Pre‐treatment predictors and in‐treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia

Abstract

We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

Dependent personality, separation anxiety disorder and other anxiety disorders in OCD

“…Therefore, it is important to identify and treat personality traits early (Tyrer, Seivewright, & Johnson, 2004;Skodol, Geier, Grant, & Hasin, 2014). Both short-term group psychotherapy and cognitive behavioral therapy have been shown to be efficacious in the treatment of dependent personality in adults (Jensen, Mortensen, & Lotz, 2008;Borge et al, 2010). One study has shown that a brief parent intervention programme for preschool children with an anxiety disorder and behavioral inhibition led to reduced anxiety and behavioral inhibition in these children (Kennedy, Rapee, & Edwards 2009).…”

“…A similar section was developed for assessing tics, Tourette disorder and other tic disorders. The structured clinical interview for DSM-IV (Spitzer, Williams, Gibbon, & First, 1992) was used for assessing other major Axis I diagnoses and the 'Kiddie' or K-SADS was used to classify Sep-AD (Chambers et al, 1985). A semistructured assessment protocol was used for additional diagnoses of interest in OCD (pathologic nail biting, pathological skin picking, trichotillomania, gambling, kleptomania and pyromania).…”

The Application of Mindfulness for Interpersonal Dependency: Effects of a Brief Intervention

“…Researchers have reported small positive effects (e.g., d = 0.19) in clinical trials of time-limited (Alexander & Abeles, 1968) and long-term (Blatt, 1992, Blatt & Ford, 1994 psychodynamic therapies for dependent clients with comorbid diagnoses. To the author's knowledge, six studies have explored the effectiveness of cognitive-behavioral treatments for dependency, with three reporting significant results (Borge et al, 2010;Nelson-Gray et al, 1996;Rathus et al, 1995) and three reporting nonsignificant findings (Black et al, 1996;Moore & Blackburn, 1996;Rector et al, 2000). Bornstein (2004) summarizes the effectiveness of current treatments for dependency as "modest" (p. 294).…”

Predictors of response to individual and group cognitive behaviour therapy of social phobia

“…Although patients with cluster A (odd or eccentric) or cluster B (dramatic) personality disorders may suffer from social phobia and may be even more difficult to treat (Dimaggio, Attin a, Popolo, & Salvatore, 2012), the opposite link is less obvious (Hummelen, Wilberg, Pedersen, & Karterud, 2007). Overall, social phobia is associated with the anxious cluster C personality disorders (avoidant, dependent and obsessive compulsive clusters), with the strongest link to avoidant personality disorder (Borge et al, 2010;Hummelen et al, 2007;Sanderson, Wetzler, Beck, & Betz, 1994;Svrakic et al, 2002;Tyrer, Gunderson, Lyons, & Tohen, 1997).…”