Early Versus Later Improvements in Dialectical Behavior Therapy Skills Use and Treatment Outcome in Eating Disorders
Dialectical behavior therapy (DBT) has demonstrated initial efficacy for the treatment of eating disorders (EDs). However, no study has examined potential processes that may contribute to observed improvements in DBT for EDs. The present study sought to investigate changes in DBT skills use throughout treatment as a predictor of symptom change in a DBT-based partial hospital program (PHP) for adults with EDs. Adults [n = 135; M(SD) age = 25.08 (7.88)] with EDs completed self-report measures at treatment admission, one-month post-admission, and discharge from PHP. DBT skills use, as measured by the DBT Ways of Coping Checklist, increased by 12.65% from admission to one-month post-admission and increased by 24.10% from admission to discharge. Early (admission to month 1) and later (month 1 to discharge) improvements in DBT skills use predicted greater improvements in ED, depressive, and emotion dysregulation symptoms from treatment admission to discharge. Notably, early versus later change in skills use was a stronger predictor of outcome. Results are consistent with the theoretical model of DBT and add to a growing literature on DBT for EDs.
KeywordsDialectical behavior therapy Eating disorders Skills use Predictors Partial hospital program
The authors thank Lauren Gomez and Tiffany Nakamura for their assistance with data collection, the patients who participated in this research, and the current and past clinical staff for their clinical expertise and support of this research.
Compliance with Ethical Standards
Conflict of Interest
Tiffany A. Brown, Anne Cusack, Leslie Anderson, Erin E. Reilly, Laura A. Berner, Christina E. Wierenga, Jason M. Lavender, and Walter H. Kaye declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of California, San Diego and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
No animal studies were carried out by the authors for this article.
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