Meta-analysis of psychotherapy outcome for Personality Disorder
Rudick, Monica Marie
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A growing number of studies suggest psychotherapy can yield positive effects for those with Personality Disorder (PD). This volume of extant therapy outcome studies is only partially consolidated in previously published meta-analyses. The present broadband meta-analyses explored two questions. First, what is the evidence of psychotherapy outcome change for those with PD? Second, are treatment effects moderated by type of therapy or PD diagnosis? Standardized gain scores (SGS) and standardized mean difference (SMD) effects were estimated from 110 studies (733 effect sizes) across randomized control trial (RCT) and naturalistic (N-RCT) studies. Summary effects of medium size were found for treatment vs. control (Hedge’s g s = 0.48-0.49) and treatment vs. treatment ( g s = 0.35-0.50) datasets. Summary effects for single treatment studies were large ( g s = 0.74-0.83). Subgroup analyses indicated significant ( p < .05) moderation for PD diagnosis and therapy type. The largest overall effects for N-RCT single treatment studies emerged from Social Skills Training and Cognitive therapies ( g s = 1.62 and 1.05, respectively), and Avoidant and Obsessive Compulsive PDs ( g s = 1.24 and 1.16, respectively). Single treatment summary effects from RCT studies were largest for Narrative/Schema and Interpersonal therapies ( g s = 1.86 and 1.59), and Borderline and Avoidant PDs ( g s = 0.94 and 0.77). No therapy or diagnosis yielded consistently larger summary effects than others across study designs. Discussion is provided regarding patterns of effects evidenced, present vs. past findings, and directions for future research such as exploring potential interactions between moderators of change.