Response to cognitive therapy in depression: The role of maladaptive beliefs and personality disorders

This study examined whether personality disorder status and beliefs that ch aracterize personality disorders affect response to cognitive therapy. In a naturalistic study, 162 depressed outpatients with and without a personali ty disorder were followed over the course of cognitive therapy. As would be hypothesized by cognitive theory (A. T. Beck & A. Freeman, 1990), it was n ot personality disorder status but rather maladaptive avoidant and paranoid beliefs that predicted variance in outcome. However, pre-to posttherapy co mparisons suggested that although patients with or without comorbidity resp ond comparably to "real-world" cognitive therapy, they report more severe d epressive symptomatology at intake and more residual symptoms at terminatio n.