DISSOCIATION PREDICTS POOR RESPONSE TO DIALECTIAL BEHAVIORAL THERAPY IN FEMALE PATIENTS WITH BORDERLINE PERSONALITY DISORDER

A substantial proportion of Borderline Personality Disorder (BPD) patients respond by a marked decrease of psychopathology when treated with Dialectical Behavioral Therapy (DBT). To further enhance the rate of DBT-response, it is useful to identify characteristics related to unsatisfactory response....

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Bibliographic Details
Published in:Journal of personality disorders 2011-08, Vol.25 (4), p.432-447
Main Authors: KLEINDIENST, Nikolaus, LIMBERGER, Matthias F, EBNER-PRIEMER, Ulrich W, KEIBEL-MAUCHNIK, Jana, DYER, Anne, BERGER, Mathias, SCHMAHL, Christian, BOHUS, Martin
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Antisocial personality disorder
Anxiety Disorders
Behavior disorders
Behavior Therapy - methods
Behavior therapy. Cognitive therapy
Biological and medical sciences
Borderline Personality Disorder - epidemiology
Borderline Personality Disorder - psychology
Borderline Personality Disorder - therapy
Comorbidity
Dissociative Disorders - epidemiology
Dissociative Disorders - psychology
Dissociative Disorders - therapy
Female
Germany
Humans
Inpatients - statistics & numerical data
Learning Processes
Medical sciences
Middle Aged
Personality disorders
Personality Problems
Psychology. Psychoanalysis. Psychiatry
Psychometrics
Psychopathology
Psychopathology. Psychiatry
Treatment Outcome
Treatments
Young Adult
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Summary:A substantial proportion of Borderline Personality Disorder (BPD) patients respond by a marked decrease of psychopathology when treated with Dialectical Behavioral Therapy (DBT). To further enhance the rate of DBT-response, it is useful to identify characteristics related to unsatisfactory response. As DBT relies on emotional learning, we explored whether dissociation-which is known to interfere with learning- predicts poor response to DBT. Fifty-seven Borderline Personality Disorder (BPD) patients (DSM-IV) were prospectively observed during a three-month inpatient DBT program. Pre-post improvements in general psychopathology (SCL-90-R) were predicted from baseline scores of the Dissociative Experiences Scale (DES) by regression models accounting for baseline psychopathology. High DES-scores were related to poor pre-post improvement (β = -0.017 ± 0.006, p = 0.008). The data yielded no evidence that some facets of dissociation are more important in predicting DBT-response than others. The results suggest that dissociation in borderline-patients should be closely monitored and targeted during DBT. At this stage, research on treatment of dissociation (e.g., specific skills training) is warranted.
ISSN:0885-579X
1943-2763
DOI:10.1521/pedi.2011.25.4.432