Multilevel Associations of Daily Skill Use and Effectiveness With Anxiety, Stress, and Depression in a Transdiagnostic Sample Undergoing Dialectical Behavior Therapy Skills Training

Dialectical Behavior Therapy (DBT) is relatively effective at treating disorders of emotion dysregulation. However, given researchers’ focus on group-level differences within disorder-specific treatments, it is unclear which transdiagnostic mechanisms influence these effects. Participants (n=19, Mage=31.8, 68% female, 95% Caucasian) with elevated emotion dysregulation completed daily reports of DBT skill use, perceived effectiveness, anxiety, stress, and depression during a DBT skills training group (1,344 observations). We tested whether within-person skill use was associated with same-day negative affect, predicted next-day changes in negative affect, and was moderated by perceived emotion regulation effectiveness. Participants used more within-person skills on days of greater stress and anxiety, which predicted next-day decreases in stress and anxiety. On days of high, but not low, perceived effectiveness, people used more skills in response to more intense negative affect. The use, and perceived effectiveness, of more skills may be mechanisms by which DBT skills groups promote improved emotional functioning