Effectiveness of Dialectical Behavior Therapy (DBT) in a Forensic Psychiatric Hospital

Article Figures & Data

Table 1

Patient Descriptive Data (N = 650)

Variable	Mean (SD)	N (%)
Age	37.1 (11.9)	—
Gender
Female	—	127 (19.5)
Male	—	523 (80.5)
Ethnicity	—
White	—	401 (61.7)
Black	—	226 (34.8)
Asian	—	9 (1.4)
Hispanic	—	6 (0.9)
Arabic	—	4 (0.6)
Indian and Alaskan Native	—	4 (0.6)
Legal Status
Not guilty by reason of insanity (NGRI)	—	498 (76.6)
Incompetent to stand trial (IST)	—	146 (22.4)
Other (civil and voluntary admission)	—	6 (1.0)
Number of Diagnoses
One	—	323 (49.7)
Two	—	240 (36.9)
Three	—	73 (11.2)
Four	—	14 (2.2)
Psychiatric Diagnosis^a
Substance use disorder	—	260 (40.1)
Psychotic disorder	—	234 (36.0)
Schizoaffective disorder	—	202 (31.1)
Bipolar disorder	—	176 (27.1)
Other affective disorder	—	51 (7.8)
Borderline PD	—	31 (4.8)
Not otherwise specified PD	—	28 (4.3)
Intellectual disability diagnosis	—	25 (3.8)
Antisocial PD	—	23 (3.5)
PTSD	—	23 (3.5)
Anxiety disorder	—	14 (2.1)
Narcissistic PD	—	6 (0.9)
Dependent PD	—	3 (0.5)

↵^aThe frequency distributions total more than N = 650 because of the overlap in diagnoses.
Abbreviations: PD = personality disorder, PTSD = posttraumatic stress disorder

Table 3

Descriptive Statistics for Paired Sample T-Test Analyses

	Baseline		6-Month Follow-Up
	Mean Score (SD)	Range	Mean Score (SD)	Range	P-Value	Cohen’s d
Self -Report Measures
AAQ-II (N = 72)	18.22 (9.70)	7.00–47.00	15.49 (8.19)	7.00–43.00	<.001^c	.386
PHQ-9 (N = 74)	5.55 (5.43)	0.00–25.00	4.22 (4.43)	0.00–18.00	.004^b	.314
BSL-23 (N = 139)	0.65 (0.72)	0.00–4.00	0.54 (0.65)	0.00–3.45	.008^b	.208
Ways of Coping
Use of DBT skills (N = 70)	1.73 (0.67)	0.00–2.95	1.78 (0.70)	0.00–2.84	.236	–.086
Use of dysfunctional coping (N = 70)	1.23 (0.72)	0.00–3.00	1.09 (0.68)	0.00–2.73	.020^a	.250
Blaming others (N = 70)	0.76 (0.77)	0.00–3.00	0.62 (0.65)	0.00–2.67	.029^a	.231
DBT Knowledge Quizzes
Mindfulness (N = 31)	5.87 (1.75)	1.00–8.00	6.23 (1.88)	1.00–8.00	.148	–.191
Distress tolerance (N = 31)	6.23 (1.96)	1.00–8.00	6.61 (1.26)	3.00–8.00	.089	–.248
Emotion regulation (N = 31)	5.23 (1.93)	0.00–8.00	5.97 (1.72)	0.00–8.00	.013^a	–.419
Interpersonal effectiveness (N = 31)	4.61 (2.06)	0.00–7.00	5.52 (2.10)	0.00–8.00	.005^b	–.488

↵^aP < .05.
↵^bP < .01.
↵^cP ≤ .001.
Abbreviations: AAQ-II = Acceptance and Action Questionnaire, BSL-23 = Borderline Symptoms List, PHQ-9 = Patient Health Questionnaire

Table 4

Descriptive Statistics for Behavioral Outcomes

Behavioral Variables	Q1 Mean (SD) Range	Q2 Mean (SD) Range	Q3 Mean (SD) Range	Q4 Mean (SD) Range
Incidents of assault^a	0.19 (0.61) 0.00–4.00	0.21 (0.80) 0.00–7.00	0.12 (0.51) 0.00–4.00	0.08 (0.41) 0.00–3.00
Incidents of behavioral dyscontrol^b	0.18 (0.94) 0.00–10.00	0.09 (0.35) 0.00–2.00	0.07 (0.30) 0.00–2.00	0.09 (0.31) 0.00–2.00
PRN medication use^c	6.28 (20.99) 0.00–179.00	4.06 (16.11) 0.00–165.00	4.24 (18.29) 0.00–177.00	1.73 (9.73) 0.00–121.00

Table 5

Repeated Measures ANOVA Post Hoc Analyses

Variable	F	P	η_p²	Mean Difference	SE	P
Assaultive incidents	5.37	.001^c	.021	—	—	—
Q1–Q2	—	1.000	—	0.02	0.040	1.00
Q1–Q3	—	.234	—	−0.07	0.036	.234
Q1–Q4	—	.028^a	—	−0.12	0.042	.028^a
Q2–Q3	—	.075	—	−0.10	0.039	.075
Q2–Q4	—	.015^a	—	−0.14	0.047	.015^a
Q3–Q4	—	1.000	—	−0.04	0.037	1.00
PRN medication use	6.61	<.001^c	.030	—	—	—
Q1–Q2	—	.108	—	−2.22	0.932	.108
Q1–Q3	—	.228	—	−2.04	0.978	.228
Q1–Q4	—	.005^b	—	−4.55	1.349	.005^b
Q2–Q3	—	1.000	—	0.18	0.801	1.00
Q2–Q4	—	.101	—	−2.33	0.966	.101
Q3–Q4	—	.096	—	−2.51	1.033	.096
Behavioral dyscontrol incidents	1.49	.229	.010	—	—	—