Dataset Information

Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder.

ABSTRACT:

Background and objectives

A considerable group of patients with anxiety disorders do not respond to guideline CBT treatment, possibly due to comorbid personality disorder (PD) traits. Schema therapy (ST) is an integrative treatment for personality disorders, and preliminary evidence suggests that it also affects anxiety. The present study examined the effects of a combination treatment ('SCHerp': ST + exposure and response prevention) in a non-responsive outpatient group suffering from chronic anxiety and comorbid cluster C personality disorder.

Methods

Psychological malfunction (n = 42), and adaptive and maladaptive schema modes (n = 49) were assessed pre- and post-treatment.

Results

Patients showed statistically significant decreases in psychological malfunction and maladaptive modes, and significant increases in adaptive modes from pre- to post-treatment. Changes in modes were correlated with changes in psychological malfunction.

Limitations

No control group or follow-up measurements were included.

Conclusions

The combination of ST and exposure with response prevention may be a viable avenue for research and treatment for this subpopulation. However, further research is needed to confirm and enhance effectiveness and identify working mechanisms of SCHerp.

Practitioner points

The SCHerp programme combines schema therapy with exposure and response prevention to tackle chronic anxiety in patients with comorbid personality disorder SCHerp significantly reduced psychological malfunction and maladaptive modes, and increased adaptive modes Changes in schema modes correlated with changes in psychological malfunction, suggesting that schema modes are an appropriate treatment target in this population No active control group was included so no therapy-specific factors can be determined at this stage.

SUBMITTER: Peeters N

PROVIDER: S-EPMC7898627 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder.

Peeters Nancy N Stappenbelt Sylvie S Burk William J WJ van Passel Boris B Krans Julie J

The British journal of clinical psychology 20201215 1

<h4>Background and objectives</h4>A considerable group of patients with anxiety disorders do not respond to guideline CBT treatment, possibly due to comorbid personality disorder (PD) traits. Schema therapy (ST) is an integrative treatment for personality disorders, and preliminary evidence suggests that it also affects anxiety. The present study examined the effects of a combination treatment ('SCHerp': ST + exposure and response prevention) in a non-responsive outpatient group suffering from c ...[more]

PMID: 33319395

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Project description:Background: Posttraumatic stress disorder (PTSD) is a serious and relatively common mental disorder causing a high burden of suffering. Whereas evidence-based treatments are available, dropout and non-response rates remain high. PTSD and Cluster C personality disorders (avoidant, dependent or obsessive-compulsive personality disorder; CPD) are highly comorbid and there is evidence for suboptimal treatment effects in this subgroup of patients. An integrated PTSD and CPD treatment may be needed to increase treatment efficacy. However, no studies directly comparing the efficacy of regular PTSD treatment and treatment tailored to PTSD and comorbid CPD are available. Whether integrated treatment is more effective than treatment focused on PTSD alone is important, since (1) no evidence-based guideline for PTSD and comorbid CPD treatment exists, and (2) treatment approaches to CPD are costly and time consuming. Present study design describes a randomized controlled trial (RCT) directly comparing trauma focused treatment with integrated trauma focused and personality focused treatment. Methods: An RCT with two parallel groups design will be used to compare the clinical efficacy and cost-effectiveness of "standalone" imagery rescripting (n = 63) with integrated imagery rescripting and schema therapy (n = 63). This trial is part of a larger research project on PTSD and personality disorders. Predictors, mediators and outcome variables are measured at regular intervals over the course of 18 months. The main outcome is PTSD severity at 12 months. Additionally, machine-learning techniques will be used to predict treatment outcome using biopsychosocial variables. Discussion: This study protocol outlines the first RCT aimed at directly comparing the clinical efficacy and cost-effectiveness of imagery rescripting and integrated imagery rescripting and schema therapy for treatment seeking adult patients with PTSD and comorbid cluster C personality pathology. Additionally, biopsychosocial variables will be used to predict treatment outcome. As such, the trial adds to the development of an empirically informed and individualized treatment indication process. Clinical Trial registration: ClinicalTrials.gov, NCT03833531.

Dataset Information

Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder.

Background and objectives

Methods

Results

Limitations

Conclusions

Practitioner points

Publications

Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder.

Similar Datasets

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