Efectos de la terapia dialéctica conductual en la reducción de manifestaciones fisiológicas e hiperreactividad emocional del trastorno de estrés postraumático en adultos: revisión sistemática
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Fecha
2026
Autores
Ortiz Jaimes, Juan Fernando
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias Jurídicas y Sociales
Facultad de Ciencias Jurídicas y Sociales
Resumen
Se realizó una revisión sistemática narrativa siguiendo la declaración PRISMA 2020 con el objetivo de analizar los efectos de intervenciones que incorporan componentes o módulos de la terapia dialéctico-conductual (DBT) en la reducción de manifestaciones fisiológicas e hiperreactividad emocional del trastorno de estrés postraumático (TEPT) en población adulta, se identificaron ensayos clínicos aleatorizados publicados entre 2020 y 2025 en cinco bases de datos, tras eliminar duplicados y aplicar criterios de elegibilidad, se incluyeron 12 estudios (n = 1.295 participantes; edad media 47,1 años), los 12 estudios lograron reportar reducciones consideradas como clínicamente de interés significativo en la severidad global del TEPT (CAPS-5/PCL-5), nueve de los once estudios con comparador activo mostraron superioridad o equivalencia no inferior de la intervención de la terapia DBT-informed frente a EMDR (Desensibilización y Reprocesamiento por Movimientos Oculares), CPT (terapia de procesamiento cognitivo),
exposición prolongada o tratamiento habitual, el hiperarousal fisiológico (subescala CAPS-5/PCL5, HRV o variabilidad de la frecuencia cardiáca) y la hiperreactividad emocional (DERS o y equivalentes) mejoraron en todos los casos con efectos grandes a muy grandes, la heterogeneidad se explicó principalmente por tipo de comparador y presencia de TEPT complejo. El riesgo de sesgo fue moderado en diez estudios, los hallazgos indican que no es necesario aplicar el protocolo completo DBT-PTSD para obtener beneficio clínico, siendo los módulos de regulación emocional y mindfulness suficientes y escalables, se recomienda su integración en formatos grupales y en línea en el sistema de salud colombiano para población víctima del conflicto armado y contextos de recursos limitados.
A systematic narrative review was carried out following the PRISMA 2020 statement with the objective of analyzing the effects of interventions that incorporate components or modules of dialectical-behavioral therapy (DBT) in the reduction of physiological manifestations and emotional hyperreactivity of post-traumatic stress disorder (PTSD) in the adult population. Randomized clinical trials published between 2020 and 2025 were identified in five databases, after eliminating duplicates and applying eligibility criteria. 12 studies were included (n = 1,295 participants; mean age 47.1 years), all 12 studies managed to report reductions considered clinically of significant interest in the global severity of PTSD (CAPS-5/PCL-5), nine of the eleven studies with active comparator showed superiority or non-inferior equivalence of the DBTinformed therapy intervention compared to EMDR (Eye Movement Desensitization and Reprocessing), CPT of cognitive processing), prolonged exposure or usual treatment, physiological hyperarousal (CAPS-5/PCL-5 subscale, HRV or heart rate variability) and emotional hyperreactivity (DERS or equivalent) improved in all cases with large to very large effects, heterogeneity was mainly explained by type of comparator and presence of complex PTSD. The risk of bias was moderate in ten studies, the findings indicate that it is not necessary to apply the complete DBT-PTSD protocol for clinical benefit, the emotional regulation and mindfulness modules being sufficient and scalable, their integration in group and online formats is recommended in the Colombian health system for population victims of the armed conflict and contexts with limited resources.
A systematic narrative review was carried out following the PRISMA 2020 statement with the objective of analyzing the effects of interventions that incorporate components or modules of dialectical-behavioral therapy (DBT) in the reduction of physiological manifestations and emotional hyperreactivity of post-traumatic stress disorder (PTSD) in the adult population. Randomized clinical trials published between 2020 and 2025 were identified in five databases, after eliminating duplicates and applying eligibility criteria. 12 studies were included (n = 1,295 participants; mean age 47.1 years), all 12 studies managed to report reductions considered clinically of significant interest in the global severity of PTSD (CAPS-5/PCL-5), nine of the eleven studies with active comparator showed superiority or non-inferior equivalence of the DBTinformed therapy intervention compared to EMDR (Eye Movement Desensitization and Reprocessing), CPT of cognitive processing), prolonged exposure or usual treatment, physiological hyperarousal (CAPS-5/PCL-5 subscale, HRV or heart rate variability) and emotional hyperreactivity (DERS or equivalent) improved in all cases with large to very large effects, heterogeneity was mainly explained by type of comparator and presence of complex PTSD. The risk of bias was moderate in ten studies, the findings indicate that it is not necessary to apply the complete DBT-PTSD protocol for clinical benefit, the emotional regulation and mindfulness modules being sufficient and scalable, their integration in group and online formats is recommended in the Colombian health system for population victims of the armed conflict and contexts with limited resources.
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Trastorno de estrés postraumático, Terapia dialéctico-conductual, Hiperarousal, Hiperreactividad emocional, Revisión sistemática
