Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: a pilot randomized controlled trial

Behav Res Ther. 2014 Aug:59:40-51. doi: 10.1016/j.brat.2014.05.005. Epub 2014 May 27.


Difficulties with emotions are common across mood and anxiety disorders. Dialectical behavior therapy skills training (DBT-ST) reduces emotion dysregulation in borderline personality disorder (BPD). Preliminary evidence suggests that use of DBT skills mediates changes seen in BPD treatments. Therefore, we assessed DBT-ST as a stand-alone, transdiagnostic treatment for emotion dysregulation and DBT skills use as a mediator of outcome. Forty-four anxious and/or depressed, non-BPD adults with high emotion dysregulation were randomized to 16 weeks of either DBT-ST or an activities-based support group (ASG). Participants completed measures of emotion dysregulation, DBT skills use, and psychopathology every 2 months through 2 months posttreatment. Longitudinal analyses indicated that DBT-ST was superior to ASG in decreasing emotion dysregulation (d = 1.86), increasing skills use (d = 1.02), and decreasing anxiety (d = 1.37) but not depression (d = 0.73). Skills use mediated these differential changes. Participants found DBT-ST acceptable. Thirty-two percent of DBT-ST and 59% of ASG participants dropped treatment. Fifty-nine percent of DBT-ST and 50% of ASG participants complied with the research protocol of avoiding ancillary psychotherapy and/or medication changes. In summary, DBT-ST is a promising treatment for emotion dysregulation for depressed and anxious transdiagnostic adults, although more assessment of feasibility is needed.

Keywords: Anxiety; Depression; Dialectical behavior therapy; Emotion dysregulation; Transdiagnostic.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affective Symptoms / complications
  • Affective Symptoms / therapy*
  • Anxiety / complications
  • Anxiety / therapy*
  • Behavior Therapy*
  • Depression / complications
  • Depression / therapy*
  • Female
  • Humans
  • Male
  • Patient Compliance
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Treatment Outcome
  • Young Adult