Group schema therapy versus group cognitive behavioral therapy for patients with social anxiety disorder and comorbid avoidant personality disorder: A randomized controlled trial.

Avoidant personality disorder Cognitive behavioral therapy Personality disorder RCT Schema therapy Social anxiety disorder

Journal

Journal of anxiety disorders
ISSN: 1873-7897
Titre abrégé: J Anxiety Disord
Pays: Netherlands
ID NLM: 8710131

Informations de publication

Date de publication:
03 Apr 2024
Historique:
received: 23 08 2023
revised: 15 02 2024
accepted: 31 03 2024
medline: 8 5 2024
pubmed: 8 5 2024
entrez: 7 5 2024
Statut: aheadofprint

Résumé

Patients with social anxiety (SAD) and comorbid avoidant personality disorder (AVPD) are severely impaired. Group cognitive behavioral therapy (GCBT) is considered an effective treatment for SAD. More knowledge on treatment of SAD with comorbid AVPD is needed. Schema therapy, developed for personality and chronic mental disorders, may be a promising treatment. We conducted a randomized controlled trial in an outpatient population (n = 154) with both SAD and AVPD. Group Schema Therapy (GST) and GCBT were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and manifestations of AVPD (Avoidant Personality Disorder Severity Index). Intention-to-treat analysis showed no significant differences between treatments at 3 months post-treatment and one-year follow-up. Both modalities led to significant and substantial improvements. No significant between-differences were found in depressive symptoms (Inventory of Depressive Symptoms) and quality of life (World Health Organization Quality of Life-BREF). Per-protocol analysis showed similar outcomes and no significant differences in recovery from SAD and AVPD. Significantly more patients completed GST. GST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment retention in ST indicates ST is more acceptable than GCBT. Future studies should focus on enhancing treatment effects and improving retention to GCBT.

Sections du résumé

BACKGROUND BACKGROUND
Patients with social anxiety (SAD) and comorbid avoidant personality disorder (AVPD) are severely impaired. Group cognitive behavioral therapy (GCBT) is considered an effective treatment for SAD. More knowledge on treatment of SAD with comorbid AVPD is needed. Schema therapy, developed for personality and chronic mental disorders, may be a promising treatment.
METHODS METHODS
We conducted a randomized controlled trial in an outpatient population (n = 154) with both SAD and AVPD. Group Schema Therapy (GST) and GCBT were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and manifestations of AVPD (Avoidant Personality Disorder Severity Index).
RESULTS RESULTS
Intention-to-treat analysis showed no significant differences between treatments at 3 months post-treatment and one-year follow-up. Both modalities led to significant and substantial improvements. No significant between-differences were found in depressive symptoms (Inventory of Depressive Symptoms) and quality of life (World Health Organization Quality of Life-BREF). Per-protocol analysis showed similar outcomes and no significant differences in recovery from SAD and AVPD. Significantly more patients completed GST.
CONCLUSION CONCLUSIONS
GST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment retention in ST indicates ST is more acceptable than GCBT. Future studies should focus on enhancing treatment effects and improving retention to GCBT.

Identifiants

pubmed: 38714138
pii: S0887-6185(24)00036-7
doi: 10.1016/j.janxdis.2024.102860
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102860

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that there is no conflict of interests.

Auteurs

Astrid E Baljé (AE)

Department of Anxiety Disorders/Psyq, The Hague, the Netherlands; Institute of Psychology/Leiden University, Leiden, the Netherlands. Electronic address: astrid.balje@psyq.nl.

Anja Greeven (A)

Department of Anxiety Disorders/Psyq, The Hague, the Netherlands; Institute of Psychology/Leiden University, Leiden, the Netherlands. Electronic address: a.greeven@psyq.nl.

Mathijs Deen (M)

Institute of Psychology/Leiden University, Leiden, the Netherlands; Parnassia Group Academy/Parnassia Psychiatric Institute, The Hague, the Netherlands. Electronic address: m.deen@parnassiagroep.nl.

Anne E van Giezen (AE)

Department of Anxiety Disorders/Psyq, The Hague, the Netherlands; Institute of Psychology/Leiden University, Leiden, the Netherlands. Electronic address: giezen@fsw.leidenuniv.nl.

Arnoud Arntz (A)

Department of Clinical Psychology/University of Amsterdam, Amsterdam, the Netherlands. Electronic address: A.R.Arntz@uva.nl.

Philip Spinhoven (P)

Department of Anxiety Disorders/Psyq, The Hague, the Netherlands; Institute of Psychology/Leiden University, Leiden, the Netherlands. Electronic address: spinhoven@fsw.leidenuniv.nl.

Classifications MeSH