcomes will be severities of depression and anxiety rated by blind assessors. Intent-to-treat and per-protocol analyses will be conducted using the hierarchical linear model. Effect sizes will be estimated using Cohen’s d. Result To the best of our knowledge, the proposed study will be the first randomized controlled trial to evaluate the efficacy of a modified DBT intervention in managing transdiagnostic emotional disorders in Chinese individuals. Conclusion This intervention is expected to improve clinical outcomes, daily functioning, and quality of life. The trial will enrich the empirical evidence for transdiagnostic interventions, facilitating the implementation of evidence-based therapy and reducing the high prevalence and challenges (e.g., disability) of emotional disorders in the Chinese population. Trial registration number NCT05989451

Dialectical behavior therapy (DBT) has shown preliminary success in the treatment of youth in forensic settings. However, the implementation of DBT varies considerably from facility to facility. A scoping review was conducted to detail DBT intervention protocols in juvenile correctional and detention facilities. We described eight works treatment setting, study design, youth characteristics, staff training, DBT approach, DBT skills modules, and main findings. All works involved DBT skills sessions, but few incorporated other DBT components such as individual therapy or skills coaching. Outcomes included reducing problematic behaviors such as aggression, improving mental health, and largely positive feedback regarding the DBT intervention from youth and staff. Our results consolidate the existing literature regarding DBT intervention in forensic settings for youth and inform future implementation and research of DBT in such facilities.

Abstract Background Mindfulness skills training is a core component of Dialectical Behavior Therapy and aims to improve emotion dysregulation (ED) in people with Borderline Personality Disorder (BPD). However, the underlying mechanisms of change are not fully understood. Methods A total of 75 BPD outpatients participated in a 10-week mindfulness skills training. Multilevel models with a time-lagged approach were conducted to examine the temporal dynamics between the proposed mechanisms and ED. Decentering, nonjudgment, body awareness and attention awareness as putative mechanisms and ED as outcome were assessed on a session-by-session basis. Results Greater nonjudgment and body awareness showed within-person effects; participants who reported higher nonjudgement of inner experience and body awareness than their own personal average at a given week showed improvement in ED at the following week. Notably, decentering moderated these associations, such that increased nonjudgment and body awareness predicted improvements in ED more strongly in those participants with high decentering ability. Lastly, a bidirectional relationship between the mechanisms and ED was found; when participants were more emotionally dysregulated than their usual state, they showed less gain in the mechanisms at the following week. Conclusions Knowing how mindfulness training works is relevant to optimize treatments. Clinicians may use strategies to increase these mechanisms when the goal is to improve emotion regulation difficulties in BPD.

Abstract Background Families and significant others of people with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavior Therapy, was designed to provide families with both information about the disorder and emotion regulation skills. It has been progressively implemented in French-speaking European countries. Methods We conducted an observational, multicenter study in France and Switzerland. In total, 149 participants of the Family Connections program were included among five centers. Burden, depression, coping, and emotion regulation were assessed before and after the intervention. Results One-way repeated measures MANOVA showed that the burden, depressive symptoms, emotion regulation and coping all changed significantly after the intervention (p

The prevalence of youth mental illness in the United States is on the rise, and this increases the need for effective counseling interventions for children. This article introduces the integration of Adlerian play therapy (AdPT) and dialectical behavior therapy (DBT) skills with children who struggle with emotion dysregulation. We include an overview of both theoretical approaches, justification for integration, and a case study illustrating this dual approach in session. Finally, counseling implications and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

Aim:This study was conducted with the aim of effecting of dialectical behavior therapy for reducing negative perfectionism in perfectionist girls. Method: In this research, a quantitative single-subject test method with an A-B baseline was used. A statistical sample of 3 students aged 16-19 years old, from teenage girls, were selected by a purposive sampling method, through interviews and Frost's perfectionism questionnaire (1990).. After performing three baseline measures, the intervention phase started with the implementation of dialectical behavior therapy. In the intervention phase, dialectical behavior therapy instruction was held with a preliminary session and 10 weekly one-hour therapy sessions, and skills related to research were taught. Finding: The analysis of the findings using graphical analysis showed that dialectical behavior therapy was effective for reducing the negative perfectionism of perfectionist girls. Conclusion: The results of the research indicated that dialectical behavior therapy is effective for reducing the negative perfectionism of teenagers. Therefore, it is suggested to use the dialectical behavior therapy method for teenagers. [ABSTRACT FROM AUTHOR]

The article discusses the importance of psychological interventions in treating bipolar disorder (BD) alongside medication. It highlights various evidence-based psychological interventions such as psychoeducation, cognitive behavioral therapy (CBT), and family-focused therapy (FFT) that have shown positive outcomes in managing BD. The paper emphasizes the need for personalized treatment plans based on individual needs and stages of the disorder, as well as the challenges of accessing evidence-based psychological interventions globally due to factors like awareness, availability, and affordability. The authors recommend large-scale efforts to develop and implement psychological interventions for BD, optimize treatments based on treatment moderators, and work towards equitable access to these interventions worldwide. [Extracted from the article]

Background: The aim of this study was to compare the effectiveness of positive therapy and dialectical behavior therapy on the self-knowledge of vulnerable teenagers under the welfare of Tehran. Materials and Methods: 60 samples were selected by using the available sampling method and by screening, and they were assigned equally and randomly in the intervention groups of positive psychology and dialectical behavior therapy and the control group. The score obtained from Kettle's SelfKnowledge Questionnaire (1998) was included in the initial screening as a pre-test. Then, the intervention of positive psychology and dialectical behavior therapy was presented to the experimental group for 10 sessions of 90 minutes each, and the control group did not receive any intervention. Then all three groups were measured in the post-test. Also, after one month, a follow-up period was conducted by implementing a self-awareness questionnaire. Results: Data analysis with mixed variance analysis showed that positive treatment and dialectical behavior therapy were effective on the selfawareness of vulnerable teenagers under the welfare of Tehran city (P<0.001). Also, the effect of positive treatment was greater than dialectical behavior therapy in improving self-knowledge (P<0.001). The results were maintained in the follow-up phase. Conclusion: The results of this research reveal the need to pay special attention to the issues of vulnerable teenagers. [ABSTRACT FROM AUTHOR]

The advent of multiple transdiagnostic treatments in recent decades has advanced the field of clinical psychology while also raising questions for clinicians and patients about how to decide between treatments and how to best deliver a chosen treatment. The purpose of this paper is to review two prominent transdiagnostic treatments that target emotion dysregulation: dialectical behaviour therapy and the unified protocol for transdiagnostic treatment for emotional disorders. First, we review the theoretical underpinnings, research support and proposed mechanisms of action for these treatments. Next, we discuss patient and therapist variables that might indicate which treatment is more appropriate for a given patient and discuss decision‐making guidelines to help make this determination with an emphasis on complex patients who may present with risk and/or clinical comorbidities. Finally, we discuss areas for future research that can help further ensure we work to match patients to the treatment that is most likely to benefit them. [ABSTRACT FROM AUTHOR]

Objective: We examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Method: Participants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome. Results: More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%–34%). Conclusions: Clients' in-session emotional experiences predict treatment outcome 8–10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. What is the public health significance of this article?: This study highlights the importance of discrete emotional experiences in dialectical behavior therapy for borderline personality disorder. Specific kinds of emotional experience in individual dialectical behavior therapy sessions anticipate treatment outcome. [ABSTRACT FROM AUTHOR]

SUMMARY: Personality disorders are a group of psychological disorders characterised by a developmental nature, long-lasting impairment and emotional suffering. Personality disorders have an estimated prevalence rate of approximately 8% in community settings, but in in-patient settings the rate might be as high as 76%. Cognitive–behavioural therapies (CBTs) include psychotherapies that emphasise the identification and modification of maladaptive thought patterns and behaviours that contribute to the maintenance of psychological disorders. CBTs have demonstrated their effectiveness in treating various types of personality disorder. This article focuses on the nature of personality disorders and their categorial and dimensional assessment and neurobiology. We present three influential CBT models used in personality disorders: schema therapy, cognitive interpersonal therapy and dialectical behaviour therapy. For each one, we outline the rationale, intervention strategies and therapeutic techniques, with practical examples and summary tables to illustrate their application. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the categories, risks and effects of various new psychoactive substances • To recognise the challenges involved in identifying new psychoactive substances • To consider psychosocial and pharmacological interventions that you could use with people who misuse new psychoactive substances. The use of new psychoactive substances is a growing concern across healthcare services in the UK. To date, more than 1,000 types of new psychoactive substances have been identified and they have a wide range of effects, potency and mechanisms of action, which can result in overdose and death. This article reviews the challenges experienced by nurses including in identifying new psychoactive substances, their associated risks and various psychosocial and pharmacological interventions. Currently, evidence surrounding the appropriate nursing interventions required for the misuse of new psychoactive substances is limited. Further research and training opportunities are required for nurses to manage service users who present having taken new psychoactive substances, particularly in hospital, substance misuse and mental health settings. [ABSTRACT FROM AUTHOR]

School teachers are susceptible to mental health issues due to the challenging responsibilities the teaching profession entails. While several interventions have demonstrated effectiveness in improving teachers' social emotional competencies and mental health outcomes, little work has examined the potential of dialectical behavior therapy–skills training (DBT‐ST) in improving teacher outcomes. This study aimed to assess the effects of a five‐session, Malay‐translated DBT‐ST on psychological symptoms (anxiety, depression, stress, burnout), social‐emotional competencies, DBT skills use, and dysfunctional coping in a sample of school teachers in East Malaysia. Fifty‐three participants were recruited and assigned into DBT‐ST or a control group, consisting of attending a mental health talk. Analyses showed that DBT‐ST participants reported greater decreases in student‐related burnout and dysfunctional coping, and greater increases in DBT skills use compared to the control group from pre‐ to post‐intervention. There were no between‐condition differences on changes in other mental health outcomes, though session attendance was linked positively to improvements in several outcomes in the DBT‐ST condition. Analyses of post‐intervention feedback indicated that brief DBT‐ST was deemed acceptable and feasible among the research participants. In conclusion, DBT‐ST holds promise as an intervention to lower student‐related burnout and facilitate adaptive coping among school teachers. Practitioner Points: Teachers undergoing dialectical behavior therapy (DBT) skills training showed greater decreases in student‐related burnout and dysfunctional coping, and greater increases in DBT skills use compared to teachers in the control condition.There were no between‐condition differences on changes in other mental health outcomes.Number of DBT skills training sessions attended was associated with decreases in depressive symptoms and personal burnout, and with increases in DBT skills use. [ABSTRACT FROM AUTHOR]

To evaluate rates of remission, recovery, relapse, and recurrence in suicidal youth who participated in a clinical trial comparing Dialectical Behavior Therapy (DBT) and Individual and Group Supportive Therapy (IGST). Participants were 173 youth, aged 12 to 18 years, with repetitive self-harm (including at least 1 prior suicide attempt [SA]) and elevated suicidal ideation (SI). Participants received 6 months of DBT or IGST and were followed for 6 months post-treatment. The sample was 95% female, 56.4% White, and 27.49% Latina. Remission was defined as absence of SA or nonsuicidal self-injury (NSSI) across one 3-month interval; recovery was defined across 2 or more consecutive intervals. Relapse and recurrence were defined as SA or NSSI following remission or recovery. Cross-tabulation with χ2 was used for between-group contrasts. Over 70% of the sample reported remission of SA at each treatment and follow-up interval. There were significantly higher rates of remission and recovery and lower rates of relapse and recurrence for SA in DBT than for IGST. Across treatments and time points, SA had higher remission and recovery rates and lower relapse and recurrence rates than NSSI. There were no significant differences in NSSI remission between conditions; however, participants receiving DBT had significantly higher NSSI recovery rates than those receiving IGST for the 3- to 9-month, 3- to 12-month, and 6- to 12-month intervals. Results showed higher percentages of SA remission and recovery for DBT as compared to IGST. NSSI was less likely to remit than SA. This study examined rates of remission, recovery, relapse, and recurrence of suicide attempts (SA) and nonsuicidal self-injury (NSSI) among the participants in the CARES Study, a randomized clinical trial of 6 months of Dialectical Behavior Therapy or Individual and Group Supportive Therapy. 173 youth aged 12 to 18 years participated in the study and were followed for 6 months post treatment. Over 70% of the sample reported remission of SA at each treatment and follow-up interval. There were significantly higher rates of remission and recovery and lower rates of relapse and recurrence for SA among participants who received Dialectical Behavioral Therapy. Across both treatments, remission and recovery rates were lower and relapse and recurrence rates were higher for NSSI than for SA. These results underscore the value of Dialectical Behavioral Therapy as a first line treatment for youth at high risk for suicide. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. Collaborative Adolescent Research on Emotions and Suicide (CARES); https://www.clinicaltrials.gov/ ; NCT01528020. [ABSTRACT FROM AUTHOR]

Background: Dialectical behaviour therapy (DBT) has been successfully adapted for use with adolescents experiencing difficulties associated with the maladaptive undercontrol of emotion. However, clinical observation and research findings suggest that adolescents may exhibit traits of both undercontrol and overcontrol—where over‐regulation of emotion predominates. In the adult population, distinct groups of individuals with under‐ and overcontrolled regulation styles can be identified, and treatments such as Group Radical Openness (GRO) have shown promise in treating difficulties associated with the latter. However, there are difficulties identifying distinct groups of under‐ and overcontrolled adolescents. Aims: The present study therefore sought to qualitatively explore the experiences of participants (adolescents and parents) and facilitators of an intervention integrating DBT for adolescents' skills training with GRO. Method: Six adolescents, seven parents and six clinicians completed semi‐structured interviews. Data were analysed using thematic analysis. Nine themes and six subthemes were generated. Findings: Findings suggested that an intervention of this type may have particular utility for adolescents with emotion regulation difficulties in the context of both overcontrol and undercontrol. Participants described improvements in symptoms and relational functioning, which they attributed to the development of a shared language for communicating about emotion and the multifamily group context within which the intervention was delivered. Findings also emphasised the utility of rolling groups. Discussion: Further research investigating the efficacy of this intervention is warranted. Strengths, limitations, future directions and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Background and aims: Self-injury and substance abuse in people with borderline personality disorder can lead to serious harm to themselves and those around them. Therefore, the purpose of this study was to investigate the effectiveness of mindfulness and emotion regulation therapy based on dialectical behavior therapy on substance abuse and self-injury in people with borderline personality disorder (BPD). Methods: This research was conducted using a single-case experimental design (SCED) of the multiple baseline type, consisting of eight one- hour sessions for three patients, followed by a one-month follow-up period. The statistical population included patients diagnosed with PBD. Three individuals were selected based on their voluntary participation and adherence to the research criteria, utilizing targeted and available sampling methods. Inclusion was based on a psychiatrist's diagnosis and a structured clinical interview. They received dialectical behavior therapy based on emotion regulation and mindfulness for eight sessions. Data were collected using the Risky Behaviors Questionnaire by Mohammadkhani and the Personality Assessment Inventory Borderline Features Scale (PAI-BFS). Results: Data analysis, presented through graphs and tables for SCED, indicated that mindfulness and emotion regulation interventions based on dialectical behavior therapy resulted in significant changes. The effect sizes for the first subject in the variables of self-harm and substance abuse were 4.526 and 2.260, respectively; for the second subject, they were 6.253 and 6.772; and for the third subject, they were 3.651 and 6.134. Conclusion: This treatment method has led to statistically significant improvements in the symptoms of substance abuse and self-harm among patients with BPD. [ABSTRACT FROM AUTHOR]

Copyright of Cyprus Turkish Journal of Psychiatry & Psychology (CTJPP) / Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi is the property of Cyprus Turkish Journal of Psychiatry & Psychology (CTJPP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Borderline personality disorder (BPD) is thought to be shaped around emotional dysregulation. Physical exercise is an effective way to improve emotional regulation in individuals both with and without mental disorder. However, to this day no study examined the effect of regular physical exercise on emotion regulation in adults with BPD. This study used a series of single case experimental design (A-B-A) combined with ecological momentary assessment and individual interviews to explore and analyze the effect of physical exercise on emotion regulation in adults with BPD. Emotions of participants were monitored thrice daily with an app that prompted them to report their emotions on a 0–100 analogue scale. Both A (control) phases lasted 2 weeks and the B phase (intervention) lasted 4 weeks (3 1-hour supervised sessions of physical exercise weekly). Emotionrelated data were analyzed by piecewise linear regression and qualitative data with thematic analysis. Seven women with BPD completed this study and five of them participated in the interviews. Three participants showed an increase in positive emotions and four participants showed a decrease in negative emotions throughout the study and those results are confirmed with interindividual analyses. Participants reported enjoying the exercise program and the trainer they were assigned. Finally, participants also reported being less reactive and more patient when encountering irritating or stressing events. In conclusion, adult women with BPD found that physical exercise decreases their negative emotions and reactivity to psychological stressors. [ABSTRACT FROM AUTHOR]