The DOI matches its Crossref record; 106 of the 110 references it cites were found in a registry or an index.
Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations
Abstract
Dialectical behavior therapy (DBT) can be considered a well-established treatment for borderline personality disorder (BPD) as evidenced by seven well-controlled randomized clinical trials across four independent research teams. The primary purpose of this article is to address a variety of potential mechanisms of change that may be associated with those aspects of DBT that are unique to the treatment and its theoretical underpinnings. Based on the biosocial theory of BPD, many of these mechanisms can be distilled down to the following process: the reduction of ineffective action tendencies linked with dysregulated emotions. Specifically we address the following interventions and associated mechanisms of change: mindfulness, validation, targeting and chain analysis, and dialectics. Patient change in BPD is conceptualized primarily as helping the patient to engage in functional, life-enhancing behavior, even when intense emotions are present. Ultimately, our goal was to provide guidance for theoretically and empirically grounded research on the mechanisms of change in DBT.
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“A hypothesized mechanism through which decreased negative reactivity may lead to improvements in psychological functioning is decreased emotional avoidance.”
From The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders (2012) · cites this paper as Lynch, Chapman, Rosenthal, Kuo & Linehan, 2006
In the citing paper
“These skills facilitate an improvement in conscious control over attentional processes, emotional and rational thinking integration, and a sense of unity with themselves (Linehan, 1993; Lynch et al., 2006).”
From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006
In the citing paper
“Mindfulness skills could address these factors by changing emotion-linked automatic responses and fear, allowing individuals to acquire new responses (Lynch et al., 2006), and, thus, disrupting avoidance and safety behaviors.”
From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006
In the citing paper
“Extant research highlights increases in mindfulness lead to increased executive and attentional control and as mindfulness skills improve so does the ability to control and direct attention (Lynch et al., 2006).”
From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006
In the citing paper
“Lynch and colleagues (Lynch et al., 2006) found DBT may increase perceived control, reduce self-focused attention and improve control over attentional processes, fostering a sense of ownership and behavioral acceptance in individuals with SAD.”
From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006
In the citing paper
“among other interventions that have proven effective in reducing symptoms of anxiety and/or depression, with particular focus on individuals with a diagnosis of borderline personality disorder [39].”
From Apps with maps-anxiety and depression mobile apps with evidence-based frameworks: Systematic search of major app stores (2020) · cites this paper as [39]
In the citing paper
“This is consistent with several findings suggesting that emotion regulation skills use is a key change mechanism of DBT (Lynch et al., 2006; Neacsiu et al., 2010; Mehlum, 2021).”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Lynch et al., 2006
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4 of the 110 references couldn’t be matched to a known paper.
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Metadata
- Authors
- Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. M.
- Affiliations
- Duke University (US)
- University of Washington (US)
- Duke Medical Center (US)
- Corresponding author
- Lynch, Thomas R.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2006-02-09
- Volume
- 62
- Issue
- 4
- Pages
- 459-480
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2136654837
- Cited by
- 628
- References
- 110
- Citations by year
- 2026: 19 · 2025: 29 · 2024: 31 · 2023: 34 · 2022: 30 · 2021: 64 · 2020: 39 · 2019: 27 · 2018: 23 · 2017: 32 · 2016: 42 · 2015: 33 · 2014: 33 · 2013: 30 · 2012: 23
- FWCI
- 29.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- National Institute of Mental Health (MH-34486, R01MH034486, K23 MH01614-01A3, K23MH001614)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- dialectical behavior therapy, mechanisms of change, borderline personality disorder, biosocial theory, mindfulness, validation, targeting, chain analysis, dialectics, emotional dysregulation, functional behavior
- MeSH terms
- Affect, Behavior Therapy, Borderline Personality Disorder, Cognition, Defense Mechanisms, Humans, Psychological Theory, Empirical Research
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