Treating impulsivity in severe substance use disorders with a
therapeutic community intervention based on the implementation of DBT
skills training
Abstract
Objectives: Impulsivity is considered a core feature of
substance use disorders (SUDs). However, the efficacy of evidence-based
treatments for SUDs on this dimension remains a topic of debate,
especially considering therapeutic community (TC) interventions for
severe forms of these clinical conditions. Therefore, the current study
aims at investigating pre- posttreatment changes in levels of
impulsivity and related psychological dimensions during a 6-month
Dialectical Behavior Therapy skills training program integrated within a
TC (DBT-ST-TC) for individuals with severe SUDs. Methods:
Impulsivity were assessed through a self-report measure (UPPS-P) and a
neuropsychological battery. There were also evaluated levels of
mindfulness (FFMQ, MAAS) emotion dysregulation (DERS) and distress
tolerance (DTS). Intention-to-treat analysis controlling for baseline
levels was performed. Contrast analyses were also conducted in order to
compare results of the DBT-ST-TC group with two control groups (i.e.,
outpatient treatment-seeking individuals with SUDs; healthy controls
[HCs]) Results: Sixty-eight patients with SUDs were
admitted to the DBT-ST-TC. The clinical control group included 41
treatment-seeking individuals with SUDs. The HC group was composed of 53
participants. Considering pre- posttreatment changes, DBT-ST-TC patients
reported that emotion dysregulation slightly improved as well as
positive urgency and sensation seeking. Neuropsychological domain of
cognitive disinhibition showed the most robust improvement, especially
considering no significant differences between DBT-ST-TC group and HCs
at the end of 6-month period of observation. Conclusion: The
DBT-ST-TC might be a promising intervention for treating impulsivity
among patients with severe SUDs. Future long-term outcomes are needed to
corroborate and extent these provisional results.