Reduction of Self-injury and Improvement of Coping Behavior during Dialectical Behaviour Therapy (DBT) of Patients with Borderline Personality Disorder

The development of self-injury and coping was studied during dialectical behavior therapy of patients with a borderline personality disorder. Coping strategies and self-injury behaviors of 19 patients were assessed at pre-treatment, after six months of treatment, and at post-treatment. Apart from correlational analyses, Reliable Changes Indices (RCIs) were used to correct for the effects of chance, measurement error, and practice and to ensure that possible changes can be attributed to the effect of DBT, i.e., that a statistically significant change had occurred in the use of coping strategies and self-injury behaviors during DBT. At baseline, passive coping was used more frequently than active coping and little support was found for a relation between self-injury and coping. After treatment completion, fewer patients resorted to self-injury and passive coping and more active coping was used. Some indication was found for more changes in coping and self-injury in the first half year than in the second half year of treatment. Clinical implications are discussed.