Dialectical behaviour therapy (DBT) for forensic psychiatric patients: An Italian pilot study

Area of Science:

• Forensic Psychiatry
• Psychological Interventions
• Personality Disorders

Background:

• Dialectical Behaviour Therapy (DBT) has shown efficacy in various populations, but its impact on offender-patients remains understudied.
• Previous trials primarily focused on suicide-related behaviors, leaving a gap in understanding DBT's effects in forensic settings.

Purpose of the Study:

• To evaluate the effectiveness of DBT in a group of offender-patients within Italian high-security forensic psychiatric facilities (REMS).
• To assess DBT's impact on impulsivity, emotion regulation, and alexithymia in this specific patient population.

Main Methods:

• A randomized controlled trial involving 21 male forensic psychiatric inpatients diagnosed with borderline personality disorder.
• Participants were assigned to either 12 months of standard DBT plus usual care or usual care alone.
• Standardized assessments including the Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), and Toronto Alexithymia Scale (TAS-20) were administered pre- and post-treatment.

Main Results:

• Patients receiving DBT demonstrated a statistically significant reduction in motor impulsiveness (BIS-11) compared to the control group.
• DBT also led to significant improvements in emotional regulation, as indicated by lower DERS scores.
• No significant differences in alexithymia scores (TAS-20) were observed between the DBT and control groups.

Conclusions:

• The study provides preliminary evidence for the efficacy of DBT in ameliorating traits associated with violent and antisocial behaviors in Italian forensic psychiatric patients.
• Innovative forensic facilities in Italy require therapeutic approaches beyond pharmacology to achieve rehabilitation goals.
• A larger-scale randomized controlled trial is recommended to confirm these findings and establish DBT as a viable treatment in forensic settings.