Reasons for premature termination of dialectical behavior therapy for inpatients with borderline personality disorder.

Abstract:

:Although one of the main aims of dialectical behavior therapy (DBT) for borderline personality disorder (BPD) is to increase the retention rates, premature termination rates for DBT inpatient programs were found to be over 30%. The aim of the study was to identify the reasons for, and to analyze, patient characteristics that are associated with premature termination. We studied 541 inpatients with BPD, who were consecutively admitted for an open-door 3-month DBT inpatient treatment in Berlin, Germany. All participants completed several self-rating measures and participated in clinical interviews. Fourteen percent, who did not complete the full 84 days of assigned treatment, were expelled, mainly due to treatment-disturbing behaviors, or substance abuse or possession. Nearly 19% dropped out of treatment, mostly due to lack of motivation, arguments with others, and poor tolerance of emotional distress. Using non-parametric conditional inference trees, expulsion was associated with anorexia nervosa and alcohol abuse, whereas more than 9 suicide attempts, antisocial personality disorders, and more than 86 weeks in a psychiatric hospital were risk factors for dropout. We discussed measures and interventions that might lead to an adaptation of DBT inpatient programs. Future research should examine the symptom course and utilization of health-care services of non-completers.

journal_name

Behav Res Ther

authors

Kröger C,Roepke S,Roepke S,Kliem S

doi

10.1016/j.brat.2014.07.001

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

46-52

eissn

0005-7967

issn

1873-622X

pii

S0005-7967(14)00098-9

journal_volume

60

pub_type

杂志文章
  • Bulimic symptomatology: the role of adaptive perfectionism, shape and weight concern, and self-esteem.

    abstract::An interactive model implicating high perfectionism, high weight and shape concern, and low self-esteem in the onset and maintenance of bulimic symptoms (Bardone, Vohs, Abramson, Heatherton, & Joiner, 2000; Vohs, Bardone, Joiner, Abramson, & Heatherton, 1999) has received mixed support. This study aimed to replicate t...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2011.04.002

    authors: Watson HJ,Steele AL,Bergin JL,Fursland A,Wade TD

    更新日期:2011-09-01 00:00:00

  • On fatalism, pessimism, and depressive symptoms among Mexican-American and other adolescents attending an obstetrics-gynecology clinic.

    abstract::There is growing evidence that Mexican-American adolescents may be at increased risk for depressive symptoms. We sought to replicate and explain this result in a study of adolescent girls attending an obstetric-gynecologic clinic. Three hundred and four girls of diverse ethnic backgrounds completed measures of depress...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/s0005-7967(00)00062-0

    authors: Joiner TE Jr,Perez M,Wagner KD,Berenson A,Marquina GS

    更新日期:2001-08-01 00:00:00

  • Health anxiety disorders: a cognitive construal.

    abstract::The features of severe health anxiety, intense and persistent anxiety about one's present and future health, are described. In common with other anxiety disorders such as GAD, PTSD and OCD, the core of HAD is distressing, uncontrollable anxiety, and is classifiable as an Anxiety Disorder, Health Anxiety Disorder (HAD)...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,评审

    doi:10.1016/j.brat.2012.05.001

    authors: Rachman S

    更新日期:2012-08-01 00:00:00

  • Acute phase cognitive therapy for recurrent major depressive disorder: who drops out and how much do patient skills influence response?

    abstract:OBJECTIVE:The aims were to predict cognitive therapy (CT) noncompletion and to determine, relative to other putative predictors, the extent to which the patient skills in CT for recurrent major depressive disorder predicted response in a large, two-site trial. METHOD:Among 523 outpatients aged 18e70, exposed to 12e14 ...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.brat.2013.01.006

    authors: Jarrett RB,Minhajuddin A,Kangas JL,Friedman ES,Callan JA,Thase ME

    更新日期:2013-05-01 00:00:00

  • Two-year outcome of internet-based relapse prevention for partially remitted depression.

    abstract::The objective of the study was to investigate the long-term effects of internet-based relapse prevention for sufferers of partially remitted depression. Eighty-four individuals with partially remitted unipolar depression were randomized to either internet-based CBT (iCBT) or to a control group. After the ten week inte...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.brat.2013.08.002

    authors: Holländare F,Anthony SA,Randestad M,Tillfors M,Carlbring P,Andersson G,Engström I

    更新日期:2013-11-01 00:00:00

  • Evaluation of an instructional program for improving medication compliance for chronically mentally ill outpatients.

    abstract::Outpatient medication adherence is a major problem, especially for patients repeatedly hospitalized for psychiatric disorders. This study included 39 such patients who were receiving case management services from a community mental health center. Patients were matched and randomly assigned to receive in a single sessi...

    journal_title:Behaviour research and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0005-7967(98)00036-9

    authors: Azrin NH,Teichner G

    更新日期:1998-09-01 00:00:00

  • Heartbeat perception and panic disorder: possible explanations for discrepant findings.

    abstract::Results on cardiac awareness in panic disorder are inconsistent. The present study attempted to clarify whether differences in instructions or the inclusion of patients taking antidepressant medication could account for these inconsistencies. 112 patients with panic disorder with agoraphobia were compared to 40 normal...

    journal_title:Behaviour research and therapy

    pub_type: 临床试验,杂志文章

    doi:10.1016/0005-7967(94)e0002-z

    authors: Ehlers A,Breuer P,Dohn D,Fiegenbaum W

    更新日期:1995-01-01 00:00:00

  • An examination of the Clinical Impairment Assessment among women at high risk for eating disorder onset.

    abstract::Identifying measures that reliably and validly assess clinical impairment has important implications for eating disorder (ED) diagnosis and treatment. The current study examined the psychometric properties of the Clinical Impairment Assessment (CIA) in women at high risk for ED onset. Participants were 543 women (20.6...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2012.02.009

    authors: Vannucci A,Kass AE,Sinton MM,Aspen V,Weisman H,Bailey JO,Wilfley DE,Taylor CB

    更新日期:2012-06-01 00:00:00

  • Failures to retrieve specific memories in previously depressed individuals: random errors or content-related?

    abstract::Failures to retrieve specific memories have been related to general tendencies to commit errors in executive functioning tasks, raising the question of whether they are simply a reflection of randomly occurring lapses in cognitive control or whether their occurrence is in any way related to memory content. This study ...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2007.02.006

    authors: Barnhofer T,Crane C,Spinhoven P,Williams JM

    更新日期:2007-08-01 00:00:00

  • Empirical fear profiles among American youth.

    abstract::Fears among children can range from relatively innocuous fears of simple objects to significant phobias that affect youths' everyday functioning in the home, school, or community environments. This study investigated empirically derived fear profiles among American youth ages 7-19 (N=556). Based upon youths' scores on...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/s0005-7967(02)00258-9

    authors: Schaefer BA,Watkins MW,Burnham JJ

    更新日期:2003-09-01 00:00:00

  • Assaultive violence and the risk of posttraumatic stress disorder following a subsequent trauma.

    abstract::Breslau, Peterson, and Shultz (2008) reported that prior trauma alone, in the absence of PTSD, did not predict an increased PTSD risk, relative to no prior trauma. Only prior trauma that resulted in PTSD predicted an increased PTSD risk following a subsequent trauma. Recently, Cougle, Resnick, and Kilpatrick (2009) pr...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2010.07.001

    authors: Breslau N,Peterson EL

    更新日期:2010-10-01 00:00:00

  • Interpersonal evaluation bias in borderline personality disorder.

    abstract:BACKGROUND:The cognitive theory of personality disorders hypothesizes that the emotional dysregulation and interpersonal problems in individuals with borderline personality disorder (BPD) are, at least partially, caused by dysfunctional cognitive schemas. These schemas lead to biased evaluation of environmental and int...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2009.02.003

    authors: Barnow S,Stopsack M,Grabe HJ,Meinke C,Spitzer C,Kronmüller K,Sieswerda S

    更新日期:2009-05-01 00:00:00

  • Patients' in-session experiences and symptom change: Session-to-session effects on a within- and between-patient level.

    abstract:OBJECTIVE:Knowledge of patients' in-session experiences that lead to symptom change in psychotherapy is limited. This study aims to investigate the within- and between-patient relationships between three in-session processes in psychotherapy (coping skills, therapeutic relationship quality, and emotional involvement) a...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2016.12.007

    authors: Rubel JA,Rosenbaum D,Lutz W

    更新日期:2017-03-01 00:00:00

  • Cognitive processes in social phobia.

    abstract::Social phobics, anxious controls and non-patient controls took part in a brief videotaped conversation with a stooge in order to investigate the cognitive model of social phobia. Thoughts, behaviour, and attention during the conversation were assessed. Compared to the control groups, social phobics had more negative s...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/0005-7967(93)90024-o

    authors: Stopa L,Clark DM

    更新日期:1993-03-01 00:00:00

  • Spider phobia in children: disgust and fear before and after treatment.

    abstract::Fear of spiders, disgust sensitivity, and spiders' disgust-evoking status were assessed in a group of spider phobic girls (n = 22) who applied for treatment, in a group of non-phobic girls (n = 21), and in the parents of both groups of children. The phobic girls were tested both before and after behavioural treatment ...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/s0005-7967(97)00002-8

    authors: De Jong PJ,Andrea H,Muris P

    更新日期:1997-06-01 00:00:00

  • The effects of verbal and imaginal worry on panic symptoms during an interoceptive exposure task.

    abstract::Previous research has documented the inhibitory effects of worry on cardiovascular reactivity to subsequently presented fear-relevant stimuli. Although theoretical assertions point to the verbal-linguistic (as opposed to imagery-based) nature of worry as the cause of these inhibitory effects, extant research investiga...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2020.103748

    authors: Behar E,Borkovec TD

    更新日期:2020-12-01 00:00:00

  • Psychometric characteristics of revised Sociotropy and Autonomy Scales in college students.

    abstract::Beck, Epstein, Harrison and Emery (unpublished manuscript, 1983) developed the Sociotropy-Autonomy Scale (SAS) to assess personality constructs that were considered possible vulnerability factors to reactive depression. Principal components and factor analyses of an expanded 93-item version of the SAS were performed w...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/0005-7967(94)00074-t

    authors: Clark DA,Steer RA,Beck AT,Ross L

    更新日期:1995-03-01 00:00:00

  • Mom told me scary things about this animal: parents installing fear beliefs in their children via the verbal information pathway.

    abstract::This study investigated whether fear beliefs can be installed in children after parents had received negatively tinted information about a novel stimulus. Parents of children aged 8-13 years (N = 88) were presented with negative, positive, or ambiguous information about an unknown animal and then given a number of ope...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2009.12.001

    authors: Muris P,van Zwol L,Huijding J,Mayer B

    更新日期:2010-04-01 00:00:00

  • Cognitive biases in three prediction tasks: a test of the cognitive model of depression.

    abstract::Cognitive therapy for depression is based on an assumption that depressed individuals have inaccurate, negative biases. Whether this assumption is accurate remains unresolved. Thus, this study sought to examine the relationship between depressive symptoms and bias in three sets of predictions (i.e., predictions of fut...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2008.10.008

    authors: Strunk DR,Adler AD

    更新日期:2009-01-01 00:00:00

  • Outcome of group cognitive-behavior therapy for bulimia nervosa: the role of core beliefs.

    abstract::It is hypothesized that individuals who benefit less from CBT will be those who have more pathological core beliefs (unconditional beliefs, unrelated to food, shape and weight). Twenty bulimic women were treated using 12 sessions of conventional group CBT. Eating behavior and attitudes were assessed pre- and posttreat...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/s0005-7967(99)00026-1

    authors: Leung N,Waller G,Thomas G

    更新日期:2000-02-01 00:00:00

  • Changes in posttraumatic stress symptoms, cognitions, and depression during treatment of traumatized youth.

    abstract:OBJECTIVE:Although there is compelling evidence that trauma-focused cognitive behavioral therapy (TF-CBT) is an effective treatment for traumatized youth, we know less about the mechanisms contributing to symptom reduction. To improve the understanding of change mechanisms in TF-CBT, this paper investigates the possibl...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/j.brat.2018.10.010

    authors: Knutsen ML,Czajkowski NO,Ormhaug SM

    更新日期:2018-12-01 00:00:00

  • Behavioral assessment of personality disorders.

    abstract::This article examines the definition of personality disorders (PDs) from a functional analytical framework and discusses the potential utility of such a framework to account for behavioral tendencies associated with PD pathology. Also reviewed are specific behavioral assessment methods that can be employed in the asse...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/s0005-7967(98)00142-9

    authors: Nelson-Gray RO,Farmer RF

    更新日期:1999-04-01 00:00:00

  • Stepped care versus face-to-face cognitive behavior therapy for panic disorder and social anxiety disorder: Predictors and moderators of outcome.

    abstract:OBJECTIVE:To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD). ME...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.brat.2015.06.002

    authors: Haug T,Nordgreen T,Öst LG,Kvale G,Tangen T,Andersson G,Carlbring P,Heiervang ER,Havik OE

    更新日期:2015-08-01 00:00:00

  • Patient adherence and treatment outcome with exposure and response prevention for OCD: Which components of adherence matter and who becomes well?

    abstract::Exposure and response prevention (EX/RP) is an evidence-based treatment for obsessive-compulsive disorder (OCD), yet not all patients achieve wellness with EX/RP. The degree to which patients adhere to EX/RP procedures outside of sessions has been found to predict therapy outcomes, including who achieves post-treatmen...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.brat.2016.07.010

    authors: Wheaton MG,Galfalvy H,Steinman SA,Wall MM,Foa EB,Simpson HB

    更新日期:2016-10-01 00:00:00

  • Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research.

    abstract::The purpose of this paper is to consider the possible origins of an inflated sense of responsibility which occupies an important place in the cognitive theory of obsessive compulsive disorder (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154. Salkovskis, P. M. (198...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,评审

    doi:10.1016/s0005-7967(99)00063-7

    authors: Salkovskis P,Shafran R,Rachman S,Freeston MH

    更新日期:1999-11-01 00:00:00

  • No interactive effects of naltrexone and benzodiazepines on pain during phobic fear.

    abstract::Animal research has shown that anxiety may inhibit pain through the release of endogenous opioids. On the other hand, anxiety is often believed to exacerbate pain in clinical situations, and anxiety reduction has been shown to attenuate the affective component of pain. In the present study phobic anxiety was induced b...

    journal_title:Behaviour research and therapy

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0005-7967(98)00100-4

    authors: Janssen SA,Arntz A

    更新日期:1999-01-01 00:00:00

  • The role of valence in attempted thought suppression.

    abstract::Thought control was investigated in participants (N = 72) who were shown either a violent, humorous or neutral film and then administered either suppression or nonsuppression instructions. Following the presentation of a three minute segment from one film, participants monitored their thoughts for two 3-minute periods...

    journal_title:Behaviour research and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0005-7967(98)00049-7

    authors: Harvey AG,Bryant RA

    更新日期:1998-07-01 00:00:00

  • Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial.

    abstract:AIMS:To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD). METHODS:Thirty-one children ages 3-8 years (M = 5.8 years) with a ...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.brat.2014.02.001

    authors: Lewin AB,Park JM,Jones AM,Crawford EA,De Nadai AS,Menzel J,Arnold EB,Murphy TK,Storch EA

    更新日期:2014-05-01 00:00:00

  • The many faces of Pan: psychological and physiological differences among three types of panic attacks.

    abstract::The thesis of this paper is that failure to recognize the psychological and physiological differences among panic attacks within DSM-IIIR precludes meaningful comparisons and evaluations of research findings, confounds theoretical issues, and impairs the development of more specific, and thereby more effective, progra...

    journal_title:Behaviour research and therapy

    pub_type: 杂志文章

    doi:10.1016/0005-7967(92)90046-j

    authors: Ley R

    更新日期:1992-07-01 00:00:00

  • Severity of unipolar depression and choice of treatment.

    abstract::The National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program (Elkin et al., Archives of General Psychiatry, 46, 971-982; 1989) reported treatment-by-severity interactions favouring pharmacotherapy for more depressed outpatients, on a minority of relevant comparisons. The presen...

    journal_title:Behaviour research and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/0005-7967(92)90028-f

    authors: McLean P,Taylor S

    更新日期:1992-09-01 00:00:00