Background and Objective: This pilot study assessed the feasibility and preliminary outcomes of integrating biofeedback into a 12-session Dialectical Behavior Therapy Skills Training (DBT-ST) program for individuals diagnosed with Borderline Personality Disorder (BPD).
Methods: This pilot study was conducted at an outpatient psychology and biofeedback clinic in Tehran, Iran, between 2020 and 2021. Patients with an initial diagnosis of BPD were interviewed using the Borderline Personality Disorder Severity Index (BPDSI-IV). Participants were assigned to either a biofeedback-enhanced DBT-ST group or a standard DBT-ST group. The outcomes were assessed using the BPDSI-IV, Difficulties in Emotion Regulation Scale, Toronto Alexithymia Scale, Beck Depression Inventory-II, and Barratt Impulsiveness Scale. Data were analyzed using IBM SPSS (version 20); effect sizes, Reliable Change Index, and remission rates were calculated.
Results: Biofeedback-enhanced DBT-ST cases showed larger reductions in BPD symptom severity (40% and 35%) than standard DBT-ST cases (5% and 13.8%). The intervention cases also showed greater improvements in alexithymia, emotion dysregulation, depressive symptoms, and impulsivity than the standard DBT-ST cases.
Conclusion: The findings suggest that adding biofeedback to DBT-ST may be a promising way to improve emotion regulation and mindfulness-related outcomes in BPD.