The Potential for a Skills-Based Dialectical Behavior Therapy Program to Reduce Aggression,Anger,and Hostility in a Canadian Forensic Psychiatric Sample: A Pilot Study
Restricted accessResearch articleFirst published online July, 2017
The Potential for a Skills-Based Dialectical Behavior Therapy Program to Reduce Aggression,Anger,and Hostility in a Canadian Forensic Psychiatric Sample: A Pilot Study
Dialectical behavior therapy (DBT) is designed to target maladaptive behaviors, such as aggression. The present pilot study assessed whether DBT reduces aggression, anger, and hostility in a forensic psychiatric sample (N = 15). A randomized waitlist control pre-post/follow-up crossover design was employed. Group-level findings indicated a reduction in hostility during and following DBT. Individual-level findings indicated some reductions in aggression during and following DBT. Individual-level findings indicated that participants in DBT improved more on measures of aggression compared to participants in treatment as usual. These results are preliminary. Implications and future directions in research are discussed.
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References
1.
18 U.S.C. s. 4242. Determination of the existence of insanity at the time of the offense (1948).
2.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
3.
AsmandP.MamiS.ValizadehR. (2015a). The effectiveness of dialectical behavior therapy and rational emotional behavior therapy in irrational believes treatment, depression prisoners who have antisocial personality disorder. Journal of. Preventive Prevent. Medicine and Holistic Health, 1(1), 27–33.
4.
AsmandP.MamiS.ValizadehR. (2015b). The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment, anxiety among young male prisoners who have antisocial personality disorder in Ilam prison. International Journal of Health System and Disaster Management, 3(2), 68–73.
5.
BlanchetteK.FlightJ.VerbruggeP.GobeilR.TaylorK. (2011). Dialectical behaviour therapy within a women's structured living environment (report r-241). Ottawa, Canada: Correctional Service Canada.
6.
BontaJ.AndrewsD. A. (2007). Risk-need-responsivity model for offender assessment and rehabilitation. Rehabilitation, 6, 1–22.
7.
BryantF. B.SmithB. D. (2001). Refining the Architecture of aggression: a measurement model for the Buss–Perry aggression questionnaire. Journal of Research in Personality, 35(2), 138–167. Journal Article. doi:10.1006/jrpe.2000.2302
8.
BussA. H.PerryM. (1992). The aggression questionnaire. Journal of Personality and Social Psychology, 63(3), 452.
9.
CharetteY.CrockerA. G.SetoM. C.SalemL.NichollsT. L.CauletM. (2015). The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 4: Criminal recidivism. Canadian Journal of Psychiatry, 60(3), 127–134.
ChristensenL.MendozaJ. L. (1986). A method of assessing change in a single subject: An alteration of the RC index. Behavior Therapy, 17(3), 305–308.
12.
CohenJ. (1992). A power primer. Psychological Bulletin, 112, 155–159. doi:10.1037/0033-2909.112.1.155
13.
Criminal Code, R.S., 1985, c. C-46, s. 16. Legal Rule or Regulation.
14.
CrockerA. G.NichollsT. L.SetoM. C.CharetteY.CôtéG.CauletM. (2015). The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2: The people behind the label. Canadian Journal of Psychiatry, 60(3), 106–116.
15.
DiamondP. M.MagalettaP. R. (2006). The short-form buss-perry aggression questionnaire (BPAQ-SF): A validation study with federal offenders. Assessment, 13(3), 227–240.
16.
DimeffL. A.RizviS. L.BrownM.LinehanM. (2000). Dialectical behavior therapy for substance abuse: A pilot application to methamphetamine-dependent women with borderline personality disorder. Cognitive and Behavioral Practice, 7(4), 457–468.
17.
DrakeE.BarnoskiR. (2006). Recidivism findings for the juvenile rehabilition administration's dialectical behavior therapy program: Final report (Document No. 0605-1202). Olympia, WA.
18.
EvershedS.TennantA.BoomerD.ReesA.BarkhamM.WatsonA. (2003). Practice-based outcomes of dialectical behaviour therapy (DBT) targeting anger and violence, with male forensic patients: A pragmatic and non-contemporaneous comparison. Criminal Behaviour and Mental Health, 13(3), 198–213.
19.
FergusonA. M.OgloffJ. R. P.ThomsonL. (2009). Predicting recidivism by mentally disordered offenders using the LSI-R:SV. Criminal Justice and Behavior, 36(1), 5–20.
20.
FerreiraC. (2012). The effects of a modified dialectical behavior therapy program on male inmates' coping skills (Doctoral Dissertation). Pacific University School of Professional Psychology, Forest Grove, OR.
21.
GaliettaM.RosenfeldB. (2012). Adapting dialectical behavior therapy (DBT) for the treatment of psychopathy. The International Journal of Forensic Mental Health, 11(4), 325–335.
22.
GeeJ.ReedS. (2013). The HoST programme: A pilot evaluation of modified dialectical behaviour therapy with female offenders diagnosed with borderline personality disorder. European Journal of Psychotherapy & Counselling, 15(3), 233–252.
GoedhardL. E.StolkerJ. J.HeerdinkE. R.NijmanH. L.OlivierB.EgbertsT. C. (2006). Pharmacotherapy for the treatment of aggressive behavior in general adult psychiatry: A systematic review. Journal of Clinical Psychiatry, 67(7), 1013–1024.
25.
GoodmanM.CarpenterD.TangC. Y.GoldsteinK. E.AvedonJ.FernandezN.HazlettE. A. (2014). Dialectical behavior therapy alters emotion regulation and amygdala activity in patients with borderline personality disorder. Journal of Psychiatric Research, 57, 108–116. doi:0.1016/j.jpsychires.2014.06.020
26.
GreenbergB. E.RiggsM.BryantF. B.SmithB. D. (2003). Validation of a short aggression inventory for law enforcement. Journal of Police and Criminal Psychology, 18(2), 12–19. doi:10.1007/BF02807243
27.
JacobsonN. S.TruaxP. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychologysychology, 59(1), 12.
28.
KayS. R.WolkenfeldF.MurrillL. M. (1988). Profiles of aggression among psychiatric patients: II. Covariates and predictors. The Journal of Nervous and Mental Disease, 176(9), 547–557.
29.
KoonsC. R.RobinsC. J.Lindsey TweedJ.LynchT. R.GonzalezA. M.MorseJ. Q.BastianL. A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32(2), 371–390. doi:10.1016/S0005-7894(01)80009-5
30.
LemmonG. (2008). Impact of a modified Dialectical Behavior Therapy treatment on coping methods and impulsiveness in female inmates. School of Professional Psychology, 115.
31.
LinehanM. (2015). DBT® Skills Training Manual. New York, NY: The Guilford Press.
32.
LongJ. L. (2011). Dialectical behavior therapy (DBT) consultation for line staff working with adolescents in residential care. West Hartford, CT.
33.
LowG.JonesD.DugganC.MacLeodA.PowerM. (2001). Dialectical behaviour therapy as a treatment for deliberate self-harm: Case studies from a high security psychiatric hospital population. Clinical Psychology & Psychotherapy, 8(4), 288–300.
34.
LynchT. R.ChapmanA. L.RosenthalM. Z.KuoJ. R.LinehanM. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology, 62(4), 459.
35.
McCannR.BallE. M. (2000). The effectiveness of dialectical behaviour therapy with forensic inpatients: A preliminary analysis (Report). Institute of Forensic Psychiatry, Colorado Mental Health Institute at Pueblo.
36.
McCannR.BallE. M.IvanoffA. (2000). DBT with an inpatient forensic population: The CMHIP forensic model. Cognitive and Behavioral Practice, 7(4), 447–456.
37.
McEwanT. E.DavisM. R.MacKenzieR.MullenP. E. (2009). The effects of social desirability response bias on STAXI‐2 profiles in a clinical forensic sample. British Journal of Clinical Psychology, 48(4), 431–436.
38.
McMainS.SayrsJ. H.DimeffL. A.LinehanM. M. (2007). Dialectical behavior therapy for individuals with borderline personality disorder and substance dependence. In DimeffL. A.KoernerK. (Eds.), Dialectical behavior therapy in clinical practice: Applications across disorders and settings (pp. 145–173). New York, NY: The Guilford Press.
39.
MezeyG. C.KavumaM.TurtonP.DemetriouA.WrightC. (2010). Perceptions, experiences and meanings of recovery in forensic psychiatric patients. The Journal of Forensic Psychiatry & Psychology, 21(5), 683–696. doi:10.1080/14789949.2010.489953
40.
MillonT.SimonsenE.Birket-SmithM.DavisR. D. (2003). Psychopathy: Antisocial, criminal, and violent behavior. New York, NY: The Guilford Press.
41.
MooreK. E.FolkJ. B.BorenE. A.TangneyJ. P.FischerS.SchraderS. W. (2016). Pilot study of a brief dialectical behavior therapy skills group for jail inmates. Psychological Services, advance online publication. doi:10.1037/ser0000105
42.
NeeC.FarmanS. (2005). Female prisoners with borderline personality disorder: Some promising treatment developments. Criminal Behaviour and Mental Health, 15(1), 2–16.
43.
NeeC.FarmanS. (2008). Treatment of borderline personality disorder in prisons: Findings from the two dialectical behaviour therapy pilots in the UK. In HagenJ.JensenE. (Eds.), Personality Disorders: New Research (pp. 107–121). New York, NY: Nova Scotia Publishers.
44.
PolA. J. F. (2013). Locked up in freedom. Pilot Dialectical Behavioral Therapy and relation suicidal behaviour and quality of life in forensic female borderline patients(Unpublished master's thesis). Utrecht University, Utrecht, The Netherlands.
45.
RobertsonP.BarnaoM.WardT. (2011). Rehabilitation frameworks in forensic mental health. Aggression and Violent Behavior, 16(6), 472–484.
46.
RomanP. M.AbrahamA. J.KnudsenH. K. (2011). Using medication-assisted treatment for substance use disorders: Evidence of barriers and facilitators of implementation. Addictive Behaviors, 36(6), 584–589.
47.
RosenfeldB.GaliettaM.IvanoffA.Garcia-MansillaA.MartinezR.FavaJ., … GreenD. (2007). Dialectical behavior therapy for the treatment of stalking offenders. International Journal of Forensic Mental Health, 6(2), 95–103.
48.
Royal College of Physicians and Surgeons (2015). Objectives in training in the speciality of psychiatry (Unpublished report). Retrieved from http://www.royalcollege.ca/cs/groups/public/documents/document/mdaw/mdg4/∼edisp/088025.pdf
49.
SakdalanJ. A.ShawJ.CollierV. (2010). Staying in the here-and-now: A pilot study on the use of dialectical behaviour therapy group skills training for forensic clients with intellectual disability. Journal of Intellectual Disability Research, 54(6), 568–572.
50.
SheltonD.KestenK.ZhangW.TrestmanR. (2011). Impact of a dialectic behavior therapy-corrections modified (DBT-CM) upon behaviorally challenged incarcerated male adolescents. Journal of Child and Adolescent Psychiatric Nursing, 24(2), 105–113.
51.
SheltonD.SamplS.KestenK. L.ZhangW.TrestmanR. L. (2009). Treatment of impulsive aggression in correctional settings. Behavioral Sciences & The Law, 27(5), 787–800.
52.
SkeemJ. L.WinterE.KennealyP. J.LoudenJ. E.TatarJ. R.II (2014). Offenders with mental illness have criminogenic needs, too: Toward recidivism reduction. Law and Human Behavior, 38(3), 212.
53.
SperryL. (2006). Cognitive behavior therapy of DSM-IV-TR personality disorders: Highly effective interventions for the most common personality disorders. New York, NY: Routledge.
TafrateR. C.MitchellD. (2013). Forensic CBT: A handbook for clinical practice. Malden, MA: John Wiley & Sons.
56.
TrupinE. W.StewartD. G.BeachB.BoeskyL. (2002). Effectiveness of a dialectical behaviour therapy program for incarcerated female juvenile offenders. Child and Adolescent Mental Health, 7(3), 121–127.
57.
ValentineS. E.BankoffS. M.PoulinR. M.ReidlerE. B.PantaloneD. W. (2015). The use of dialectical behavior therapy skills training as stand‐alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71(1), 1–20.
58.
WahlC. T. (2011). Evaluation of a dialectical behavior therapy skills group for female inmates who voluntarily seek treatment: A pilot study(Unpublished doctoral dissertation). University of Louisville, Louisville, Kentucky.
59.
WarburtonK. D. (2015). A new standard of care for forensic mental health treatment: prioritizing forensic intervention. CNS Spectr, 20(3), 172–176. doi:10.1017/s1092852915000140
