Un programa de entrenamiento para familiares de pacientes con trastorno límite de la personalidad basado en la terapia dialéctica comportamental

• Autores: Sara Fonseca Baeza, Verónica Guillén Botella, José Heliodoro Marco Salvador, Amparo Navarro, Rosa María Baños Rivera
• Localización: Psicología conductual = behavioral psychology: Revista internacional de psicología clínica y de la salud, ISSN 1132-9483, Vol. 29, Nº. 2, 2021, págs. 219-236
• Idioma: español
• DOI: 10.51668/bp.8321201s
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Los familiares de pacientes con trastorno límite de la personalidad (TLP) experimentan ansiedad y depresión, y están inmersos en un clima familiar disfuncional. Aunque existen tratamientos eficaces para el TLP, se ha prestado menos atención a los familiares. El objetivo de este trabajo fue adaptar para familiares el entrenamiento grupal en habilidades de la terapia dialéctica comportamental, en 14 sesiones. La muestra estuvo formada por 12 familiares:

    50% madres, 41,7% padres y 8,3% parejas. Se evaluaron los niveles de depresión (BDI-II), ansiedad (OASIS) y emoción expresada (LEE-S) antes y después de la intervención. Los resultados indican que tras la intervención se produce una mejoría estadística y clínica significativa en depresión; clínica en ansiedad, hostilidad, tolerancia a la frustración y emoción expresada; y estadística de la actitud negativa hacia la enfermedad. La intrusión aumenta tanto estadística como clínicamente, sin embargo, sus niveles son similares a los de la población general. Resulta imprescindible seguir investigando sobre la eficacia de las intervenciones para familiares.

  • English

    Family members of patients with borderline personality disorder (BPD) experience suffering, anxiety, and depression, and are involved in a dysfunctional family atmosphere. Although effective treatments for patients with BPD have been developed, family members have received less attention. The aim of this paper was to adapt the dialectical behaviour therapy skills training group for family members in 14 sessions. The sample comprised 12 family members: 50% mothers, 41.7% fathers, and 8.3% partners. The levels of depression (BDI-II), anxiety (OASIS) and expressed emotion (LEE-S) were measured before and after the intervention. The results show a statistical and clinical improvement in depression, and a clinically significant improvement in anxiety, hostility, lack of tolerance and expressed emotion after the intervention. Negative attitude toward illness presents a statistical improvement. Furthermore, intrusion increases both statistically and clinically. However, the levels of intrusion are equal to those in the general population. Further research into the effectiveness of family interventions is essential.

• Referencias bibliográficas
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5ª ed.). Arlington, VA: American...
  • Bailey, R. C. y Grenyer, B. F. S. (2013). Burden and support needs of carers of persons with borderline personality disorder: a systematic...
  • Bailey, R. C. y Grenyer, B. F. S. (2014). Supporting a person with personality disorder: a study of carer burden and well-being. Journal of...
  • Bailey, R. C. y Grenyer, B. F. S. (2015). The relationship between expressed emotion and wellbeing for families and carers of a relative with...
  • Bateman, A. y Fonagy, P. (2018). A randomized controlled trial of a mentalization-based intervention (MBT-FACTS) for families of people with...
  • Beck, A. T., Steer, R. A. y Brown, G. K. (1996). Beck Depression Inventory-II (2ª ed.). San Antonio, TX: Psychological Corporation.
  • Blum, N., Pfohl, B., St. John, D., Monahan, P. y Black, D. W. (2002). STEPPS: a cognitivebehavioral systems-based group treatment for outpatients...
  • Bolo, S., Marco Salvador, J. H., Navarro, A., Baños, R. y Guillén, V. (en prensa). Descripción de las características psicológicas de una...
  • Chesney, E., Goodwin, G. M. y Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry,...
  • Crespo-Delgado, E., Suso-Ribera, C. y García-Palacios, A. (2020). Comparing the contribution of affect, emotion and self-efficacy in emotional...
  • Cole, J. D. y Kazarian, S. S. (1988). The Level of Expressed Emotion Scale: a new measure of expressed emotion. Journal of Clinical Psychology,...
  • Ekdahl, S., Idvall, E. y Perseius, K. I. (2014). Family skills training in dialectical behaviour therapy: the experience of the significant...
  • Ekdahl, S., Idvall, E., Samuelsson, M. y Perseius, K. I. (2011). A life tiptoeing: being a significant other to persons with borderline personality...
  • Flynn, D., Kells, M., Joyce, M., Corcoran, P., Herley, S., Suarez, C., Cotter, P., Hurley, J., Weihrauch, M. y Groeger, J. (2017). Family...
  • Fruzzetti, A. E., Shenk, C. y Hoffman, P. D. (2005). Family interaction and the development of borderline personality disorder: a transactional...
  • Giffin, J. (2008). Family experience of borderline personality disorder. Australian and New Zealand Journal of Family Therapy, 29(3), 133-138....
  • González-Robles, A., Mira, A., Miguel, C., Molinari, G., Díaz-García, A., García-Palacios, A., Bretón-López, J. M., Quero, S., Baños, R. M....
  • Goodman, M., Alvarez Tomas, I., Temes, C. M., Fitzmaurice, G. M., Aguirre, B. A. y Zanarini, M. C. (2017). Suicide attempts and self-injurious...
  • Goodman, M., Patil, U., Triebwasser, J., Hoffman, P., Weinstein, Z. A. y New, A. (2011). Parental burden associated with borderline personality...
  • Grenyer, B. F. S., Bailey, R. C., Lewis, K. L., Matthias, M., Garretty, T. y Bickerton, A. (2018). A randomized controlled trial of group...
  • Guillén, V., Díaz-García, A., Mira, A., García-Palacios, A., Escrivá-Martínez, T., Baños, R. y Botella, C. (2021). Interventions for family...
  • Guillén, V., Marco Salvador, J. H., Jorquera Rodero, M., Bádenes, L., Roncero Sanchís, M. y Baños Rivera, R. (2018). Who cares for the caregiver?...
  • Hoffman, P. D., Buteau, E., Hooley, J. M., Fruzzetti, A. E. y Bruce, M. L. (2003). Family members’ knowledge about borderline personality...
  • Hoffman, P. D., Fruzzetti, A. E. y Buteau, E. (2007). Understanding and engaging families: an education, skills and support program for relatives...
  • Hoffman, P. D., Fruzzetti, A. E., Buteau, E., Neiditch, E. R., Penney, D., Bruce, M. L., Hellman, F. y Struening, E. (2005). Family connections:...
  • Hooley, J. M. y Gotlib, I. H. (2000). A diathesis-stress conceptualization of expressed emotion and clinical outcome. Applied and Preventive...
  • Hooley, J. M., Gruber, S. A., Parker, H. A., Guillaumot, J., Rogowska, J. y Yurgelun-Todd, D. A. (2010). Neural processing of emotional overinvolvement...
  • Hooley, J. M. y Hoffman, P. D. (1999). Expressed emotion and clinical outcome in borderline personality disorder. American Journal of Psychiatry,...
  • Iverson, G. L. (2019). Reliable change index. En J. Kreutzer, J. DeLuca y B. Caplan (dirs.), Encyclopedia of clinical neuropsychology (pp....
  • Jacobson, N. S. y Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research....
  • Jaén, I. y Cebolla, A. (2016). Emoción expresada y carga del cuidador en los trastornos de personalidad del grupo B. Àgora de Salut, 3, 185-194....
  • Kay, M. L., Poggenpoel, M., Myburgh, C. P. y Downing, C. (2018). Experiences of family members who have a relative diagnosed with borderline...
  • Kendall, P. C., Marrs-Garcia, A., Nath, S. R. y Sheldrick, R. C. (1999). Normative comparisons for the evaluation of clinical significance....
  • Liljedahl, S. I., Kleindienst, N., Wångby-Lundh, M., Lundh, L. -G., Daukantaitė, D., Fruzzetti, A. E. y Westling, S. (2019). Family Connections...
  • Linehan, M. M. (1993). The skills training manual for treating borderline personality disorder. Nueva York, NY: Guilford.
  • Madriz, E. (2000). Focus groups in feminist research. En N. K. Denzin y Y. S. Lincoln (dirs.), Handbook of qualitative research (pp. 835-850)....
  • Miller, M. L. y Skerven, K. (2017). Family skills: a naturalistic pilot study of a family-oriented dialectical behavior therapy program. Couple...
  • Navarro-Haro, M. V., Pérez-Hernández, N., Serrat, S. y Gasol-Colomina, M. (2018). Effectivity and acceptability of dialectical behavioral...
  • Norman, S. B., Cissell, S. H., Means-Christensen, A. J. y Stein, M. B. (2006). Development and validation of an Overall Anxiety Severity and...
  • Pearce, J., Jovev, M., Hulbert, C., Mckechnie, B., Mccutcheon, L., Betts, J. y Chanen, A. M. (2017). Evaluation of a psychoeducational group...
  • Rajalin, M., Wickholm-Pethrus, L., Hursti, T. y Jokinen, J. (2009). Dialectical behavior therapybased skills training for family members of...
  • Rathus, J. H. y Miller, A. L. (2002). Dialectical behavior therapy adapted for suicidal adolescents. Suicide and Lifethreatening Behavior,...
  • Regalado, P., Pechon, C., Stoewsand, C. y Gagliesi, P. (2011). Familiares de personas con trastorno límite de la personalidad: estudio pre-experimental...
  • Santisteban, D. A., Mena, M. P. D., Muir, J., Mccabe, B. E., Abalo, C. y Cummings, A. M. (2015). The efficacy of two adolescent substance...
  • Santisteban, D. A., Muir, J. A., Mena, M. P. y Mitrani, V. B. (2003). Integrative borderline adolescent family therapy: meeting the challenges...
  • Sanz, J., Perdigón, A. L. y Vázquez, C. (2003). Adaptación española del Inventario para la depresión de Beck-II (BDI-II): 2. Propiedades psicométricas...
  • Scheirs, J. G. M. y Bok, S. (2007). Psychological distress in caretakers or relatives of patients with borderline personality disorder. International...
  • Sepúlveda, A. R., Anastasiadou, D., del Río, A. M. y Graell, M. (2012). The Spanish validation of Level of Expressed Emotion Scale for relatives...
  • Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B. y Pantalone, D. W. (2015). The use of dialectical behavior therapy skills...
  • Vallés, M. S. (2003). Técnicas cualitativas de investigación social. Madrid: Síntesis. Wilks, C. R., Valenstein-Mah, H., Tran, H., King, A....
  • Dialectical behavior therapy skills for families of individuals with behavioral disorders: initial feasibility and outcomes. Cognitive and...
  • Woodberry, K. A. y Popenoe, E. J. (2008). Implementing dialectical behavior therapy with adolescents and their families in a community outpatient...