Is There Any Influence of Personality Disorder on the Short Term Intensive Group Cognitive Behavioral Therapy of Social Phobia?

Vyskocilova, J.; Praško, Ján; Novák, Tomáš; Pohlova, L.

doi:10.5507/bp.2011.005

Cited by 5 publications

(7 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 107 In a study by Prasko et al, 111 there was a less significant decrease in specific panic and agoraphobic symptoms in patients with a comorbid personality disorder than in patients without a personality disorder. Also, Vyskocilova et al 112 found that social phobia patients with a comorbidity of personality disorder displayed a smaller reduction of symptoms during therapy than patients with social phobia without comorbidity.…”

Section: Discussionmentioning

confidence: 99%

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

Ocisková¹,

Praško²,

Látalová³

et al. 2016

NDT

Self Cite

View full text Add to dashboard Cite

BackgroundAnxiety disorders are a group of various mental syndromes that have been related with generally poor treatment response. Several psychological factors may improve or hinder treatment effectiveness. Hope has a direct impact on the effectiveness of psychotherapy. Also, dissociation is a significant factor influencing treatment efficiency in this group of disorders. Development of self-stigma could decrease treatment effectiveness, as well as several temperamental and character traits. The aim of this study was to explore a relationship between selected psychological factors and treatment efficacy in anxiety disorders.Subjects and methodsA total of 109 inpatients suffering from anxiety disorders with high frequency of comorbidity with depression and/or personality disorder were evaluated at the start of the treatment by the following scales: the Mini-International Neuropsychiatric Interview, the Internalized Stigma of Mental Illness scale, the Adult Dispositional Hope Scale, and the Temperament and Character Inventory – revised. The participants, who sought treatment for anxiety disorders, completed the following scales at the beginning and end of an inpatient-therapy program: Clinical Global Impression (objective and subjective) the Beck Depression Inventory – second edition, the Beck Anxiety Inventory, and the Dissociative Experiences Scale. The treatment consisted of 25 group sessions and five individual sessions of cognitive behavioral therapy or psychodynamic therapy in combination with pharmacotherapy. There was no randomization to the type of group-therapy program.ResultsGreater improvement in psychopathology, assessed by relative change in objective Clinical Global Impression score, was connected with low initial dissociation level, harm avoidance, and self-stigma, and higher amounts of hope and self-directedness. Also, individuals without a comorbid personality disorder improved considerably more than comorbid patients. According to backward-stepwise multiple regression, the best significant predictor of treatment effectiveness was the initial level of self-stigma.ConclusionThe initial higher levels of self-stigma predict a lower effectiveness of treatment in resistant-anxiety-disorder patients with high comorbidity with depression and/or personality disorder. The results suggest that an increased focus on self-stigma during therapy could lead to better treatment outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

Ocisková¹,

Praško²,

Látalová³

et al. 2016

NDT

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, there is a dearth of information on comorbidity of PD in the treatment of social phobia. In a 6-week complex therapeutic program with a combination of CBT and antidepressants, Vyskocilova et al 49 showed that patients with social phobia and comorbid PD displayed a lesser decrease in specific symptomatology after treatment, when compared to patients with social phobia without PDs. However, a significant reduction in symptomatology occurred in PD patients as well.…”

Section: Dissociationmentioning

confidence: 99%

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

Praško

Grambal

Kasalová

et al. 2016

NDT

Self Cite

View full text Add to dashboard Cite

ObjectiveThe central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders.MethodsThe research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale.ResultsA total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients’ mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without personality disorders. Higher degree of dissociation at the beginning of the treatment predicted minor improvement, and also, higher therapeutic change was connected to greater reduction of the dissociation level.ConclusionDissociation is an important factor that influences the treatment effectiveness in anxiety/depression patients with or without personality disorders resistant to previous treatment. Targeting dissociation in the treatment of these disorders may be beneficial.

show abstract

“…9 They display high affective instability, are prone toward impulsive, self-mutilating, aggressive, and suicidal behavior, unstable identity, dissociation, conflicting interpersonal relations, chaotic lifestyle, high comorbidity levels, and low treatment efficacy. 10 – 12 They provoke robust countertransferences in the therapist, who may become too rejecting or too seductive, or probably could fluctuate more among the extremes. 6 , 13 – 15 Treatment possibilities include pharmacotherapy (especially mood stabilizers, atypical antipsychotics, or antidepressants) and psychotherapeutic interventions that are focused on affective dysregulation, increasing distress tolerance, changing distorted schemas and beliefs, and introducing new communication, and social and relationship problem-solving skills, especially in Dialectical Behaviour Therapy, Cognitive Therapy, and Schema Therapy or through intensive work with transference or mentalization in psychodynamic approaches like Transference Focus Therapy or Mentalization Therapy.…”

Section: Introductionmentioning

confidence: 99%

Quality of life in borderline patients comorbid with anxiety spectrum disorders – a cross-sectional study

Grambal¹,

Praško²,

Kamarádová³

et al. 2016

PPA

Self Cite

View full text Add to dashboard Cite

IntroductionBorderline personality disorder (BPD) significantly reduces the quality of life (QoL) in mental, social, and work domains. Patients with BPD often suffer from depressive anxiety symptoms. The purpose of this cross-sectional study was to compare the QoL and demographic and clinical factors of inpatients diagnosed with BPD and comorbid anxiety spectrum disorders, and healthy controls.MethodsNinety-two hospitalized patients treated in the psychotherapeutic department and 40 healthy controls were included. Subjects were assessed by the Quality of Life Satisfaction and Enjoyment Questionnaire (Q-LES-Q), Dissociative Experiences Scale, Beck Depression Inventory (BDI)-II, Beck Anxiety Inventory, Clinical Global Impression, demographic questionnaire, Sheehan Disability Scale (SDS), and Sheehan Anxiety Scale.ResultsBPD patients suffered from comorbid anxiety disorders, panic disorder (18.5%), social phobia (20.7%), generalized anxiety disorder/mixed anxiety depression disorder (17.4%), adjustment disorder (22.8%), and posttraumatic stress disorder (8.7%); 19.6% patients had two or more anxiety disorder comorbidities. Patients score in Q-LES-Q (general) was 36.24±9.21, which was significantly lower in comparison to controls (57.83±10.21) and similar in all domains (physical health, feelings, work, household, school/study, leisure, social activities). The subjective level of depression measured by BDI and SDS (social life and family subscales) negatively correlated with all Q-LES-Q domains.ConclusionPatients suffering from BPD and comorbid anxiety disorders have a lower level of QoL compared to healthy controls in all measured domains. Negative correlations of the Q-LES-Q domains with clinical scales (Dissociative Experiences Scale, BDI, Beck Anxiety Inventory, Sheehan Anxiety Scale, Clinical Global Impression, and SDS) are noticeable.

show abstract

Is There Any Influence of Personality Disorder on the Short Term Intensive Group Cognitive Behavioral Therapy of Social Phobia?

Cited by 5 publications

References 27 publications

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

Quality of life in borderline patients comorbid with anxiety spectrum disorders – a cross-sectional study

Contact Info

Product

Resources

About

Is There Any Influence of Personality Disorder on the Short Term Intensive Group Cognitive Behavioral Therapy of Social Phobia?

Cited by 5 publications

References 27 publications

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

Quality of life in borderline patients comorbid with anxiety spectrum disorders &ndash; a cross-sectional study

Contact Info

Product

Resources

About

Quality of life in borderline patients comorbid with anxiety spectrum disorders – a cross-sectional study