Trial reportJournal of consulting and clinical psychology2023
Processes of change in a randomized clinical trial of radically open dialectical behavior therapy (RO DBT) for adults with treatment-refractory depression.
Trial report in Journal of consulting and clinical psychology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed, 17 citations in OpenAlex.
- Obsessive-compulsive personality disorder in radically open dialectical behavior therapy for treatment-refractory depression.Personality disorders · 2026Trial
- The Self-Identification Program (SIP): A Clinically Implemented Third-Wave CBT Deepening Dysfunctional Self-Identification in Mood Disorders.Medicina (Kaunas, Lithuania) · 2025Article
- The mediating role of social connectedness between inflexibility, the suppression of emotional expression, and symptoms of eating disorders and depression in adolescents with restrictive eating disorders referred for radically open dialectical behaviour therapy (RO DBT).Journal of eating disorders · 2025Article
- The Path to Loneliness for Psychiatric Patients: A Qualitative Study of a Journey Marked by Pain, Hopelessness, Prosocial Signaling Deficits, and Coping Strategies That Are Not Effective.Scandinavian journal of psychology · 2025Article
- Telehealth-Delivered Radically Open Dialectical Behavior Therapy for Adolescents (RO DBT-A): A Pilot Mixed-Methods Study.American journal of psychotherapy · 2024Article
- Non-randomised feasibility study of training workshops for Talking Therapies service high-intensity therapists to optimise depression and anxiety outcomes for individuals with co-morbid personality difficulties: a study protocol.Pilot and feasibility studies · 2023Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
objectiveRadically open dialectical behavior therapy (RO DBT) is an empirically supported psychotherapy for treatment-refractory depression (TRD) that targets psychological inflexibility and interpersonal functioning within the context of maladaptive overcontrol. However, it is unknown whether change in these mechanistic processes is associated with decreased symptoms. This study tested whether change in psychological inflexibility and interpersonal functioning is associated with change in depressive symptoms in RO DBT.
methodAdults with TRD from The Refractory Depression: Mechanisms and Efficacy of RO DBT (RefraMED) randomized controlled trial of RO DBT, n = 250; M (SD) age = 47.2 (11.5); 65% female; 90% White, were assigned to RO DBT or treatment as usual. Psychological inflexibility and interpersonal functioning were assessed at baseline, 3 (midtreatment), 7 (posttreatment), 12, and 18 months. Mediation analyses and latent growth curve modeling (LGCM) assessed whether change in psychological inflexibility and interpersonal functioning was associated with change in depressive symptoms.
resultsThe effect of RO DBT in decreasing depressive symptoms was mediated by changes in psychological inflexibility and interpersonal functioning at 3 (95% CI [-2.35, -0.15]; [-1.29, -0.04], respectively), 7 (95% CI [-2.80, -0.41]; [-3.39, -0.02]), and only psychological inflexibility at 18 (95% CI [-3.22, -0.62]) months. LGCM indicated only in RO DBT was a decrease in psychological inflexibility through 18 months associated with a decrease in depressive symptoms (B = 0.13, p < .001).
conclusionsThis supports RO DBT theory about targeting processes related to maladaptive overcontrol. Interpersonal functioning, and in particular, psychological flexibility, may be mechanisms that decrease depressive symptoms in RO DBT for TRD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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