Effectiveness of Dialectical Behavior Therapy on Executive Functions and Emotion Dysregulation in Adults with Bipolar Disorder
Objective: To evaluate whether dialectical behavior therapy (DBT) improves executive functions and reduces emotion dysregulation in adults with bipolar disorder using a quasi-experimental, pretest–posttest, controlled design with four-month follow-up.
Methods and Materials: Thirty adults with DSM-5 bipolar disorder (25–45 years) were recruited via purposive sampling and randomly assigned to DBT (n=15) or wait-list control (n=15). The intervention comprised eight 90-minute group sessions over four weeks based on Linehan’s skills modules (mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness). Outcomes were assessed at pretest, posttest, and four-month follow-up using Nejati’s Executive Function Questionnaire (30 items) and the Difficulties in Emotion Regulation Scale (36 items). Data were analyzed in SPSS 26 using mixed repeated-measures ANOVA with assumption checks and Greenhouse–Geisser corrections; significance was set at .05.
Findings: Groups were demographically comparable at baseline. Significant group and time effects emerged for both outcomes. Executive functions improved in the DBT group from pretest to posttest and were largely maintained at follow-up, whereas controls showed no meaningful change (group effect F large; partial η²≈.66; time effect partial η²≈.69). Emotion dysregulation decreased significantly in DBT relative to control and remained improved at follow-up (group effect partial η²≈.89; time effect partial η²≈.31). No adverse events were reported, and retention exceeded 80%.
Conclusion: Brief group-based DBT produced clinically and statistically significant improvements in executive functions and reductions in emotion dysregulation that persisted for four months. Findings support integrating DBT skills training as an adjunct to standard care for bipolar disorder; larger randomized trials with longer follow-up and treatment-fidelity monitoring are warranted.
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