Psychology and Criminology, School of Arts and Humanities, Edith Cowan University, Joondalup, Western Australia, Australia.
Fremantle Mental Health Service, Fremantle, Western Australia, Australia.
J Clin Psychol. 2022 Dec;78(12):2396-2409. doi: 10.1002/jclp.23349. Epub 2022 Mar 25.
The present study investigated the effectiveness of dialectical behavioral therapy (DBT) and the effect of improvement in DBT skills on clinical outcomes.
Participants included 57 adults who attended a community mental health service and underwent one of two modes of DBT. Twenty-six adults had been diagnosed with borderline personality disorder (BPD) and participated in comprehensive DBT (DBT-C; including group skills training, individual therapy, and phone coaching). Thirty-one adults had BPD traits and participated in DBT skills training (DBT-S; group skills training only). In the present study, the DBT skills examined were mindfulness, emotion regulation, and interpersonal effectiveness; the clinical outcomes examined were borderline symptoms, psychological distress, and quality of life.
Six 2 × 2 analysis of covariances indicated significant improvements in psychological distress, quality of life, mindfulness, and interpersonal effectiveness (but not borderline symptoms and emotion regulation), over a 6-month period. Mode of delivery of DBT did not impact on the improvement in DBT skills and clinical outcomes over the 6-month period. Hierarchical multiple regression results indicated that improvement in DBT skills (mindfulness, emotion regulation, and interpersonal effectiveness) were associated with reductions in borderline symptoms and psychological distress, with emotion regulation the only skill uniquely associated with improvements in clinical outcomes.
The results of the present study support the effectiveness of DBT and the specific role of emotion regulation for favorable clinical outcomes over a 6-month period, independent of the mode of delivery of DBT.
本研究旨在调查辩证行为疗法（DBT）的有效性，以及 DBT 技能的改善对临床结果的影响。
参与者包括 57 名参加社区心理健康服务的成年人，他们接受了两种 DBT 模式之一。26 名成年人被诊断患有边缘型人格障碍（BPD），并参加了综合 DBT（包括团体技能训练、个体治疗和电话辅导）。31 名成年人有 BPD 特征，参加了 DBT 技能训练（仅团体技能训练）。在本研究中，所检查的 DBT 技能包括正念、情绪调节和人际效能；所检查的临床结果包括边缘症状、心理困扰和生活质量。
6 个 2×2 协方差分析表明，在 6 个月的时间内，心理困扰、生活质量、正念和人际效能显著改善（但边缘症状和情绪调节没有改善）。DBT 的交付模式在 6 个月内对 DBT 技能和临床结果的改善没有影响。分层多元回归结果表明，DBT 技能的改善（正念、情绪调节和人际效能）与边缘症状和心理困扰的减少有关，情绪调节是唯一与临床结果改善相关的技能。
本研究的结果支持 DBT 的有效性，以及情绪调节在 6 个月内对有利的临床结果的特定作用，独立于 DBT 的交付模式。
