Differential Effects of Psychological Interventions in Online and Face-to-Face Settings on DSM-5 and ICD-11 Maladaptive Trait Domains: An Exploratory Pilot Study

André Kerber; Carmen Schaeuffele; Tobias Krieger; Antoine Urech; Heleen Riper; Thomas Berger; Johanna Boettcher; Christine Knaevelsrud

doi:10.3389/fpsyt.2021.648367

Differential Effects of Psychological Interventions in Online and Face-to-Face Settings on DSM-5 and ICD-11 Maladaptive Trait Domains: An Exploratory Pilot Study

Front Psychiatry. 2021 Jun 14:12:648367. doi: 10.3389/fpsyt.2021.648367. eCollection 2021.

Authors

André Kerber¹, Carmen Schaeuffele¹, Tobias Krieger², Antoine Urech^{2

3}, Heleen Riper^{4

5}, Thomas Berger², Johanna Boettcher^{5

6}, Christine Knaevelsrud¹

Affiliations

¹ Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
² Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
³ Department of Neurology, Inselspital Bern, Bern University Hospital, Bern, Switzerland.
⁴ Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands.
⁵ Department of Research and Innovation, GGZ in Geest/Amsterdam University Medical Center, VU University Medical Center, Amsterdam, Netherlands.
⁶ Psychologische Hochschule Berlin, Berlin, Germany.

Abstract

While mental health treatments have proven to be effective for a range of mental health problems, there is comparably little research on its effects on personality disorders or difficulty (PD). New dimensional conceptualizations of PD such as the ICD-11 PD model enable the cost- and time-effective dimensional assessment of severity and style of PD. Furthermore, they constitute a promising tool to investigate PD, not only as a treatment endpoint but also as a predictive or influencing factor for mental health treatments. In this study, we investigated the effects in two different mental health treatment settings [online (N = 38); face-to-face and blended [FTF/blended] (N = 35)] on the reduction of maladaptive personality traits as well as the interaction between maladaptive personality patterns and the response on primary endpoints (i.e., mental distress). Results indicate that both treatment settings have comparable within-group effects on the reduction of distress symptoms, while the treatment in the FTF/blended setting seems to have a stronger impact on the reduction of maladaptive traits. Further, reduction of maladaptive trait expressions was a reliable predictor of treatment response in the FTF/blended setting while explaining less variance in the online setting. Beyond the promising findings on the utility of maladaptive trait change as an outcome measure, we discuss possible applications as an information source for treatment decisions.

Keywords: DSM-5 AMPD; ICD-11 personality disorders; PID5BF+; internet-based interventions for mental health; maladaptive traits; psychotherapy.