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Summary of research on DBT
 
DBT's effectiveness continues to be highlighted as more and more results of studies become available.  Here you will find a brief summary of the outcomes of numerous studies.  Click links to see the abstract or full article for each study.  *This summary provided as a quick reference and does not take the place of further investigation of methodology, results, and limitations of each study.
 
Research on Effectiveness of DBT in Treating BPD
 
Linehan et al (2006) NIMH 3 Two-Year Randomized Control Trial and Follow up of DBT

• Subjects receiving DBT were half as likely to make a suicide attempt
• Required less hospitalization for suicide ideation
• Had lower medical risk across all suicide attempts and self-injurious acts combined.
  
• Were less likely to drop out of treatment
• Had fewer psychiatric hospitalizations and emergency department visits
  

Koons, C.R., Robins, C.J., Tweed, J.L., Lynch, T.R., Gonzalez, A.M., Morse, J.Q., Bishop, G.K., Butterfield, M.I., Bastian, L.A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32(2), 371-390.

• DBT group reported significantly greater decreases in suicidal ideation, hopelessness, depression, and anger expression.
• Demonstrated significant decreases in number of parasuicidal acts, anger experienced but not expressed, and dissociation, and a strong trend on number of hospitalizations
  

Linehan,M.M., Heard,H.L., Armstrong,H.E. (1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry, 50, 971-974.

• Throughout the follow-up, DBT subjects had significantly higher global functioning.
• During the initial 6 mo, DBT subjects had significantly less parasuicidal behavior, less anger, and better self-rated social adjustment.
• During the final 6 mo, DBT subjects had fewer inpatient days and better interviewer-rated social adjustment.

Rathus, J.H., Miller, A.L. (2002). Dialectical Behavior Therapy adapted for suicidal adolescents. Suicide and Life-Threatening Behavior, 32(2), 146-157.

• Within the DBT group, there were significant reductions in suicidal ideation, general psychiatric symptoms, and symptoms of borderline personality.
  

Bohus, M., Haaf, B., Stiglmayr, C., Pohl, U., Boehme, R., Linehan, M. (2000). Evaluation of inpatient Dialectical-Behavioral Therapy for Borderline Personality Disorder--A prospective study. Behaviour Research and Therapy, 38(9): 875-887.

• The results indicate significant improvements in ratings of depression, dissociation, anxiety and global stress between assessments.
  
• Significant decrease in the number of parasuicidal acts is also reported.

Linehan,M.M., Armstrong,H.E., Suarez,A., Allmon,D., Heard,H.L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060-1064.

• There was a significant reduction in the frequency and medical risk of parasuicidal behavior DBT effectively retained patients in therapy.
  
• The number of days of inpatient psychiatric hospitalization was fewer for Ss who received DBT than for controls.

Linehan,M.M., Tutek,D.A., Heard,H.L., Armstrong,H.E. (1994). Interpersonal outcome of cognitive behavioral treatment for chronically suicidal borderline patients. American Journal of Psychiatry, 151, 1771-1776.

• DBT had significantly better scores on measures of anger, interviewer-rated global social adjustment, and the Global Assessment Scale and tended to rate themselves better on overall social adjustment.
  

Verheul, R., van den Bosch, L.M.C., Koeter, M.W.J., de Ridder, M.A.J., Stijnen, T., van den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in the Netherlands. British Journal of Psychiatry, 182, 135-140.

• DBT resulted in better retention rates and greater reductions of self-mutilating and self-damaging impulsive behaviors
  

Neacsiu AD, Rizvi SL, Linehan MM. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behav Res Ther. Sep;48(9):832-9. Epub 2010 May 23.  University of Washington, Behavioral Research and TherapyClinics, Department of Clinical Psychology, Seattle, 98195-1525, USA. andrada@u.washington.edu

• First study to clearly support the skills deficit model for BPD by indicating that increasing skills use is a mechanism of change for suicidal behavior, depression, and anger control
   

McMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL. (2009) A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder.  Am J Psychiatry. Dec;166(12):1365-74. Epub 2009 Sep 15. Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada. shelley_mcmain@camh.net

• Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment

Harned MS, Jackson SC, Comtois KA, Linehan MM. (2010). Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder. J Trauma Stress. Jul 20; [Epub ahead of print] University of Washington.

• By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment
  
• BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT.

Carter GL, Willcox CH, Lewin TJ, Conrad AM, Bendit N. (2010). Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Aust N Z J Psychiatry. Feb;44(2):162-73.  Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia. gregory.carter@newcastle.edu.au

• Disability (days spent in bed) and quality of life (Physical, Psychological and Environmental domains) were significantly improved for the DBT group.

Rajalin M, Wickholm-Pethrus L, Hursti T, Jokinen J. (2009). Dialectical behavior therapy-based skills training for family members of suicide attempters. Arch Suicide Res.;13(3):257-63. Sodermalm Psychiatric Outpatient Services, Stockholm County Council and Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden. mia.rajalin@sll.se

• The results showed significant reduction in burden, improved psychic health and an increase in well-being regarding the relation with the patient.
  
• These results provide support for the need and importance of a DBT-based skills training program addressed specifically to family members of suicide attempters.

DBT and Substance Abuse
 
Van den Bosch, L.M.C., Verheul, R., Schippers, G.M., van den Brink, W. (2002). Dialectical Behavior Therapy of borderline patients with and without substance use problems: Implementation and long-term effects. Addictive Behaviors, 27(6), 911-923.

• Results show that standard DBT can be applied in a group of borderline patients with and without comorbid substance abuse.
  

Linehan,M.M., Schmidt,H., Dimeff,L.A., Craft,J.C., Kanter,J., Comtois,K.A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addiction, 8(4), 279-292.

• Results show a drop-out rate of 36% from DBT compared with a rate of 73% from treatment as usual.
  
• Urinalysis showed a significant reduction in substance abuse among the DBT Ss
  significant improvements in social and global adjustment in DBT Ss at 16-mo follow-up.
  

Linehan, M.M., Dimeff, L.A., Reynolds, S.K., Comtois, K.A., Welch, S.S., Heagerty, P., Kivlahan, D.R. (2002). Dialectical behavior therapy versus comprehensive validation plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67(1), 13-26.

• DBT maintained reductions in mean opiate use through 12 mo of active treatment
  

DBT and Eating Disorders
 
Telch, C.F., Agras, W.S., Linehan, M.M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69(6), 1061-1065.

• Treated women evidenced significant improvement on measures of binge eating and eating pathology compared with controls, and 89% of the women receiving DBT had stopped binge eating by the end of treatment
  

Safer, D.L., Telch, C.F., Agras, W.S. (2001). Dialectical behavior therapy for bulimia nervosa. American Journal of Psychiatry, 158(4), 632-634.

• Analysis showed highly significant decreases in binge/purge behavior with dialectical behavior therapy compared to the waiting-list condition.
  

DBT and Treatment Resistant Depression
 
Lynch, T.R., Morse, J.Q., Mendelson, T., Robins, C.J. (2003). Dialectical behavior therapy for depressed older adults: A randomized pilot study. American Journal of Geriatric Psychiatry, 11(1), 33-45.

• Only MED+DBT showed significant decreases on mean self-rated depression scores
  At a 6 mo followup, 75% of MED+DBT patients were in remission, compared with only 31% of MED patients
  
• Results suggest that DBT skills training and telephone coaching offer promise to effectively augment the effects of antidepressant medication in depressed older adults.

Feldman G, Harley R, Kerrigan M, Jacobo M, Fava M. Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder. Behav Res Ther. 2009 Apr;47(4):316-21. Epub 2009 Jan 17.

• Results offer preliminary support for the idea that participating DBT-based skills training may help individuals with treatment-resistant MDD to develop skills that facilitate processing emotions in a way that helps to reduce rather than exacerbate depression symptoms.