This research to and evaluate Dialectical Behavior (DBT), a proposal continues our develop Therapy one-year outpatient treatment for suicidal individuals meeting criteria for Borderline Personality Disorder (BPD). DBT was developed from a combined behavioral management/capability deficit model of BPD. The idea was two-fo d: 1) borderline individuals lack important interpersonal, self-regulation (including emotional regulation) and distress tolerance skills, which are provided via DBT group skills training, and 2) personal and environmental factors inhibit or interfere with the use of behavioral skills the individual does have and often reinforce inappropriate borderline behaviors which are addressed in DBT individual therapy. All empirical studies of DBT with severely dysfunctional BPD patients to date have provided both skills training and individual therapy. In practice, however, DBT skills training is frequently offered with standard case management instead of individual DBT (usually in resource-poor mental health clinics). Other providers offer DBT individual therapy without any skills training (usually in solo private practice where group therapy is not offered). DBT skills training is viewed as a sufficient DBT component in one setting and as expendable in the other. The overarching aim of this proposed study is to begin the process of dismantling DBT by examining the importance of DBT skills training in reducing suicidal behavior and use of crisis services, and improving quality of life in BPD patients. The secondary aim is to evaluate knowledge, use, and perceive benefits of DBT skills and their relation to outcome. The research proposed here is a three arm, randomized component analysis design comparing standard full-program DBT (SDBT), standard DBT Individual therapy without the skills training component (DBT-I), and standard DBT Skills training without the DBT individual therapy (DBT-S). Ninety-nine women meeting criteria for both current chronic suicidal behavior and borderline personality disorder will be enrolled in one year of treatment and one year of follow-up assessments. As in our previous studies, clinical assessments will occur at four-month intervals over the two years.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH034486-21
Application #
6800491
Study Section
Interventions Research Review Committee (ITV)
Program Officer
Kozak, Michael J
Project Start
1987-01-01
Project End
2008-06-30
Budget Start
2004-07-01
Budget End
2005-06-30
Support Year
21
Fiscal Year
2004
Total Cost
$780,542
Indirect Cost
Name
University of Washington
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
605799469
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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