Table 2.

Treatment Outcomes of CBT for PDs

Citation	Study Type	Subject(s)	Treatment	Duration, Frequency	Findings
Borderline PD
Linehan et al. (20, 21, 22)	RCT	Outpatients with BPD and parasuicide n = 44 100% female	1. TAU	12 months of weekly individual DBT and skills group	1. Symptomatic behaviors: DBT>TAU
			2. DBT		2. Social functioning: DBT > TAU
					3. Global functioning: DBT > TAU
Turner (24)	RCT	Outpatients with BPD n = 24 76% female	1. CCT	49–84 individual sessions	DBT>CCT
			2. DBT		1. Symptoms: DBT > CCT Decreased depression, anger, impulsivity, suicidal ideation
					2.DBT > CCTymptomatic behavior: Decreased suicide, NSSI
					4.Global Functioning: DBT > CCT
Koons et al. (23)	RCT	Outpatients with BPD n = 20 100% female	1. TAU	5 months of weekly individual DBT and skills group	1. Symptoms: DBT > TAU
			2. DBT		2. Symptomatic behaviors: DBT > TAU
Verheul et al. (19)	RCT	Outpatients with BPD with and without substance dependence n = 58 100% female	1. TAU	12 months of weekly individual DBT and skills group	1. Symptomatic behaviors: DBT > TAU
			2. DBT
Linehan et al. (25)	RCT	Outpatients with BPD and parasuicide n = 100 100% female	1. CTBE	12 months of weekly individual DBT and skills group	1. Symptoms: DBT = CTBE
			2. DBT		2. Symptomatic behaviors: DBT > CTBE
Clarkin et al. (26)	RCT	Outpatients with BPD n = 90 83% female	1. ST	52 weekly sessions	1. Symptoms: SC = TFP = DBT
			2. TFP		2. Symptomatic behavior: TFP > DBT = SC
			3. DBT		3. Social functioning: SC = TFP = DBT
					4. Global functioning: SC = TFP = DBT
McMain et al. (27)	RCT	Outpatients with BPD with 2+ self-injurious episodes in prior 5 years n = 180 90% female	1. GPM	Weekly sessions for one year	1. Symptoms: DBT = GPM
			2. DBT		2. Symptomatic Behavior: DBT = GPM
					3. Social Functioning: DBT = GPM
Harley et al. (80)	Controlled trial	Outpatients with BPD n = 45 92% female	1. DBT (w/DBT skills)	7 months of weekly individual and group sessions	1. Symptoms: Improvement in symptoms regardless of individual treatment
			2. Non-DBT individual + DBT skills		2. Symptomatic behavior: Improvement in symptoms regardless of individual treatment
Brassington & Krowitz (81)	Open trial	Outpatients with BPD n = 10 100% female	DBT	6 months of weekly individual DBT and skills group	1. Symptoms: Decreased BPD, depression, anxiety. Improved SCL-90-R
Prendergast et al. (82)	Open trial	Outpatients with BPD n 11 100% female	DBT	6 months of weekly individual and group sessions	1. Symptomatic Behaviors: Decreased parasuicide and frequency of medically severe suicide attempts
Comtois et al. (28)	Open trial	Outpatients with BPD (community) n = 24 96% female	DBT	One year	1. Symptomatic Behaviors: Reduced self-injurious behaviors, psychiatric inpatient admissions, days, emergency room visits
Ben-Porath et al. (29)	Open trial	Patients with DBT and an Axis I diagnosis	DBT	Six months	1. Symptoms: Reduced suicidal thoughts
					2. Symptomatic behaviors: Reduction in behaviors interfering with quality of life and therapy interfering behaviors
Hopko et al. (83)	Case study	Outpatient with BPD, OCPD, and MDD (community) Female	BA + DBT skills in individual therapy	12 weekly sessions	1. Symptoms: diminished depressive symptoms
Kerr et al. (30)	Case study	Outpatient with BPD (community) Female	DBT (No group skills, on-call system, or consultation team)	6 months	1. Symptoms: decreased suicidality and misery
Bohus et al. (32, 33)	RCT	Inpatients with BPD n = 50 100% female	1. WL-TAU	3 months inpatient treatment	1. Symptoms: DBT > TAU
			2. DBT (inpatient)		2. Symptomatic Behaviors: DBT > TAU
Barley et al. (31)	Controlled trial	Inpatients with BPD	1. Inpatient TAU	Average of 103 inpatient days	1. Symptomatic behavior: Inpatient DBT > TAU
			2. DBT (inpatient)
Davidson et al. (40)	RCT	Outpatients with BPD n = 106 84% female	1. TAU	Average of 16 sessions over 52 weeks	1. Symptoms: TAU+CBT>TAU
			2. TAU + CBT		2. Symptomatic behaviors: TAU+CBT > TAU
Cottraux et al. (41)	RCT	Outpatients with BPD n = 65	1. SC	12 months of weekly sessions	1. Symptomatic behaviors: CBT > SC
			2. CBT
Turner (84)	Open trial	Outpatients with BPD n = 4 50% female	CBT + Alprazolam	3× a week for 3 months, then weekly for 9–18 months	1. Symptoms: reduced BPD symptoms
Evans et al. (42)  MacLeod et al. (43)	RCT	Individuals with Cluster B PDs and a parasuicide attempt in the past 12 months n = 34	1. MACT	6 weekly sessions	Lower suicide attempts, self-rated depressive symptoms, and cost of care in MACT. Improvements in positive future thinking.
			2. TAU
Weinberg et al. (44)	RCT	Borderline personality disorder patients n = 30 100% female	1. TAU	6 weekly sessions	1. Symptomatic behavior: TAU+MACT > TAU
			2. TAU + MACT
Nordahl & Nysæter (49)	Single case study series	Outpatients with BPD n = 6 50% female	1. SFP	65–120 weekly sessions	1. Symptoms: 50% of patients no longer met diagnostic criteria for BPD at the end of treatment
Blum et al. (53)	RCT	Outpatients with BPD n = 24 83% female	1. TAU	20 weekly group sessions	1. Symptoms: TAU+CBGT > TAU
			2. TAU + STEPPS		2. Symptomatic behaviors: TAU+STEPPS = TAU
Black et al. (56)	Open Trial	Offenders with BPD n = 12 100% female	STEPPS	20 weekly sessions	1. Symptoms: BPD and depression
					2. Symptomatic behaviors: decreased engagement in impulsive and self-damaging behaviors, increased positive coping
Gratz & Gunderson (57)	RCT	Outpatients with BPD and non-suicidal self-injury n = 22 100% female	1. TAU	14 weekly sessions	1. Symptoms: TAU + skills group > TAU
			2. TAU + ERGT		2. Symptomatic behaviors: TAU + ERGT > TAU
Avoidant PD
Alden (62)	RCT	Outpatients with AVPD n = 76 45% female	1. WL	10 weekly sessions	1. Symptoms : all CBGTs > WL; addition of skill modules did not improve outcomes beyond CBGT.
			2. CBGT		2. Social functioning: CBGT+intimacy focus > all other CBGTs; all conditions produced improvements.
			3. CBGT + social skills
			4. CBGT + intimacy skills
Stravynski et al. (64)	RCT	Outpatients with AVPD n = 21	1. CBGT with social skills	5 weekly sessions	1. Symptoms: Skills = Discussion
			2. CBGT with discussion		2. Symptomatic behaviors: Skills = Discussion
Renneberg et al. (63)	Open trial	Outpatients with AVPD n = 17 47% female	CBGT	32 hours over 4 days	1. Symptoms: Modestly improved at post-treatment assessment.
					2. Symptomatic Behaviors: Improved at post-treatment assessment.
Stravynski et al. (65)	Open trial	Outpatients with AVPD n = 28%	CBGT	14 weekly sessions	1. Symptoms: improved at post-assessment
Emmelkamp et al. (68)	RCT	Outpatients with AVPD n = 62 52% female	1. WL	20 weekly sessions	1. Symptoms: CBT > BDT = WL
			2. CBT		2. Symptomatic Behavior: CBT > BDT = WL
			3. BDT
Strauss et al. (67)	Open trial	Outpatients with AVPD n = 24	CBT	Up to 52 weekly sessions	1. Symptoms: Improvements in depressive symptoms and PD symptoms;
Hyman & Schneider (70)	Case study	Outpatient with AVPD, GSP Female	CBT	21 weekly sessions	1. Symptoms: reduced at treatment termination
Hofmann (86)	Case study	Outpatient with AVPD, GSP Male	CBT	27 sessions over 18 months	1. Symptoms: below clinical cutoff on symptom measures at termination and follow-up
					2. Symptomatic behaviors: improved interpersonal and occupational functioning.
Obsessive Compulsive PD
Strauss et al. (67)	Open trial	Outpatients with OCPD n = 16	CBT	Up to 52 weekly sessions	1. Symptoms: Improvements in depressive symptoms and PD symptoms
Antisocial PD
Davidson et al. (13)	RCT	Outpatients with ASPD and aggression n = 52 100% male	1. TAU	15 sessions over 6 months or 30 sessions over 12 months	1. Symptoms: TAU = TAU+CBT; both treatments produced reductions in symptoms
			2. TAU + CBT		2. Symptomatic behaviors: TAU = TAU+CBT; both treatments reduced symptomatic behaviors.
					3. Social functioning: TAU = TAU+CBT; both treatments produced improvement.
Other PDs, Comorbid PDs, PDNOS or Mixed PD Samples
Muran et al. (71)	RCT	Outpatients with Cluster C or PDNOS n = 128 53% female	1. BRT	30 weekly sessions	1. Symptoms: BRT = BDT = CBT
			2. BDT		2. Symptomatic behaviors: BRT = BDT = CBT
			3. CBT
Springer et al. (34)	RCT	Inpatients with PDs n = 31 68% female	1. ST	10 sessions daily sessions	1. Symptoms: DBT = TAU; both groups exhibited improvements in symptoms during the trial.
			2. DBT skills group		2. Symptomatic behaviors: DBT = TAU Both groups exhibited improvements in symptomatic behaviors during treatment.
Lynch et al. (72)	RCT	Outpatients with PDs and MDD Study 1: n = 34 (46% female) Study 2 n = 37 (46% female)	Study 1	Study 1: 28 weekly group sessions	Study 1
			1. MED		1. Symptoms: MED+DBT > MED (depression)
			2. MED + DBT skills	Study 2: 24 weekly group and individual sessions	Study 2
			Study 2		1. Symptoms: MED + DBT > MED (PD)
			1. MED
			2. MED + DBT
Williams (73)	Case study	Outpatient with PPD, MDD Male	CBT	11 weekly sessions	1. Symptoms: Remission of depressive symptoms during treatment
					2. Symptomatic behaviors: Fewer suspicious comments and greater self-disclosure
Lynch & Cheavens (74)	Case study	Outpatient with PPD, OCPD, MDD Male	DBT (mod)	9 months of weekly individual DBT; 6 months of weekly skills group	1. Symptoms: no longer met diagnostic criteria for PPD, OCPD or MDD at follow-up.
					2. Symptomatic behaviors: Diminished interpersonal sensitivity, aggression, improved interpersonal relationships at follow-up
Busch et al. (72)	Single subject	Outpatient with HPD Female	CBT + FAP	20 weekly sessions	1. Symptoms: Remission of depressive symptoms
					2. Symptomatic behaviors: reduced engagement in aversive interpersonal behaviors in and out of session; greater perceived social support
Callaghan et al. (78)	Single subject	Outpatient with PDNOS (histrionic, narcissistic features) Male	FAP	23 weekly sessions	1. Symptomatic behaviors: fewer aversive interpersonal behaviors; greater involvement in prosocial behaviors; improved emotional expression

ASPD = antisocial PD; AVPD = avoidant PD; BA = behavioral activation; BDT = brief dynamic therapy; BPD = borderline PD; BRT = brief relational therapy; CBGT = cognitive behavioral group therapy; CBT = cognitive behavioral therapy; CTBE = community treatment by experts; DBT = dialectical behavior therapy; ERGT = emotion regulation group treatment; FAP = functional analytic psychotherapy; GPM = general psychiatric management; GSP = generalized social phobia; HPD = histrionic PD; MACT = Manual Assisted Cognitive Therapy; MDD = major depressive disorder; MED = Medication management; OCPD = obsessive compulsive PD; PDNOS = PD not otherwise specified; PPD = paranoid PD; SC = supportive counseling; SFP = schema focused psychotherapy; ST = standard treatment; STEPPS = Systems Training for Emotional Predictability and Problem Solving; TAU = treatment as usual; TFP = transference focused psychotherapy; WL = waitlist control