Differential Effects of Psychological Interventions in Online and Face-to-Face Settings on DSM-5 and ICD-11 Maladaptive Trait Domains: An Exploratory Pilot Study

Abstract

While mental health treatments have proven to be effective for a range of mental health problems, there is comparably little research on its effects on personality disorders or difficulty (PD). New dimensional conceptualizations of PD such as the ICD-11 PD model enable the cost- and time-effective dimensional assessment of severity and style of PD. Furthermore, they constitute a promising tool to investigate PD, not only as a treatment endpoint but also as a predictive or influencing factor for mental health treatments. In this study, we investigated the effects in two different mental health treatment settings [online (N = 38); face-to-face and blended [FTF/blended] (N = 35)] on the reduction of maladaptive personality traits as well as the interaction between maladaptive personality patterns and the response on primary endpoints (i.e., mental distress). Results indicate that both treatment settings have comparable within-group effects on the reduction of distress symptoms, while the treatment in the FTF/blended setting seems to have a stronger impact on the reduction of maladaptive traits. Further, reduction of maladaptive trait expressions was a reliable predictor of treatment response in the FTF/blended setting while explaining less variance in the online setting. Beyond the promising findings on the utility of maladaptive trait change as an outcome measure, we discuss possible applications as an information source for treatment decisions.

Adverse childhood experiences and personality functioning interact substantially in predicting depression, anxiety, and somatization

“…Clinicians treating patients with depression and/or anxiety should routinely assess impairments in PF along with ACE as our study results imply that individuals with both PF impairments and reported ACE are more prone to severe and enduring symptomatology. Applied this way, pretreatment PF scores may inform the necessity and centrality of process‐based interactional experiences in the treatment of depression or anxiety disorders (Kerber et al, 2021) and could be used as a decision tool for “personalized medicine” (Bach & Simonsen, 2021).…”

Effects of a Self-Guided Transdiagnostic Smartphone App on Patient Empowerment and Mental Health: Randomized Controlled Trial

“…The most predictive variables for trial discontinuation in the IG were younger age and higher personality dysfunction. In particular, the latter is a relevant predictor of the amount of guidance required in psychological interventions [92]. Tackling this issue may require, besides human-delivered guidance, adjusting app behavior and content according to dimensional measures of personality functioning or other dimensional conceptualizations of psychopathology such as HiTOP [20].…”

Future Challenges in Psychotherapy Research for Personality Disorders

“…More research is needed to learn whether the dimensional constructs defining PDs may parallel specific functional domains ( [21], e.g., reward responsiveness and valuation, and their relationship with the disinhibition trait domain [22]). Such re-conceptualization of PDs may have an impact on treatment content [14], length [23], and format of delivery [24].…”