Of traditional individual CBT (69). The trial, which included 16 patients with OCPD and 24 with AVPD, attended up to 52 weekly sessions of CBT. Results indicated that 53 of patients with OCPD showed clinically significant reductions in depressive symptoms, and 83 exhibited clinically significant reductions in OCPD symptom severity. Of note, the CBT-based approach was equally effective for both disorders (67).NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Peretinoin chemical information ManuscriptAntisocial Personality Disorder (ASPD)Only one order AZD-8835 treatment outcome study has evaluated CBT for ASPD. CBT for ASPD is a brief, structured treatment that applies a cognitive formulation to target the dysfunctional beliefs that underlie aggressive, criminal or self-damaging behaviors (13). Davidson and colleagues randomized men with ASPD and recent histories of aggression to receive either CBT (n = 25) or TAU (n = 27). Because of the exploratory nature of this study, patients in the CBT group received either 15 sessions over 6 months or 30 sessions over 12 months. Patients were assessed at baseline and followed up at 12 months. No group differences were observed in terms of depression, anxiety, anger, or negative beliefs about others. Patients in both treatment conditions reported lower frequency of verbal and physical aggression at follow-up, although the groups did not differ from one another. Patients who received six months of CBT showed trends for less problematic alcohol use, more positive beliefs about others, and better social functioning, but there was no significant effect for CBT on any of the outcomes assessed. Comorbid PDs, PDNOS and Mixed PD Samples The majority of interventions for PDs are disorder-specific and, as a result, treatment outcome research is usually conducted separately for each disorder. However, three RCTs have used samples composed of patients with different PDs, co-occurring PDs, or a diagnosis of PD not otherwise specified (PDNOS). For example, Springer and colleagues (34) conducted a small-scale RCT on an inpatient psychiatric unit. Of 31 patients, 6 received a diagnosis of PDNOS. Of the remaining patients, 65 had a primary diagnosis of a Cluster C PD, and 44 had a primary diagnosis of BPD, although co-occurring PDs were common. Patients were randomized to receive either 10 daily sessions of supportive group treatment (n = 15) or DBT skills (n = 16). The DBT group consisted of emotion regulation skills, interpersonal effectiveness training, and distress tolerance. The control condition was a “lifestyle and wellness” discussion group that was not intended to be therapeutic. Patients were assessed at baseline and at discharge. Both treatment groups improved over the course of treatment, and there were no group differences on measures of hopelessness, depression, suicidal ideation, anger, or coping-skill knowledge. Contrary to expectations, however, patients in the DBT-based group were more likely to “act out” (i.e., engaging in selfinjurious behavior, threatening to harm oneself or others, attempting to leave the unit, refusing to eat for one day or more). Based on these findings, a brief inpatient DBT-based skills intervention may not enhance treatment outcome beyond the effects of a discussion group among a group of patients with mixed personality disorder diagnoses. Muran and colleagues (71) examined treatment outcomes among outpatients with Cluster C PDs or a diagnosis of PDNOS. The majority of the patients (66 ) were diagno.Of traditional individual CBT (69). The trial, which included 16 patients with OCPD and 24 with AVPD, attended up to 52 weekly sessions of CBT. Results indicated that 53 of patients with OCPD showed clinically significant reductions in depressive symptoms, and 83 exhibited clinically significant reductions in OCPD symptom severity. Of note, the CBT-based approach was equally effective for both disorders (67).NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptAntisocial Personality Disorder (ASPD)Only one treatment outcome study has evaluated CBT for ASPD. CBT for ASPD is a brief, structured treatment that applies a cognitive formulation to target the dysfunctional beliefs that underlie aggressive, criminal or self-damaging behaviors (13). Davidson and colleagues randomized men with ASPD and recent histories of aggression to receive either CBT (n = 25) or TAU (n = 27). Because of the exploratory nature of this study, patients in the CBT group received either 15 sessions over 6 months or 30 sessions over 12 months. Patients were assessed at baseline and followed up at 12 months. No group differences were observed in terms of depression, anxiety, anger, or negative beliefs about others. Patients in both treatment conditions reported lower frequency of verbal and physical aggression at follow-up, although the groups did not differ from one another. Patients who received six months of CBT showed trends for less problematic alcohol use, more positive beliefs about others, and better social functioning, but there was no significant effect for CBT on any of the outcomes assessed. Comorbid PDs, PDNOS and Mixed PD Samples The majority of interventions for PDs are disorder-specific and, as a result, treatment outcome research is usually conducted separately for each disorder. However, three RCTs have used samples composed of patients with different PDs, co-occurring PDs, or a diagnosis of PD not otherwise specified (PDNOS). For example, Springer and colleagues (34) conducted a small-scale RCT on an inpatient psychiatric unit. Of 31 patients, 6 received a diagnosis of PDNOS. Of the remaining patients, 65 had a primary diagnosis of a Cluster C PD, and 44 had a primary diagnosis of BPD, although co-occurring PDs were common. Patients were randomized to receive either 10 daily sessions of supportive group treatment (n = 15) or DBT skills (n = 16). The DBT group consisted of emotion regulation skills, interpersonal effectiveness training, and distress tolerance. The control condition was a “lifestyle and wellness” discussion group that was not intended to be therapeutic. Patients were assessed at baseline and at discharge. Both treatment groups improved over the course of treatment, and there were no group differences on measures of hopelessness, depression, suicidal ideation, anger, or coping-skill knowledge. Contrary to expectations, however, patients in the DBT-based group were more likely to “act out” (i.e., engaging in selfinjurious behavior, threatening to harm oneself or others, attempting to leave the unit, refusing to eat for one day or more). Based on these findings, a brief inpatient DBT-based skills intervention may not enhance treatment outcome beyond the effects of a discussion group among a group of patients with mixed personality disorder diagnoses. Muran and colleagues (71) examined treatment outcomes among outpatients with Cluster C PDs or a diagnosis of PDNOS. The majority of the patients (66 ) were diagno.
