Group schema therapy for cluster-C personality disorders: A multicentre open pilot study

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2023-09-10 DOI:10.1002/cpp.2903

Carlijn J. M. Wibbelink, Anne-Sophie S. M. Venhuizen, Raoul P. P. P. Grasman, Nathan Bachrach, Charlotte van den Hengel, Sandy Hudepohl, Liselotte Kunst, Hinde de Lange, Mark A. Louter, Suzy J. M. A. Matthijssen, Arita Schaling, Simone Walhout, Karen (Renske) Wichers, Arnoud Arntz

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Abstract

Background

Group schema therapy (GST) is increasingly popular as a treatment for personality disorders (PDs), including Cluster-C PDs. Individual ST has proven to be effective for Cluster-C PD patients, while the evidence for GST is limited. This study aimed to investigate the effectiveness of GST for Cluster-C PD. Moreover, differences between the specific Cluster-C PDs (avoidant PD, dependent PD and obsessive-compulsive PD) were explored.

Methods

A multicentre open trial was conducted, including 137 patients with a Cluster-C PD (avoidant PD: n = 107, dependent PD: n = 11 and obsessive-compulsive PD: n = 19). Patients received 30 weekly GST sessions with a maximum of 180 min of individual ST and five optional monthly booster sessions. Outcome measures including Cluster-C PD severity, general psychopathological symptoms, quality of life, functional impairment, happiness, PD-related beliefs, self-esteem, self-ideal discrepancy, schemas and schema modes were assessed at baseline until 2-year follow-up with semi-structured interviews and self-report measures. Change over time and differences between the specific Cluster-C PDs were analysed with mixed regression analyses.

Results

The outcome measures showed significant improvements for all Cluster-C PDs, with medium to large effect sizes after 2 years. A treatment dropout rate of 11.7% was found. There were some indications for differences between the Cluster-C PDs in severity at baseline, change trajectories and effectiveness of GST.

Conclusions

This study demonstrated that GST is a promising treatment for Cluster-C PDs. The following step is a randomized controlled trial to further document the (cost-)effectiveness of GST.

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C类人格障碍的团体模式治疗：一项多中心开放性试点研究。

背景：群体图式疗法（GST）作为一种治疗人格障碍（PD）的方法越来越受欢迎，包括集群型人格障碍。个体ST已被证明对C群PD患者有效，而GST的证据有限。本研究旨在探讨GST治疗丛集型帕金森病的有效性。此外，还探讨了特定丛集型PD（回避型PD、依赖型PD和强迫症PD）之间的差异。方法：进行了一项多中心开放试验，包括137例C群帕金森病患者（回避型帕金森病： = 107，依赖PD:n = 11和强迫症PD:n = 19）。患者每周接受30次GST治疗，最多180次分钟的个人ST和五个可选的每月加强疗程。结果指标包括C群帕金森病严重程度、一般精神病理学症状、生活质量、功能损害、幸福感、帕金森病相关信念、自尊、自我理想差异、图式和图式模式，在基线时进行评估，直到2年随访，采用半结构化访谈和自我报告措施。通过混合回归分析分析了随时间的变化以及特定聚类-C PD之间的差异。结果：结果测量显示，所有C簇PD都有显著改善，2天后效果大小为中等至较大年。治疗中途退出率为11.7%。在基线时的严重程度、变化轨迹和GST的有效性方面，C簇PDs之间存在一些差异。结论：本研究表明GST是治疗C簇PDs的一种有前途的方法。以下步骤是一项随机对照试验，以进一步证明GST的（成本）有效性。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.