Treatment Predictors of Dialectical Behavior Therapy Among Adolescent Females in Residential Care

Abstract

Dialectical Behavior Therapy (DBT) is a comprehensive intervention for the treatment of borderline personality disorder (BPD), which is characterized by significant emotion dysregulation and associated parasuicidal behaviors. Findings from 21 randomized-controlled trials indicated that DBT is effective in the treatment of BPD symptoms. While effective, some individuals do not obtain symptoms reductions after completing DBT. The aim of the current study was to identify factors that predict treatment response among adolescent females (N = 107) receiving DBT in a residential setting. It was hypothesized that residents with elevated scores of emotion regulation difficulties, intolerance of uncertainty, experiential avoidance, social anxiety symptoms, and PTSD-related symptoms would show less improvement of BPD symptoms. On average, there were no significant predictors to response to DBT. The results showed that irrespective of pre-treatment clinical predictors, DBT was effective, on average, in reducing clinical outcome symptoms for approximately half of the sample: 55% of the residents showed reliable change (RC) from pre-treatment to post-treatment, 41% showed no RC, and 3% showed RC toward deterioration. Further, 22% of the residents in the current study showed clinically significant change, meaning that their post-treatment outcome scores would indicate symptom remission. None of the study predictors were able to predict whether a resident showed clinically significant change or no clinically significant change at post-treatment. Limitations and future directions were discussed.