{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:42:50Z","timestamp":1787319770592,"version":"build-2736575974"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004168","name":"Universit\u00e4t zu L\u00fcbeck","doi-asserted-by":"publisher","award":["Einzelprojektf\u00f6rderung und Habiliationsf\u00f6rderung f\u00fcr Wissenschaftlerinnen, Sektion Medizin"],"award-info":[{"award-number":["Einzelprojektf\u00f6rderung und Habiliationsf\u00f6rderung f\u00fcr Wissenschaftlerinnen, Sektion Medizin"]}],"id":[{"id":"10.13039\/501100004168","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","award":["2018_A152"],"award-info":[{"award-number":["2018_A152"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Distress Tolerance Skills (DTS) are an important component of Dialectical Behavioral Therapy (DBT), a therapy method frequently used for treating patients with Borderline Personality Disorder (BPD). However, little is known about how DTS-training is experienced by individuals with BPD. The aim of this study was to explore BPD patients\u2019 experiences with receiving DTS-training. Qualitative data were collected through semi-structured interviews with 24 individuals (87.5% females) with a primary diagnosis of BPD who received DTS-training in the context of 18 months of DBT treatment. Interview data were analyzed following the procedures of qualitative content analysis. Participants reported various effects of DTS including an immediate reduction of tension. Patients perceived DTS as a tool to cope with difficult interpersonal situations and emergencies and stated that this helped them to feel stable, safe and self-confident. Patients reported difficulties during the initial engagement, the learning process and the application of DTS as well as various facilitating factors. Implications of the findings for further research and for optimizing DTS-training in clinical practice are discussed.<\/jats:p>","DOI":"10.1371\/journal.pone.0252403","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T13:28:50Z","timestamp":1623763730000},"page":"e0252403","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["How do patients with borderline personality disorder experience Distress Tolerance Skills in the context of dialectical behavioral therapy?\u2014A qualitative study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7398-8756","authenticated-orcid":true,"given":"Anja","family":"Schaich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Braakmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"Rogg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Meine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ambrosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Assmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Borgwardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Schweiger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Fassbinder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"pone.0252403.ref001","volume-title":"DBT skills training manual:","author":"M Linehan","year":"2014"},{"issue":"5","key":"pone.0252403.ref002","article-title":"Psychological therapies for people with borderline personality disorder","volume":"2020","author":"OJ Storeb\u00f8","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"4","key":"pone.0252403.ref003","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1001\/jamapsychiatry.2016.4287","article-title":"Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis","volume":"74","author":"IA Cristea","year":"2017","journal-title":"Jama psychiatry"},{"key":"pone.0252403.ref004","article-title":"Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling","author":"S Kliem","year":"2010","journal-title":"American Psychological Association"},{"key":"pone.0252403.ref005","article-title":"Psychological therapies for people with borderline personality disorder","author":"JM Stoffers","year":"2012","journal-title":"The Cochrane Library"},{"issue":"9","key":"pone.0252403.ref006","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.brat.2010.05.017","article-title":"Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder","volume":"48","author":"AD Neacsiu","year":"2010","journal-title":"Behaviour research and therapy"},{"key":"pone.0252403.ref007","article-title":"The independent roles of mindfulness and distress tolerance in treatment outcomes in dialectical behavior therapy skills training","author":"RJ Zeifman","year":"2019","journal-title":"Personality Disorders: Theory, Research, and Treatment"},{"issue":"3","key":"pone.0252403.ref008","first-page":"278","article-title":"Process and impact of dialectical behaviour therapy: A systematic review of perceptions of clients with a diagnosis of borderline personality disorder. 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