Efficacy of Dialectical Behavioral Therapy for Emotion Dysregulation in Patients with dual diagnosis of Borderline Personality Disorder and Substance Use Disorder

Background: The published evidence supports dialectical behavioral therapy (DBT) efficacy to treat patients with borderline personality disorder and particular emphasis on emotion dysregulation as a psychopathological construct. Aim: To assess the efficacy of DBT for improving emotion dysregulation among patients with a dual diagnosis of borderline personality disorder and substance use disorder. Methods: We recruited 40 patients meeting DSM-5 criteria for borderline personality disorder and substance use disorder and assigned them to two groups of 20 participants each. One group underwent DBT therapy, and the other group followed a treatment-as-usual (TAU) protocol over one year. We used the difficulties in emotion regulation scale (DERS) scores at baseline, immediately after therapy, and four months after treatment to assess emotion dysregulation. Results: We found significant improvements (p<0.05) in the DBT group after therapy that was maintained at least for four months afterward based on the DERS scores (including subscale scores). More patients dropped out of the treatment in the TAU group than in the DBT group. Conclusion: DBT is a potentially effective psychological intervention to treat emotion dysregulation in patients with borderline personality disorder and substance use disorder.

How do patients with borderline personality disorder experience Distress Tolerance Skills in the context of dialectical behavioral therapy?—A qualitative study

Distress Tolerance Skills (DTS) are an important component of Dialectical Behavioral Therapy (DBT), a therapy method frequently used for treating patients with Borderline Personality Disorder (BPD). However, little is known about how DTS-training is experienced by individuals with BPD. The aim of this study was to explore BPD patients’ experiences with receiving DTS-training. Qualitative data were collected through semi-structured interviews with 24 individuals (87.5% females) with a primary diagnosis of BPD who received DTS-training in the context of 18 months of DBT treatment. Interview data were analyzed following the procedures of qualitative content analysis. Participants reported various effects of DTS including an immediate reduction of tension. Patients perceived DTS as a tool to cope with difficult interpersonal situations and emergencies and stated that this helped them to feel stable, safe and self-confident. Patients reported difficulties during the initial engagement, the learning process and the application of DTS as well as various facilitating factors. Implications of the findings for further research and for optimizing DTS-training in clinical practice are discussed.

Treating Bruised Badges

Policing may lead officers to physical, psychological, and emotional distress. Nonetheless, there is an additional, albeit less studied, threat to officers' well-being. Moral risks, an umbrella term encompassing two interrelated moral struggles—moral distress and moral injury—exacerbate officers' emotional difficulties, spiritual distress, and job dissatisfaction, as well as increase the likelihood of officer misconduct. However, there are psychological interventions that help to minimize the intensity of the psychological and behavioral problems associated with these moral risks and facilitate officers' recovery from these difficulties. This chapter examines the utilization of cognitive behavioral therapy, dialectical behavioral therapy, and other techniques to treat the moral suffering of law enforcement personnel. It provides practical suggestions for using the strategies of these modalities to increase police officers' well-being.