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Biomedical subjects

M M Linehan

Publications and source records attributed to M M Linehan.

17 recordsLinked to original sources
PubMed1994

Dialectical behavior therapy for borderline personality disorder: theoretical and empirical foundations.

Dialectical behavior therapy (DBT) is a cognitive-behavioral psychotherapy developed by Linehan for parasuicidal patients with a diagnosis of borderline personality disorder (BPD). DBT is based on a biosocial theory that views BPD as primarily a dysfunction of the emotion regulation system. The treatment is organized around a hierarchy of behavioral goals that vary in different modes of therapy. In two randomized trials, DBT has shown superiority in reducing parasuicide, medical risk of parasuicides, number of hospital days, dropout from treatment and anger while improving social adjustment. Most gains were maintained through a 1-year follow-up. In one process study testing DBT theory, dialectical techniques balancing acceptance and change were more effective than pure change or acceptance techniques in reducing suicidal behavior.

Borderline Personality Disorder↗
PubMed1994

Interpersonal outcome of cognitive behavioral treatment for chronically suicidal borderline patients.

OBJECTIVE: This study reports the efficacy of a cognitive behavioral outpatient treatment on interpersonal outcome variables for patients diagnosed with borderline personality disorder. METHOD: In a 1-year clinical trial, 26 female patients with borderline personality disorder were randomly assigned to either dialectical behavior therapy or a treatment-as-usual comparison condition. All subjects met criteria of DSM-III-R and Diagnostic Interview for Borderline Patients for borderline personality disorder and were chronically suicidal. RESULTS: In both the intent-to-treat and treatment completion groups, dialectical behavior therapy subjects had significantly better scores on measures of anger, interviewer-rated global social adjustment, and the Global Assessment Scale and tended to rate themselves better on overall social adjustment than treatment-as-usual subjects. CONCLUSIONS: These results suggest that dialectical behavior therapy is a promising psychosocial intervention for improving interpersonal functioning among severely dysfunctional patients with borderline personality disorder.

Adaptation, Psychological↗
PubMed1993

Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients.

BACKGROUND: A randomized clinical trial was conducted to evaluate whether the superior performance of dialectical behavior therapy (DBT), a psychosocial treatment for borderline personality disorder, compared with treatment-as-usual in the community, is maintained during a 1-year posttreatment follow-up. METHODS: We analyzed 39 women who met criteria for borderline personality disorder, defined by Gunderson's Diagnostic Interview for Borderline Personality Disorder and DSM-III-R criteria, and who had a history of parasuicidal behavior. Subjects were randomly assigned either to 1 year of DBT, a cognitive behavioral therapy that combines individual psychotherapy with group behavioral skills training, or to treatment-as-usual, which may or may not have included individual psychotherapy. Efficacy was measured on parasuicidal behavior (Parasuicide History Interview), psychiatric inpatient days (Treatment History Interview), anger (State-Trait Anger Scale), global functioning (Global Assessment Scale), and social adjustment (Social Adjustment Scale--Interview and Social Adjustment Scale--Self-Report). Subjects were assessed at 6 and 12 months into the follow-up year. RESULTS: Comparison of the two conditions revealed that throughout the follow-up year, DBT subjects had significantly higher Global Assessment Scale scores. During the initial 6 months of the follow-up, DBT subjects had significantly less parasuicidal behavior, less anger, and better self-reported social adjustment. During the final 6 months, DBT subjects had significantly fewer psychiatric inpatient days and better interviewer-rated social adjustment. CONCLUSION: In general, the superiority of DBT over treatment-as-usual, found in previous studies at the completion of 1 year of treatment, was retained during a 1-year follow-up.

Adolescent↗
PubMed1991

Cognitive-behavioral treatment of chronically parasuicidal borderline patients.

A randomized clinical trial was conducted to evaluate the effectiveness of a cognitive-behavioral therapy, ie, dialectical behavior therapy, for the treatment of chronically parasuicidal women who met criteria for borderline personality disorder. The treatment lasted 1 year, with assessment every 4 months. The control condition was "treatment as usual" in the community. At most assessment points and during the entire year, the subjects who received dialectical behavior therapy had fewer incidences of parasuicide and less medically severe parasuicides, were more likely to stay in individual therapy, and had fewer inpatient psychiatric days. There were no between-group differences on measures of depression, hopelessness, suicide ideation, or reasons for living although scores on all four measures decreased throughout the year.

Adolescent↗
PubMed1985

Modeling effects on suicidal behavior.

Knowledge of suicidal behavior, i.e., psychiatric patients indicating that they have an acquaintance or relative who has attempted or committed suicide, has been cited as a risk factor in the assessment of suicide potential. The authors evaluated psychiatric patients hospitalized for a suicide attempt (N = 30), serious suicidal ideation (N = 26), or other non-suicide-related reasons (N = 20) and also a control group of 18 patients admitted for orthopaedic surgery. Information derived from a structured clinical interview revealed that suicide attempters have fewer suicidal models than individuals in the other patient groups, and they are more interpersonally distant from the models they do know. Depression level was not positively related to the recall and reporting of suicidal models. Measures assessing suicide-related beliefs revealed that suicide attempters rated suicide as an effective solution for problems to a greater extent that did patients in the remaining three groups. The implications of these results for social learning models of suicidal behavior are discussed.

Adult↗
PubMed1982

Suicidal behaviors among clients at an outpatient psychology clinic versus the general population.

The focus of this paper is on the comparison of suicidal behaviors among two populations in the same geographical area: clients at a psychology clinic vs. individuals from the general population sampled at an area shopping center. In both samples 10 percent of the individuals reported prior parasuicidal behavior; the two populations were also quite similar on reports of prior suicidal ideation: 31 percent in the clinical and 24 percent in the general population reported never, or only briefly, considering suicide at any point in their lives. Suicidal behavior was related to sex and income in the general population.

Community Mental Health Centers↗