Shireen L Rizvi

Rutgers, The State University of New Jersey | Rutgers · Graduate School of Applied and Professional Psychology

The COVID-19 pandemic presented unprecedented challenges for school communities with long term impacts still unknown. School personnel working in high need, low wealth schools are uniquely at risk for pandemic-related stress given extensive changes to their work life and concerns regarding student trauma exposure. We delivered DBT skills training t...

As the popularity of dialectical behavior therapy (DBT) grows, so does its use with increasingly diverse groups of clients. In this article, we demonstrate that DBT in its standard form can incorporate the sequelae of oppression as a target of treatment by providing clients with skills to identify oppression and its impact while responding effectiv...

Purpose There is a dearth of research on suicidal ideation (SI) that occurs specifically in the context of drinking alcohol. Alcohol use and binge drinking are both elevated among college students, among whom sexual and gender minority (SGM) students are at particular risk for SI. This manuscript examines alcohol use, SI, and SI specifically in the...

Around the world, suicide ideation, attempts, and deaths pose a major public and mental health challenge for patients (and their loved ones). Accordingly, there is a clear need for effective clinical treatments that reliably reduce suicidal thoughts and behaviors. In this article, we review the Collaborative Assessment and Management of Suicidality...

UNSTRUCTURED Novel technologies, such as ecological momentary assessment (EMA) and wearable biosensor wristwatches, are increasingly being utilized to assess outcomes and mechanisms of change in psychological treatments. However, there is still a dearth of information on the feasibility and acceptability of these technologies and whether they can b...

Background Novel technologies, such as ecological momentary assessment (EMA) and wearable biosensor wristwatches, are increasingly being used to assess outcomes and mechanisms of change in psychological treatments. However, there is still a dearth of information on the feasibility and acceptability of these technologies and whether they can be reli...

Purpose Although there is research establishing that physical pain is a risk factor for suicidal ideation, there is limited understanding of how physical pain confers risk. Methods The current study uses ecological momentary assessment to explore hopelessness as a potential mechanism of physical pain’s effect on suicidal ideation in two distinct s...

Introduction Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self‐injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention. Methods The current study examined whether, and how, the specific emotion...

The present study compared the efficacy of dialectical behavior therapy (DBT) for lesbian, gay, bisexual, and queer (LGBQ) and heterosexual adults who were diagnosed with borderline personality disorder (BPD). Clients were 100 clients (n = 35 LGBQ and n = 70 heterosexual) who participated in a 6-month comprehensive DBT program. The study had two ai...

Schleider et al. (2023, International Journal of Eating Disorders) provide an overview and compelling rationale for incorporating single-session interventions (SSIs) into the eating disorder field. As intervention researchers working with complex mental health problems, including suicide risk, we agree that there is much to be gained by developing...

Although ecological momentary assessment (EMA) provides an opportunity for the examination of intervention mechanisms in real time, there are few validated tools to assess key treatment mechanisms in EMA studies. Our focus in this study is a potentially critical treatment mechanism, improvement in self-efficacy for managing negative emotions. We ex...

Objective: Prior studies of Dialectical Behavior Therapy (DBT) for borderline personality disorder (BPD) have yielded heterogeneous findings on what factors differentiate individuals with or without sufficient treatment response, highlighting the need for further research. Method: We investigated a sample of 105 individuals with BPD receiving a...

Dialectical behavior therapy (DBT) is built on a rich foundation of behavior therapy traditions and, through its innovative blend of dialectical philosophy, Zen Buddhism, and radical behaviorism, extends and enriches these traditions. Ultimately, DBT is a therapy that rests heavily on precise case formulation and the treatment plans that follow fro...

Introduction: The prediction of affective experiences, also known as affective forecasting, is an integral component of individuals’ decision-making processes. Yet, research consistently demonstrates that affective forecasts (AF) and recollections (AR) are generally inaccurate. Recent research has demonstrated distinct patterns of AF/R bias related...

Despite recognition that borderline personality disorder (BPD) is one of the most stigmatized psychological disorders, destigmatization efforts have thus far focused on the views and actions of clinicians and the general public, neglecting the critical role that psychological science plays in perpetuating or mitigating stigma. This article was cata...

Introduction Despite the pressing need for primary care-based suicide prevention initiatives and growing acknowledgement of recruitment difficulties and Institutional Review Board (IRB) challenges in suicide research, we are aware of no illustrative examples describing how IRB decisions in the design of a primary care trial can compound recruitment...

Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) are often grouped together as “third-wave” cognitive behavioral therapies and have become increasingly popular among therapists treating a wide variety of presenting problems. This paper describes areas of conceptual overlap between DBT and ACT, notably both being princi...

This study examined the feasibility and promise of using virtual Dialectical Behavior Therapy Skills Training (DBT‐ST) with educators. DBT‐ST was offered to 39 educators (89% female, mean age 46.45) in one high‐poverty school district during the COVID‐19 pandemic using a pre–post design. Educators attended five of eight groups (Mode = 8) and there...

Initial research has indicated that college students have experienced numerous stressors as a result of the pandemic. The current investigation enrolled the largest and most diverse sample of college students to date ( N = 4714) from universities in New York (NY) and New Jersey (NJ), the epicenter of the North American pandemic in Spring 2020. We d...

Dialectical behavior therapy (DBT) is an empirically supported behavioral treatment for individuals with borderline personality disorder who frequently exhibit life-threatening behavior, such as suicide attempts, nonsuicidal self-injury urges and actions, and suicidal ideation. We provide an overview of the theoretical framework by which DBT concep...

This randomized clinical trial aimed to determine feasibility, acceptability, and initial efficacy of brief Dialectical Behavior Therapy (DBT) skills videos in reducing psychological distress among college students during the COVID-19 pandemic. Over six weeks, 153 undergraduates at a large, public American university completed pre-assessment, inter...

Despite ample evidence for Dialectical Behavior Therapy (DBT) as an effective treatment for borderline personality disorder (BPD), close examination of the trajectory of change in BPD symptoms over the course of DBT is lacking. There also remain questions regarding the directionality of changes in different domains of BPD symptoms, such as improvem...

Given the severity and suicide risk of patients typically treated by Dialectical Behavior Therapy (DBT) and the absence of guidelines regarding delivery of DBT via telehealth, it is crucial that the DBT treatment community gather and rapidly disseminate information about effective strategies for delivering DBT via telehealth. The current study surv...

Objective: Dialectical behavior therapy (DBT) targets suicidal behavior and non-suicidal self-injury (NSSI) as well as urges/ideation to engage in these behaviors. However, it remains unclear which specific suicidal ideation (SI) and NSSI ideation domains (i.e., frequency, worst intensity, average intensity, perceived likelihood of future ideation...

Suicide rates have risen in the United States, and there has been a simultaneous, nearly ubiquitous decrease in services provided on psychiatric inpatient units (e.g., shorter stays, almost exclusive emphasis on crisis management). Despite limited research demonstrating its efficacy for reducing suicide risk, inpatient hospitalization remains the t...

Evidence-based borderline personality disorder (BPD) treatments such as dialectical behavior therapy (DBT) emphasize the acquisition and use of strategies to down regulate negative emotion. However, little research examines whether specific emotions change during DBT. Further, it is unclear if BPD-relevant comorbidities that involve heightened emot...

Background: Research suggests that a major barrier to mental health treatment is not knowing where to go for services, yet little is known about the specific steps people take to find treatment. Aims: To (1) understand the process people would undertake if they decided they needed mental health treatment and (2) examine how well the process that cu...

Dialectical behavior therapy is a widely popular treatment that has been demonstrated to be efficacious with individuals with severe emotion dysregulation problems. DBT is a highly flexible treatment that relies heavily on assessment throughout all phases of treatment to generate idiographic interventions that closely match each client’s varied nee...

Borderline personality disorder (BPD) is a diagnosis characterized by intense and labile emotion; dialectical behavior therapy, a common treatment for BPD, aims to reduce the intensity and lability of clients' emotion through multiple methods, some of which occur in the therapy session, with the expectation that changes will generalize to the rest...

Introduction: The ability to predict emotional experiences, “affective forecasting,” is an essential factor in individuals' decision-making processes. Research has shown that, generally, individuals are inaccurate in their affective forecasts/recollections, and that certain psychological disorders may be related to individual differences in these i...

Objective: Almost all individuals in methadone treatment for opioid dependence smoke cigarettes, and half of people in methadone treatment have an opioid relapse within six months. Dialectical behavior therapy (DBT) skills training has shown promise for addressing substance use and a variety of health behaviors and conditions; however, it has never...

Telephone coaching is a treatment mode in Dialectical Behavior Therapy (DBT) that is designed to help clients generalize skills, prevent suicidal behaviors, and repair therapeutic ruptures. To date, phone coaching has received scant empirical investigation. The aims of this study were to (1) describe patterns in frequency of telephone calls and tex...

Dialectical Behavior Therapy (DBT) is a complex cognitive-behavioral treatment designed for a population with multiple problematic and high-risk behaviors. As with any behavioral treatment, the role of assessment in DBT is critical. Although there is a significant body of research supporting the efficacy of DBT, there is a relative dearth of practi...

This chapter reviews components of the major models of borderline personality disorder (BPD) with respect to empirical support and an emphasis on the dialectical behavior therapy (DBT) model. It discusses how theoretical mechanisms of BPD may interfere with empirically supported treatments and outcomes, and provides clinical recommendations for how...

Objective: The aim of the current study was to evaluate the effectiveness of a 6-month course of comprehensive dialectical behavior therapy (DBT) provided in a training clinic with doctoral students as therapists and assessors. Method: Clinical outcomes for 50 individuals with borderline personality disorder (80% female, Mage = 29.52 [SD = 9.64]...

Dialectical behavior therapy (DBT) is a comprehensive, multimodal, cognitive-behavioral treatment developed as a treatment for chronically suicidal individuals with borderline personality disorder (BPD). DBT has since been adapted to address a variety of problematic behaviors broadly associated with emotion dysregulation. A principle-based treatmen...

Dialectical behavior therapy (DBT) is a treatment for borderline personality disorder, a disorder for which emotion dysregulation is central. Within DBT, there are 6 explicitly defined validation strategies that range hierarchically from validation level (VL) 1 to VL 6. To date, there have been no studies on the frequency of use of VLs in actual DB...

Acquisition and generalization of specific behavioral skills is a key component of dialectical behavior therapy (DBT) for individuals with borderline personality disorder (BPD). We examined the feasibility, acceptability, usability, and immediate effects of the DBT Coach, a mobile phone application (app) designed specifically to augment skills gene...

Dialectical behavior therapy (DBT) has been shown effective for the treatment of borderline personality disorder (BPD) and other high-risk, suicidal, and diagnostically complex populations. However, little has been written about how to train therapists in DBT's highly structured framework of target hierarchies, behavioral chain analyses, and stylis...

Describe several uses of smartphone technology as an adjunct or alternative delivery system for assessment and intervention. Summarize the clinical utility of some of the most recent controlled trials of smartphone apps for reducing symptoms or preventing lapses. Provide suggestions for the generalization of the most recent smartphone apps as adjun...

Objective: There are six strategies or validation levels in dialectical behavior therapy (DBT), yet there are no measures designed to code for them. This absence limits our understanding of the relationship between validation strategies and treatment outcome. The DBT-Validation Level Coding Scale (DBT-VLCS) was developed to overcome this limitatio...

Research has begun to identify factors that may moderate the effects of interventions for symptomatology associated with child sexual abuse (CSA). However, there is disagreement about which factors may be important for different populations. The present investigation examined predictors of treatment outcomes among 166 predominantly economically dis...

Youth school refusal is a significant societal problem with broad negative long-term consequences yet few treatments have been developed for this population. This paper reports on the development and implementation of a novel treatment program, Dialectical Behavior Therapy for School Refusal (DBT-SR), that attempts to address limitations in both ex...

Objective: To examine the feasibility and initial efficacy of 2 abbreviated dialectical behavior therapy (DBT) skills training groups: emotion regulation skills only and emotion regulation with mindfulness skills. Participants: Participants were 24 undergraduates (aged 18-29) with significant emotion dysregulation who participated between Februa...

Scherb (2014) describes the case of Sonia, a 44-year-old woman with severe and complex presentation of borderline personality disorder, along with diagnoses of bipolar disorder, trichotillomania, borderline intellectual functioning, and obesity. At the end of 10 years of therapy with decreasing frequency, Sonia has made a dramatic recovery from alm...

Objective Nonsuicidal self-injury (NSSI) is a public health concern and risk factor for suicide. The Emotional Cascade Model (ECM) proposes that NSSI partially functions as a distraction from cascades of negative affect and rumination. The purpose of this study was to examine the roles of trait rumination, and momentary instability of rumination an...

The review by Teng and colleagues (2013) makes clear that there exist a number of problems in how we currently conceptualize, assess, and treat (or not treat) comorbid disorders. We make a number of assessments and clinical research suggestions that are meant to improve our understanding and treatment of comorbid conditions that likely share import...

Insurance companies and clinicians may appear to be strange bedfellows, however, both have common objectives. This commentary describes how, using Koons, O’Rourke, Carter, and Erhardt (2013) as a model, CBT clinicians can learn to actively change the system to benefit both the providers and the clients. By doing so, we can increase the availability...

Dialectical behavior therapy (DBT) is an evidence-based treatment for borderline personality disorder (BPD), an Axis II disorder characterized by severe emotional dysregulation, and one of the few psychological disorders to have anger as a diagnostic criterion. Individuals with BPD may be more sensitive to perceived injustices in their environment,...

Chapter 12 covers Borderline Personality Disorder (BPD), and includes definition and history of the condition, description and background of dialectical behavior therapy (DBT) used to treatm BPD, background history of the patient, assessment strategy, case formulation and treatment approach, course of treatment, treatment transfer specific to this...

Behavioral chain analyses, which are common in behavioral and cognitive-behavioral treatments more broadly, are the primary assessment tool in Dialectical Behavior Therapy (DBT). As such, they are conducted in nearly every DBT session. Despite their importance in the treatment, very little has been written about the “how-tos” of chain analyses in D...

The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of co...

Dialectical Behavior Therapy (DBT) is a comprehensive psychosocial treatment originally designed for individuals meeting criteria for borderline personality disorder (BPD). The purpose of this article is to provide an overview of the principles and techniques of DBT for BPD, summarize current research, and discuss the implications for psychologists...

Dialectical behavior therapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have bee...

Dialectical behavior therapy (DBT) has become a widely used treatment model for individuals with borderline personality disorder (BPD) and other individuals with significant emotion dysregulation problems. Despite its strong empirical support, DBT obviously does not have positive outcomes for all individuals. It is critical that cases of DBT nonres...

The authors examined the impact of co-occurring posttraumatic stress disorder (PTSD) on women with borderline personality disorder who had attempted suicide in the preceding year. Female borderline personality disorder outpatients (N=94) either with (N=53, 56.4%) or without PTSD (N=41, 43.6%) and with recent and repeated suicidal or self-injurious...

Research on the emotion of shame has increased significantly in recent years. However, there remains a need for more psychometrically sound measures of shame, including measures of shame in response to specific, idiographic experiences. The Shame Inventory was developed in order to assess both global feelings of shame as well as shame in response t...

A central component of Dialectical Behavior Therapy (DBT) is the teaching of specific behavioral skills with the aim of helping individuals with Borderline Personality Disorder (BPD) replace maladaptive behaviors with skillful behavior. Although existing evidence indirectly supports this proposed mechanism of action, no study to date has directly t...

Skills training is a crucial mode of treatment in dialectical behavioral therapy (DBT; Linehan, 1993b), yet a psychometrically sound measure of DBT skills use does not exist. We adapted the Revised Ways of Coping Checklist (RWCCL; Vitaliano, Russo, Carr, Maiuro, & Becker, 1985) to create the DBT Ways of Coping Checklist (DBT-WCCL). Using factor ana...

Pharmacotherapy and psychotherapy are generally effective treatments for major depressive disorder (MDD); however, research suggests that patient preferences may influence outcomes. We examined the effects of treatment preference on attrition, therapeutic alliance, and change in depressive severity in a longitudinal randomized clinical trial compar...

This study examined cognitive and affective predictors of treatment dropout and treatment efficacy in Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) for PTSD. Study participants were women with PTSD from a sexual assault who received at least one session of either treatment (n = 145) as part of a randomized clinical trial. Results r...

This study investigated sudden gains, i.e., rapid and stable improvements, in posttraumatic stress disorder (PTSD) symptoms that may occur in cognitive-behavioral therapy. Twenty-nine of 72 participants (39.2%) experienced a sudden gain during treatment. Mixed model ANOVAs analyzed sudden gains impact on clinician-rated PTSD symptom severity, patie...

Borderline personality disorder (BPD) is a severe personality disorder characterized by prominent and pervasive dysregulation of emotion, behavior, and cognition. Current diagnostic criteria for BPD include difficulties with interpersonal relationships, affective instability, problems with anger, destructive impulsive behaviors, frantic efforts to...

Single-case experimental designs (SCEDs) provide a time- and cost-effective alternative to randomized clinical trials and offer significant advantages in terms of internal and external validity. A brief history and primer on SCEDs is provided, specifically for use in suicide intervention research. Various SCED methodologies, such as AB, ABAB, multi...

This study examines peritraumatic (and posttrauma) responses in a sample of female crime victims who had been sexually or physically assaulted within the previous 2 months. Women were interviewed about their emotional and behavioral responses during the trauma and assessed for posttraumatic stress disorder and depression symptomatology. Results ind...

This study followed treatment responders from a randomized controlled trial of adults with major depression. Patients treated with medication but withdrawn onto pill-placebo had more relapse through 1 year of follow-up compared to patients who received prior behavioral activation, prior cognitive therapy, or continued medication. Prior psychotherap...

IntroductionDesigns of Studies Examining Suicidal Behaviour and Personality DisordersMethodological IssuesPrevalence of Personality Disorders Among Individuals Who Commit SuicideIncidence of Suicide Among Individuals Meeting Criteria for an Axis II DiagnosisCo-Variation of Personality Disorders and Attempted SuicideRisk Factors for Suicide Among In...

Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment outco...

Nonsuicidal self-injury (NSSI) and suicide attempts (SAs) are especially prevalent in borderline personality disorder. One proposed mechanism for the maintenance of NSSI and SAs is escape conditioning, whereby immediate reductions in aversive emotional states negatively reinforce the behaviors. Psychophysiological and subjective indicators of negat...

Although many studies have examined hardiness as a protective factor against stress reactions, to the authors' knowledge no studies have yet examined the impact of stress reactions on hardiness. However, there is theoretical support for this notion. In this longitudinal study of 1,571 Marine recruits who participated in a highly stressful training...

In this article, the authors take the perspective that effective treatment of complex trauma-related problems requires, in the absence of empirically supported treatments, a reliance on theory, idiographic assessment, and empirically supported principles of change. Dialectical behavior therapy (DBT; M. M. Linehan, 1993) is used to demonstrate the a...

This chapter focuses on the use of mindfulness strategies in the treatment of borderline personality disorder (BPD), the rationale for their use with clients with BPD, difference among them and other mindfulness-based treatments, and possible mechanisms of efficacy. Dialectical behavior therapy (DBT) is a comprehensive psychosocial treatment that w...

This study examined the relationship between changes in coping and posttraumatic stress disorder (PTSD) symptomatology among recent female rape and physical assault victims as a function of assault type and perpetrator status. Participants were assessed within 1 month after trauma and again at 3 months after trauma. Results indicate that changes in...

Peritraumatic responses, aside from dissociation, have been understudied in acute trauma populations. Participants were 172 female rape, 68 assault, and 80 robbery victims recruited through formal reporting agencies and assessed 1 month after the crime. Despite substantial overlap across crimes, rape victims reported more emotional responses reflec...

This study sought to pilot test a short-term intervention for maladaptive shame in borderline personality disorder (BPD) based on the skill of “opposite action” from dialectical behavior therapy. Five women with BPD were treated with the intervention using a single-subject, multiple-baseline design. Results indicate that, although state ratings of...

Thesis (Ph. D.)--University of Washington, 2004 Research on the emotion of shame has increased dramatically in recent years. Shame has been found to be associated with suicidal behavior, interpersonal difficulties, deficits in problem solving, and problems with other negative affect such as anger and depression. However, despite empirical evidence...

Interest in dialectical behavior therapy (DBT) as a treatment for personality disorders has increased dramatically in recent years. Although originally designed for the outpatient treatment of suicidal individuals with borderline personality disorder (BPD), DBT has been applied to many more diverse populations including comorbid substance dependenc...

The purpose of this investigation was to determine the test-retest reliability of the Eating Disorder Examination (EDE). This study examined the test-retest and interrater reliability of the EDE in 20 adult women with a range of eating disorder symptoms. Trained assessors administered the EDE to participants on two separate occasions, ranging from...

Objective: The purpose of this investigation was to determine the test-retest reliability of the Eating Disorder Examination (EDE). Method: This study examined the test-retest and interrater reliability of the EDE in 20 adult women with a range of eating disorder symptoms. Trained assessors administered the EDE to participants on two separate occas...

The primary aim of this paper is to describe key modifications made to standard Dialectical Behavior Therapy (DBT) for use with substance-dependent individuals with borderline personality disorder (BPD). Key modifications include application of dialectics to issues surrounding abstinence, a new set of substance abuse behavioral targets, a set of at...

Reports 2 errors in the original article by E. Stice et al ( Psychological Assessment , 2000, vol 12[2], 123–131). On page 130 in Appendix A under heading "Bulimia Nervosa," EDDS Item 8 response should be "greater than or equal to 2." Under heading "Binge-Eating Disorder," EDDS Item 7 response should be "greater than or equal to 2." (The following...

Reports 2 errors in the original article by E. Stice et al ( Psychological Assessment , 2000, vol 12[2], 123–131). On page 130 in Appendix A under heading "Bulimia Nervosa," EDDS Item 8 response should be "greater than or equal to 2." Under heading "Binge-Eating Disorder," EDDS Item 7 response should be "greater than or equal to 2." (The following...

This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N...

This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N...

This study investigated the course of eating attitudes and eating-disordered behaviors in a community sample of adult women. Participants (N = 166; mean age = 32.8 years) completed the Eating Disorder Inventory (EDI), the Three-Factor Eating Questionnaire (TFEQ), and a questionnaire assessing bulimic behaviors at two time points, 6 years apart. Cor...

Objective This study investigated the course of eating attitudes and eating-disordered behaviors in a community sample of adult women.Method Participants (N = 166; mean age = 32.8 years) completed the Eating Disorder Inventory (EDI), the Three-Factor Eating Questionnaire (TFEQ), and a questionnaire assessing bulimic behaviors at two time points, 6...