Effects of dialectical behaviour therapy on reducing self-harming behaviours and negative emotions in patients with borderline personality disorder: A meta-analysis

Abstract

Introduction: Dialectical behaviour therapy(DBT) has been widely used for borderline personality disorder(BPD). Existing studies are limited to behaviours such as self-harm, and the results for reducing self-harm were controversial. Few have systematically evaluated the effect of DBT on self-harming behaviours and negative emotions.

Aim: This study aims to evaluate the effects of DBT on self-harming behaviours and negative emotions in patients with BPD.

Methods: RCTs on DBT for BPD were searched from PubMed, Embase, etc., and the results were performed by RevMan 5.3.

Results: The meta-analysis demonstrated that DBT reduced self-harming behaviours, and alleviated depression, but had a negligible effect on suicidal ideation and anger. One subgroup revealed that standard DBT improved depression significantly, but DBT skills training improved poorly. Another subgroup revealed that there was a significant reduction in depression among patients receiving DBT for 4 months to 14 months, but not at 4 months.

Discussion and implications for practice: Findings indicate that DBT can reduce self-harming behaviours and improve depression, but effects on suicidal ideation and anger are insignificant. Subgroup analysis suggests that standard DBT and DBT-ST lasting beyond 4 months benefits on BPD. Given the quality and quantity restrictions of RCTs, more high-quality RCTs need to verify these effects.

Keywords: borderline personality disorder; dialectical behavioural therapy; meta-analysis; negative emotions; self-harm.