Dialectical Behavioral Therapy

This study was used to prove whether Dialectical Behavior Therapy would increase active coping skills, reduce passive coping skills and decrease self injury in people with Borderline Personality Disorder. Active coping is defined as any effort to fix the cause of distress, such as changing negative thought processes. Passive coping is the use of maladaptive skills to temporarily relieve pain and ignore the root of the problem. In this study, there were 19 participants that consisted of 16 women and 3 men. The study was conducted in a Dutch psychiatric outpatient institution. Each participant fit the criteria for BPD and were referred to DBT by a psychologist or psychiatrist. They underwent three weeks of pre-treatment with a personal therapist,
The participants rated on a scale of 0-10 how often they committed each behavior. After the interview, they were given a self injury score based on how they answered. Following the assessment, the participants completed one year of DBT therapy with trained professionals. This included weekly individual therapy sessions, in which they executed recovery goals, and group therapy session where they were taught how to actively cope. Every six months, they learned four modules: mindfulness skills, interpersonal effectiveness skills, emotion regulation skills and coping with a crisis. These modules were repeated during the second half of the year as well. The researchers studied this because they wanted to figure out if active coping decreased self injury and if passive coping increased self injury. Their hypothesis was that 1) people with BPD used passive coping more than active coping, 2) that the use of passive coping increases self injury while the use of active coping decreases self injury and 3) through DBT, people with BPD will use more active coping than passive
According to the UCL, the participants had a mean of 7.66 for passive coping, versus a mean of 5.92 for active coping. They rated their use of passive coping as “sometimes” and “often” whereas they rated their use of active coping as “hardly/never” and “sometimes.” They found a minor positive correlation between self injury and passive coping, and a negative correlation between self injury and active coping, which supports their second hypothesis. Their third hypothesis was supported by the fact that 36% of the participants increased their use of active coping after half a year and 27% showed a decrease in the amount of passive coping they used. 86% of the subjects showed a drastic decrease in at least one self injury behavior after half a year of DBT. 29% actually showed an increase in self injury behaviors, and one patient increased their use of avoidance, which is a passive coping skill. The researchers found the changes in coping and self injury after the second half of the year to be similar to the first half, only less statistically significant. Many of these findings were concluded insignificant because 42% (8/19) of the participants dropped out before the first half year of treatment was finished and only 5 of the 11 remaining people completed the post-treatment assessment. In addition to this, there were too many zero scores on the BPDSI to accurately calculate the