Personality disorders have no excessively negative impact on therapist-rated therapy process in the cognitive and behavioural treatment of Axis I anxiety disorders
L. Dreessen et A. Arntz, Personality disorders have no excessively negative impact on therapist-rated therapy process in the cognitive and behavioural treatment of Axis I anxiety disorders, CLIN PSY PS, 6(5), 1999, pp. 384-394
The impact of DSM-III-R personality pathology on the Axis I therapy process
was studied in 70 outpatients who received cognitive and/or behavioural th
erapy for an Axis I anxiety disorder. The Axis I therapy process was evalua
ted by the therapist. DSM-III-R personality pathology was assessed first by
an independent rater using a semi-structured interview (Structured Clinica
l Interview for DSM-III-R Personality Disorders (SCID-II)) and second by th
e therapist in the course of treatment. Results showed poor diagnostic agre
ement between SCID-and therapist-derived personality pathology. SCID-derive
d personality pathology was only weakly related to a dysfunctional Axis I t
herapy process, as reported by the therapist. Therapist-derived personality
pathology, an the contrary, was strongly related to a dysfunctional Axis I
therapy process, as reported by the therapist. Possibly, therapists errone
ously attributed Axis I therapy failure to assumed personality pathology. T
his is the first study on the impact of personality pathology, as assessed
by an independent semi-structured interview, on the process of cognitive-be
havioural therapy for Axis I anxiety disorders. The findings are consistent
with studies that show no negative impact of personality pathology, as ass
essed by independent semi-structured interviews, on therapy outcome of Axis
I anxiety disorders. Copyright (C) 1999 John Wiley & Sons, Ltd.