(PS9-87) Exploring Self-Validation as a Mechanism of Change Underlying Emotion Dysregulation Treatment Effects: a pilot study of youth in an intensive Dialectical Behavior Therapy day program

Emotion dysregulation is a key risk factor for various mental health concerns, making it a primary treatment target of Dialectical Behavior Therapy through the use of manualized group skill modules (DBT; Berk et al., 2020; Hoffman et al., 2012; Linehan, 2014). However, less is known about mechanisms driving these treatment effects. Self-validation—the ability to affirm the truth in the individual's own experience, emotional reactions, thoughts, or opinions—is an important acceptance intervention in DBT (Linehan, 1993). Our study aims to examine whether changes in self-validation mediate DBT treatment effects of emotion dysregulation among adolescents and young adults admitted to an intensive DBT day program. Specifically, we will examine whether changes in emotion dysregulation from intake to discharge are explained by the degree of change in an individual’s consistency of using self validation by mid treatment. Given that validation has been found to regulate client distress (Linehan, 1997), and by definition involves acknowledging one’s emotional experience, we hypothesize that more consistent use of self-validation will explain reductions in emotion dysregulation over treatment. Participants (to date: n = 17, M[SD]age = 18.41 [2.12], M[SD]treatment days = 47.94 [15.47]) are admitted to a comprehensive DBT day program to manage emotion dysregulation symptoms. Participants complete an assessment battery for routine progress monitoring to inform clinical care at intake and every two weeks until discharge. The battery includes assessment of emotion dysregulation and self-validation, with higher scores indicating greater emotion dysregulation and more consistent self-validation, respectively. Written consent and assent is obtained at intake to use routine clinical progress monitoring data for research purposes. Data collection is ongoing with an expected sample increase of at least 10 participants by November 2025. Due to limitations in statistical power with the current sample size (n = 17), preliminary descriptive and bivariate Pearson correlations bootstrapped with 10,000 resamples are presented. To date, mid-treatment change in emotion dysregulation (M[SD] = -0.70 [7.08]) and change in self-validation (M[SD] = 3.44[4.08]) were significantly associated (r[15] = -0.56, 95% CI [-0.88, -0.15], p = .015). Over the course of treatment, the change in emotion dysregulation (M[SD] = -7.33 [10.37]) and change in self-validation (M[SD] = 5.38 [6.01]) were significantly associated (r[15] = -0.65, 95% CI [-0.82, -0.40], p = .004). Given the preliminary correlational results, there is promise for mediation with an increased sample size. Planned analyses include a mediation model using Hayes PROCESS model 4 in SPSS v.29, bootstrapped with 10,000 resamples. Age and length of treatment will be included as conceptually relevant covariates in the final mediation model. By identifying whether self-validation mediates treatment effects on emotion dysregulation, our findings could inform more targeted interventions and refine treatment approaches in DBT to better support adolescents and young adults struggling with emotion dysregulation.