Abstract
This chapter describes the origins, structure and applications of dialectical behaviour therapy (DBT) and the evidence base for its efficacy across adult patient populations. A review of current literature, prospective directions and contraindications for DBT in the treatment of pathological gambling (PG), and a case study are included. Despite strong evidence for the efficacy of DBT for other addictions, disorders with a high comorbidity with PG, and commonly co-occurring features such as emotion dysregulation, there has been limited research in the application of this therapy to the PG population. Research is needed to delineate the groups for which DBT treatment may be effective. The theoretical links outlined suggest a cautiously hopeful outlook for the use of this intervention for a subgroup of pathological gamblers (PGs), particularly for those who are less responsive to traditional CBT.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.
Andreasson, K., Krogh, J., Wenneberg, C., Jessen, H., Krakauer, K., Gluud, C., Thomsen, R. R., Randers, L., & Nordentoft, M. (2016). Effectiveness of dialectical behavior therapy versus collaborative assessment and management of suicidality treatment for reduction of self-harm in adults with borderline personality traits and disorder- a randomized observer-blinded clinical trial. Journal of Depression and Anxiety, 33, 520–530.
Axelrod, S. R., Perepletchikova, F., Holtzman, K., & Sinha, R. (2011). Emotion regulation and substance use frequency in women with substance dependence and borderline personality disorder receiving dialectical behaviour therapy. The American Journal of Drug and Alcohol Abuse, 37, 37–42.
Bagby, M., Bachon, D. D., Bulmash, E., & Quilty, L. C. (2008). Personality disorders and pathological gambling: A review and re-examination of prevalence rates. Journal of Personality Disorders, 22, 191–207.
Berk, M. S., Jeglic, E., Brown, G. K., Henriques, G. R., & Beck, A. T. (2007). Characteristics of recent suicide attempts with and without borderline personality. Archives of Suicide Research, 11, 91–104.
Binks, C., Fenton, M., McCarthy, L., Lee, T., Adams, C. E., & Duggan, C. (2006). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews: John Wiley & Sons.
Black, D. W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behaviour in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18, 226–239.
Blaszczynski, A., & Steel, Z. (1998). Personality disorders among pathological gamblers. Journal of Gambling Studies, 14(1), 51–71.
Bouchard, S., Sabourin, S., Lussier, Y., & Villeneuve, E. (2009). Relationship quality and stability in couples where one partner suffers from borderline personality disorder. Journal of Marital and Family Therapy, 35, 446–455.
Bray, S., Barrowclough, C., & Lobban, F. (2007). The social problem-solving abilities of people with borderline personality disorder. Behaviour Research and Therapy, 45, 1419–1417.
Brown, M., Allen, J. S., & Dowling, N. A. (2015). The application of an etiological model of personality disorders to problem gambling. Journal of Gambling Studies, 31, 1179. doi:10.1007/s10899-014-9504-z.
Brown, M., Oldenhof, E., Allen, J. S., & Dowling, N. A. (2016). An empirical study of personality disorders among treatment-seeking problem gamblers. Journal of Gambling Studies, 32(4), 1079–1100. Online publication date: 26-Mar-2016.
Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010). Hunter DBT project: Randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Australian New Zealand Journal of Psychiatry, 44, 162–173.
Chapman, A. L. (2006). Dialectical behavior therapy: Current indications and unique elements. Psychiatry (Edgmont), 3(9), 62–68.
Christensen, D. R., Dowling, N. A., Jackson, A. C., Brown, M., Russo, J., Francis, K. L., & Umemoto, A. (2013). A proof of concept for using brief dialectical behavior therapy as a treatment for problem gambling. Behaviour Change, 30(2), 117–137. doi:10.1017/bec.2013.10.
Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multiwave study. American Journal of Psychiatry, 164(6), 922–928.
Courbasson, C., Nishikawa, Y., & Dixon, L. (2012). Outcome of dialectical behaviour therapy for concurrent eating and substance use disorders. Clinical Psychology and Psychotherapy, 19(5), 434–449.
Cowlishaw, S., Merkouris, S., Chapman, A., & Radermacher, H. (2014). Pathological and problem gambling in substance use treatment: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 46(2), 98.
Crockford, D. N., & el-Guebaly, N. (1998). Psychiatric co-morbidity in pathological gambling: A critical review. Canadian Journal of Psychiatry, 43, 43–50.
Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial development model borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 135, 45–510.
de Lisle, S., Dowling, N. A., & Allen, S. J. (2012). Mindfulness and problem gambling: A review of the literature. Journal of Gambling Studies, 28, 719–739.
de Lisle, S., Dowling, N. A., & Allen, J. S. (2014). Mechanisms of action in the relationship between mindfulness and problem gambling behaviour. International Journal of Mental Health Addiction, 12, 206. doi:10.1007/s11469-014-9475-4.
Delfabbro, P., Lahn, J., & Grabosky, P. (2006). Psychosocial correlates of problem gambling in Australian students. Australian and New Zealand Journal of Psychiatry, 40, 587–595.
Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., et al. (2015). The prevalence of comorbid personality disorders in treatment-seeking problem gamblers: A systematic review and meta-analysis. Journal of Personality Disorders, 29(6), 735–754. doi:10.1521/pedi_2014_28_168.
Dowling, N. A., Merkouris, S. S., & Lorains, F. K. (2016). Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research. Addictive Behaviours, 58, 21–30.
Fernandez- Montalvo, J., & Echeburua, E. (2004). Pathological gambling and personality disorders: An exploratory study with the IPDE. Journal of Personality Disorders, 18, 500–505.
Jacob, G. A., Guenzler, C., Zimmermann, S., Scheel, C. N., Rusch, N., et al. (2008). Time course of anger and other emotions in women with borderline personality disorder: A preliminary study. Journal of Behaviour Therapy and Experimental Psychiatry, 39, 391–402.
Kaare, P., Mottus, R., & Konstabel, K. (2009). Pathological gambling in Estonia: Relationships with personality, self-esteem, emotional states and cognitive ability. Journal of Gambling Studies, 25, 377–390.
Kim, S. W., Grant, J. E., Eckert, E. D., Faris, P. L., & Hartman, B. K. (2006). Pathological gambling and mood disorders: Clinical associations and treatment implications. Journal of Affective Disorders, 92, 109–116.
Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzelez, A. M., Morse, J. Q., et al. (2001). Efficacy of dialectical behaviour therapy in women veterans with borderline personality disorder. Behavior Therapy, 32, 371–390.
Korman, L., Collins, J., Littman-Sharp, N., McMain, S., & Skinner, W. (2005). Concurrent gambling, substance use and anger: Development of a brief integrated treatment (final report). Guelph: Ontario Problem Gambling Research Centre.
Korman, L., Collins, J., Dutton, D., Dhayananthan, B., Littman-Sharp, N., & Skinner, W. (2008). Problem gambling and intimate partner violence. Journal of Gambling Studies, 24, 13–23.
Linehan, M. M. (1987). Dialectical behavioral therapy: A cognitive behavioral appraoch to parasuicide. Journal of Personality Disorders, 1, 328–333.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioural treatment of chronically suicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.
Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, C. C., Kanter, M. A., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. The American Journal on Addictions, 8(4), 279–292.
Linehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Welch, S. S., Heagerty, P., & Kivlahan, D. R. (2002). Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67(1), 13–26.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behaviour therapy vs. therapy by experts for suicidal behaviour and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.
Lorains, F. K., Cowlishaw, S., & Tomas, S. (2011). Prevalence of co-morbid disorders in problem and pathological gambling. Addiction, 106, 490–498.
Lynch, T. R., Morse, J. Q., Mendelson, T., & Robins, C. J. (2003). Dialectical behavior therapy for depressed older adults. American Journal of Geriatric Psychiatry, 11, 33–45.
Lynch, T. R., Cheavens, J. S., Cukrowicz, K. C., Thorp, S. R., Bronner, L., & Beyer, J. (2007). Treatment of older adults with co-morbid personality disorder and depression: A dialectical behavior therapy approach. International Journal of Geriatric Psychiatry, 22(2), 131–143.
MacCallum, F., & Blaszczynski, A. (2003). Pathological gambling and suicidality: An analysis of severity and lethality. Suicide and Life Threatening Behavior, 33, 88–98.
MacKay, M., Wood, J. C., & Brantley, J. (2007). Dialectical behaviour therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, & distress tolerance. Oakland: New Harbinger Publications.
McMain, S. F., Links, P. A., Gnam, W. H., Guimond, T., Cardish, R. J., Korman, L., & Streiner, D. L. (2009). A randomized trial of dialectical behaviour therapy versus general psychiatric management for borderline personality disorder. American Journal of Psychiatry, 166, 1365–1374.
Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40–51.
Nower, L., & Blaszczynski, A. (2006). Impulsivity and pathological gambling: A descriptive model. International Gambling Studies, 6, 61–75.
Petry, N. M. (2005). Pathological gambling: Etiology, comorbidity, and treatment. Washington, DC: American Psychological Association.
Petry, N. M. (2007). Gambling and substance use disorders: Current status and future directions. The American Journal on Addictions, 16, 1–9.
Priebe, S., Bhatti, N., Barnicot, K., Bremner, S., Gaglia, A., Katsakou, C., Molosankwe, I., McCrone, P., & Zinkler, M. (2012). Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: A pragmatic randomised controlled trial. Psychotherapy and Psychosomatics, 81, 356–365.
Querney, D. (2006). STEPS: A modified DBT group for preventing relapse among problem gamblers and substance abusers. Retrieved March 25, 2017, from http://www.responsiblegambling.org/articles/deirdre_querney_discovery_2006.pdf
Stanley, B., & Wilson, S. T. (2006). Heightened subjective experience of depression in borderline personality disorder. Journal of Personality Disorders, 20, 307–318.
Ste-Marie, C., Gupta, R., & Derevensky, J. (2006). Anxiety and social stress related to adolescent gambling behaviour and substance use. Journal of Child and Adolescent Substance Use, 15, 55–74.
Stepp, S. D., Epler, A. J., Jahng, S., & Trull, T. J. (2008). The effect of dialectical behaviour therapy skills use on borderline personality disorder features. Journal of Personality Disorders, 22, 549–563.
Trull, T., Sher, K. J., Minks-Brown, C., Durbin, J., & Burr, R. (2000). Borderline personality disorder and substance use disorders: A review and integration. Clinical Psychology Review, 20, 235–253.
Turner, R. M. (2000). Naturalistic evaluation of dialectical behaviour therapy-oriented treatment for borderline personality disorder. Cognitive and Behavioural Practice, 7(4), 413–419.
Verheul, R., Van Den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder. The British Journal of Psychiatry, 182(2), 135–140.
Wanner, B., Ladoucer, R., Auclair, A. V., & Vitaro, F. (2006). Flow and dissociation: Examination of mean levels, cross links, and links to emotional well-being across sports and recreational and pathological gambling. Journal of Gambling Studies, 22, 289–304.
Williams, A. D., Grisham, J. R., Erskine, A., & Cassedy, E. (2011). Deficits in emotion regulation associated with pathological gambling. British Journal of Clinical Psychology, 51, 223–238. doi:10.1111/j.2044-8260.2011.02022.x.
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Fennessy, K. (2017). Dialectical Behaviour Therapy and Pathological Gambling. In: Evidence-Based Treatments for Problem Gambling. SpringerBriefs in Psychology. Springer, Cham. https://doi.org/10.1007/978-3-319-62485-3_8
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