The effect of dialectical behavior therapy on anger and aggressive behavior: A systematic review with meta-analysis

Dysregulated anger, and its common behavioral urge, aggression, pose substantial costs to public health and society. Though some studies have shown DBT to be efficacious in treating aggression and anger dyscontrol, the overall effects of DBT on these outcomes are unknown. To address this limitation, a systematic review with meta-analysis was conducted on 34 studies (N = 2536) published in PsycINFO and PubMed between January 1994 and February 2022 assessing the effect of DBT on anger and/or aggression. Included studies were empirical research articles published in a peer-reviewed journal and assessed the delivery of DBT on quantitative outcome measures of anger or aggression. Included studies delivered the standard outpatient DBT program or DBT adapted for the population and treatment setting, though all studies included the core components of DBT. Risk of publication bias was assessed. Results demonstrated that DBT significantly reduced anger (Hedge's G = -0.21, 95% CI [-0.32, -0.11]) independent of study design and participant variables, though longer treatment duration was associated with greater reductions in anger. There was also a non-significant trend for DBT in reducing aggression (Hedge's G = -0.10, 95% CI [-0.21, 0.00]). Findings from this study suggest that DBT demonstrates efficacy in reducing dysregulated anger transdiagnostically.