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Behav Res Ther. 2014 Apr;55:7-17. doi: 10.1016/j.brat.2014.01.008. Epub 2014 Feb 11.

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.

Author information

1
Behavioral Research and Therapy Clinics, Box 355915, University of Washington, Seattle, WA 98195-5915, USA. Electronic address: mharned@u.washington.edu.
2
Behavioral Research and Therapy Clinics, Box 355915, University of Washington, Seattle, WA 98195-5915, USA.

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.

KEYWORDS:

Borderline personality disorder; Posttraumatic stress disorder; Self-injury; Suicide

PMID:
24562087
PMCID:
PMC3987949
DOI:
10.1016/j.brat.2014.01.008
[Indexed for MEDLINE]
Free PMC Article

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