The Effectiveness of 6 versus 12 Months of Dialectical Behavior Therapy for Borderline Personality Disorder: A Noninferiority Randomized Clinical Trial

Introduction: Evidence-based psychotherapies for borderline personality disorder (BPD) are lengthy, posing a barrier to their access. Brief psychotherapy may achieve comparable outcomes to long-term psychotherapy for BPD. Evidence is needed regarding the comparative effectiveness of short- versus long-term psychotherapy for BPD. Objective: The aim was to determine if 6 months of Dialectical Behavior Therapy (DBT) is noninferior to 12 months of DBT in terms of clinical effectiveness. Methods: This two-arm, single-blinded, randomized controlled noninferiority trial with suicidal or self-harming patients with BPD was conducted at two sites in Canada. Participants (N = 240, M (SD) age = 28.27 (8.62), 79% females) were randomized to receive either 6 (DBT-6) or 12 months (DBT-12) of comprehensive DBT. Masked assessors obtained measures of clinical effectiveness at baseline and every 3 months, ending at month 24. DBT-6 and DBT-12 were outpatient treatments consisting of weekly individual therapy sessions, weekly DBT skills training group sessions, telephone consultation as needed, and weekly therapist consultation team meetings. Results: The noninferiority hypothesis was supported for the primary outcome, total self-harm (6 months: margin = −1.94, Mdiff [95% CI] = 0.16 [−0.14, 0.46]; 12 months: margin = −1.47, Mdiff [95% CI] = 0.04 [−0.17, 0.23]; 24 months: margin = −1.25, Mdiff [95% CI] = 0.12 [−0.02, 0.36]). Results also supported noninferiority of DBT-6 for general psychopathology and coping skills at 24 months. Furthermore, DBT-6 participants showed more rapid reductions in BPD symptoms and general psychopathology. There were no between-group differences in dropout rates. Conclusions: The noninferiority of a briefer yet comprehensive treatment for BPD has potential to reduce barriers to treatment access.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
The Effectiveness of 6 versus 12 Months of Dialectical Behavior Therapy for Borderline Personality Disorder: A Noninferiority Randomized Clinical Trial ; volume:91 ; number:6 ; year:2022 ; pages:382-397 ; extent:16
Psychotherapy and psychosomatics ; 91, Heft 6 (2022), 382-397 (gesamt 16)

Urheber
McMain, Shelley F.
Chapman, Alexander L.
Kuo, Janice R.
Dixon-Gordon, Katherine L.
Guimond, Timothy Henry
Labrish, Cathy
Isaranuwatchai, Wanrudee
Streiner, David L.

DOI
10.1159/000525102
URN
urn:nbn:de:101:1-2022112323131436094740
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:23 MESZ

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Beteiligte

  • McMain, Shelley F.
  • Chapman, Alexander L.
  • Kuo, Janice R.
  • Dixon-Gordon, Katherine L.
  • Guimond, Timothy Henry
  • Labrish, Cathy
  • Isaranuwatchai, Wanrudee
  • Streiner, David L.

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