The proposed research is designed to continue the clinical evaluation of the efficacy of Dialectical Behavior Therapy (DBT) with chronically parasuicidal women with borderline personality disorder (BPD). Previous research has indicated the effectiveness of standard DBT, which consists of concurrent individual psychotherapy and group behavioral skills training. What remains unclear is whether these results can be replicated under more tightly controlled conditions (e.g., guaranteeing that all subjects in the control group receive at least some psychotherapy). The proposed treatment study addresses this question and aims to 1) replicate the initial study comparing standard DBT to the control condition of community treatment-as-usual (TAU); 2) evaluate whether gains in DBT are due characteristics of DBT rather than a) general factors associated with receiving any psychotherapy, b) availability of affordable treatment, c) number of hours o individual psychotherapy offered or received, d) total hours of outpatient therapy received or d) years of therapist clinical experience and 3) analyze the association of specific therapy characteristics to treatment outcome. In the proposed study, 100 females with a history of repeated parasuicides and a diagnosis of BPD will be randomly assigned to one of two conditions: Standard DBT or TAU. Outcome measures will focus on suicidal behaviors, therapy-interfering behaviors (e.g. treatment compliance), psychiatric hospitalization, affect, social functioning and global functioning. Subjects will be assessed at pre-treatment, at 4-month intervals during the treatment year and at 4-month intervals for one year following treatment, for a total of seven assessments. Additional daily patient ratings and weekly patient and therapist ratings for subjects in the DBT condition will be obtained.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH034486-14
Application #
2415869
Study Section
Treatment Assessment Review Committee (TA)
Project Start
1987-01-01
Project End
1999-04-30
Budget Start
1997-09-01
Budget End
1998-04-30
Support Year
14
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of Washington
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Harned, Melanie S; Lungu, Anita; Wilks, Chelsey R et al. (2017) Evaluating a Multimedia Tool for Suicide Risk Assessment and Management: The Linehan Suicide Safety Net. J Clin Psychol 73:308-318
Wilks, Chelsey R; Korslund, Kathryn E; Harned, Melanie S et al. (2016) Dialectical behavior therapy and domains of functioning over two years. Behav Res Ther 77:162-9
Linehan, Marsha M; Korslund, Kathryn E; Harned, Melanie S et al. (2015) Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry 72:475-82
Bedics, Jamie D; Atkins, David C; Harned, Melanie S et al. (2015) The therapeutic alliance as a predictor of outcome in dialectical behavior therapy versus nonbehavioral psychotherapy by experts for borderline personality disorder. Psychotherapy (Chic) 52:67-77
Neacsiu, Andrada D; Lungu, Anita; Harned, Melanie S et al. (2014) Impact of dialectical behavior therapy versus community treatment by experts on emotional experience, expression, and acceptance in borderline personality disorder. Behav Res Ther 53:47-54
Bedics, Jamie D; Atkins, David C; Comtois, Katherine A et al. (2012) Treatment differences in the therapeutic relationship and introject during a 2-year randomized controlled trial of dialectical behavior therapy versus nonbehavioral psychotherapy experts for borderline personality disorder. J Consult Clin Psychol 80:66-77
Harned, Melanie S; Pantalone, David W; Ward-Ciesielski, Erin F et al. (2011) The prevalence and correlates of sexual risk behaviors and sexually transmitted infections in outpatients with borderline personality disorder. J Nerv Ment Dis 199:832-8
Harned, Melanie S; Rizvi, Shireen L; Linehan, Marsha M (2010) Impact of co-occurring posttraumatic stress disorder on suicidal women with borderline personality disorder. Am J Psychiatry 167:1210-7
Harned, Melanie S; Jackson, Safia C; Comtois, Katherine A et al. (2010) Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder. J Trauma Stress 23:421-9
Neacsiu, Andrada D; Rizvi, Shireen L; Linehan, Marsha M (2010) Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behav Res Ther 48:832-9

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