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Dialectical Behavior Therapy of borderline patients with and without substance use problems. Implementation and
Louisa M C van den Bosch1, Roel Verheul, Gerard M Schippers
1Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, Netherlands. wiesvdbosch@wxs.nl
Addictive Behaviors
|October 9, 2002
Summary
Dialectical Behavior Therapy (DBT) effectively treats borderline personality disorder symptoms in patients with or without substance abuse (SA). However, standard DBT did not reduce SA severity, suggesting a need for multitargeted therapeutic approaches.
Area of Science:
- Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Borderline personality disorder (BPD) frequently co-occurs with substance abuse (SA).
- Dialectical Behavior Therapy (DBT) is an established treatment for BPD, but its efficacy in comorbid populations requires further investigation.
Purpose of the Study:
- To assess the implementability and efficacy of standard DBT in a mixed BPD population with and without comorbid SA.
- To determine if DBT reduces BPD symptomatology and substance use problems in these patients.
Main Methods:
- A qualitative examination of DBT implementation.
- A randomized clinical trial comparing DBT with treatment-as-usual (TAU) in 58 female BPD patients (31 with SA, 27 without SA).
Main Results:
- Standard DBT was successfully implemented in mixed BPD and comorbid SA populations without major issues.
- DBT significantly reduced severe BPD symptoms compared to TAU, irrespective of SA comorbidity.
- Standard DBT did not demonstrate efficacy in reducing substance use problems.
Conclusions:
- Standard DBT is applicable and effective for BPD symptoms in patients with or without comorbid SA.
- Current standard DBT protocols are insufficient for addressing co-occurring substance use disorders.
- A 'multitargeted' DBT approach, addressing a broader spectrum of impulse control issues including SA, is proposed for dual-diagnosis patients.