Change in obsessive-compulsive and avoidant personality disorders following time-limited supportive-expressive therapy.

Abstract

Twenty-four patients with a DSM-III-R diagnosis of Avoidant Personality Disorder (AVPD) and 14 patients with a diagnosis of Obsessive-CompulsivePersonality Disorder (OCPD) were assigned to 52 sessions of time-limited Supportive-Expressive (SE) dynamic psychotherapy. At intake, most patients had at least one concurrent Depressive and/or Anxiety disorder. OCPD patients lost their personality disorder diagnoses significantly faster than did AVPD patients. By the end of treatment, 39 percent of AVPD still retained their diagnosis while only 15 percent of OCPD did so. Using hierarchical linear modeling, both patient groups improved significantly across time on measures of personality disorders, depression, anxiety, general functioning, and interpersonal problems. OCPD patients remained in treatment significantly longer and tended to improve (nonsignificantly) more than did AVPD This study was supported in part by National Institute of Mental Health grants P50-MH45178 and RO1-MH49902. The authors thank Drs. Leigh McCullough Vaillant and Karla Moras for training and supervising the diagnosticians. We also thank the therapists and patients for their participation.

Effectiveness of Long-term Psychodynamic Psychotherapy

“…[17][18][19][20][21] This condition was true for 8 studies of LTPP alone. 55,60,62,65,69,71,74,77 In 5 studies of LTPP alone, the majority of patients had complex depressive and anxiety disorders. 60,62,64,69,74 All of these studies included patients with multiple mental disorders.…”

Explanatory style change in supportive-expressive dynamic therapy

“…The manual-guided form of psychodynamic psychotherapy was a time-limited version of SE Psychodynamic Psychotherapy (Luborsky, 1984;Luborsky & Mark, 1991) that was specifically adapted for each patient group (for depression: Luborsky et al, 1995;Luborsky et al, 1996; for GAD: Crits-Christoph, CritsChristoph, K., Wolf-Palacio, Fichter, & Rudick, 1995; Crits-Christoph, Connolly, Azarian, Crits-Christoph, K., & Shappell, 1996; and for the personality disorders: Barber, 1990;Barber, Morse, Krakauer, Chittams, & Crits-Christoph, 1997). Therapists were trained using the general SE manual and these special adaptations of the general SE manual.…”

Psychodynamic short-term therapy of social phobia

“…Die Dauer von Langzeitbehandlungen liegt zwischen einigen Monaten und mehreren Jahren (Luborsky 1995). Inzwischen liegen mehrere manualgeleitete Adaptierungen der SET für verschiedene psychische Störungen vor: Depression, GAD, Bulimia nervosa, vermeidende und zwanghafte Persönlich-keitsstörung sowie Opiat-und Kokainabhängigkeit (Barber et al 1997;Crits-Christoph et al 2005;Garner et al 1993;Luborsky et al 1995b;Luborsky et al 1995a;Mark u. Faude 1995;Mark et al 2003). Die Wirksamkeit der SET bei spezifischen psychischen Störungen wurde in mehreren randomisierten kontrollierten Studien nachgewiesen.…”

“…Bei diesen Störungen handelte es sich um Opiatabhängigkeit (Woody et al 1990;Woody et al 1983;Woody et al 1995), Kokainmissbrauch (Crits-Christoph et al 1995Crits-Christoph et al 1999b;Crits-Christoph et al 2001), Bulimia nervosa (Garner et al 1993) und GAD (Crits-Christoph et al 2005Leichsenring et al 2007b). Außerdem liegen zwei offene Studien zur SET bei depressiven Stö-rungen sowie bei zwanghaften und vermeidenden Persönlichkeitsstörungen vor (Barber et al 1997;Diguer et al 1993). …”