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Dialectical behavior therapy skills training affects defense mechanisms in borderline personality disorder: An integrative approach of mechanisms in psychotherapy.
Euler, Sebastian; Stalujanis, Esther; Allenbach, Gilles; Kolly, Stéphane; de Roten, Yves; Despland, Jean-Nicolas; Kramer, Ueli.
Afiliación
  • Euler S; Psychiatric University Hospital (UPK), University of Basel , Basel , Switzerland.
  • Stalujanis E; Psychiatric University Hospital (UPK), University of Basel , Basel , Switzerland.
  • Allenbach G; Division of Clinical Psychology and Psychiatry, University of Basel , Basel , Switzerland.
  • Kolly S; Division of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University , Berlin , Germany.
  • de Roten Y; Psychiatric University Hospital (CHUV), University of Lausanne , Lausanne , Switzerland.
  • Despland JN; Psychiatric University Hospital (CHUV), University of Lausanne , Lausanne , Switzerland.
  • Kramer U; Psychiatric University Hospital (CHUV), University of Lausanne , Lausanne , Switzerland.
Psychother Res ; 29(8): 1074-1085, 2019 11.
Article en En | MEDLINE | ID: mdl-30005584
Objective: Borderline personality disorder (BPD) is characterized by immature defense mechanisms. Dialectical behavior therapy (DBT) is an effective treatment for BPD. However, understanding the underlying mechanisms of change is still limited. Using a transtheoretical framework, we investigated the effect of DBT skills training on defense mechanisms. Method: In this randomized controlled trial, 16 of 31 BPD outpatients received DBT skills training adjunctive to individual treatment as usual (TAU), while the remaining 15 received only individual TAU. Pre-post changes of defense mechanisms, assessed with the Defense Mechanism Rating Scale, were compared between treatment conditions using ANCOVAs. Partial correlations and linear regressions were conducted to explore associations between defenses and symptom outcome. Results: Overall defense function improved significantly more in the skills training condition (F(1, 28) = 4.57, p = .041). Borderline defenses decreased throughout skills training, but not throughout TAU only (F(1, 28) = 5.09, p = .032). In the skills training condition, an increase in narcissistic defenses was associated with higher symptom scores at discharge (ß = 0.58, p = .02). Conclusions: Although DBT does not explicitly target defense mechanisms, skills training may have favorable effects on defense function in BPD. Our findings contribute to an integrative understanding of mechanisms of change in BPD psychotherapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación de Procesos y Resultados en Atención de Salud / Trastorno de Personalidad Limítrofe / Mecanismos de Defensa / Terapia Conductual Dialéctica Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Psychother Res Asunto de la revista: PSICOLOGIA / PSIQUIATRIA Año: 2019 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación de Procesos y Resultados en Atención de Salud / Trastorno de Personalidad Limítrofe / Mecanismos de Defensa / Terapia Conductual Dialéctica Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Psychother Res Asunto de la revista: PSICOLOGIA / PSIQUIATRIA Año: 2019 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido