Effectiveness, response, and dropout of dialectical behavior therapy for borderline personality disorder in an inpatient setting

Kröger, Christoph; Harbeck, Susanne; Armbrust, Michael; Kliem, Sören

doi:10.1016/j.brat.2013.04.008

Cited by 95 publications

(54 citation statements)

References 25 publications

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“…The results indicating that higher levels of baseline non-acceptance of emotional responses were a predictor of dropout are in line with previous literature demonstrating that higher baseline experiential avoidance is a predictor of dropout in consumers with BPD and/or in DBT [5, 7, 34, 35]. While non-acceptance and avoidance are different constructs, they may be related in that individuals who refuse to accept emotional responses are also likely to avoid the experience.…”

Section: Discussionsupporting

confidence: 90%

“…In two studies, no significant differences were found between treatment completers and dropouts [32, 33]. Others have found that fewer lifetime suicide attempts, higher experiential avoidance, substance use disorder, younger age, antisocial personality disorder, and more than 86 weeks in a psychiatric hospital predicted dropout [7, 34, 35]. In a brief intensive outpatient DBT program, Perroud et al [20] found that only low educational level predicted dropout.…”

Section: Introductionmentioning

confidence: 99%

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Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability

Landes

Chalker

Comtois

2016

bord personal disord emot dysregul

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BackgroundRates of treatment dropout in outpatient Dialectical Behavior Therapy (DBT) in the community can be as high as 24 % to 58 %, making dropout a great concern. The primary purpose of this article was to examine predictors of dropout from DBT in a community mental health setting.MethodsParticipants were 56 consumers with borderline personality disorder (BPD) who were psychiatrically disabled participating in a larger feasibility trial of Dialectical Behavior Therapy- Accepting the Challenges of Exiting the System. The following variables were examined to see whether they predicted dropout in DBT: age, education level, baseline level of distress, baseline level of non-acceptance of emotional responses, and skills module in which a consumer started DBT skills group. These variables were chosen based on known predictors of dropout in consumers with BPD and in DBT, as well as an interest in what naturally occurring variables might impact dropout.ResultsThe dropout rate in this sample was 51.8 %. Results of the logistic regression show that younger age, higher levels of baseline distress, and a higher level of baseline non-acceptance of emotional responses were significantly associated with dropout. The DBT skills module in which an individual started group did not predict dropout.ConclusionsThe implications of these findings are that knowledge of consumer age and pretreatment levels of distress and non-acceptance of emotional responses can impact providers’ choice of commitment and treatment strategies to reduce dropout. Future research should examine these strategies, as well as the impact of predictor variables on outcome and reasons for dropout.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability

Landes

Chalker

Comtois

2016

bord personal disord emot dysregul

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“…The results demonstrated that, in contrast to the Emotional/Disinhibited subtype and Inhibited subtype, the Low Anxiety subtype did not improve significantly in general clinical and borderline specific symptoms and dissociation. These aforementioned results are in line with a previous study of Kröger et al, 7 who also reported a reduction in clinical symptoms in almost all patients after a 3-month DBT program, but for borderline-specific symptoms only for half of them.…”

Section: Discussionsupporting

confidence: 92%

“…6,7 However, a third of the patients did not benefit from treatment. 7 In addition, in DBT, the dropout rate was estimated around 27%, and till now few predictors of dropout have been identified (e.g. Kliem et al 8 ).…”

Section: Introductionmentioning

confidence: 99%

Do treatment outcomes differ after 3 months DBT inpatient treatment based on borderline personality disorder subtypes?

Sleuwaegen

Claes

Luyckx

et al. 2018

Personality & Mental Health

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Heterogeneity in borderline personality disorder (BPD) drives the search for BPD subtypes to optimize the assessment and treatment of these patients. Therefore, the aims of the present study were (1) to replicate previously identified BPD subtypes based on reactive and regulative temperament; (2) to compare them on symptomatology and coping; and (3) to investigate whether these subtypes show different treatment responses after 3 months of inpatient dialectical behaviour therapy (DBT). A total of 145 BPD inpatients were assessed by means of measures of temperament, symptomatology and coping. Through model-based clustering on the Behavioural Inhibition and Behavioural Activation Scales (BISBAS) and Effortful Control Scale (ECS), we identified three BPD subtypes: an Emotional/Disinhibited subtype (15%, high BAS and low ECS); a Low Anxiety subtype (41%, low BIS) and an Inhibited subtype (44%, low BAS). After 3 months of DBT, 75 patients completed the measures for a second time. Repeated measure ANOVAs demonstrated a general improvement on all symptoms and coping strategies. In addition, the BPD subtypes showed trajectory differences in clinical and borderline specific symptomatology and dissociation. These findings indicate that BPD subtypes based on temperament demonstrate different treatment responses, which can contribute to the search of more BPD subtype tailored treatment interventions. © 2018 John Wiley & Sons, Ltd.

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“…To analyse associations between endorsement of particular criteria and a DSM‐5 diagnosis of IGD, non‐parametric conditional inference trees (C‐Trees ), based on the principle of recursive partitioning, were applied (for examples see Kröger et al . and Grocholewski et al . ).…”

Section: Methodsmentioning

confidence: 89%

Prevalence of internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM‐5 criteria in a state‐wide representative sample

et al. 2015

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Effectiveness, response, and dropout of dialectical behavior therapy for borderline personality disorder in an inpatient setting

Cited by 95 publications

References 25 publications

Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability

Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability

Do treatment outcomes differ after 3 months DBT inpatient treatment based on borderline personality disorder subtypes?

Prevalence of internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM‐5 criteria in a state‐wide representative sample

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