Forgiveness in the Treatment of Borderline Personality Disorder: A Quasi-Experimental Study.

OBJECTIVE: This pilot study evaluated a manualized group forgiveness module within dialectical behavior therapy (DBT). METHOD: The study utilized a quasi-experimental double pretest design with adults (N = 40; 88.1% female, 11.9% male) diagnosed with borderline personality disorder in outpatient DBT. Measures of forgiveness, attachment, and psychiatric symptoms were completed at 4 time points. RESULTS: Participants showed increases in all measures of forgiveness and decreases in attachment insecurity and psychiatric symptoms during the forgiveness module and maintained to the 6-week follow-up. These effects were not observed during the prior distress tolerance module. Latent change score modeling showed reductions in anxious attachment mediated the effect of changes in benevolent motivations to forgive and trait forgiveness scores on reductions in psychiatric symptoms. CONCLUSIONS: Effect sizes were similar to meta-analytic findings on (a) forgiveness interventions and (b) reductions in psychiatric symptoms in DBT. Participant feedback suggested elements for further development. A randomized controlled trial is needed.

Efficacy of extended-release divalproex combined with "condensed" dialectical behavior therapy for individuals with borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is a significant psychiatric illness for which medication treatments are still being explored. The goal of this study was to assess divalproex extended release (ER) vs placebo for patients receiving dialectal behavior therapy (DBT). METHODS: Patients with BPD received 4 weeks of "condensed DBT." Those with Symptom Checklist-90 (SCL-90) scores >150 after this treatment were then randomly and blindly assigned to placebo or divalproex ER for 12 weeks. Repeated measures analysis of variance utilizing last observation carried forward was used to assess the results. RESULTS: Seventeen participants completed the full assessment. Two patients had a significant decrease in SCL-90 in the first 4 weeks, leaving 15 patients for the medication phase of the trial. There were no significant differences between the participants assigned to divalproex ER compared with placebo. However, there was a significant improvement in both groups from baseline to endpoint (P = .001). CONCLUSIONS: The response of 2 of 17 participants in the first 4 weeks prior to medication may point to a practice strategy in approaching outpatients with BPD. Although the patients had a decrease in symptoms during the study, there was no advantage observed for divalproex ER and DBT over placebo and DBT.