Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2015 Feb:65:29-35.
doi: 10.1016/j.brat.2014.12.005. Epub 2014 Dec 13.

Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder

Kim L Gratz  1 , Joseph R Bardeen  2 , Roy Levy  3 , Katherine L Dixon-Gordon  4 , Matthew T Tull  5
Affiliations
Randomized Controlled Trial

Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder

Kim L Gratz et al. Behav Res Ther. 2015 Feb.

Abstract

Despite growing evidence for the efficacy of Gratz and colleagues' emotion regulation group therapy (ERGT) for deliberate self-harm (DSH) among women with borderline personality disorder (BPD), the proposed mechanism of change in this treatment (i.e., emotion regulation) remains largely unexamined. This study examined change in emotion dysregulation as a mediator of the effects of this ERGT on DSH and BPD symptoms, as well as the extent to which change in emotion dysregulation during treatment predicts further improvements in DSH during a 9-month follow-up. Participants included 61 female outpatients with BPD and recent DSH who were randomly assigned to receive this ERGT in addition to their ongoing outpatient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of emotion dysregulation, DSH, and BPD symptoms were administered pre- and post-treatment or -waitlist, and at 9-months post-treatment (for participants in both conditions who received ERGT). Results from a series of mediation analyses provide further support for emotion regulation as a mechanism of change in this treatment. Specifically, results revealed that improvements in emotion dysregulation over the course of treatment mediated the observed reductions in BPD cognitive and affective symptoms during treatment and predicted further improvements in DSH during follow-up.

Keywords: Borderline personality; Emotion regulation; Group therapy; Mechanisms of change; Self-injury; Treatment.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

All authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Analyses include intent-to-treat sample (N = 61). Standardized coefficients are presented. Δ = residualized gain score (pre- to post-treatment); DERS = Difficulties in Emotion Regulation Scale total score; ZAN-BPD = Zanarini Rating Scale for Borderline Personality Disorder (Affect and Cognitive Disturbance subscales); DSHI = Deliberate Self-Harm Inventory. *p < .05. **p <.01. ***p < .001.
See this image and copyright information in PMC

References

    1. Allison PD. Missing data techniques for structural equation modeling. Journal of Abnormal Psychology. 2003;112:545–557. - PubMed
    1. Bateman AW, Fonagy P. Mentalization-based treatment of BPD. Journal of Personality Disorders. 2004;18:36–51. - PubMed
    1. Campbell-Sills L, Barlow DH, Brown TA, Hofmann SG. Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy. 2006;44:1251–1263. - PubMed
    1. Chapman AL, Gratz KL, Brown MZ. Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy. 2006;44:371–394. - PubMed
    1. Clifton A, Pilkonis PA. Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Comprehensive Psychiatry. 2007;48:70–78. - PubMed

Publication types