Navarro-Haro, M. V., Botella, C., Guillen, V., Moliner, R., Marco, H., Jorquera, M., Baños, R., & Garcia-Palacios, A. (2018). Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder and Eating Disorders Comorbidity: A Pilot Study in a Naturalistic Setting. Cognitive Therapy and Research, 42(5), 636–649. https://doi.org/10.1007/s10608-018-9906-9

Saint Olaf College

The two approaches in treating comorbid BPD and ED:

- Cognitive Behavioral Therapy
- Dialectical Behavioral Therapy

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are both widely used to treat comorbid Borderline Personality Disorder (BPD) and Eating Disorders (EDs), but they approach symptom management differently.

Transdiagnostic Treatment Approaches for Comorbid BPD and ED.

Key Considerations of Marsha Linehan’s Biosocial Model for Eating Disorders and Borderline Personality Disorder (Lee et al. 2023):

- Invalidating Environment
- Emotional Vulnerability
- Inability to return to baseline quickly.
- Highly reactive.

Although this model was initially developed for BPD, it has become a useful model in interpreting eating disorders since eating disorders often are a means to cope with uncomfortable emotions or thoughts.

Is Linehan’s Biosocial Model Accurate Among Co-Occurring Disorders with BPD?


DBT, in contrast, prioritizes crisis de-escalation and emotional regulation. Its four stages begin with reducing self-harm/suicidal behaviors, then fostering open communication and therapy engagement, followed by developing healthier coping mechanisms and refining impulse-control skills (Navarro-Haro et al., 2018).

The Role of DBT in Comorbid BPD and ED

In comorbid cases, CBT often begins by targeting impulsive behaviors (e.g., binge eating, purging) through increased awareness of maladaptive actions and restructuring distorted thinking patterns. Clinicians may use reward-based procedures to promote internal attribution and prevent relapse (Navarro-Haro et al., 2018).

The Role of CBT in Comorbid BPD and ED

Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder and Eating Disorders Comorbidity: A Pilot Study in a Naturalistic Setting.

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