What is More Important for Positive Outcome - The Degree of Insight or the Intensity of Emotional Activation for Patients With Cluster C Personality Disorders?

Abstract

Common factors as insight and emotional activation have proven to be of importance in the process of change in therapy (Greenberg & Watson, 2006; Wampold et al., 2007). But which of them are closest associated to positive outcome of the therapy? And are these factors even more important in patients with avoidant personality disorder (AvPD), compared to patients with cluster C personality disorders as a group? To answer these questions a population of 50 patients with cluster C personality disorder received therapy, either Short-Term Dynamic Psychotherapy or Cognitive Therapy. Insight and Emotional activation were measured every 10 minutes in session 26 and 36, using ATOS as guideline, creating a mean of the capacity of the patient’s ability to display insight and emotional activation in therapy. The result revealed that emotional activation explained a significant part of the variability in symptom relief, reduction of interpersonal problems and character change. Insight did not account for a significant part of the variability in symptom relief, reduction in interpersonal problems and character change. When comparing patients with AvPD to patients with DPD and OCPD, the variability in character change could not be explained by Emotional activation or Insight. This was because the variation explained by this model was not significant different from chance and therefore this hypothesis was rejected.