(PS12-A5) Positive and Negative Affect Changes in DBT-A Treatment Sessions in Adolescents with Borderline Symptomatology

Dialectical behavior therapy (DBT), including DBT for adolescents (DBT-A), is an evidence-based treatment for people with severe emotion dysregulation (Linehan, 1993; Kliem et al., 2010). There is evidence that people with borderline personality disorder, a disorder characterized by emotion dysregulation, have more sudden changes in affect compared to non-clinical samples and individuals with depression (for a review, see Nica & Links, 2009). However, less is known about affect changes within treatment sessions. Such information has implications to support DBT-A as an effective treatment for affect regulation. One study found evidence demonstrating that in an adult sample of individuals with BPD, positive affect increased after individual DBT sessions while negative affect decreased, and over time, levels of negative affect pre-session decreased (King et al., 2019). Given that adolescence is a crucial period for the development of emotion dysregulation (Crowell et al., 2009), it would be useful to know if these same patterns are found in DBT-A. The aims of this study are to investigate if levels of positive affect increase/negative affect decrease during DBT-A individual sessions and if levels of affect changes over time.  

Data were drawn from a sample of adolescents (n = 17) ages 13-17 who were part of a 6-month comprehensive DBT-A program. The participants had an average age of 15.18 years old and were 100% female and 23.5% non-Hispanic white (n = 4). At the beginning and end of each individual session, positive and negative affect were assessed using the Positive and Negative Affect Scale (PANAS). PANAS ratings were collected over 398 total sessions across the sample, with an average of 23.41 sessions per participant. We will use hierarchal linear modeling (HLM) to examine changes in positive and negative affect within person from pre- to post- session as well as changes in positive and negative affect at pre-session over time. 

This research may better inform us of the process of affect changes within adolescents with borderline pathology receiving DBT thereby enhancing our understanding of DBT’s potential to successfully reduce emotion dysregulation. Future research could investigate whether such changes in affect within DBT sessions is related to critical treatment outcomes.