A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD.

Abstract

OBJECTIVE:

This study evaluates the efficacy of integrating PTSD treatment into Dialectical Behavior Therapy (DBT) for women with borderline personality disorder, PTSD, and intentional self-injury.

METHODS:

Participants were randomized to DBT (n=9) or DBT with the DBT Prolonged Exposure (DBT PE) protocol (n=17) and assessed at 4-month intervals during the treatment year and 3-months post-treatment.

RESULTS:

Treatment expectancies, satisfaction, and completion did not differ by condition. In DBT+DBT PE, the DBT PE protocol was feasible to implement for a majority of treatment completers. Compared to DBT, DBT+DBT PE led to larger and more stable improvements in PTSD and doubled the remission rate among treatment completers (80% vs. 40%). Patients who completed the DBT PE protocol were 2.4 times less likely to attempt suicide and 1.5 times less likely to self-injure than those in DBT. Among treatment completers, moderate to large effect sizes favored DBT+DBT PE for dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and global functioning.

CONCLUSIONS:

DBT with the DBT PE protocol is feasible, acceptable, and safe to administer, and may lead to larger improvements in PTSD, intentional self-injury, and other outcomes than DBT alone. The findings require replication in a larger sample.

• Authors: Melanie S Harned, Kathryn E Korslund, Marsha M Linehan
• Journal: Behaviour research and therapy (Behav Res Ther) Vol. 55 Pg. 7-17 (Apr 2014) ISSN: 1873-622X [Electronic] England
• PMID: 24562087 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Behavior Therapy (methods)
• Borderline Personality Disorder (complications, therapy)
• Combined Modality Therapy
• Female
• Humans
• Implosive Therapy (methods)
• Middle Aged
• Patient Compliance
• Pilot Projects
• Self-Injurious Behavior (complications, therapy)
• Stress Disorders, Post-Traumatic (complications, therapy)
• Suicide, Attempted
• Treatment Outcome
• Young Adult