Emotion dysregulation is present in many personality disorders. Emotion dysregulation is not just explained by heightened symptoms and interpersonal problems in personality disorders. Emotion dysregulation could be considered a treatment target in personality disorders other than borderline.
Objectives:The study aimed to assess the effectiveness of Metacognitive Interpersonal Therapy (MIT) as a psychological treatment for presentations consistent with non-borderline personality disorders (PD).
Design and MethodsWe conducted a single-case series of 3 patients with personality disorders meeting inclusion criteria. Clients received 2 years of weekly individual MIT. Outcomes were assessed every 3 months for the first year at the end of treatment and at 3-months follow-up. Co-primary outcomes were reduction in the number of SCID-II PD criteria met and reduction in self-reported global distress (SCL-90-R GSI). Secondary outcomes were reduction in self-reported interpersonal problems (IIP-32), anxiety (STAI-Y), depression (BDI-II) and emotional dysregulation (DERS).Reliable Change Indices were calculated for all outcomes.
ResultsAll three patients completed treatment, achieving reliable change at the end of treatment for reduction in total number of personality disorder criteria and in overall symptoms. For secondary outcomes, two patients improved in emotion regulation, one in depression. There was no evidence of reliable change on self-reported anxiety or interpersonal problems. At 3-months post treatment improvements in overall symptoms and emotional regulation were observed for all patients. Plot analyses of the results showed a trend towards reduction for all outcomes.
ConclusionsMIT is a new manualized treatment for non-borderline PD's. We demonstrate preliminary evidence of acceptability and effectiveness in this understudied population. Future studies are required to establish the effectiveness of MIT in larger PD samples, including patients with lower socioeconomic status.
Psychological mechanisms of overcontrol are a maintaining factor in many PDs. Both perfectionism and emotional inhibition impact on a broad range of PDs and there is an urgent need for research into these processes, and to adapt psychological interventions to consider these factors.
A persecutory delusion (PD) is a person's false belief that others are focusing their attention on him or her with malevolent intentions, which often results in intense anxiety and significant disruption of daily life. PDs are common in schizophrenia, and many patients with schizophrenia do not respond well to current pharmacological treatments. Therefore, effective psychological treatments are needed. The most well-known intervention for PDs continues to be cognitive-behavioral therapy. It aims to reduce patients' stigma and then help them to question the delusional meaning they attribute to events. The authors hypothesized that it is possible to reinforce the clinical approach to PDs on the basis of two important considerations: delusions have a meaning that is connected to a fundamental experiencing of the self as being ontologically vulnerable, and PDs seem to be correlated
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