Terapia dialéctico-conductual para estudiantes universitarios con desregulación emocional

Background: Dialectical Behavior Therapy (DBT) is an evidence-based intervention that has shown efficacy in treating university students experiencing emotional dysregulation. However, research findings have not yet provided sufficient information on the empirical selection of core content and a specific analysis of the components of the therapeutic process. Objective: Thus, the present study aimed to identify the effect of DBT for college students with emotional dysregulation and to examine relatively specific effects related to the participants’ surrounding conditions. Method: A sequential mixed-methods exploratory design was used employing semi-structured interviews and a within-subject experimental design. Qualitative data were processed using thematic content analysis, while quantitative data were analyzed using the non-overlap index of all pairs (NAP) and the Wilcoxon statistical test. Results: The intervention resulted in reduced maladaptive coping strategies and the occurrence of problem behaviors. Discussion: The findings document positive effects on the variables of interest in virtually all participants. However, future studies would benefit from adjusting the intervention to improve interpersonal effectiveness strategies.

https://doi.org/10.25009/pys.v36i1.3031

PDF (Español)

References

Anderson, G., Tung, E., Brown, T. y Rosellini, A. (2021). Facets of emotion regulation and emotional disorder symptom dimensions: differential associations and incremental validity in a large clinical sample. Behavior Therapy, 52(4), 917-931. Doi: 10.1016/j.beth.2020.11.003

Aráoz C., R. y Pinto T., B. (2021). Criterios de validez de una investigación cualitativa: Tres vertientes epistemológicas para un mismo propósito. Summa Psicológica UST, 18(1), 47-56.

Bailey, R., Erekson, D., Cattani, K., Jensen, D., Simpson, D., Klundt, J., Vogeler, H., Schmuck, D., Worthen, V., Caldwell, Y., Beecher, M., Griner, D y Hobbs, K. (2022). Adapting stepped care: Changes to service delivery format in the context of high demand. Psychological Services, 19(3), 494-501. Doi: 10.1037/ser0000564

Beanlands, H., McCay, E., Fredericks, S., Newman, K., Rose, D., Santa Mina, E., Schindel-Martin, L., Schwind, J., Sidani, S., Aiello, A. y Wang, A. (2019). Decreasing stress and supporting emotional well-being among senior nursing students: A pilot test of an evidence-based intervention. Nurse Education Today, 76, 222-227. Doi: 10.1016/j.nedt.2019.02.009

Beanlands, H., McCay, E., Wang, A., Aiello, A., Schwind, J., Martin, L., Mina, E., Rose, D., Fredericks, S. y Newman, K. (2021). Exploring undergraduate nursing students’ experiences of engaging with a dialectical behavior therapy-skills group intervention: findings of a thematic analysis. The Canadian Journal of Nursing Research, 53(1), 39-46. Doi: 10.1177/0844562119896487

Benjet, C., Gutiérrez G., R., Abrego R., A., Borges, G., Covarrubias D., A., Durán, M. del S., González G., R., Hermosillo T., A., Martínez M., K., Medina-Mora, M., Mejía Z., H., Pérez T., G., Zavala B., M., Mortier, P. y Mortier, P. (2019). Psychopathology and self-harm among incoming first-year students in six Mexican universities. Salud Pública de México, 61(1), 16-26. Doi: 10.21149/9158

Bishop, J. (2006). College and University Counseling Centers: Questions in search of answers. Journal of College Counseling, 9(1), 6-19. Doi: 10.1002/j.2161-1882.2006.tb00088.x

Braun, V. y Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. Doi: 10.1191/1478088706qp063oa

Cavicchioli, M., Tobia, V. y Ogliari, A. (2023). Emotion regulation strategies as risk factors for developmental psychopathology: A meta-analytic review of longitudinal studies based on cross-lagged correlations and panel models. Research on Child and Adolescent Psychopathology, 51(3), 295-315. Doi: 10.1007/s10802-022-00980-8

Chugani, C. (2015). Dialectical behavior therapy in college counseling centers: Current literature and implications for practice. Journal of College Student Psychotherapy, 29(2), 120-131. Doi: 10.1080/87568225.2015.1008368

Chugani, C. (2017). Adapting dialectical behavior therapy for college counseling centers. Journal of College Counseling, 20(1), 67-80. Doi: 10.1002/jocc.12059

Chugani, C., Fuhrman, B., Abebe, K., Talis, J., Miller, E. y Coulter, R. (2020). Wellness and resilience for college and beyond: Protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course. BMJ Open, 10(6), e036833. Doi: 10.1136/bmjopen-2020-036833

Chugani, C., Ghali, M. y Brunner, J. (2013). Effectiveness of short-term dialectical behavior therapy skills training in college students with cluster B personality disorders. Journal of College Student Psychotherapy, 27, 323-336. Doi: 10.1080/87568225.2013.824337

Chugani, C. y Landes, S. (2016). Dialectical behavior therapy in college counseling centers: Current trends and barriers to implementation. Journal of College Student Psychotherapy, 30, 176-186. Doi: 10.1080/87568225.2016.1177429

Chugani, C., Murphy, C., Talis, J., Miller, E., McAneny, C., Condosta, D., Kamnikar, J., Wehrer, E. y Mazza, J. (2022). Implementing dialectical behavior therapy skills training for emotional problem solving for adolescents (DBT STEPS-A) in a low-income school. School Mental Health, 14(2), 391-401. Doi: 10.1007/s12310-021-09472-4

Creswell, J. y Plano-Clark, V. (2007). Designing and conducting mixed methods research. SAGE Publications.

Demkowicz, O., Chatburn, E., Archer, C., Thompson, R. y Plackett, R. (2025). Advancing mixed methods in mental health research. BMJ Mental Health, 28(1), e301401. Doi: 10.1136/bmjment-2024-301401

Ebert, D., Mortier, P., Kaehlke, F., Bruffaerts, R., Baumeister, H., Auerbach, R., Alonso, J., Vilagut, G., Martínez, K., Lochner, C., Cuijpers, P., Kuechler, A., Green, J., Hasking, P., Lapsley, C., Sampson, N. y Kessler, R. (2019). Barriers of mental health treatment utilization among first‐year college students: First cross‐national results from the WHO World Mental Health International College Student Initiative. International Journal of Methods in Psychiatric Research, 28(2), 1-14. Doi: 10.1002/mpr.1782

ElBarazi, A., Mohamed, F., Mabrok, M., Adel, A., Abouelkheir, A., Ayman, R., Mustfa, M., Elmosallamy, M., Yasser, R. y Mohamed, F. (2024). Efficiency of assertiveness training on the stress, anxiety, and depression levels of college students (Randomized control trial). Journal of Education and Health Promotion, 13, 203. Doi: 10.4103/jehp.jehp_264_23

Engle, E., Gadischkie, S., Roy, N. y Nunziato, D. (2013). Dialectical behavior therapy for a college population: Applications at Sarah Lawrence College and beyond. Journal of College Student Psychotherapy, 27, 11-30. Doi: 10.108087568225.2013.739014

Faustino, B. (2021). Transdiagnostic perspective on psychological inflexibility and emotional dysregulation. Behavioural and Cognitive Psychotherapy, 49(2), 233-246. Doi: 10.1017/S1352465820000600

Fitzpatrick, S., Bailey, K. y Rizvi, S. (2020). Changes in emotions over the course of dialectical behavior therapy and the moderating role of depression, anxiety, and posttraumatic stress disorder. Behavior Therapy, 51(6), 946-957. Doi: 10.1016/j.beth.2019.12.009

Fleming, A., McMahon, R., Moran, L., Peterson, A. y Dreessen, A. (2015). Pilot randomized controlled trial of dialectical behavior therapy group skills training for ADHD among college students. Journal of Attention Disorders, 19(3), 260-271. Doi: 10.1177/1087054714535951

Flick, U. (2004). Introducción a la investigación cualitativa (3a ed.). Morata.

Forni, P. y Grande, P.D. (2020). Triangulación y métodos mixtos en las ciencias sociales contemporáneas. Revista Mexicana de Sociología, 82(1), 159-189. Doi: 10.22201/iis.01882503p.2020.1.58064

Gasol, X., Navarro H., M., Fernández F., I., García P., A., Suso R., C. y Gasol C., M. (2022). Preventing emotional dysregulation: acceptability and preliminary effectiveness of a DBT skills training program for adolescents in the Spanish school system. International Journal of Environmental Research and Public Health, 19(1), 494. Doi: 10.3390/ijerph19010494

Gil D., M., Rivera H., M., López P., J., Hermosillo de la T., A., Sánchez L., L. y Reyes O., M. (2025). Programa de diez sesiones en entrenamiento de habilidades DBT-A con universitarios mexicanos: ensayo clínico piloto. Revista de Psicología y Educación, 20(1), 35-46. Doi:10.70478/rpye.2025.20.04

Graham, J., Karmarkar, A. y Ottenbacher, K. (2012). Small sample research designs for evidence-based rehabilitation: Issues and methods. Archives of Physical Medicine and Rehabilitation, 93(8 Suppl.), S111-116. Doi: 10.1016/j.apmr.2011.12.017

Hawton, K., Witt, K., Taylor S., T., Arensman, E., Gunnell, D., Hazell, P., Townsend, E. y Heeringen, K. (2016). Psychosocial interventions for self-harm in adults. The Cochrane Database of Systematic Reviews, 2016(5), CD012189. Doi: 10.1002/14651858.CD012189

Jacobson, N. y Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19. Doi: 10.1037//0022-006x.59.1.12

Kassing, F., Seeley, J., Rizvi, S., Compton, S., Sinclair, J., Oshin, L., Blalock, K., Jobes, D., Crumlish, J., Stadelman, S., Gözenman-Sapin, F., Snyderman, T., Ruork, A., Fry, C., Gallop, R.J., Goodrich, J. y Pistorello, J. (2024). Assessing the implementation of suicide-focused treatments delivered in hybrid telemental health format in a real-world setting. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 1-15. Doi: 10.1080/10503307.2024.2415104

Kazdin, A. (2019). Single-case experimental designs. Evaluating interventions in research and clinical practice. Behaviour Research and Therapy, 117, 3-17.

Kazdin, A. (2021). Single-case experimental designs: Characteristics, changes, and challenges. Journal of the Experimental Analysis of Behavior, 115(1), 56-85. Doi: 10.1002/jeab.638

Kitzrow, M. (2003). The mental health needs of today’s college students: challenges and recommendations. NASPA Journal, 41(1), 167-181. Doi: 10.2202/1949-6605.1310

Koç, M. y Uzun, R. (2023). Investigating the link between dispositional mindfulness, beliefs about emotions, emotion regulation, and psychological health: a model testing study. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 42(2), 475-494. Doi: 10.1007/s10942-023-00522-1

Kvale, S., Blanco C., M. y Amo, T. (2011). Las entrevistas en investigación cualitativa. Morata.

Lancastle, D., Davies, N.H., Gait, S., Gray, A., John, B., Jones, A., Kunorubwe, T., Molina, J., Roderique-Davies, G. y Tyson, P. (2025). A systematic review of interventions aimed at improving emotional regulation in children, adolescents, and adults. Journal of Behavioral and Cognitive Therapy, 34(3), 100505. Doi: 10.1016/j.jbct.2024.100505

Lee, S. y Mason, M. (2019). Effectiveness of brief DBT-informed group therapy on psychological resilience: A preliminary naturalistic study. Journal of College Student Psychotherapy, 33, 25-37. Doi: 10.1080/87568225.2018.1425646

Liang, L., Feng, L., Zheng, X., Wu, Y., Zhang, C., y Li, J. (2021). Effect of dialectical behavior group therapy on the anxiety and depression of medical students under the normalization of epidemic prevention and control for the COVID-19 epidemic: A randomized study. Annals of Palliative Medicine, 10(10), 10591-10599. Doi: 10.21037/apm-21-2466

Lin, T., Ko, H., Wu, J., Oei, T., Lane, H. y Chen, C. (2019). The effectiveness of dialectical behavior therapy skills training group vs. cognitive therapy group on reducing depression and suicide attempts for borderline personality disorder in Taiwan. Archives of Suicide Research, 23(1), 82-99. Doi: 10.1080/13811118.2018.1436104

Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. The Guilford Press.

Linehan, M. y Gagliesi, P. (2020). Manual de entrenamiento en habilidades DBT para el/la terapeuta. Universidad Nacional de la Plata.

Lukas, C., Ebert, D., Fuentes, H., Caspar, F. y Berking, M. (2018). Deficits in general emotion regulation skills-Evidence of a transdiagnostic factor. Journal of Clinical Psychology, 74(6), 1017-1033. Doi: 10.1002/jclp.22565

Medina-Mora, M., Guerrero, B. y Cortés, J. (2022). ¿Cómo impactó a la salud mental de los estudiantes mexicanos la retracción de la economía resultado del largo periodo del confinamiento por COVID-19? Boletín sobre COVID-19. Salud Pública y Economía, 3(28), 3-6.

Menefee, D., Ledoux, T. y Johnston, C. (2022). The importance of emotional regulation in mental health. American Journal of Lifestyle Medicine, 16(1), 28-31. Doi: 10.1177/15598276211049771

Moya L., C. y Andrade A., J. (2022). Desafíos en la educación superior y salud mental en estudiantes universitarios en tiempos de covid-19. Étic@net, 22(2). Doi: 10.30827/eticanet.v22i2.23696

Muhomba, M., Chugani, C., Uliaszek, A. y Kannan, D. (2017). Distress tolerance skills for college students: A pilot investigation of a brief DBT group skills training program. Journal of College Student Psychotherapy, 31, 247-256. Doi: 10.1080/87568225.2017.1294469

Padesky, C. (2020). Collaborative case conceptualization. Client knows best. Cognitive and Behavioral Practice, 27(4), 392-404. Doi: 10.1016/j.cbpra.2020.06.003

Pallmann, P., Bedding, A.W., Choodari-Oskooei, B., Dimairo, M., Flight, L., Hampson, L.V., Holmes, J., Mander, A., Odondi, L., Sydes, M., Villar, S., Wason, J., Weir, C., Wheeler, G., Yap, C., y Jaki, T. (2018). Adaptive designs in clinical trials: Why use them, and how to run and report them. BMC Medicine, 16(1), 29. Doi: 10.1186/s12916-018-1017-7

Parker, R. y Vannest, K. (2009). An improved effect size for single-case research: non overlap of all pairs. Behavior Therapy, 40(4), 357-367. Doi: 10.1016/j.beth.2008.10.006

Paz P., M., Gutiérrez G., R., Benjet, C., Albor, Y., Martínez-M., K., Torre, A., González-G., R. y Switalski, C. (2022). Estudio exploratorio de preferencias y barreras de atención para la salud mental en universitarios. Health and Addictions/Salud y Drogas, 22(1), 226-235. Doi: 10.21134/haaj.v22i1.654

Pistorello, J., Fruzzetti, A., Maclane, C., Gallop, R. e Iverson, K. (2012). Dialectical behavior therapy (DBT) applied to college students: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 80(6), 982-994. Doi: 10.1037/a0029096

Riveros, A., Rubio, T., Candelario, J. y Mangín, M. (2013). Características psicológicas y desempeño académico en universitarios de profesiones de pronta ocupación. Revista Latinoamericana de Psicología, 45(2), 265-278.

Rizvi, S. y Steffel, L. (2014). A pilot study of 2 brief forms of dialectical behavior therapy skills training for emotion dysregulation in college students. Journal of American College Health, 62(6), 434-439. Doi: 10.1080/07448481.2014.907298

Rosa G., A., Hernández P., A., Valencia, P. y Guajardo G., D. (2021). Análisis dimensional de la Escala de Dificultades en la Regulación Emocional (DERS) en universitarios mexicanos. Evaluar, 21(2), Article 2. Doi: 10.35670/1667-4545.v21.n2.34401

Sandín, B., Simons, J., Valiente, R., Simons, R. y Chorot, P. (2017). Psychometric properties of the Spanish version of the Distress Tolerance Scale and its relationship with personality and psychopathological symptoms. Psicothema, 29(3), 421-428. Doi: 10.7334/psicothema2016.239

Sanz, J. y García-Vera, M. (2015). Técnicas para el análisis de diseños de caso único en la práctica clínica: ejemplos de aplicación en el tratamiento de víctimas de atentados terroristas. Clínica y Salud, 26(3), 167-180. Doi: 10.1016/j.clysa.2015.09.004

Smith, A. y MacDougall, D. (2020). Dialectical behaviour therapy for people with borderline personality disorder: a rapid qualitative review. Canadian Agency for Drugs and Technologies in Health. Recuperado de http://www.ncbi.nlm.nih.gov/books/NBK567202/

Southward, M., Howard, K. y Cheavens, J. (2023). Less is more: Decreasing the frequency of maladaptive coping predicts improvements in DBT more consistently than increasing the frequency of adaptive coping. Behaviour Research and Therapy, 163, 104288. Doi: 10.1016/j.brat.2023.104288

Tate, R., Perdices, M., Rosenkoetter, U., Shadish, W., Vohra, S., Barlow, D., Horner, R., Kazdin, A., Kratochwill, T., McDonald, S., Sampson, M., Shamseer, L., Togher, L., Albin, R., Backman, C., Douglas, J., Evans, J.., Gast, D., Manolov, R., … Wilson, B. (2016). The Single-Case Reporting Guideline in Behavioural Interventions (SCRIBE) 2016 Statement. Physical Therapy, 96(7), e1-e10. Doi: 10.2522/ptj.2016.96.7.e1

Tobon, J., Zipursky, R., Streiner, D., Colvin, E., Bahl, N., Ouimet, A., Burckell, L., Jeffs, L. y Bieling, P. (2020). Motivational enhancement as a pretreatment to a transdiagnostic intervention for emerging adults with emotion dysregulation: a pilot randomized controlled trial. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 29(3), 132-148.

Uliaszek, A., Rashid, T., Williams, G. y Gulamani, T. (2016). Group therapy for university students: A randomized control trial of dialectical behavior therapy and positive psychotherapy. Behaviour Research and Therapy, 77, 78-85. Doi: 10.1016/j.brat.2015.12.003

Üstündağ-Budak, A., Özeke-Kocabaş, E. e Ivanoff, A. (2019). Dialectical behaviour therapy skills training to improve turkish college students’ psychological well-being: A pilot feasibility study. International Journal for the Advancement of Counselling, 41(4), 580-597. Doi: 10.1007/s10447-019-09379-5

Vannest, K., Parker, R., Gonen, O. y Adiguzel, T. (2016). Single case research: Web based calculators for SCR analysis (Version 2.0) [Web-based application]. College Station, TX: Texas AyM University.

Wilfley, D., Agras, W., Fitzsimmons-Craft, E., Bohon, C., Eichen, D., Welch, R., Jo, B., Raghavan, R., Proctor, E. y Wilson, G. (2020). Training models for implementing evidence-based psychological treatment: A cluster-randomized trial in college counseling Centers. JAMA Psychiatry, 77(2), 139-147. Doi: 10.1001/jamapsychiatry.2019.3483

World Health Organization (1998). Wellbeing measures in primary health care/the DepCare Project: Report on a WHO meeting. Stockholm (Sweden), 12–13 February 1998. Recuperado de https://iris.who.int/handle/10665/349766

Zalewski, M., Lewis, J. y Martin, C. (2018). Identifying novel applications of dialectical behavior therapy: Considering emotion regulation and parenting. Current Opinion in Psychology, 21, 122-126. Doi: 10.1016/j.copsyc.2018.02.013

Zeinali-Davarani, Z. y Heydarinasab, L. (2019). The effectiveness of dialectical behavior therapy skills to reduction in difficulty in emotion regulation among students. Revista Argentina de Clínica Psicológica, 28(5), 842-848.

Esta obra está bajo una Licencia Creative Commons Atribución 4.0 Internacional.

Usted es libre de:

Compartir: copia y redistribuye el material en cualquier medio o formato
Adaptar: remezclar, transformar y construir sobre el material para cualquier propósito, incluso comercialmente.

El licenciante no puede revocar estas libertades siempre y cuando siga los términos de licencia.

Bajo los siguientes términos:

Atribución — Debe dar el crédito adecuado, proporcionar un enlace a la licencia e indicar si se realizaron cambios. Usted puede hacerlo de cualquier manera razonable, pero no de ninguna manera que sugiera que el licenciante lo respalda a usted o a su uso.
Sin restricciones adicionales — No puede aplicar términos legales o medidas tecnológicas que restrinjan legalmente a otros hacer cualquier cosa que la licencia permita.

Avisos:

Usted no tiene que cumplir con la licencia para elementos del material en el dominio público o cuando su uso está permitido por una excepción o limitación aplicable.
No se dan garantías. Es posible que la licencia no le dé todos los permisos necesarios para su uso previsto. Por ejemplo, otros derechos como la publicidad, la privacidad o los derechos morales pueden limitar la forma en que utiliza el material.