Dialectic behavioural therapy has an impact on self‐concept clarity and facets of self‐esteem in women with borderline personality disorder

Abstract Identity disturbance and an unstable sense of self are core criteria of borderline personality disorder (BPD) and significantly contribute to the suffering of the patient. These impairments are hypothesized to be reflected in low self‐esteem and low self‐concept clarity. The objective of this study was to evaluate the impact of an inpatient dialectic behavioral therapy (DBT) programme on self‐esteem and self‐concept clarity. Forty women with BPD were included in the study. Twenty patients were treated with DBT for 12 weeks in an inpatient setting and 20 patients from the waiting list served as controls. Psychometric scales were used to measure different aspects of self‐esteem, self‐concept clarity and general psychopathology. Patients in the treatment group showed significant enhancement in self‐concept clarity compared with those on the waiting list. Further, the scales of global self‐esteem and, more specifically, the facets of self‐esteem self‐regard, social skills and social confidence were enhanced significantly in the intervention group. Additionally, the treatment had a significant impact on basic self‐esteem in this group. On the other hand, the scale of earning self‐esteem was not significantly abased in patients with BPD and did not show significant changes in the intervention group. Our data provide preliminary evidence that DBT has an impact on several facets of self‐esteem and self‐concept clarity, and thus on identity disturbance, in women with BPD. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Self‐concept clarity, which refers to the BPD criterion identity disturbance, and facets of self‐esteem, are impaired in patients with BPD compared with reference data from healthy controls. • Our study replicates that depressive symptoms and general psychopathology are improved after a 12‐week DBT programme in BPD patients compared with a waiting list. • The 12‐week inpatient DBT treatment programme shows significant enhancement in self‐concept clarity and facets of self‐esteem compared with the waiting list. • Thus, in BPD patients, self‐esteem and the diagnostic criteria identity disturbance, captured by self‐concept clarity, can be influenced with short‐term psychotherapy.