title: Practice-based outcomes of dialectical behaviour therapy (DBT) targeting anger and violence, with male forensic patients: a pragmatic and non-contemporaneous comparison.
abstract: OBJECTIVE
  To examine the effectiveness of an eighteen-month treatment based on dialectical behaviour therapy (DBT) targeting anger and violence, on a group of male forensic patients.
  
  
  METHODS
  Eight male forensic patients in a high security hospital who met the criteria for borderline personality disorder measured by the Personality Assessment Inventory underwent 18 months of treatment. They completed three psychometric tests at pre-, mid- and post-treatment and at a six-month follow up. A comparison group (TAU) of nine patients, assessed as having similar personality disorders, received the usual treatment available in the hospital but excluding DBT. They completed the same tests at the same time intervals corresponding to the pre-, mid- and post-testing of the DBT group. In both groups, all instances behaviours related to anger and violence were monitored for three six-month periods, prior to, during and post-treatment.
  
  
  RESULTS
  Overall, patients in the DBT group made greater gains than patients in the TAU group in reducing the seriousness of violence-related incidents, and in self report measures of hostility, cognitive anger, disposition to anger, outward expression of anger and anger experience.
  
  
  CONCLUSIONS
  The results suggest a potential for DBT to impact positively and lastingly on violent behaviour and components of anger in male forensic patients when compared with standard treatment. The power of the current study to detect group differences was reduced by small ns, large confidence intervals, and a non-contemporaneous comparison group. Cost-effective strategies are proposed to take forward research on DBT with this population.
authors.affiliation: Psychology Department, Rampton Hospital, Retford, Nottinghamshire DN22 0PD, UK. Sue.Evershed@rampton-hosp.trent.nhs.uk
authors.forename: Sue
authors.initials: S
authors.lastname: Evershed
authors.forename: Allison
authors.initials: A
authors.lastname: Tennant
authors.forename: Debbie
authors.initials: D
authors.lastname: Boomer
authors.forename: Anne
authors.initials: A
authors.lastname: Rees
authors.forename: Michael
authors.initials: M
authors.lastname: Barkham
authors.forename: Alison
authors.initials: A
authors.lastname: Watsons
mesh_terms: D000328:Adult; D000786:Anger; D001521:Behavior Therapy / Q000379:methods*; D005500:Follow-Up Studies; D005555:Forensic Psychiatry / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis; D010555:Personality Inventory; D010818:Practice Patterns, Physicians'; D011329:Prisoners / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires; D014754:Violence / Q000517:prevention & control*