Lyng Jim, Swales Michaela A, Hastings Richard P, Millar Tracy, Duffy Daniel J, Booth Richard
Department of Psychology, Cluain Mhuire Community Mental Health Services, Blackrock, Co. Dublin, Ireland.
School of Psychology, Bangor University, Adeilad Brigantia, Bangor, Gwynedd, LL57 2AS, UK.
Community Ment Health J. 2020 Feb;56(2):238-250. doi: 10.1007/s10597-019-00485-7. Epub 2019 Oct 31.
We describe a naturally occurring, real-world comparison of outcomes following 6 months in standalone DBT skills training group for adults with Borderline Personality Disorder (BPD) without recent suicidal or severe self-harming behaviours and standard (i.e. all modes) DBT for BPD including patients with recent high-risk behaviours. 34 patients chose standalone skills over waiting for standard DBT and 54 were offered standard DBT. Dropout was higher for standalone skills than standard DBT (38.2% vs. 16.7%). No statistically or clinically significant differences were found among completers between conditions on borderline symptoms, general psychopathology, and suicide ideation. There was a moderate effect for standalone skills on hopelessness and emotion regulation difficulties which may have reflected non-equivalence of treatment groups. Significant methodological factors limit generalisability of findings which offer support for feasibility of standalone DBT skills as an effective alternative to waitlist for standard DBT for at least some patients with BPD in the community.
我们描述了一项针对无近期自杀或严重自伤行为的边缘性人格障碍（BPD）成人患者的独立辩证行为疗法（DBT）技能培训组与包括近期有高风险行为患者的标准（即所有模式）DBT治疗6个月后自然发生的、真实世界的疗效比较。34名患者选择独立技能培训而非等待标准DBT治疗，54名患者接受标准DBT治疗。独立技能培训组的退出率高于标准DBT组（38.2%对16.7%）。在完成治疗者中，两组在边缘性症状、一般精神病理学和自杀观念方面未发现统计学或临床显著差异。独立技能培训对绝望感和情绪调节困难有中等程度的影响，这可能反映了治疗组的不等效性。显著的方法学因素限制了研究结果的普遍性，这些结果为独立DBT技能作为社区中至少部分BPD患者等待标准DBT治疗的有效替代方案的可行性提供了支持。
