Differential Change of Borderline Personality Disorder Traits During Dialectical Behavior Therapy for Adolescents
Abstract
Despite the expansion of treatment options for adults with borderline personality disorder (BPD), research on treatment options for adolescent BPD is scarce. The aim of this study was to investigate the impact of dialectical behavior therapy for adolescents (DBT-A) on the individual trait level as primary outcome; and the frequency of suicide attempts and nonsuicidal self-injury, self-reported BPD core pathology, and general psychopathology as secondary outcomes. Seventy-two adolescents (aged 12–17 years) with full- or subsyndromal BPD were treated with DBT-A (25 single sessions, 20 sessions of skills training), and 13 patients (18.1%) withdrew during treatment. From baseline to post-treatment, the number of BPD traits decreased significantly (p ≤ .001). All secondary outcomes decreased significantly as well (p ≤ .001). Results of this uncontrolled study suggest that beside self-harm, DBT-A may also have a beneficial impact on other features of BPD.
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Buerger and colleagues had similar inclusion criteria and treatment duration and found a large reduction in self-harm episodes from baseline to post-treatment.
“Buerger and colleagues had similar inclusion criteria and treatment duration and found a large reduction in self-harm episodes from baseline to post-treatment [40].”
From Evaluation of dialectical behavior therapy for adolescents in routine clinical practice: a pre-post study (2024) · cites this paper as [40]
The results from the current study align with findings from a similar pre-post study in an outpatient setting in Germany.
“The results from the current study align with findings from a similar pre-post study in an outpatient setting in Germany [40].”
From Evaluation of dialectical behavior therapy for adolescents in routine clinical practice: a pre-post study (2024) · cites this paper as [40]
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“There are treatment options which are useful in the treatment of NSSI, like dialectical behavior therapy for adolescents [DBTA (29, 30)] and mentalization-based treatment for adolescents [MBT-A (31)].”
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“…therapy (brief CBT; Kaess et al., 2020; Rockstroh et al., 2023), which was followed by Dialectical Behavioral Therapy for Adolescents (DBT-A; Buerger et al., 2019) for those with persistent symptoms, along with psychiatric management and specialist crisis involvement (e.g. outpatient crisis…”
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“The potential effectiveness of DBT-A in reducing a variety of BPD symptoms was also previously confirmed by an uncontrolled treat-ment study that revealed a reduction of all nine BPD criteria during outpatient DBT-A (Buerger et al., 2019).”
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BackgroundResultInfluentialDialektisch-Behaviorale Therapie für Adoleszente
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Koenig, J., Steiner, S., Reichl, C., Cavelti, M., Zimmermann, R., Schmeck, K., & Kaess, M. (2024) · Psychotherapy Research · doi:10.1080/10503307.2024.2385396
“…that affective and interpersonal instability—measured retrospectively via clinical interviews—can be successfully reduced following DBT-A: Buerger and colleagues (Buerger et al., 2019) showed that all nine BPD criteria (i.e., including affective instability) decreased significantly following DBT-A.”
InfluentialSelf-citationPersönlichkeitsstörungen bei Kindern und Jugendlichen
Schmeck, K., & Kaess, M. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-66744-6_117
Self-citationNicht-suizidales selbstverletzendes Verhalten bei Kindern und Jugendlichen
Kaess, M., Resch, F., & Rockstroh, F. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-66744-6_110
Self-citationCavelti, M., Blaha, Y., Lerch, S., Hertel, C., Berger, T., Reichl, C., Koenig, J., & Kaess, M. (2024) · Figshare · doi:10.6084/m9.figshare.26735361
Self-citationSyversen, A. M., Schønning, V., Fjellheim, G., Elgen, I. B., & Wergeland, G. J. (2024) · Figshare · doi:10.6084/m9.figshare.26733987
Thomson, M., Cavelti, M., Lerch, S., Koenig, J., Reichl, C., Mürner-Lavanchy, I. M., Wyssen, A., & Kaess, M. (2024) · Figshare · doi:10.6084/m9.figshare.26703676
Self-citationCavelti, M., Lerch, S., Ghinea, D., Fischer-Waldschmidt, G., The Bella Study Group, Koenig, J., & Kaess, M. (2021) · Figshare · doi:10.6084/m9.figshare.14220942
Self-citationMurad, R., Pollard, K., Glover, N., Wong, V., & Rowe, S. L. (2026) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-026-03030-6
“Across multiple studies, DBT demonstrated reductions in symptoms or criteria for BPD, with improvements observed both immediately post-treatment and at follow-up [41, 44–50].”
Maxwell, C. A., Holland, K. E., Young, L., Chen, E. Y., Olino, T. M., & Kendall, P. C. (2026) · Journal of Clinical Psychology · doi:10.1002/jclp.70195
- Authors
- Buerger, A., Fischer-Waldschmidt, G., Hammerle, F., Auer, K. V., Parzer, P., & Kaess, M.
- Affiliations
- Universitätsklinikum Würzburg (DE)
- Heidelberg University (DE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- DBT-A-Center North, Hamburg, Germany.
- University of Bern (CH)
- Venue
- Journal of Personality Disorders
- Publisher
- Guilford Publications
- Published
- 2019-02
- Volume
- 33
- Issue
- 1
- Pages
- 119-134
- ISSN
- 0885-579X (ISSN-L)
- OpenAlex
- W2884757603
- Cited by
- 46
- References
- 48
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 13 · 2023: 6 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 3 · 2018: 1
- FWCI
- 4.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality Disorders (publishedVersion)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- borderline personality disorder, adolescents, dialectical behavior therapy for adolescents, suicide attempts, non-suicidal self-injury, self-harm, psychopathology, treatment outcomes
- MeSH terms
- Dialectical Behavior Therapy, Adolescent, Borderline Personality Disorder, Child, Female, Humans, Male, Treatment Outcome
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