Benchmarks for dialectical behavioural therapy intervention in adults and adolescents with borderline personality symptoms

IF 5.3 1区 心理学 Q1 PSYCHOLOGY, CLINICAL International Journal of Clinical and Health Psychology Pub Date : 2024-02-06 DOI:10.1016/j.ijchp.2024.100446
Julieta Azevedo , Diogo Carreiras , Caitlin Hibbs , Raquel Guiomar , Joshua Osborne , Richard Hibbs , Michaela Swales
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Abstract

Background

Dialectical Behaviour Therapy (DBT) is a multi-component cognitive behavioural intervention with proven efficacy in treating people with borderline personality disorder symptoms. Establishing benchmarks for DBT intervention with both adults and adolescents is essential for bridging the gap between research and clinical practice, improving teams' performance and procedures.

Aim

This study aimed to establish benchmarks for DBT using the EQ-5D, Borderline Symptoms List (BSL) and Difficulties in Emotion Regulation Scale (DERS) for adults and adolescents.

Methods

After searching four databases for randomised controlled trials and effectiveness studies that applied standard DBT to people with borderline symptoms, a total of 589 studies were included (after duplicates' removal), of which 16 met our inclusion criteria. A meta-analysis and respective effect-size pooling calculations (Hedges-g) were undertaken, and heterogeneity between studies was assessed with I2 and Q tests. Benchmarks were calculated using pre–post treatment means of the studies through aggregation of adjusted effect sizes and critical values.

Results

DBT aggregated effect sizes per subsample derived from RCTs and effectiveness studies are presented, along with critical values, categorised by age group (adults vs adolescents), mode of DBT treatment (full-programme vs skills-training) and per outcome measure (EQ-5D, BSL and DERS).

Conclusions

Practitioners from routine clinical practice delivering DBT and researchers can now use these benchmarks to evaluate their teams' performance according to their clients' outcomes, using the EQ-5D, BSL and DERS. Through benchmarking, teams can reflect on their teams' efficiency and determine if their delivery needs adjustment or if it is up to the standards of current empirical studies.

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对有边缘型人格症状的成人和青少年进行辩证行为疗法干预的基准
背景辩证行为疗法(DBT)是一种多成分认知行为干预方法,在治疗边缘型人格障碍症状患者方面疗效显著。本研究旨在使用 EQ-5D、边缘型症状列表 (Borderline Symptoms List, BSL) 和情绪调节困难量表 (Difficulties in Emotion Regulation Scale, DERS) 为成人和青少年的 DBT 干预建立基准。方法在检索了四个数据库中对边缘症患者采用标准 DBT 的随机对照试验和有效性研究后,共纳入了 589 项研究(去除重复研究后),其中 16 项符合我们的纳入标准。我们进行了荟萃分析和相应的效应大小汇集计算(Hedges-g),并通过 I2 和 Q 检验评估了研究之间的异质性。结果按照年龄组(成人 vs 青少年)、DBT 治疗模式(全方案 vs 技能培训)和结果测量(EQ-5D、BSL 和 DERS)分类,列出了从 RCT 和有效性研究中得出的每个子样本的 DBT 合计效应大小以及临界值。结论提供 DBT 的常规临床实践人员和研究人员现在可以使用这些基准,根据客户的结果,使用 EQ-5D、BSL 和 DERS 评估其团队的表现。通过基准评估,团队可以反思其团队的效率,并确定其实施是否需要调整,或者是否达到了当前实证研究的标准。
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来源期刊
CiteScore
10.70
自引率
5.70%
发文量
38
审稿时长
33 days
期刊介绍: The International Journal of Clinical and Health Psychology is dedicated to publishing manuscripts with a strong emphasis on both basic and applied research, encompassing experimental, clinical, and theoretical contributions that advance the fields of Clinical and Health Psychology. With a focus on four core domains—clinical psychology and psychotherapy, psychopathology, health psychology, and clinical neurosciences—the IJCHP seeks to provide a comprehensive platform for scholarly discourse and innovation. The journal accepts Original Articles (empirical studies) and Review Articles. Manuscripts submitted to IJCHP should be original and not previously published or under consideration elsewhere. All signing authors must unanimously agree on the submitted version of the manuscript. By submitting their work, authors agree to transfer their copyrights to the Journal for the duration of the editorial process.
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