Comparing the Effectiveness of Mentalization-Based Therapy and Dialectical Behavior Therapy on Interpersonal Needs in Adolescents with Self-Injurious Behaviors
Keywords:
Dialectical Behavior Therapy, Mentalization, Based Therapy, Interpersonal Needs, Self, Injurious Behavior, AdolescentsAbstract
Introduction and Aim: The aim of this study was to determine the difference in effectiveness between Mentalization-Based Therapy and Dialectical Behavior Therapy on interpersonal needs in adolescents with self-injurious behaviors.
Methodology: This applied study used a quasi-experimental pretest–posttest design with a control group and a follow-up phase. The statistical population consisted of adolescent girls with self-injurious behaviors referred to counseling centers in Tehran in 2024. A total of 45 participants were selected through purposive sampling and randomly assigned into three groups: Mentalization-Based Therapy, Dialectical Behavior Therapy, and control. Data were collected using the Interpersonal Needs Questionnaire at three stages: pretest, posttest, and follow-up. Data analysis was conducted using multivariate analysis of variance, repeated measures ANOVA, and Bonferroni post hoc tests in SPSS version 26.
Findings: The results indicated that the main effect of group (p<0.001), the main effect of time (p<0.001), and the interaction effect of group and time (p<0.001) on interpersonal needs were statistically significant. Bonferroni test results also showed significant differences between experimental groups and the control group in posttest and follow-up stages (p<0.05), while no significant difference was observed at pretest (p>0.05).
Conclusion: Both therapeutic approaches were effective in reducing interpersonal needs among adolescents with self-injurious behaviors; however, Dialectical Behavior Therapy demonstrated relatively greater effectiveness, suggesting its strong applicability in improving interpersonal functioning in this population.
Downloads
References
Babaei, S., Dehghani, M., & Zahdi Tajrishi, K. (2023). Interpersonal Trust Modeling Among Couples Based on Mentalization Capacity, Conflict Resolution, and Internal Working Model. Iranian Journal of Psychiatry and Clinical Psychology, 29(3), 304-319. https://doi.org/10.32598/ijpcp.29.3.4680.1
Bateman, A. W. (2022). Theory and Practice of Mentalization-Based Treatment. In Gabbard?s Textbook of Psychotherapeutic Treatments. American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9781615375233.gg04
Baucom, D. H., Fischer, M. S., Hahlweg, K., & Epstein, N. B. (2019). Cognitive behavioral couple therapy. In APA handbook of contemporary family psychology: Family therapy and training, Vol. 3 (pp. 257-273). American Psychological Association. https://doi.org/10.1037/0000101-016
Damavandian, A., Golshani, F., Saffarinia, M., & Baghdasarians, A. (2021). Comparing the effectiveness of Compassion- Focused Therapy) CFT (and Dialectic Behavior Therapy (DBT (on aggression, self-harm behaviors and emotional self-regulation in Juvenile offenders of Tehran Juvenile Correction and Rehabilitation Center. Social Psychology Research, 11(41), 31-58. https://doi.org/10.22034/spr.2021.253334.1579
Dixon-Gordon, K. L., Chapman, A. L., & Turner, B. J. (2015). A preliminary pilot study comparing dialectical behavior therapy emotion regulation skills with interpersonal effectiveness skills and a control group treatment. Journal of Experimental Psychopathology, 6(4), 369-388. https://doi.org/10.5127/jep.041714
Euler, S., Nolte, T., Constantinou, M., Griem, J., Montague, P. R., Fonagy, P., Personality, & Mood Disorders Research, N. (2021). Interpersonal Problems in Borderline Personality Disorder: Associations With Mentalizing, Emotion Regulation, and Impulsiveness. Journal of personality disorders, 35(2), 177-193. https://doi.org/10.1521/pedi_2019_33_427
Farhadi Khoozani, M. (2021). The relationship between attachment styles and mentalization with symptoms of eating disorders with the mediation of interpersonal emotion regulation strategies
Farjami, M., Farjami, Z., Shakibaeinejad, A., & Paeezy, L. (2024). Developing a Model of Self-Harm Behaviors Based on Childhood Trauma Experience and Alexithymia with the Mediation of Mentalization in Adolescents. Journal of psychiatric nursing, 12(1). https://ijpn.ir/article-1-2356-en.html
Fassbinder, E., Schweiger, U., Martius, D., Brand-de Wilde, O., & Arntz, A. (2016). Emotion Regulation in Schema Therapy and Dialectical Behavior Therapy [Methods]. Frontiers in psychology, 7. https://doi.org/10.3389/fpsyg.2016.01373
Hadizadeh, M. H., Navabinejad, S., Farzad, V., & Nooranipour, R. (2017). Effectiveness of Dialectical Behavior Therapy on Self-Efficacy and Interpersonal Problems of Women with Dependent Personality Disorder. Journal of Woman and Society, 8(2), 97-114. https://www.magiran.com/paper/1731368/effectivenessof-dialectical-behaviour-therapy-on-self-efficacy-and-interpersonal-problems-of-women-with-dependent-personality-disorder?lang=en
Jiang, W., Yao, J., Wang, Y., Su, S., Zheng, Z., Yang, Y. H., & Qiu, J. (2025). Efficacy of Dynamic Interpersonal Therapy in Improving Mentalising in Patients With Major Depressive Disorder and the Mediating Effect of Mentalising on Changes in Depressive Symptoms. General Psychiatry, 38(1), e101774. https://doi.org/10.1136/gpsych-2024-101774
Johnstone, O. K., Marshall, J. J., & McIntosh, L. G. (2022). A review comparing dialectical behavior therapy and mentalization for adolescents with borderline personality traits, suicide and self-harming behavior. Adolescent Research Review, 7(2), 187-209. https://doi.org/10.1007/s40894-020-00147-w
Kazemi, A., Peyman, A., Kazemie Rezaei, S. V., & Salehi, A. (2020). Emotion Regulation Training Based on Dialectical Behavior Therapy Effectiveness on Reducing Students' Anxiety and Anger. yums-armaghan, 25(4), 451-465. https://doi.org/10.52547/armaghanj.25.4.451
Kumpasoğlu, G. B., Saunders, R., Campbell, C., Nolte, T., Montague, R., Pilling, S., & Fonagy, P. (2025). Mentalizing, epistemic trust and interpersonal problems in emotion regulation: A sequential path analysis across common mental health disorders and community control samples. Journal of affective disorders, 372, 502-511. https://doi.org/10.1016/j.jad.2024.12.050
Kyron, M. J., Hooke, G. R., Bryan, C. J., & Page, A. C. (2022). Distress tolerance as a moderator of the dynamic associations between interpersonal needs and suicidal thoughts. Suicide and Life‐Threatening Behavior, 52(1), 159-170. https://doi.org/10.1111/sltb.12814
Lang, C. M., Edwards, A. J., Mittler, M. A., & Bonavitacola, L. (2018). Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research. Cognitive and Behavioral Practice, 25(3), 416-426. https://doi.org/10.1016/j.cbpra.2017.12.005
McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. New Harbinger Publications. https://books.google.com/books?hl=en&lr=&id=NpeQ3q5e58MC&oi=fnd&pg=PR3&ots=qhHa1-DlGZ&sig=G3Ljo5uvlP0qOet3oLxu6-8bIXg
Oehlman Forbes, D., Lee, M., & Lakeman, R. (2021). The role of mentalization in child psychotherapy, interpersonal trauma, and recovery: A scoping review. Psychotherapy, 58(1), 50. https://pubmed.ncbi.nlm.nih.gov/32881544/
Rahmani, M., & Omidi, A. (2019). The Effectiveness of Dialectical Behavior Therapy on Quality of Life Among Women with Overweight and Binge Eating Disorder: A Clinical Trial [Research]. Journal of Rafsanjan University of Medical Sciences, 18(2), 133-146. http://journal.rums.ac.ir/article-1-4122-en.html
Samadi, B., Seyed, A., Razjouyan, & Shahabizadeh. (2023). Comparison of the effectiveness of behavioral activation therapy and dialectical behavior therapy on self-harming and self-critical behaviors in adolescents with bipolar disorder. Journal of the Faculty of Medicine, Mashhad University of Medical Sciences, 66(2), 394-408. https://stoptransingkids.wordpress.com
Samadi, F., Bahrinian, S. A., Razjouyan, K., & Shahabizadeh, F. (2023). The effectiveness of dialectical behavior therapy on aggression, self-criticism, and self-harming behaviors in adolescents aged 12-18 with bipolar disorder. Royesh Psychology, 12(3), 55-66. http://frooyesh.ir/article-1-4633-en.html
Simonsen, S., Popolo, R., Juul, S., Frandsen, F. W., Sørensen, P., & Dimaggio, G. (2022). Treating Avoidant Personality Disorder With Combined Individual Metacognitive Interpersonal Therapy and Group Mentalization-Based Treatment: A Pilot Study. The Journal of Nervous and Mental Disease, 210(3). https://journals.lww.com/jonmd/fulltext/2022/03000/treating_avoidant_personality_disorder_with.3.aspx
Skymba, H. V., Joyce, C., Telzer, E. H., & Rudolph, K. D. (2022). Peer Adversity Predicts Interpersonal Needs in Adolescent Girls. Journal of Research on Adolescence, 32(4), 1566-1579. https://doi.org/10.1111/jora.12741
Slemp, G. R., Field, J. G., Ryan, R. M., Forner, V. W., Van den Broeck, A., & Lewis, K. J. (2024). Interpersonal supports for basic psychological needs and their relations with motivation, well-being, and performance: A meta-analysis. Journal of personality and social psychology, 127(5), 1012-1037. https://doi.org/10.1037/pspi0000459
Smits, M. L., Luyten, P., Feenstra, D. J., Bales, D. L., Kamphuis, J. H., Dekker, J. J. M., Verheul, R., & Busschbach, J. J. V. (2022). Trauma and Outcomes of Mentalization-Based Therapy for Individuals With Borderline Personality Disorder. American Journal of Psychotherapy, 75(1), 12-20. https://doi.org/10.1176/appi.psychotherapy.20210027
Sobhi Gharamaleki, N., Pourabdol, S., Saravani, R., & Saravani, S. (2017). The Effectiveness of Dialectical Behavior Therapy in Decreasing High Risk Behaviors Among Students Suffering From Attention Deficit / Hyperactivity Disorder [Research Article]. Zahedan J Res Med Sci, 19(1), e5703. https://doi.org/10.17795/zjrms-5703
Sotomayor-Enriquez, K., Folco, S. D., & Schwannauer, M. (2024). Emotion Regulation Mediates the Association Between Hypermentalizing and Interpersonal Difficulties in Young People. https://doi.org/10.31234/osf.io/65squ
Tavakkoli, B., Abolmaali Alhoseini, K., & Pourseyyedaghaei, Z. (2023). The effect of the integrated intervention of mentallization and educational package of building a lasting connection on attachment behaviors and sexual satisfaction among insecure spouses. Journal-of-Psychological-Science, 22(128), 1545-1564. https://doi.org/10.52547/JPS.22.128.1545
Valinezhad, A., Nemattavousi, M., Rezabakhsh, H., Kraskian Mujemnari, A., & Hovassi Soomer, N. (2021). The Mediating Role of Interpersonal needs, Parent- Adolescent Conflict in the Relationship Between Parenting Styles, Basic Needs with Non-Suicidal Self-Injury, Suicidal Ideation. Applied Psychology, 15(3), 564-537. https://doi.org/10.52547/apsy.2021.222881.1093
Wilks, C. R., Korslund, K. E., Harned, M. S., & Linehan, M. M. (2016). Dialectical behavior therapy and domains of functioning over two years. Behaviour Research and Therapy, 77, 162-169. https://doi.org/10.1016/j.brat.2015.12.013
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Mehri Mehrmanesh (Author); Elham Zarghami; Bita Nasrolahi (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
