Research And Empirical Support

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One of the strengths of cognitive therapy is that the approach is based on extensive research. In addition, both the adequacy of cognitive conceptualizations and the effectiveness of cognitive therapy have been tested empirically.

The Validity of Cognitive Conceptualizations of Personality Disorder

Cognitive conceptualizations of personality disorders are of recent vintage and, consequently, only limited research into the validity of these conceptualizations has been reported. Recent studies have examined the relationships between the sets of beliefs hypothesized to play a role in each of the personality disorders and diagnostic status. These hypotheses have been supported for Borderline Personality Disorder (Arntz, Dietzel, & Dreesen, 1999) and for Avoidant, Dependent, Obsessive-Compulsive, Narcissistic, and Paranoid Personality Disorders (A. T. Beck et al., 2001). The other personality disorders were not studied because of an inadequate number of subjects. These studies show that dysfunctional beliefs are related to personality disorders in ways that are consistent with cognitive theory but do not provide grounds for conclusions about causality and do not provide a comprehensive test of cognitive conceptualizations of personality disorders.

The Effectiveness of Cognitive Therapy with Personality Disorders

Cognitive therapy has been found to provide effective treatment for a wide range of Axis I disorders. However, research into the effectiveness of cognitive-behavioral approaches to treating individuals with personality disorders is more limited. Table 9.6 provides an overview of the available evidence about the effectiveness of cognitive-behavioral interventions with individuals diagnosed as having personality disorders. It is immediately apparent from this table that there have been many uncontrolled clinical reports that assert that cognitive-behavioral therapy can provide effective treatment for personality disorders but fewer controlled outcome studies.

A number of single-case design studies (Nelson-Gray, Johnson, Foyle, Daniel, & Harmon, 1996; Turkat & Maisto, 1985) have provided evidence that some clients with personality disorders can be treated effectively, but also have shown that other clients do not respond to treatment or show mixed results. Springer, Lohr, Buchtel, and Silk (1995) report that a short-term cognitive-behavioral therapy group produced significant improvement in a sample of hospitalized subjects

Table 9.6

The Effectiveness of Cognitive-Behavioral Treatment with Personality Disorders

Table 9.6

The Effectiveness of Cognitive-Behavioral Treatment with Personality Disorders

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