Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT)
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Objective: The objective was to quantitatively and qualitatively examine the efficacy of DBT (e.g., decreasing life-threatening suicidal and parasuicidal acts, attrition, and depression) explicitly with borderline personality disorder (BPD) and using conservative assumptions and criteria, across treatment providers and settings. Method: Five randomized controlled trials (RCTs) were identified in a systematic search that examined the efficacy of DBT in reducing suicide attempts, parasuicidal behavior, attrition during treatment, or symptoms of depression, in adult patients with BPD. Results: Combining effect measures for suicide and parasuicidal behavior (five studies total) revealed a net benefit in favor of DBT (pooled Hedges’ g −0.622). DBT was only marginally better than treatment as usual (TAU) in reducing attrition during treatment in five RCTs (pooled risk difference −0.168). DBT was not significantly different from TAU in reducing depression symptoms in three RCTs (pooled Hedges’ g −0.896). Discussion: DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.
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DBT was excluded from the current review because it has been mainly tested in RCTs for the treatment of borderline personality disorder.
“DBT was excluded from the current review as this approach has been mainly tested in RCTs for the treatment of borderline personality disorder (Panos et al. , 2014).”
From A meta-analysis of third wave mindfulness-based cognitive behavioral therapies for older people (2017) · cites this paper as Panos et al. , 2014
The Method (Study Selection) limits this review to DBT RCTs involving adults with borderline personality disorder, and the Results (Description of Included Studies) report five such trials. Because the search was restricted to BPD, the paper does not establish that DBT RCTs have mainly tested that condition rather than others. It also does not address the citing authors’ decision to exclude DBT from their review. (LLM, conf=0.83)
Experimental — accuracy not yet measuredDialectical behavior therapy (DBT) has been proved effective to treat ED in disorders other than autism spectrum disorder.
“Dialectical behavior therapy (DBT) has been proved effective to treat ED in disorders other than autism spectrum disorder.”
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 Panos et al., 2014
The Introduction and Discussion report that DBT targets emotional regulation and is effective for some outcomes in adults with borderline personality disorder, a disorder other than autism spectrum disorder. But the Introduction says the review dropped its behavioral-skills outcome because it was not consistently measured, and the Discussion says there is insufficient evidence that DBT successfully teaches those skills. It therefore does not establish that DBT is effective specifically for emotional dysregulation (ED). (LLM, conf=0.86)
Experimental — accuracy not yet measuredOverall, the significant improvement in self-reported ED is consistent with our clinical observations and with findings relative to DBT in several disorders.
“Overall, the significant improvement in self-reported ED is consistent with our clinical observations and with findings relative to DBT in several disorders (Panos et al., 2014; DeCou et al., 2019).”
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 Panos et al., 2014
The Results and Discussion report that DBT reduced suicidal and self-harming behavior in patients with borderline personality disorder. The Introduction identifies emotional regulation as a DBT target, but the paper does not establish improvement in self-reported emotional dysregulation; the Discussion says evidence is insufficient to conclude that DBT teaches skills needed for long-term improvement. This paper therefore supports a DBT finding in one disorder, not the broader implication that it found improvement in emotional dysregulation across several disorders (page numbers unavailable in our copy). (LLM, conf=0.86)
Experimental — accuracy not yet measuredDBT is highly effective in treating self-harm among those with borderline personality disorder.
“DBT is highly effective in treating presentations of self-harm among those with borderline personality disorder and is frequently delivered as group therapy [10].”
From Efficacy of acceptance and commitment therapy in reducing suicidal ideation and deliberate self-harm: Systematic review (2018) · cites this paper as [10]
The absence of an intervention effect for secondary outcomes appears to corroborate findings from prior meta-analytic studies that even face-to-face DBT does not significantly reduce depressive symptoms among adolescents (p=0.099) nor adults (p=0.08).
“The absence of an intervention effect for secondary mental health and well-being outcomes was unexpected yet appears to corroborate findings from prior meta-analytic studies that even face-to-face DBT does not significantly reduce depressive symptoms among adolescents (p = 0.099; [32]) nor adults (p = 0.08; [33]).”
From The effect of a therapeutic smartphone application on suicidal ideation in young adults: Findings from a randomized controlled trial in Australia. (2022) · cites this paper as [33]
These improvements are in line with previous studies that support effectiveness of DBT in reducing suicidal behaviors.
“These improvements are in line with previous studies that support the effectiveness of DBT in reducing suicidal behaviors (Panos et al., 2014; DeCou et al., 2019).”
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 Panos et al., 2014
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- Authors
- Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A.
- Affiliations
- University of Utah (US)
- Harvard University (US)
- Corresponding author
- Panos, Patrick T.
- Venue
- Research on Social Work Practice
- Publisher
- SAGE Publications
- Published
- 2013-09-19
- Volume
- 24
- Issue
- 2
- Pages
- 213-223
- ISSN
- 1049-7315 (ISSN-L)
- 1552-7581
- PMC
- PMC6405261
- OpenAlex
- W2043982193
- Cited by
- 299
- References
- 39
- Citations by year
- 2026: 26 · 2025: 32 · 2024: 33 · 2023: 35 · 2022: 27 · 2021: 44 · 2020: 22 · 2019: 21 · 2018: 15 · 2017: 14 · 2016: 16 · 2015: 8 · 2014: 6
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research on Social Work Practice (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (T32MH017119)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- dialectical behavior therapy, borderline personality disorder, suicide attempts, parasuicide, treatment discontinuation, depressive symptoms, treatment efficacy, self-destructive behavior
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