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Sex and gender in treatment response to dialectical behaviour therapy: current knowledge, gaps, and future directions

Published online by Cambridge University Press:  22 June 2022

S. Penta ,
S. Correia ,
M.A. Schneider ,
K. Holshausen ,
A.A. Nicholson ,
S.A. Haefner ,
C. Mutschler ,
A. Ferdossifard ,
K. Boylan  and
J. Hewitt
...Show all authors
S. Penta
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
S. Correia
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
M.A. Schneider
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
K. Holshausen
Affiliation:
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
A.A. Nicholson
Affiliation:
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
S.A. Haefner
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
C. Mutschler
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
A. Ferdossifard
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
K. Boylan
Affiliation:
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
J. Hewitt
Affiliation:
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
S.L. Roth
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
R. Wilson
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
T. Hatchard*
Affiliation:
Youth Wellness Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada Peter Boris Centre for Addictions Research, McMaster University and St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
*
*Corresponding author. Email: thachar@stjosham.on.ca
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Abstract

Borderline personality disorder (BPD) is a mental health condition characterized by emotion dysregulation, interpersonal impairment, and high suicidality. Dialectical behaviour therapy (DBT) is the most widely studied psychotherapeutic treatment for BPD. To date, the vast majority of DBT research has focused on cisgender women, with a notable lack of systematic investigation of sex and/or gender differences in treatment response. In order to encourage effective, equitable treatment of BPD, further investigation into treatment targets in this population is critical. Here, we employed a systematic strategy to delineate gaps in the DBT literature pertaining to sex and gender differences and propose directions for future research. Findings demonstrate a significant discrepancy in measurement of sex and gender, particularly among gender-diverse individuals. Exploring DBT treatment response across the full spectrum of genders will facilitate the provision of more tailored, impactful care to all individuals who suffer from BPD.

Key learning aims

  1. (1) To date, DBT treatment literature has focused almost exclusively on cisgender women, with only two of 253 DBT studies in current literature accounting for transgender and gender diverse (TGD) individuals.

  2. (2) Recognize how gender minority stress may impact the prevalence of BPD among TGD individuals.

  3. (3) Learn how future research initiatives can be employed to rectify this gap in the DBT literature.

Keywords

borderline personality disorderdialectical behaviour therapygender minority stresstransgender and gender diverse
Type
Empirically Grounded Clinical Guidance Paper
Information
the Cognitive Behaviour Therapist , Volume 15 , 2022 , e30
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Goldhammer, H., Crall, C., & Keuroghlian, A. S. (2019). Distinguishing and addressing gender minority stress and borderline personality symptoms. Harvard Review of Psychiatry, 27, 317–325. https://doi.org/10.1097/HRP.0000000000000234 CrossRefGoogle ScholarPubMed
Sloan, C. A., Berke, D. S., & Shipherd, J. C. (2017). Utilizing a dialectical framework to inform conceptualization and treatment of clinical distress in transgender individuals, Psychology: Research, Theory, and Practice, 48, 301–309. https://doi.org/10.1037/pro0000146 Google Scholar
Testa, R. J., Habarth, J., Peta, J., Balsam, K. & Bockting, W. (2015). Development of the gender minority stress and resilience measure. Psychology of Sexual Orientation and Gender Diversity, 2, 65–77. https://doi.org/10.1037/sgd0000081 CrossRefGoogle Scholar
Wupperman, P., & Edwards, E. (2017). Dialectical behavior therapy and gender. In Nadal, K. (ed), The SAGE Encyclopedia of Psychology and Gender (pp. 447–451). Thousand Oaks, CA, USA: SAGE Publications, Inc. https://doi.org/10.4135/9781483384269.n146 Google Scholar

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