Emotions observed during sessions of dialectical behavior therapy predict outcome for borderline personality disorder.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2024-09-01 DOI:10.1037/ccp0000903

Stephanie Nardone,Antonio Pascual-Leone,Ueli Kramer,Florencia Cristoffanini,Loris Grandjean,Ines Culina,Shelley McMain

{"title":"Emotions observed during sessions of dialectical behavior therapy predict outcome for borderline personality disorder.","authors":"Stephanie Nardone,Antonio Pascual-Leone,Ueli Kramer,Florencia Cristoffanini,Loris Grandjean,Ines Culina,Shelley McMain","doi":"10.1037/ccp0000903","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\r\nWe examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD).\r\n\r\nMETHOD\r\nParticipants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome.\r\n\r\nRESULTS\r\nMore emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%-34%).\r\n\r\nCONCLUSIONS\r\nClients' in-session emotional experiences predict treatment outcome 8-10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"44 1","pages":"607-618"},"PeriodicalIF":4.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of consulting and clinical psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/ccp0000903","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}

引用次数: 0

Abstract

OBJECTIVE We examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD). METHOD Participants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome. RESULTS More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%-34%). CONCLUSIONS Clients' in-session emotional experiences predict treatment outcome 8-10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

查看原文本刊更多论文

辩证行为疗法疗程中观察到的情绪可预测边缘型人格障碍的治疗效果。

目的我们研究了客户在治疗过程中体验到的情绪是否与边缘型人格障碍（BPD）的辩证行为疗法（DBT）的治疗结果有关。情感-意义状态分类是一种由观察者评定的离散情绪测量方法，用于对 DBT 单个疗程的视频进行编码。评分员对每位参与者的三个心理治疗疗程进行编码：心理治疗早期、工作期和晚期各一个疗程。结果早期阶段的总体情绪体验越多，12 个月治疗结果中的 BPD 症状就越少，占症状差异的 19%。然而，在整个治疗过程中，整体痛苦的增加预示着治疗结束时BPD（解释了24%的变异）和抑郁症状（解释了15%的变异）水平的提高。从早期阶段到工作阶段，情绪灵活性（即不同状态之间的变化）的增加预示着终止治疗时抑郁症状的减少（14% 的解释率）。在工作阶段编码的自我同情也预示着更好的治疗结果（解释率为 19%-34%）。患有 BPD 的患者可能会受益于 DBT 早期对其情绪体验的更全面的探索，以及自我同情的表达。非特异性、强烈负面情绪的增加预示着不良预后，而早期治疗中情绪灵活性的增加则预示着更好的预后。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.