Emotion Predicts Treatment Outcome in Dialectical Behaviour Therapy for Borderline Personality Disorder: An Observational Study of Client Process
Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: Objective: The present study examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behaviour therapy (DBT) for borderline personality disorder (BPD). Method: Participants were 52 adults (75% female; mean age 27.7) who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States (Pascual-Leone & Greenberg, 2005), an observer-rated measure of experienced emotion, was used to code video recordings of individual DBT sessions for participants’ emotion. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome. Results: More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% of variance explained) at termination. Early increases in emotional flexibility predicted fewer depressive symptoms at termination (14% of variance explained). Self-compassion coded during the working phase also predicted better treatment outcome (explaining 19% to 34% of variance). Conclusions: Clients’ in-session emotional experiences predict treatment outcome 8 to 10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in non-specific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis.
Author: Nardone, Stephanie
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7037745295