Treatment of older adults with co‐morbid personality disorder and depression: a dialectical behavior therapy approach

Lynch, Thomas R.; Cheavens, Jennifer S.; Cukrowicz, Kelly C.; Thorp, Steven R.; Bronner, Leslie; Beyer, John L.

doi:10.1002/gps.1703

Cited by 227 publications

(105 citation statements)

References 58 publications

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“…Given that this census-based sample found that 1 in 10 older adults were characterized by a profile of histories of serious suicidal ideation/behavior in the absence of current psychological distress other than recent death wishes, research is needed to examine the potential benefits of regular screening of suicide risk among all older adults, not just those with depression. Research is also needed regarding clinical management of those older adults presenting with death wishes in the absence of significant depression—specifically, whether treatments shown to be effective for older adults with suicidal ideation and depression 31–33 are useful and whether treatments targeting factors other than depression (e.g., targeting loneliness 34 ) are also useful.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

Orden

Simning

Conwell

et al. 2013

The American Journal of Geriatric Psychiatry

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Objective To determine whether death ideation in late life is associated with markers of elevated risk for suicide, or reflects normal psychological processes in later life. Design/Setting Population based cross sectional study in Gothenburg, Sweden. Participants The sample consists of 345 men and women aged 85 (born 1901-02) and living in Gothenburg, Sweden. Main Outcome Measures The Paykel Scale measured the most severe level of suicidality over an individual’s lifetime. Other key measures were severity of depression and anxiety and frequency of death/suicidal ideation over the previous month. Results Latent class analysis revealed distinct groups of older adults who reported recent death ideation. Recent death ideation did not occur apart from other risk factors for suicide; instead individuals reporting recent death ideation also reported either 1) recent high levels of depression and anxiety, or 2) more distant histories of serious suicidal ideation (indicative of worst point severity of suicidal ideation)—both of which elevate risk for eventual suicide. Conclusions Our results indicate a heterogeneous presentation of older adults who report death ideation, with some presenting with acute distress and suicidal thoughts, and others presenting with low distress but histories of serious suicidal ideation. The presence of death ideation is associated with markers of increased risk for suicide, including “worst point” active suicidal ideation.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

Orden

Simning

Conwell

et al. 2013

The American Journal of Geriatric Psychiatry

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“…Por tanto, se excluyeron estudios de caso, teóricos, metodológicos, correlacionales, cualitativos y/o protocolos experimentales sin muestra clínica. Se excluyeron del presente análisis el estudio de Lych, Morse, Mendelson y Robins (2003) y el de Gallagher y Thompson (1983) por presentar datos parcialmente repetidos (véase Gallagher y Thompson, 1982;Lynch et al, 2007). Figura 1.…”

Section: Métodounclassified

Terapias conductuales de tercera generación en personas mayores: una revisión de la literatura

Sánchez

Ruiz

2017

PSYE

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RESUMEN:El objetivo de este estudio fue analizar el grado de evidencia clínica de las Terapias Conductuales de Tercera Generación en la población mayor a través de una revisión de los estudios más relevantes en la literatura científica. De un total de 332 referencias identificadas, 16 estudios cumplieron el criterio de selección. El análisis de estos estudios mostró que las intervenciones basadas en mindfulness acumulan mayor evidencia, seguidas por la Terapia de Aceptación y Compromiso (ACT) y la Activación Conductual (BA). Sin embargo, los resultados son limitados. Son necesarios más estudios controlados aleatorizados para clarificar la eficacia de este tipo de tratamientos. Palabras clave: personas mayores, revisión, conciencia plena, terapia de aceptación y compromiso, activación conductual, terapia dialéctico-conductual. Third generation of behavior therapies with older adults: a review of literature.ABSTRACT:The aim of this study was to determine the degree of clinical evidence of Third Generation of Behavior Therapies with older adults from a review of the most relevant studies in the scientific literature. From a total of 332 references identified,16 studies met the selection criteria. The analysis of these studies showed that intervention based on Mindfulness accumulates more evidence, followed by Acceptance and Commitment Therapy (ACT) and Behavior Activation (BA). Nevertheless, the results are limited. More randomized controlled trials are needed to clarify the efficacy of this kind of treatments. Keywords: older adults, review, mindfulness, acceptance and commitment therapy, behavior activation, dialectical behavior therapy . INTRODUCCIóNLa mayoría de aproximaciones terapéuticas a la población mayor se basan en intervenciones psicosociales, cognitivo-conductuales, de solución de problemas y/o programación de actividades (Areán y Cook, 2002;Mackin y Areán, 2005). Este tipo de intervenciones presentan un marcado énfasis en el cambio o control de los pensamientos como eje causal del problema, una excesiva importancia del bienestar de tipo hedónico, una tendencia a estandarizar los tratamientos y un estilo eminentemente psicoeducativo (véase Petkus y Wetherell, 2013;Márquez,

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“…Dos ensayos clínicos aleatorizados demostraron también que la TDC generó disminución en el consumo de sustancias (29,45). Un estudio conducido por Lynch en el 2007, encontró efectos positivos de la TDC estándar en depresión en adultos mayores (46). Harned en el 2010 realizó un ensayo Reducir y eliminar conductas que atentan contra la vida.…”

Section: Rev Neuropsiquiatr 79 (2) 2016unclassified

Terapia Dialéctico Conductual en el trastorno límite de personalidad: el equilibrio entre la aceptación y el cambio.

Vásquez-Dextre¹

2016

Rev Neuropsiquiatr

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RESUMENEl objetivo de este artículo es presentar una breve revisión de la Terapia Dialéctico Conductual (TDC) como programa terapéutico para el Trastorno Límite de Personalidad (TLP). La TDC fue creada por Marsha Linehan, basada en conceptos de ciencias de la conducta y articulada con elementos como validación y mindfulness a través de la filosofía dialéctica. Está conformada por cinco modalidades de tratamiento: terapia individual, entrenamiento en habilidades, coaching telefónico, terapia de familia y reuniones de equipo. Tiene una duración variable, con una etapa de pretratamiento y cuatro de tratamiento, cada una con sus respectivos objetivos. La TDC ha demostrado eficacia no solo en la reducción de síntomas de TLP tales como conductas autoagresivas e ideación suicida, sino que hay también evidencia de su efectividad en trastornos de conducta alimentaria, adolescentes con síntomas de TLP, abuso de sustancias y otros trastornos de personalidad y comorbilidades psiquiátricas.PALABRAS CLAVE: Terapia conductista, trastorno de personalidad limítrofe, atención plena. SUMMARYThe aim of this article is to provide a brief review of Dialectic Behavioral Therapy (DBT) as a therapeutic program for Borderline Personality Disorder (BPD). DBT was developed by Marsha Linehan, based on concepts from the behavioral sciences and articulated with elements such as validation and mindfulness through modalities of dialectical philosophy. It consists of five treatment modalities: individual therapy, skills training, telephone coaching, family therapy and team meetings. It has a variable duration, with a pretreatment step and four treatment stages, each with their respective objectives. DBT has not only demonstrated efficacy in reducing symptoms of BPD, such as self-injurious behaviors and suicidal ideation, but there is also evidence of their effectiveness in eating disorders, adolescents with symptoms of Borderline and other personality disorders, as well as in patients with diagnoses of substance abuse and other psychiatric comorbidities.

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Treatment of older adults with co‐morbid personality disorder and depression: a dialectical behavior therapy approach

Cited by 227 publications

References 58 publications

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

Terapias conductuales de tercera generación en personas mayores: una revisión de la literatura

Terapia Dialéctico Conductual en el trastorno límite de personalidad: el equilibrio entre la aceptación y el cambio.

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