3 - (SYM 149) Improved Quality of Life Through Social Connectedness: Transdiagnostic RO-DBT for Adolescents

Background: Overcontrol is a phenotype characterized by inflexibility, perfectionism, and a need for control or structure, which increases risk for disorders such as anorexia nervosa, social anxiety, and obsessive-compulsive disorder. Given high comorbidity and limited efficacy of current treatments for these disorders, Radically Open Dialectical Behavior Therapy for adolescents (RO DBT-A) attempts to improve outcomes by targeting overcontrol as a transdiagnostic mechanism, especially by increasing social connectedness. Specifically, RO DBT focuses on targeting maladaptive social communication styles often seen in overcontrol (e.g., disingenuous or inhibited emotional expression) that may impair social connectedness, in order to help patients create “a life worth sharing”. Thus, this study aimed to test preliminary efficacy of telehealth-delivered RO DBT-A in targeting overcontrol as a mechanism of psychopathology in a heterogeneous clinical sample that included anxiety, depression, and eating disorders. 

Method: Participants were female adolescents (ages 13-21; 83% white; 80% non-Hispanic/Latino) who presented with elevated overcontrol. RO DBT-A was provided as the sole psychological treatment for those who wanted it (n = 13) over 16 weeks via skills group and individual sessions. Therapy was delivered via online platform due to the study being during the 2020 COVID pandemic. Non-treatment seeking participants served as controls (n = 7). Outcomes measured at baseline and post-treatment included psychiatric symptoms, quality of life, and overcontrol. 

Results: There were significant improvements in depression and quality of life in the RO DBT group compared to the control group. Testing change within the RO DBT group from baseline to post treatment demonstrated significant improvements in overcontrol, anxiety, depression and quality of life, even after FDR correction. 

Discussion: This study provides preliminary evidence for efficacy of telehealth-delivered RO DBT-A in targeting behavioral overcontrol, decreasing symptomology, and importantly, improving quality of life, in a heterogenous clinical sample of teens. Given the chronic nature of many disorders of overcontrol, improvements in quality of life may be especially important as symptoms wax and wane over the life course. Future studies should employ randomized design in larger sample sizes.