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Originalia

Eine Meta-Analyse zur Wirksamkeit der Dialektisch Behavioralen Therapie bei Borderline-Persönlichkeitsstörungen

Published Online:March 12, 2007https://doi.org/10.1026/1616-3443.36.1.11

Abstract

Zusammenfassung.Theoretischer Hintergrund: Die Dialektisch Behaviorale Therapie (DBT) gilt inzwischen als empirisch bewährte Behandlungsform für die Borderline-Persönlichkeitsstörung im ambulanten wie stationären Setting. Fragestellung: Wie groß ist die durchschnittliche Wirksamkeit in den bisherigen Studien? Gibt es Hinweise auf eine differenzielle Effektivität? Unterscheidet sich die Wirksamkeit im ursprünglich ambulanten Konzept von der stationären Adaptation? Methode: Eine Literaturrecherche erbringt zehn Primärstudien, die in die Meta-Analyse eingehen. Berechnet werden neben summarischen Effektstärken (ES) über alle Maße spezifische ES für die Bereiche Impulsivität, Soziale Anpassung und allgemeine Symptombelastung. Ergebnisse: Die globale Wirksamkeit der DBT liegt bei ES = 0,62. Verbesserungen der Sozialen Anpassung fallen mit einer ES von 1,09 noch höher aus. Zwischen ambulantem und stationärem Setting ergaben sich keine Unterschiede. Schlussfolgerungen: DBT kann als wirksames Behandlungsverfahren gelten. Notwendig erscheinen weitere kontrollierte Studien besonders im stationären Bereich.


A meta-analysis of the efficacy of Dialectical Behavior Therapy in borderline personality disorder

Abstract.Background: Dialectical Behavioral Therapy (DBT) is currently thought to be efficacious in the outpatient and inpatient treatment of Borderline Personality Disorder (BPD). Objective: What is the overall empirical evidence for DBT? Are there specific areas where its efficacy differs? Are there differences in effectiveness between the original outpatient model and the adaptation for inpatient treatment? Method: A review of the literature revealed 10 studies investigating DBT’s effectiveness. Effect sizes (ES) were calculated across all measures as well as specifically for impulsivity, social adjustment, and general psychopathology. Results: The overall mean ES is 0.62. The ES of 1.09 suggests that the treatment is most powerful in enhancing social adjustment. No differences in effectiveness were found between inpatient and outpatient DBT treatments. Conclusions: DBT seems to be generally effective. There is a need for more controlled studies especially for inpatient DBT.

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