The Effects of Affect Exposure in Short-term Dynamic Psychoterapy and Cognitive Therapy for Patients with Cluster C Personality Disorder: A randomized controlled process study
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- Institutt for psykologi 
Objective: This study examined if the amount of exposure to anger/assertiveness, grief, positive feelings for self or closeness in the early stages of treatment could predict treatment outcome in the different Cluster C personality disorders (PDs) independently of treatment modality. Method: The sample consisted of patients who met the criteria for one or more Cluster C PDs (N=50), and was taken from a randomized controlled trial comparing 40 sessions of either short-term dynamic psychotherapy (STDP) or cognitive therapy (CT). 31 had an Avoidant personality disorder (AVPD), 17 had an Obsessive-Compulsive personality disorder (OCPD) and 10 had a Dependent personality disorder (DPD). Some patients met criteria for more than one Cluster C PD. All sessions were videotaped and rated using the Achievement of Therapeutic Scale (ATOS), and ATOS ratings from an early session (mainly session six) were used as process measures. Outcome variables included measures of psychiatric symptoms, interpersonal problems and personality pathology. Results: Amount of exposure to anger/assertiveness in early stages of treatment predicted lower personality pathology in all Cluster C PDs, but seems to be especially beneficial for patients with AVPD. Conclusion: Anger/assertiveness seem to be the most important activating affect to focus on in the treatment of Cluster C patients, and our results show that the more time spent experiencing anger/assertiveness in treatment, the better treatment outcome. This is contrary to an earlier trial that found a differentiated affect focus to be beneficial to different Cluster C patients.