Comparing the Effectiveness and Durability of Mentalization-Based Therapy and Dialectical Behavior Therapy on Impulsivity in Adolescents with Self-Injurious Behaviors
Keywords:
Mentalization, Based Therapy, Dialectical Behavior Therapy, Impulsivity, Self, Injurious Behaviors, AdolescentsAbstract
Background: Impulsivity is one of the major psychological factors associated with the onset and maintenance of self-injurious behaviors in adolescents and may intensify their emotional and behavioral vulnerability. Therefore, identifying and comparing effective interventions for reducing impulsivity in this population is of substantial clinical importance. The present study aimed to compare the effectiveness and durability of Mentalization-Based Therapy (MBT) and Dialectical Behavior Therapy (DBT) on impulsivity in adolescents with self-injurious behaviors.
Methods: This applied study used a quasi-experimental pretest–posttest design with a control group and a three-month follow-up. The statistical population included all 13- to 18-year-old male and female adolescents with self-injurious behaviors who had referred to counseling and psychological service centers in District 20 of Tehran during the second half of 2024. The study sample consisted of 45 participants who were selected using purposive sampling and, after matching, were randomly assigned to three groups of 15: a mentalization-based treatment group, a dialectical behavior therapy group, and a control group. The interventions were delivered in 12 weekly group sessions, each lasting 60 minutes, while the control group remained on a waiting list. Data were collected using the Barratt Impulsiveness Scale (BIS-11) and analyzed in SPSS-26 using mixed repeated-measures ANOVA, MANOVA, and Bonferroni post hoc tests.
Results: The results indicated that the main effect of time was significant , and the interaction effect of time × group was also significant , whereas the main effect of group was not significant . In the posttest, the adjusted mean of impulsivity was in the MBT group and in the DBT group, both of which were significantly lower than the control group mean . However, the difference between the two intervention groups was not statistically significant . Pairwise comparisons across time also showed that impulsivity scores in both intervention groups remained significantly lower at follow-up compared to pretest , indicating the durability of treatment effects.
Conclusion: The findings suggest that both Mentalization-Based Therapy and Dialectical Behavior Therapy are effective in reducing impulsivity among adolescents with self-injurious behaviors, and their therapeutic effects remain stable over a three-month follow-up period. Although DBT showed a slightly greater mean reduction in impulsivity, the difference between the two treatments was not statistically significant. Therefore, both interventions may be considered useful therapeutic approaches for reducing impulsivity in adolescents with self-injurious behaviors.
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Abdullahi, R., & Nouri, T. (2024). Dialectical Behavior Therapy: Impact on Self-Harming Behaviors, Bullying, and Cognitive Emotion Regulation in Delinquent Teenagers. Journal of Adolescent and Youth Psychological Studies, 5(5), 14-21. https://doi.org/10.61838/kman.jayps.5.5.3
Aggarwal, S., Borschmann, R., & Patton, G. C. (2021). Tackling Stigma in Self-Harm and Suicide in the Young. The Lancet Public Health, 6(1), e6-e7. https://doi.org/10.1016/S2468-2667(20)30259-0
Brokke, S. S., Landrø, N. I., & Haaland, V. (2022). Impulsivity and Aggression in Suicide Ideators and Suicide Attempters of High and Low Lethality. BMC psychiatry, 22(1), 753. https://doi.org/10.1186/s12888-022-04398-w
Bruno, S., Anconetani, G., Rogier, G., Del Casale, A., Pompili, M., & Velotti, P. (2023). Impulsivity Traits and Suicide-Related Outcomes: A Systematic Review and Meta-Analysis Using the UPPS Model. Journal of affective disorders, 339, 571-583. https://doi.org/10.1016/j.jad.2023.07.086
Dibaj, I. S., Tørmoen, A. J., Klungsøyr, O., Haga, E., & Mehlum, L. (2024). Trajectories and Predictors of Change in Emotion Dysregulation and Deliberate Self-Harm amongst Adolescents with Borderline Features. Clinical Child Psychology and Psychiatry, 29(2), 407-423. https://doi.org/10.1177/13591045231177374
Fan, X. F., Peng, J. Y., Zhang, L., Hu, Y. L., Li, Y., Shi, Y., & Zhang, T. M. (2024). The Impact of Mindfulness Therapy Combined with Mentalization-Based Family Therapy on Suicidal Ideation in Adolescents with Depressive Disorder: Randomized Intervention Study. Annals of General Psychiatry, 23(1), 16. https://doi.org/10.1186/s12991-024-00503-3
Gilbey, D., Brealey, G., Mateo-Arriero, I., Waters, Z., Ansell, M., Janse van Rensburg, E., De Gouveia Belinelo, P., Milroy, H., Pace, G., Runions, K., Salmin, I., & Woolard, A. (2023). The Effectiveness of a Day Hospital Mentalization-Based Therapy Programme for Adolescents with Borderline Personality Traits: Findings from Touchstone-Child and Adolescent Mental Health Service. Clinical Psychology & Psychotherapy, 30(6), 1303-1312. https://doi.org/10.1002/cpp.2854
Guertin, T., Lloyd-Richardson, E., Spirito, A., Donaldson, D., & Boergers, J. (2021). Self-Mutilative Behavior in Adolescents Who Attempt Suicide by Overdose. Journal of the American Academy of Child and Adolescent Psychiatry, 40(9), 1062-1068. https://doi.org/10.1097/00004583-200109000-00015
Gutierrez, P. M., Osman, A., Barrios, F. X., & Kopper, B. A. (2021). Development and Initial Validation of the Self-Harm Behavior Questionnaire. Journal of Personality Assessment, 77(3), 475-491. https://doi.org/10.1207/S15327752JPA7703_08
Ip, J. W. Y., McMain, S. F., Chapman, A. L., & Kuo, J. R. (2024). The Role of Emotion Dysregulation and Interpersonal Dysfunction in Nonsuicidal Self-Injury during Dialectical Behavior Therapy for Borderline Personality Disorder. Behaviour Research and Therapy, 180, 104594. https://doi.org/10.1016/j.brat.2024.104594
Lynam, D. R., Miller, D. J., Bornovalova, M. A., & Lejuez, C. W. (2021). Testing the Relations between Impulsivity-Related Traits, Suicidality, and Nonsuicidal Self-Injury: A Test of the Incremental Validity of the UPPS Model. Journal of personality disorders, 2(2), 151-160. https://doi.org/10.1037/a0019978
Mahboobi, E., Emaneali Khani, T., Shabrang Moridani, M., & Yousefi, N. (2025). The Effect of Mentalization-Based Treatment on Alexithymia and Impulsivity in Individuals with Eating Disorders. Journal of psychiatric nursing, 13(4), 1-12.
Malberg, N. T. (2021). Working with Autistic Children and Their Families from a Mentalization-Based Therapy for Children (MBT-C) Approach. Psychoanalytic Perspectives, 18(1), 22-42. https://doi.org/10.1080/1551806X.2021.1845033
Maleki, S., Lilabadi, L., & Koushki, S. (2025). The Effectiveness of Mentalization-Based Group Therapy on Object Relations and Emotion Regulation Difficulties in Individuals with Dependent Personality Disorder Symptoms. Journal of Applied Psychological Research, 16(2), 233-250.
Mohajerin, B., Shamsi, A., & Howard, R. (2024). A Randomized Controlled Trial Comparing Mentalization-Based Therapy with the Unified Protocol in the Treatment of Psychopathy and Comorbid Borderline and Antisocial Personality Disorders. Clinical Psychology & Psychotherapy, 31(4), e3047. https://doi.org/10.1002/cpp.3047
Moore, F. R., Doughty, H., Neumann, T., McClelland, H., Allott, C., & O'Connor, R. C. (2022). Impulsivity, Aggression, and Suicidality Relationship in Adults: A Systematic Review and Meta-Analysis. EClinicalMedicine, 45, 101307. https://doi.org/10.1016/j.eclinm.2022.101307
Nematpour Darzi, A., Avar, Z., Rahmati Tuseh Kalleh, F., & Janalizadeh Chenari, S. (2024). Effectiveness of Mentalization-Based Therapy on Emotion Regulation Difficulties and Self-Control in Adolescents with High Aggression. Royesh-e Ravanshenasi, 13(6), 241-250.
Rizzi, E., Weijers, J. G., Kate, C. T., & Selten, J. P. (2024). Mentalization-Based Treatment for a Broad Range of Personality Disorders: A Naturalistic Study. BMC psychiatry, 24(1), 429. https://doi.org/10.1186/s12888-024-05865-2
Shogren, N. P., Tirpak, J. W., Porter, N. P., Kaplan, C., Ronzio, B., Au, J. S., & Fruzzetti, A. E. (2024). Dialectical Behavior Therapy for Adolescents with Borderline Personality Disorder: Emotion Dysregulation, Abuse, and Treatment Outcomes. Evidence-Based Practice in Child and Adolescent Mental Health. https://doi.org/10.1080/23794925.2024.2306625
Zarei, F. Z., Fakhri, M. K., & Norouzi, A. (2025). Comparison of the Effectiveness of Mindful Self-Compassion Therapy and Mentalization-Based Treatment on Impulsivity among Adolescents with Self-Injurious Behaviors. Royesh-e Ravanshenasi, 14(7), 165-174.
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Copyright (c) 2026 Mahdieh Mahdavi (Author); Naser Amini; Moloud Keykhosravani (Author)
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