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Modified DBT reduces inmates' anger and aggression.

CHICAGO -- A modified form of dialectical behavioral therapy may be an effective and economical intervention for reducing anger and aggression among prison and jail inmates, Dr. Robert L. Trestman said during a poster session at the annual meeting of the American Academy of Psychiatry and the Law.

"Our data suggest that within the prison environment, individual psychotherapy may not be a critical component for success, which may make our approach a far more affordable intervention within many prison systems," said Dr. Trestman, professor of psychiatry at the University of Connecticut in Farmington.

Dialectical behavioral therapy (DBT), pioneered by Marsha Linehan, Ph.D., was developed to treatment outpatients diagnosed with borderline personality disorder.

"We realized from our experience and that of many others that [dialectical behavioral therapy] was a very useful tool for helping to reduce impulsive aggression, manage suicidal behavior, and reduce self-mutilation behaviors in the community, and I postulated that we could adapt it in a cost-effective manner for use in prison settings," Dr. Trestman said.

Mindful that more than one-third of prisoners have suffered traumatic brain injury, Dr. Trestman and his colleagues converted the DBT manual and handout information to a fifth-grade reading level. A cohort of 63 inmates at three Connecticut prisons was recruited to receive 16 weeks of twice-weekly DBT-informed skills training, followed by random assignment to 8 weeks of either skills coaching or case management.

After 6 months, there was substantial improvement on the Buss-Perry Aggression (BPA) questionnaire dimensions of physical aggression, anger, and irritability. No changes were seen in BPA scores for verbal aggression or hostility, nor for hostility as assessed using the Brief Psychiatric Rating Scale. No difference was found between the two groups randomized to skills coaching or case management.


Chicago Bureau
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Article Details
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Title Annotation:Forensic Psychiatry; Dialectical behavioral therapy
Author:Dixon, Bruce K.
Publication:Clinical Psychiatry News
Article Type:Brief article
Geographic Code:1U3IL
Date:Mar 1, 2007
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