serval:BIB_76402F1DF247
Dialectical behavior therapy skills training affects defense mechanisms in borderline personality disorder: An integrative approach of mechanisms in psychotherapy.
10.1080/10503307.2018.1497214
000487612400011
30005584
Euler
S.
author
Stalujanis
E.
author
Allenbach
G.
author
Kolly
S.
author
de Roten
Y.
author
Despland
J.N.
author
Kramer
U.
author
article
2019-11
Psychotherapy research
1468-4381
1050-3307
journal
29
8
1074-1085
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 (β = 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.
borderline personality disorder
defense mechanisms
dialectical behavior therapy
model integration
psychotherapy research
eng
60_published
peer-reviewed
Publication types: Journal Article
Publication Status: ppublish
University of Lausanne
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