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Trial registered on ANZCTR


Registration number
ACTRN12625001021460
Ethics application status
Approved
Date submitted
10/08/2024
Date registered
15/09/2025
Date last updated
15/09/2025
Date data sharing statement initially provided
15/09/2025
Type of registration
Retrospectively registered

Titles & IDs
Public title
Effectiveness of Dialectical behavior therapy intervention for borderline personality traits among adolescents: A randomized control trial
Scientific title
Effectiveness of Dialectical behavior therapy intervention for borderline personality traits among adolescents: A randomized control trial
Secondary ID [1] 312729 0
Nil
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Borderline Personality traits 334750 0
Emotional dysregulation 334751 0
Depression 334752 0
Anxiety 334753 0
Stress 334754 0
low self esteem 334756 0
Suicidal Ideation 334757 0
Coping style 336675 0
Condition category
Condition code
Mental Health 331311 331311 0 0
Psychosis and personality disorders
Mental Health 331312 331312 0 0
Studies of normal psychology, cognitive function and behaviour
Mental Health 331313 331313 0 0
Depression
Mental Health 331314 331314 0 0
Anxiety
Mental Health 331315 331315 0 0
Suicide

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
The treatment group attended weekly group-based DBT skills training sessions for a total of 8 weeks. Each session lasted 90 minutes and included a 5-minute mindfulness exercise, a review of the weekly topic, and group discussions. This DBT Skills training program covered five key modules: Basic DBT Skill’s training Introduction, Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
The intervention was based on standardized Dialectical Behavior Therapy (DBT) resources, including the DBT Skills Manual for Adolescents (Rathus & Miller, 2014), Expanded Dialectical Behavior Therapy Skills Training Manual (Pederson & Pederson, 2017), the Dialectical Behavior Therapy Skills Training with Adolescents: A Practical Workbook for Therapists, Teens & Parents (Eich, 2020) and DBT Skills Training Handouts and Worksheets (2nd ed.) (Linehan, 2015) were utilized. Participants practiced worksheets during session to support their learning and practice of DBT skills.
This intervention consists of eight group based Dialectical Behavior Therapy (DBT) skills training for young adults with Borderline Personality symptoms. Each session introduces and practices specific DBT skills:

Session 1: Mindfulness Skills
Teaching "What" (Observe, Describe, Participate) and "How" (Non-Judgmentally, One-Mindfully, Effectively) skills to enhance present-moment awareness and emotional regulation. Includes Loving-Kindness practice.

Session 2: Crisis Survival Skills
Strategies for distress tolerance, including Wise Mind ACCEPTS (distraction techniques), self-soothing, improving the moment, half-smile technique, and creative outlets for emotional regulation.

Session 3: Reality Acceptance Skills
Teaching Pros and Cons evaluation, Radical Acceptance, Turning the Mind, and Willingness to accept and manage difficult emotions and situations.

Session 4: Emotional Self-Care & Mastery
Focus on physical and emotional well-being through self-care (PLEASE), building mastery, task engagement, and self-recognition of achievements.

Session 5: Emotion Regulation Skills
Building positive experiences, practicing the opposite action to difficult emotions, and allowing emotions to be experienced and processed healthily.

Session 6: Interpersonal Effectiveness Basics
Understanding relationship beliefs, balancing independence and support, evaluating interpersonal needs, and practicing skills for effective communication.

Session 7: Advanced Interpersonal Effectiveness
Enhancing relationships through GIVE skills, assertiveness training (DEAR MAN), and self-respect strategies (FAST).

Session 8: Boundaries & Review
Setting and evaluating personal boundaries, summarizing learned DBT skills, and reviewing progress in applying them to daily life.
Intervention code [1] 329251 0
Treatment: Other
Intervention code [2] 329384 0
Behaviour
Comparator / control treatment
Waitlist Control Group
Participants in the waitlist control group will not receive group DBT skills training during the initial 8 weeks but will be offered the same 8-week group based sessions of DBT skills training program after the study period. This group will serve as a comparison to evaluate the effectiveness of the DBT skills training against no immediate intervention.
Control group
Active

Outcomes
Primary outcome [1] 339075 0
Participant Borderline Personality traits
Timepoint [1] 339075 0
Screening (Baseline ) and after 8 week post-intervention
Primary outcome [2] 339076 0
Emotion Dysregulation
Timepoint [2] 339076 0
Screening At baseline, before the intervention begins and (Post-intervention assessment) after all 8 sessions are completed.
Secondary outcome [1] 438477 0
Depression
Timepoint [1] 438477 0
Pre intervention and post-intervention
Secondary outcome [2] 438478 0
Coping skills
Timepoint [2] 438478 0
Pre intervention and post-intervention
Secondary outcome [3] 438479 0
Self-esteem
Timepoint [3] 438479 0
Pre intervention and post-intervention
Secondary outcome [4] 438480 0
Suicidal ideation
Timepoint [4] 438480 0
Pre intervention and post-intervention
Secondary outcome [5] 439709 0
Anxiety
Timepoint [5] 439709 0
Pre intervention and post-intervention
Secondary outcome [6] 439710 0
Stress
Timepoint [6] 439710 0
Pre intervention and post-intervention

Eligibility
Key inclusion criteria
Participants will be eligible for the study if they are aged between 15 and 18 years, as this range represents the developmental stage of adolescence. Adolescents under the age of 18 will require parental or guardian consent, ensuring ethical compliance. To accommodate participants already enrolled, individuals who turn 19 during the study will also remain eligible to avoid disruption of their participation. Eligibility will further depend on participants scoring =40 on the Difficulties with Emotion Regulation Scale-16 (DERS-16) (Bjureberg et al., 2016) and/or responding “yes” to seven or more items on the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) (Zanarini et al., 2003).
Minimum age
15 Years
Maximum age
18 Years
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Previous participation in Dialectical Behavior Therapy (DBT).
Presence of a hearing impairment that could interfere with their ability to participate.
Current experience of serious medical or psychological conditions, as such conditions could confound study outcomes.
Acute withdrawal from alcohol or drugs at the time of recruitment.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
After confirming participants’ eligibility, allocation was done by sealed opaque envelopes to effectively minimize bias in this study. For this purpose, 52 envelopes were prepared; 26 for the “treatment” group and 26 for the “control” group. All envelopes were then sealed and mixed thoroughly in a container to ensure randomness. When an eligible participant was to be assigned, an envelope was drawn from the shuffled container without prior knowledge of its content, which determined whether the participant was in the “treatment” or “control” group. This method was used to ensure that the process was random and concealed, reducing potential bias.
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization for this study was achieved by using the lottery method. Each participant’s identifier was placed into a container, e.g., a box. Then the participants’ assignments to either the treatment or control group were drawn randomly. This method ensured that all participants had an equal chance of being assigned to any group, thereby maintaining a random and unbiased allocation process.
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Efficacy
Statistical methods / analysis
Data analysis was conducted using IBM Statistics version 27. Descriptive statistics were calculated for all study variables. Baseline comparisons between the treatment and control groups were conducted using independent sample t-tests to ensure the effectiveness of randomization. Paired sample t-tests were performed to assess within-group changes over time from pre- to post-intervention for each variable. A multivariate analysis was conducted to examine the effect of gender, group (experimental vs. Control) and their interaction. Furthermore, repeated measures manova was performed to evaluate the effect of time ( pre vs. Post), group and their interaction effect on all study variables.Statistical significance was set at p < .05. All analyses were conducted following the intention-to-treat principle to account for all participants initially randomized to groups.

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment outside Australia
Country [1] 26499 0
Pakistan
State/province [1] 26499 0
Punjab

Funding & Sponsors
Funding source category [1] 317406 0
Self funded/Unfunded
Name [1] 317406 0
Ilsa Gul
Country [1] 317406 0
Pakistan
Primary sponsor type
Individual
Name
Ms. Ilsa Gul - National University of Medical Sciences, Rawalpindi,
Address
Country
Pakistan
Secondary sponsor category [1] 322462 0
None
Name [1] 322462 0
Address [1] 322462 0
Country [1] 322462 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 315907 0
National University of Medical Sciences' (NUMS) Institutional Review Board and Ethical Committee (IRB & EC)
Ethics committee address [1] 315907 0
Ethics committee country [1] 315907 0
Pakistan
Date submitted for ethics approval [1] 315907 0
12/08/2024
Approval date [1] 315907 0
31/01/2025
Ethics approval number [1] 315907 0
31/01/2025

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 136174 0
Ms Ilsa Gul
Address 136174 0
National University of Medical Sciences (NUMS) PWD Campus PWD Housing Society Rawalpindi Postal Code 46000 Pakistan
Country 136174 0
Pakistan
Phone 136174 0
+923023388450
Fax 136174 0
Email 136174 0
Contact person for public queries
Name 136175 0
Ilsa Gul
Address 136175 0
National University of Medical Sciences (NUMS) PWD Campus PWD Housing Society Rawalpindi Postal Code 46000 Pakistan
Country 136175 0
Pakistan
Phone 136175 0
+923023388450
Fax 136175 0
Email 136175 0
Contact person for scientific queries
Name 136176 0
Ilsa Gul
Address 136176 0
National University of Medical Sciences (NUMS) PWD Campus PWD Housing Society Rawalpindi Postal Code 46000 Pakistan
Country 136176 0
Pakistan
Phone 136176 0
+923023388450
Fax 136176 0
Email 136176 0

Data sharing statement
Will the study consider sharing individual participant data?
No
No IPD sharing reason/comment: The individual participant data (IPD) for this trial will not be made available. This decision is based on several important considerations. First, the study involves sensitive information related to Borderline Personality Disorder traits, emotional dysregulation, and suicidality. To ensure the privacy and confidentiality of the participants, it is crucial to keep their data secure and private. Upholding ethical standards and respecting the terms of participant consent is a priority. Lastly, as a sole researcher working within a limited timeframe, I lack the resources necessary to anonymize and prepare the data for public sharing in a way that fully adheres to ethical guidelines. Therefore, the IPD will remain confidential and will not be shared.



What supporting documents are/will be available?

No Supporting Document Provided


Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.