ABSTRACT

Dialectical Behavior Therapy (DBT) is effective at treating disorders of emotion dysregulation. However, it is unclear which mechanisms contribute to these effects. The aim of this study was to characterize the within-person associations of two theoretically relevant mechanisims of change, skill use and skill effectiveness, with anxiety, stress, and depression. Participants (n = 19, M_age = 31.8, 68% female) with a primary anxiety or depressive disorder completed daily reports (N = 1344) of DBT skill use, perceived effectiveness, anxiety, stress, and depression during a 16-session DBT skills training group. DBT skill use increased across treatment, p < .01, but effectiveness did not, p = .64. Within persons, participants used more skills on days with greater stress and anxiety, p < .01, which predicted next-day decreases in stress and anxiety, p = .03. On days when participants reported higher effectiveness, they used more skills than their personal average when experiencing more intense negative affect, p < .01. These results suggest using more skills, especially when used more effectively, is a mechanism by which DBT skills groups address emotional dysfunction for those with transdiagnostic emotional disorders.

摘要

辩证行为疗法 (DBT) 可有效治疗情绪失调。然而，尚不清楚是哪些机制促成了这些影响。本研究的目的是描述两种理论上相关的变化机制、技能使用和技能有效性与焦虑、压力和抑郁之间的个人关联。患有原发性焦虑或抑郁症的参与者（n = 19，M_年龄 = 31.8，68% 女性）在 16 次 DBT 期间完成了 DBT 技能使用、感知有效性、焦虑、压力和抑郁的每日报告（ N = 1344）技能培训组。DBT 技能的使用在整个治疗过程中有所增加，p < .01，但有效性没有，p= .64。在人体内，参与者在压力和焦虑更大的日子里使用了更多的技能，p < .01，这预示着第二天的压力和焦虑会减少，p = .03。在参与者报告效率更高的日子里，他们在经历更强烈的负面影响时使用了比个人平均水平更多的技能，p < .01。这些结果表明，使用更多技能，尤其是在更有效地使用时，是 DBT 技能组解决情绪障碍患者情绪障碍的一种机制。