Cargando…

Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients

BACKGROUND: Anxiety disorders are a group of various mental syndromes that have been related with generally poor treatment response. Several psychological factors may improve or hinder treatment effectiveness. Hope has a direct impact on the effectiveness of psychotherapy. Also, dissociation is a si...

Descripción completa

Detalles Bibliográficos
Autores principales: Ociskova, Marie, Prasko, Jan, Latalova, Klara, Kamaradova, Dana, Grambal, Ales
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928674/
https://www.ncbi.nlm.nih.gov/pubmed/27445474
http://dx.doi.org/10.2147/NDT.S104301
_version_ 1782440475672707072
author Ociskova, Marie
Prasko, Jan
Latalova, Klara
Kamaradova, Dana
Grambal, Ales
author_facet Ociskova, Marie
Prasko, Jan
Latalova, Klara
Kamaradova, Dana
Grambal, Ales
author_sort Ociskova, Marie
collection PubMed
description BACKGROUND: Anxiety disorders are a group of various mental syndromes that have been related with generally poor treatment response. Several psychological factors may improve or hinder treatment effectiveness. Hope has a direct impact on the effectiveness of psychotherapy. Also, dissociation is a significant factor influencing treatment efficiency in this group of disorders. Development of self-stigma could decrease treatment effectiveness, as well as several temperamental and character traits. The aim of this study was to explore a relationship between selected psychological factors and treatment efficacy in anxiety disorders. SUBJECTS AND METHODS: A total of 109 inpatients suffering from anxiety disorders with high frequency of comorbidity with depression and/or personality disorder were evaluated at the start of the treatment by the following scales: the Mini-International Neuropsychiatric Interview, the Internalized Stigma of Mental Illness scale, the Adult Dispositional Hope Scale, and the Temperament and Character Inventory – revised. The participants, who sought treatment for anxiety disorders, completed the following scales at the beginning and end of an inpatient-therapy program: Clinical Global Impression (objective and subjective) the Beck Depression Inventory – second edition, the Beck Anxiety Inventory, and the Dissociative Experiences Scale. The treatment consisted of 25 group sessions and five individual sessions of cognitive behavioral therapy or psychodynamic therapy in combination with pharmacotherapy. There was no randomization to the type of group-therapy program. RESULTS: Greater improvement in psychopathology, assessed by relative change in objective Clinical Global Impression score, was connected with low initial dissociation level, harm avoidance, and self-stigma, and higher amounts of hope and self-directedness. Also, individuals without a comorbid personality disorder improved considerably more than comorbid patients. According to backward-stepwise multiple regression, the best significant predictor of treatment effectiveness was the initial level of self-stigma. CONCLUSION: The initial higher levels of self-stigma predict a lower effectiveness of treatment in resistant-anxiety-disorder patients with high comorbidity with depression and/or personality disorder. The results suggest that an increased focus on self-stigma during therapy could lead to better treatment outcomes.
format Online
Article
Text
id pubmed-4928674
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-49286742016-07-21 Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients Ociskova, Marie Prasko, Jan Latalova, Klara Kamaradova, Dana Grambal, Ales Neuropsychiatr Dis Treat Original Research BACKGROUND: Anxiety disorders are a group of various mental syndromes that have been related with generally poor treatment response. Several psychological factors may improve or hinder treatment effectiveness. Hope has a direct impact on the effectiveness of psychotherapy. Also, dissociation is a significant factor influencing treatment efficiency in this group of disorders. Development of self-stigma could decrease treatment effectiveness, as well as several temperamental and character traits. The aim of this study was to explore a relationship between selected psychological factors and treatment efficacy in anxiety disorders. SUBJECTS AND METHODS: A total of 109 inpatients suffering from anxiety disorders with high frequency of comorbidity with depression and/or personality disorder were evaluated at the start of the treatment by the following scales: the Mini-International Neuropsychiatric Interview, the Internalized Stigma of Mental Illness scale, the Adult Dispositional Hope Scale, and the Temperament and Character Inventory – revised. The participants, who sought treatment for anxiety disorders, completed the following scales at the beginning and end of an inpatient-therapy program: Clinical Global Impression (objective and subjective) the Beck Depression Inventory – second edition, the Beck Anxiety Inventory, and the Dissociative Experiences Scale. The treatment consisted of 25 group sessions and five individual sessions of cognitive behavioral therapy or psychodynamic therapy in combination with pharmacotherapy. There was no randomization to the type of group-therapy program. RESULTS: Greater improvement in psychopathology, assessed by relative change in objective Clinical Global Impression score, was connected with low initial dissociation level, harm avoidance, and self-stigma, and higher amounts of hope and self-directedness. Also, individuals without a comorbid personality disorder improved considerably more than comorbid patients. According to backward-stepwise multiple regression, the best significant predictor of treatment effectiveness was the initial level of self-stigma. CONCLUSION: The initial higher levels of self-stigma predict a lower effectiveness of treatment in resistant-anxiety-disorder patients with high comorbidity with depression and/or personality disorder. The results suggest that an increased focus on self-stigma during therapy could lead to better treatment outcomes. Dove Medical Press 2016-06-24 /pmc/articles/PMC4928674/ /pubmed/27445474 http://dx.doi.org/10.2147/NDT.S104301 Text en © 2016 Ociskova et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Ociskova, Marie
Prasko, Jan
Latalova, Klara
Kamaradova, Dana
Grambal, Ales
Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
title Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
title_full Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
title_fullStr Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
title_full_unstemmed Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
title_short Psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
title_sort psychological factors and treatment effectiveness in resistant anxiety disorders in highly comorbid inpatients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928674/
https://www.ncbi.nlm.nih.gov/pubmed/27445474
http://dx.doi.org/10.2147/NDT.S104301
work_keys_str_mv AT ociskovamarie psychologicalfactorsandtreatmenteffectivenessinresistantanxietydisordersinhighlycomorbidinpatients
AT praskojan psychologicalfactorsandtreatmenteffectivenessinresistantanxietydisordersinhighlycomorbidinpatients
AT latalovaklara psychologicalfactorsandtreatmenteffectivenessinresistantanxietydisordersinhighlycomorbidinpatients
AT kamaradovadana psychologicalfactorsandtreatmenteffectivenessinresistantanxietydisordersinhighlycomorbidinpatients
AT grambalales psychologicalfactorsandtreatmenteffectivenessinresistantanxietydisordersinhighlycomorbidinpatients