Emotion regulation as a mechanism of change in an acceptance-based emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology

Despite the clinical importance of deliberate self-harm (DSH) within borderline personality disorder (BPD), there are few empirically supported treatments for this behavior among individuals with BPD; and those that do exist are difficult to implement in many clinical settings. Thus, Gratz and colleagues developed an adjunctive emotion regulation group therapy (ERGT) for women with BPD that directly targets both DSH and its proposed underlying mechanism of emotion dysregulation. Although previous studies support the use of this ERGT in reducing DSH, no studies have examined emotion regulation as a mechanism of change in this treatment. Therefore, this study examined the mediating role of changes in emotion dysregulation in DSH improvement across two separate trials of this ERGT. As hypothesized, changes in emotion dysregulation mediated the observed reductions in DSH frequency. Results provide support for the theoretical model underlying this ERGT and highlight the importance of targeting emotion dysregulation in treatments for DSH.