Radically Open-Dialectical Behavior Therapy for Disorders of Over-Control: Signaling Matters.
Abstract
Radically Open-Dialectical Behavior Therapy (RO-DBT) is a transdiagnostic treatment designed to address a spectrum of difficult-to-treat disorders sharing similar phenotypic and genotypic features associated with maladaptive over-control-such as anorexia nervosa, chronic depression, and obsessive compulsive personality disorder. Over-control has been linked to social isolation, aloof and distant relationships, cognitive rigidity, high detailedfocused processing, risk aversion, strong needs for structure, inhibited emotional expression, and hyper-perfectionism. While resting on the dialectical underpinnings of standard DBT, the therapeutic strategies, core skills, and theoretical perspectives in RO-DBT often substantially differ. For example, RO-DBT contends that emotional loneliness secondary to low openness and social-signaling deficits represents the core problem of over-control, not emotion dysregulation. RO-DBT also significantly differs from other treatment approaches, most notably by linking the communicative functions of emotional expression to the formation of close social bonds and via skills targeting social-signaling and changing neurophysiological arousal. The aim of this paper is to provide a brief overview of the core theoretical principles and unique treatment strategies underlying RO-DBT.
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Adults with resistant depressive disorders may display traits of overcontrol, such as heightened self-criticism, diminished autonomy, rigid internalized expectations, heightened control over spontaneous emotions, and a fear of making mistakes.
“Adults with resistant depressive disorders may display traits of overcontrol, such as heightened self-criticism, diminished autonomy, rigid internalized expectations, heightened control over spontaneous emotions, and a fear of making mistakes [28–30].”
From Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis (2024) · cites this paper as [28]
Radically Open Dialectical Behavioral Therapy has some evidence for use in Treatment Resistant Depression.
“Therefore, RODBT has some evidence for use in Treatment Resistant Depression [28,32].”
From Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis (2024) · cites this paper as [28]
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- Authors
- Lynch, T. R., Hempel, R. J., & Dunkley, C.
- Affiliations
- University of Southampton (GB)
- Southern Health NHS Foundation Trust (GB)
- Venue
- American Journal of Psychotherapy
- Published
- 2015-04
- Volume
- 69
- Issue
- 2
- Pages
- 141-162
- ISSN
- 0002-9564 (ISSN-L)
- 2575-6559
- OpenAlex
- W2174738676
- Cited by
- 103
- References
- 27
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 10 · 2023: 11 · 2022: 12 · 2021: 13 · 2020: 8 · 2019: 4 · 2018: 9 · 2017: 3 · 2016: 7 · 2015: 2
- FWCI
- 8.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Department of Biotechnology, Ministry of Science and Technology, India
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- overcontrol, social signaling, emotional loneliness, social isolation, anorexia nervosa, chronic depression, obsessive-compulsive personality disorder, emotional expression, social bonding, transdiagnostic treatment
- MeSH terms
- Anorexia Nervosa, Compulsive Personality Disorder, Depression, Humans, Interpersonal Relations, Social Adjustment, Social Isolation, Cognitive Behavioral Therapy, Expressed Emotion, Behavior Control
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