AzTrials
AzTrials

Borderline Personality DisorderMAP-DBTNCT04626310

Mapping Aspects of Psychotherapy in Dialectical Behavior Therapy

A study testing Dialectical behavior therapy - emotion regulation skills training, Dialectical behavior therapy - interpersonal effectiveness skills training and Interpersonal psychotherapy in people with Borderline Personality Disorder, run by University of Massachusetts, Amherst at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Although dialectical behavior therapy (DBT) skills training is effective in the treatment of borderline personality disorder, it contains four skills modules and there is little research to guide their modular application. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Borderline Personality Disorder
What is being tested?
Dialectical behavior therapy - emotion regulation skills training, Dialectical behavior therapy - interpersonal effectiveness skills training and Interpersonal psychotherapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
1 siteUnited States
Study dates
26 Oct 2020to 6 Feb 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • exhibit 4+ BPD symptoms,
  • have a history of recent (i.e., past-year) and recurrent (> 1 instance) of self-injury,
  • commit to participate in one of our 6-week experimental groups,
  • have an individual health provider who can manage imminent issues,
  • be between 18-60 years old,

Who cannot join

  • not fluent in English,
  • have impaired (uncorrected) vision or hearing that would impair ability to understand study stimuli,
  • a current manic, psychotic, or active physiological dependence on substances (to limit interference in the lab),
  • low cognitive functioning (IQ ≤ 70.4 (TOPF; Pearson Assessments, 2009),
  • past DBT treatment

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Psychological Services Center, University of Massachusetts Amherst

    Amherst, Massachusetts, 01002

Other trials in United States

About this study

Official title: Mapping Treatment Components to Targets in Dialectical Behavior Therapy

Although dialectical behavior therapy (DBT) skills training is effective in the treatment of borderline personality disorder, it contains four skills modules and there is little research to guide their modular application. This study compares the unique effects of two distinct DBT skills training modules, relative to a non-DBT therapy group for adults with borderline personality disorder. Using innovative laboratory-based assessment methods, the proposed study will examine the effects of these conditions on emotional responding and interpersonal functioning, as well as clinical outcomes.

Read the detailed description

Borderline personality disorder (BPD) is a severe mental health condition with high morbidity and mortality. Although dialectical behavior therapy (DBT) is an efficacious treatment for BPD, it is resource-intensive and lengthy in its full form, involving one year of weekly individual therapy and group skills training in mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. As a result, few patients have access to the full treatment. A better understanding of how the distinct components of DBT affect different sets of symptoms could help to streamline this treatment and personalize its use with specific patients.

Improvements in both interpersonal and emotional functioning are theorized to underlie improvements in BPD. Thus, emotion regulation and interpersonal effectiveness skills training may be particularly important components of DBT. Therefore, this study examines the unique effects of two distinct DBT skills training modules.

Participants are adults with BPD and recent, recurrent self-injurious behaviors (planned N = 81) who are randomly assigned to six weeks of DBT emotion regulation skills training (DBT-ER), DBT interpersonal effectiveness skills training (DBT-IE), or a non-skills control group. Using innovative laboratory-based multimethod assessments, this study examines the effects of these conditions on emotional responding and interpersonal functioning, as well as BPD related outcomes. Aim 1 examines the unique effects of DBT-ER and DBT-IE on their respective emotion-related (subjective and biological emotional reactivity, behavioral emotion regulation, skills use) and interpersonal (subjective and behavioral) targets, compared to the non-DBT treatment. Aim 2 examines whether improved emotional functioning predicts reductions in BPD symptoms and self-injury. Aim 3 examines whether baseline emotion dysregulation interacts with treatment condition to predict treatment response.

The proposed research is innovative in its experimental examination of the effects of DBT components on specific targets in BPD. Given the high societal costs of BPD, this work has important public health significance. Findings will inform larger studies evaluating the potential modular use of DBT components to result in briefer and more efficient individualized treatments for patients.

Being tested
Dialectical behavior therapy - emotion regulation skills training, Dialectical behavior therapy - interpersonal effectiveness skills training, Interpersonal psychotherapy
Keywords
Dialectical behavior therapy, Emotions, Behavior and Behavior mechanisms, Randomized Controlled Trials
Medical subject headings
Borderline Personality Disorder, Behavior

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dialectical behavior therapy - emotion regulation skills trainingBehavioural

    Arm 1. Dialectical behavior therapy - emotion regulation skills training follows the emotion regulation skills DBT Skills Training Manual Second Edition and the DBT Skills Training Handouts and Worksheets Second Edition. This group involves 6 weekly sessions.

    Arm 2. Dialectical behavior therapy - interpersonal effectiveness skills training follows the interpersonal effectiveness skills DBT Skills Training Manual Second Edition and the DBT Skills Training Handouts and Worksheets Second Edition. This group involves 6 weekly sessions.

  • Dialectical behavior therapy - interpersonal effectiveness skills trainingBehavioural

    Arm 2. Dialectical behavior therapy - interpersonal effectiveness skills training follows the interpersonal effectiveness skills DBT Skills Training Manual Second Edition and the DBT Skills Training Handouts and Worksheets Second Edition. This group involves 6 weekly sessions.

  • Interpersonal psychotherapyBehavioural

    Arm 3. Non-skills-oriented interpersonal psychotherapy group follows evidence-based principles on common factors in a group therapy context. This group involves 6 weekly sessions.

Study groups in NCT04626310
Study groupRoleWhat they receive
Dialectical behavior therapy - emotion regulation skills trainingExperimentalDialectical behavior therapy - emotion regulation skills training
Receives: Behavioral: Dialectical behavior therapy - emotion regulation skills training
Dialectical behavior therapy - interpersonal effectiveness skills trainingExperimentalDialectical behavior therapy - interpersonal effectiveness skills training
Receives: Behavioral: Dialectical behavior therapy - interpersonal effectiveness skills training
Non-skills-oriented interpersonal psychotherapy groupActive comparatorNon-skills-oriented interpersonal psychotherapy group
Receives: Behavioral: Interpersonal psychotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Emotional Functioning - Linear

    Assessed with the Difficulties in Emotion Regulation Scale (DERS), which has total scores that range from 36-180, with higher scores indicating more difficulties. Outcomes are reported as slopes (scores over weeks, centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/multilevel models. This measure is listed separately to permit presentation of two units of measure (that are in the same model) - the Linear unit of measure (DERS scores/week), and the Quadratic unit of measure (DERS scores/week^2). This measure reflects the Linear measure.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7, follow-up week 13-14

  2. Change in Borderline Personality Disorder Features - Linear

    Assessed with the abbreviated Borderline Symptom List (BSL23), which has mean scores that range from 0-4, with higher scores indicating more symptoms. Outcomes are reported as slopes (scores rescaled *100 over weeks, centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/multilevel models. This measure is listed separately to permit presentation of two units of measure (that are in the same model) - the Linear unit of measure (BSL scores/week), and the Quadratic unit of measure (BSL scores/week^2). This measure reflects the Linear measure.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7, follow-up week 13-14

  3. Change in Emotional Functioning - Quad

    Assessed with the Difficulties in Emotion Regulation Scale (DERS), which has total scores that range from 36-180, with higher scores indicating more difficulties. Outcomes are reported as slopes (scores over weeks, centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/multilevel models. This measure is listed separately to permit presentation of two units of measure (that are in the same model) - the Linear unit of measure (DERS scores/week), and the Quadratic unit of measure (DERS scores/week^2). This measure reflects the Quadratic measure.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7, follow-up week 13-14

  4. Change in Borderline Personality Disorder Features - Quad

    Assessed with the abbreviated Borderline Symptom List (BSL23), which has mean scores that range from 0-4, with higher scores indicating more symptoms. Outcomes are reported as slopes (scores rescaled *100 over weeks, centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/multilevel models. This measure is listed separately to permit presentation of two units of measure (that are in the same model) - the Linear unit of measure (BSL scores/week), and the Quadratic unit of measure (BSL scores/week^2). This measure reflects the Quadratic measure.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7, follow-up week 13-14

Secondary outcomes (6)
  1. Change in Self-reported Emotional Reactivity

    Assessed with self-reported emotions on the PANAS negative affect (NA) scale (mean scores on a scale of 1-5) in response to emotional scripts (Neg: neutral (Neu), negative (Neg)) by emotion regulation condition (Reg: emotional maintain instructions, and negative with decrease instructions) presented in the lab. Outcomes are reported as slopes differences in PANAS NA scores between neutral and negative-maintain over weeks (centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/multilevel models.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7

  2. Change in Self-reported Emotional Regulation

    Assessed with self-reported emotions on the PANAS negative affect (NA) scale (mean scores on a scale of 1-5) in response to emotional scripts (neutral (Neu), negative (Neg)) by emotion regulation condition (Reg: with emotional maintain (Main) instructions, and negative with decrease (Dec) instructions) presented in the lab. Outcomes are reported as slopes differences in PANAS NA scores between Reg conditions in response to negative stimuli (negative-decrease and negative-maintain) over weeks (centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/ multilevel models.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7

  3. Change in Affect-modulated Startle

    Assessed with eyeblink startle amplitude (mV) in response to emotional cues presented in the lab (of note, per protocol, we examined eyeblink in response to negative and neutral image stimuli across initial [novel] and repeated presentations) which were presented along with sound bursts to elicit startle. This outcome was transformed and then rescaled (*100, = mVtr). Outcomes are reported as slopes per condition over weeks (centered around the start of treatment, with standard errors) per condition, extracted from mixed effects/multilevel models with image valence (Neg: negative vs. neutral) and type (Novel: novel vs. repeated) within-person condition effects.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7

  4. Change in Emotional Habituation

    Assessed with skin conductance (SC; microsiemens, μS) in response to emotional cues presented in the lab (of note, per protocol, we examined DV in response to negative and neutral image stimuli [Neg] across initial [Novel] and repeated presentations) which were presented along with sound bursts to elicit startle. Data were transformed to address skew (μStr). Outcomes are reported as novel x negative slopes (SLP) over weeks (centered around the start of treatment, with standard errors) per condition, extracted from mixed effects / multilevel models.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7

  5. Change in Physiological Emotional Reactivity

    Assessed with skin conductance (SC; microsiemens, μS) in response to emotional scripts (Neg: neutral, negative) by emotion regulation (Reg: emotional maintain instructions, and negative with decrease instructions) presented in the lab. Data were transformed to address skew (μStr). Outcomes are reported as slopes of Negative (Neg) condition effects on SC over weeks (centered around the start of treatment, with standard errors) per condition, extracted from mixed effects / multilevel models.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7

  6. Change in Deliberate Physiological Emotional Regulation

    Assessed with high frequency heart rate variability (HRV, ms2/hz) in response to emotional scripts (Negative: negative vs. neutral) with emotion regulation instructions (Reg: Maintain vs. Decrease in the Negative condition) presented in the lab. Data were transformed to address skew (ms2/hztr). Outcomes are reported as slopes of the effect of the Reg condition on HRV over weeks (centered around the start of treatment, with standard errors) per condition, extracted from mixed effects /multilevel models.

    Measured: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Nov 2020
  2. Study start26 Oct 2020
  3. Primary completion6 Feb 2023
  4. Study completion6 Feb 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
84 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04626310
Sponsor's protocol ID
1710 1R21MH119530-01A1
Other IDs
R21MH119530-01A1
Acronym
MAP-DBT
Status last verified
Nov 2024
First submitted
1 Nov 2020
Last updated
27 Nov 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Data will be shared via NDA.

Questions about this trial

What is this clinical trial studying?

A study testing Dialectical behavior therapy - emotion regulation skills training, Dialectical behavior therapy - interpersonal effectiveness skills training and Interpersonal psychotherapy in people with Borderline Personality Disorder, run by University of Massachusetts, Amherst at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 27 Nov 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Emotional Functioning - Linear (time frame: Pre-treatment, mid-treatment week 3-4, post-treatment week 6-7, follow-up week 13-14). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Nov 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in