Lidia Fortaner-Uyà, Camilla Monopoli, Marco Cavicchioli, Federico Calesella, Federica Colombo, Ilaria Carretta, Chiara Talè, Francesco Benedetti, Raffaele Visintini, Cesare Maffei, Benedetta Vai
{"title":"A Longitudinal Prediction of Suicide Attempts in Borderline Personality Disorder: A Machine Learning Study","authors":"Lidia Fortaner-Uyà, Camilla Monopoli, Marco Cavicchioli, Federico Calesella, Federica Colombo, Ilaria Carretta, Chiara Talè, Francesco Benedetti, Raffaele Visintini, Cesare Maffei, Benedetta Vai","doi":"10.1002/jclp.23763","DOIUrl":"10.1002/jclp.23763","url":null,"abstract":"<div>\u0000 \u0000 <p>Borderline personality disorder (BPD) is associated with a high risk of suicide. Despite several risk factors being known, identifying vulnerable patients in clinical practice remains a challenge so far. The current study aimed at predicting suicide attempts among BPD patients during disorder-specific psychotherapeutic interventions exploiting machine learning techniques. The study took into account several potential predictors relevant to BPD psychopathology: emotion dysregulation, temperamental and character factors, attachment style, impulsivity, and aggression. The sample included 69 patients with BPD who completed the Temperament and Character Inventory, Attachment Style Questionnaire, Difficulties in Emotion Regulation Scale, Barratt Impulsiveness Scale, and Aggression Questionnaire at baseline and after 6 months of psychotherapy. To detect future suicide attempts, baseline questionnaires were entered as predictors into an elastic net penalized regression, whose predictive performance was assessed through nested fivefold cross-validation. At the same time, 5000 iterations of a non-parametric bootstrap were used to determine predictors’ robustness. The elastic net model discriminating BPD suicide attempters from non-attempters reached a balanced accuracy of 64.09% and an area under the receiver operating curve of 70.44%. High preoccupation with relationships, harm avoidance, and reward dependence, along with low motor impulsiveness, verbal aggression, cooperativeness, and self-transcendence were the most contributing predictors. Our findings suggest that interpersonal vulnerability and internalizing factors are the strongest predictors of future suicide attempts in BPD. Machine learning on self-report psychological scales may be helpful to identify individuals at suicidal risk, potentially helping clinical settings to develop individualized preventive strategies.</p>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 4","pages":"222-236"},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Roles of Interpersonal and Intrapersonal Emotion Regulation on Psychological Distress: A Longitudinal Panel Study","authors":"Koray Akkuş, Mehmet Peker, Ceren Gökdağ","doi":"10.1002/jclp.23762","DOIUrl":"10.1002/jclp.23762","url":null,"abstract":"<div>\u0000 \u0000 <p>The present study was designed to test the hypothesis that interpersonal emotion regulation leads to increased difficulties in intrapersonal emotion regulation, which in turn, leads to general psychological distress utilizing a three-wave cross-lagged panel design. Undergraduate students rated self-report measurements of interpersonal emotion regulation, difficulties in intrapersonal emotion regulation, and psychological distress at baseline (T1, <i>N</i> = 369) and two follow-up waves (T2 and T3), each separated by 3 months. The results indicated that although some lagged correlations between interpersonal emotion regulation strategies and difficulties in intrapersonal emotion regulation were significant, interpersonal emotion regulation strategies did not prospectively predict difficulties in intrapersonal emotion regulation. Notably, difficulties in intrapersonal emotion regulation significantly predicted psychological distress in subsequent waves. Additionally, psychological distress at T1 predicted distress at T3 through difficulties in intrapersonal emotion regulation at T2. This study is significant as it is the first to test the interpersonal emotion regulation model in a longitudinal design. However, the hypothesized pathway where interpersonal emotion regulation contributes to psychological distress through difficulties in intrapersonal emotion regulation, was not supported.</p>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 4","pages":"199-208"},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Examining Longitudinal Relations Between Eating Disorder Symptoms and Negative Emotion Variability in Military Members","authors":"Olivia M. Clancy, Lauren Forrest, April R. Smith","doi":"10.1002/jclp.23760","DOIUrl":"10.1002/jclp.23760","url":null,"abstract":"<div>\u0000 \u0000 <p>Up to a third of service members and Veterans experience disordered eating. Disordered eating can be maintained through negative reinforcement of painful and unpleasant emotions such as guilt, shame, sadness, and hostility. Hostility is a negative emotion that may be particularly relevant for service members and Veterans, yet hostility's relation to disordered eating remains understudied. Further, variability in emotions may be particularly relevant, given that variability in emotions is often a stronger predictor of psychopathology than mean levels. Thus, the goal of the present study was to assess a potential bidirectional relationship between disordered eating symptoms and individuals' variability of hostility, stress, anxiety, sadness, and shame. Participants (<i>N</i> = 94, <i>M</i><sub>age</sub> = 32.2, 75.8% men; 81.8% White) completed 30 days of ecological momentary assessment (EMA) with four assessments per day along with baseline and follow-up measures including the Eating Pathology Symptom Interview (EPSI), which assessed eight disordered eating symptom domains. Hierarchical regressions revealed that higher baseline levels of Binge Eating and Excessive Exercise predicted greater intraindividual hostility variability. Further, more hostility variability predicted higher Cognitive Restraint at 1-month follow-up. Baseline disordered eating symptoms were not associated with intraindividual variability in stress, anxiety, sadness, or shame. However, greater intraindividual variability in shame predicted higher Muscle Building at 1-month follow-up. Hostility variability was the only emotion that was predicted by, and predictive of, disordered eating symptoms. These findings suggest that hostility may be a relevant treatment target for service members with disordered eating.</p>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 4","pages":"209-221"},"PeriodicalIF":2.5,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Expressive Suppression of Emotions in Bulimia Nervosa: An Electroencephalography Study","authors":"Lorena Desdentado, Olga Pollatos","doi":"10.1002/jclp.23761","DOIUrl":"10.1002/jclp.23761","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Previous research has found dysfunctional emotion regulation in bulimia nervosa (BN), including self-reported greater habitual use of maladaptive strategies such as suppression than in healthy individuals. However, there is no evidence on the performance in the implementation of expressive suppression in BN. The aim of this study was to investigate brain activity (in terms of ERP) and self-reported ratings associated with expressive suppression of emotions elicited by positive and negative stimuli in women with BN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Event-related potentials (ERP) were recorded from 23 female individuals with BN and 26 matched healthy controls. Participants were shown emotional pictures under two conditions: using facial suppression or attentively viewing. High-density EEG was used to characterize the time course of emotion regulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ERP amplitudes varied significantly with valence, with positive (vs. neutral and negative) pictures eliciting larger ERP amplitudes. However, no significant differences in ERP were observed between the groups or conditions. The BN group reported lower self-efficacy in implementing suppression compared to the control group, the latter with a positive correlation between the perceived self-efficacy and the change in emotional arousal between conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings suggest that individuals with BN might have difficulties in monitoring the emotion regulation process compared to healthy individuals. This suggests that other processes (e.g., metacognitive difficulties, self-esteem) rather than a failure to implement suppression, might underlie these results. However, further research is needed to validate this interpretation. Implications and directions for future research are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 3","pages":"158-170"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ACT for OCD: An Example of ACT and Values-Based Exposures","authors":"Leila K. Capel, Michael P. Twohig","doi":"10.1002/jclp.23759","DOIUrl":"10.1002/jclp.23759","url":null,"abstract":"<div>\u0000 \u0000 <p>Exposure exercises as seen in cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) are standard in the treatment of obsessive-compulsive disorder (OCD). In the last two decades, additional research has been conducted on acceptance and commitment therapy (ACT) and the ways that exposure exercises are conducted from an ACT model. Empirical support for conducting exposures from an ACT model exists. Group level statistics suggest that ACT with ACT-based exposures is as effective as traditional ERP or CBT. A key component of ACT and values-based exposures is the focus on teaching psychological flexibility to allow for engagement with values-based exposures. In this case study, we present an adult woman with OCD who completed 24 sessions of ACT+ values-based exposures. Client scores on the Y-BOCS decreased from severe levels to mild-moderate levels through treatment. Additionally, the client was more actively engaged in her life and reported greater quality of life at the conclusion of treatment. The goal of this case study is to demonstrate how values-based exposures can be used in the treatment of OCD.</p>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 2","pages":"93-101"},"PeriodicalIF":2.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strategies for Optimizing Traditional Exposure and Response Prevention: A Case Study Example in an Adolescent With Contamination-Based OCD","authors":"Sarah C. Jessup, Amy Mariaskin, Bunmi O. Olatunji","doi":"10.1002/jclp.23758","DOIUrl":"10.1002/jclp.23758","url":null,"abstract":"<div>\u0000 \u0000 <p>Cognitive Behavioral Therapy (CBT) with an emphasis on Exposure and Response Prevention (ERP) has consistently been observed to be an efficacious treatment for obsessive-compulsive disorder (OCD). Although ERP is currently considered the gold-standard, first-line psychological treatment, individuals with chronic fluctuations in symptom presentations or especially severe cases may require additional supplements to exposure that maximize learning and facilitate greater generalization of learning experiences. The present case study serves as an example of how traditional aspects of exposure-based CBT (e.g., psychoeducation, hierarchy building, functional analysis, homework) can be successfully used in addition to leveraging more contemporary stylistic modifications (e.g., explicit expectancy violation, context variability) that may optimize treatment in complex or difficult cases. In the present case study of a patient with contamination-based OCD, functional impairment and disorder symptoms responded to treatment and remained improved at a 3-month follow-up. Implications of the case study are discussed and recommendations are offered for clinicians treating complex or challenging OCD cases.</p>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 3","pages":"182-192"},"PeriodicalIF":2.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Binyamin Skalski-Bednarz, Loren L. Toussaint, Paweł Dobrakowski
{"title":"Forgiveness in Poland: Rye Forgiveness Scale Adaptation and Its Longitudinal Impact on Mental Health in HIV-Positive Individuals","authors":"Sebastian Binyamin Skalski-Bednarz, Loren L. Toussaint, Paweł Dobrakowski","doi":"10.1002/jclp.23757","DOIUrl":"10.1002/jclp.23757","url":null,"abstract":"<p>Within psychological research, the concept of forgiveness has gained recognition for its potential impact on health, underlining the need for culturally adapted assessment tools and longitudinal studies to substantiate its effects. In this two-phase research project, we initially adapted the Rye Forgiveness Scale (RFS) to measure state forgiveness in the Polish context with 740 participants. Reliability analysis and confirmatory factor analysis confirmed the RFS's structure and internal consistency (absence of negative <i>α</i> = 0.87, presence of positive <i>α</i> = 0.86, full scale <i>α</i> = 0.84). Positive associations with other measures of forgiveness, religiosity, connection to nature, and mental well-being validated the scale's efficacy. The second phase evaluated the impact of state forgiveness on the mental health of 214 HIV-positive Polish individuals across three 6-month intervals. Utilizing the stress-and-coping model, this phase investigated forgiveness as a protective factor against negative mental health outcomes. The findings indicated that forgiveness could positively influence mental health, underscoring its importance in promoting well-being among vulnerable groups. This research provides a culturally validated tool for measuring forgiveness and illuminates its health benefits, emphasizing its significance for diverse populations.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 3","pages":"145-157"},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zafra Cooper, Brian N. Smith, Shannon Kehle-Forbes, Julianne Dorset, Karen S. Mitchell
{"title":"Eating Disorders, Co-Morbid Disorders and Early Risk Factors Amongst Post-9/11 Veteran Men and Women","authors":"Zafra Cooper, Brian N. Smith, Shannon Kehle-Forbes, Julianne Dorset, Karen S. Mitchell","doi":"10.1002/jclp.23756","DOIUrl":"10.1002/jclp.23756","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess, by interview, the rates of eating disorders in a nationally representative sample of recent veterans, describe their DSM-5 eating disorder diagnoses and the occurrence of comorbid psychiatric disorders. To conduct an exploratory case-control analysis of previously documented and additional specific military risk factors before eating disorder onset to inform studies of prospective risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Using a two-stage design, probable cases and controls were identified by screening questionnaires from a sample of 1494 veterans who completed a survey study and interviewed to establish case status and confirm probable co-morbid psychiatric diagnoses. Previously documented risk factors and military risk factors occurring before disorder onset were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-one cases and 51 controls were confirmed. Weighted prevalence for any eating disorder was 5.2%, with estimates for anorexia nervosa, bulimia nervosa, binge eating disorder and other specified eating disorder being 0.01%, 0.6%, 1.4%, and 1.6%, respectively. Seventy-nine (86.8%) confirmed cases had a diagnosis of one or more co-morbid psychiatric disorders. Previously documented risk factors were associated with subsequent case status, while in this sample, military risk factors were not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Rates of eating disorder and co-occurring psychiatric disorders in recent veterans were comparable to those reported for non-veterans, with levels of posttraumatic stress disorder likely higher. As co-occurring psychiatric disorders, particularly posttraumatic stress disorder, may complicate achieving good outcomes with existing evidence-based treatments, there is an urgent need to adapt them where necessary to improve outcomes. Military risk factors may maintain or exacerbate pre-existing problems and need to be investigated alongside other maintaining factors in longitudinal studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Public Significance</h3>\u0000 \u0000 <p>Rates of eating disorder and co-occurring psychiatric disorders in recent veterans were comparable to those reported for non-veterans, highlighting a need to detect eating problems and address unmet treatment need. Co-occurring psychiatric disorders may complicate achieving good outcomes with existing treatments, emphasising a need to adapt them to improve outcomes. Investigating maintaining fa","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 3","pages":"133-144"},"PeriodicalIF":2.5,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23756","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Depression, Drinking to Cope, and Alcohol Use Severity Among Latinos Who Drink: The Moderating Role of Sex","authors":"Cory L. Cobb","doi":"10.1002/jclp.23755","DOIUrl":"10.1002/jclp.23755","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present study evaluated sex differences in the direct and indirect links between depressive symptoms, coping motives to drink, and alcohol use severity among Latinos who drink.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A large and diverse panel sample of Latinos, who were strategically sampled to be reflective of the Latino demographics of the state of Texas, completed questionnaires assessing their depressive symptomatology, coping motives to drink, and alcohol use behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Direct effects were significant in hypothesized directions such that depressive symptoms was positively associated with both coping motives to drink and alcohol use severity, and drinking motives to cope were positively associated with alcohol use severity. Moderator analysis showed that, compared to Latina women, the association of depressive symptoms with both drinking to cope and alcohol use severity was significantly higher among Latino men. Regarding indirect effects, a moderated mediation analysis showed that the indirect effect of depressive symptoms on alcohol use severity through coping motives to drink was statistically significant for both Latino/a men and women; however, the index of moderated mediation showed that this indirect effect was significantly greater among Latino men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although both Latino/a men and women may consume alcohol and turn to alcohol to drink with negative affect associated with depressive symptoms, this process may be stronger among Latino men. Findings are discussed considering prior work and implications for practitioners.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 2","pages":"62-70"},"PeriodicalIF":2.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Vicenta Navarro-Haro, Alba Abanades Morillo, Azucena García-Palacios
{"title":"Applying Dialectical Behavior Therapy as a Transdiagnostic Treatment in a Case of Borderline Personality Disorder and Eating Disorder","authors":"María Vicenta Navarro-Haro, Alba Abanades Morillo, Azucena García-Palacios","doi":"10.1002/jclp.23754","DOIUrl":"10.1002/jclp.23754","url":null,"abstract":"<p>This article presents a case study of a 31-year-old woman with a dual diagnosis of Borderline Personality Disorder (BPD) and Eating Disorder Not Otherwise Specified (EDNOS). Paula received a 12-month Dialectical Behavior Therapy (DBT) outpatient treatment. DBT is considered a transdiagnostic treatment approach to address emotion dysregulation, which shifts the therapy focus traditionally placed only on behavioral change toward including also validation and acceptance and dialectical strategies. DBT addresses eating symptomatology as a dysfunctional form of emotional regulation and has shown promising results regarding its efficacy for the treatment of BPD and EDNOS comorbidity. Given the growing evidence, a standard DBT treatment plan was developed for this case. Specifically, pretreatment and phase 1 of the DBT program are described. During pretreatment and phase 1, individual therapy aims to improve and maintain client's motivation to change and engage in treatment, as well as to establish and prioritize treatment goals. As for group therapy, the main goal of the skills training in DBT is to enhance individual's capability by increasing skillful behavior (mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills). Paula received 24 weekly skills training sessions over a year. The results after a 12-month standard DBT treatment showed that Paula no longer met criteria for BPD, she had a significant decrease in difficulties in emotional regulation and impulsiveness and in EDNOS symptomatology. This case study may enhance learning about how to apply a transdiagnostic treatment to address BPD and EDNOS together in clinical practice.</p>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"81 2","pages":"102-112"},"PeriodicalIF":2.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}