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ViewAttendees 5

Symposia

Personality Disorders

Pinpointing Mechanisms and Moderators of Treatment for Borderline Personality Disorder

3 - (SYM 113) Distress Tolerance as a Mechanism of Change in Intensive Residential Dialectical Behavior Therapy for Adolescents with Borderline Personality Disorder

Sunday, November 17, 2024
8:30 AM – 10:00 AM EST
Location: Grand Ballroom D, Level 5, Downtown Marriott
Abstract Body



Background: Dialectical behavior therapy (DBT) has gained significant empirical support for treating borderline personality disorder (BPD). However, the majority of DBT outcome studies in adolescent populations rely on self-report of symptoms, which is limiting because it relies on insight/self-awareness that is still developing in adolescents, uses retrospective recall, and are typically cross-sectional. There is a clear need to better understand the behavioral mechanisms driving BPD in adolescents, and if/how DBT targets these mechanisms so as to inform treatment optimization and efficiency. This study sought to evaluate a behavioral task measure of distress tolerance as a mechanism of change in intensive residential DBT for adolescents.



Methods: Participants included 13-23 year-old (N=127; BPD = 83 vs. HC = 39). At baseline, all participants administered the Computerized Mirror Tracing Persistence Task (MTPT-C), a behavioral task that measures distress intolerance, and self-report measures of BPD symptoms were completed at pre- and post- one month of intensive residential DBT. Independent t-tests were conducted to test group differences in distress tolerance. Mixed model analysis of variance (ANOVA) was used to test changes in BPD symptoms following one month of intensive residential DBT. Partial eta squared (ηp2) was used to measure effect sizes.



Results: Preliminary results showed a significant main effect of group at baseline. Participants in the patient group reported significantly lower rates of distress tolerance as measured by faster time to quit on the MTPT-C than those in the control group, F(1, 108.04 = 9.09, p < .01; ηp2 = .08]. The main effect of time was also significant suggesting an overall decrease in BPD symptoms from baseline to post-treatment, F(1, 94.90 = 18.25, p < .001; ηp2 = .16]. The group x time interaction was also significant, indicating greater reduction in symptoms for the patient group compared to the control group, F(1, 91.63 = 12.34, p < .001; ηp2 = .11. Additional analyses will be conducted to test performance on the MTPT-C distress tolerance task as a mediator of treatment outcome.



Conclusions: Results suggest adolescents with BPD demonstrate less distress tolerance as measured with the MTPT-C behavioral task than healthy controls on an objective distress tolerance task, and self-reported BPD symptoms improve over the course of a brief, intensive residential DBT program. Further research is needed to evaluate distress tolerance as a mediator or moderator of treatment outcomes.