Schema therapy for violent PD offenders: a randomized clinical trial.
| Autor: | Bernstein, David P., Keulen-de Vos, Marije, Clercx, Maartje, de Vogel, Vivienne, Kersten, Gertruda C. M., Lancel, Marike, Jonkers, Philip P., Bogaerts, Stefan, Slaats, Mariëtte, Broers, Nick J., Deenen, Thomas A. M., Arntz, Arnoud |
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| Předmět: |
PERSONALITY disorders
PROFESSIONAL practice HOSPITALS STATISTICAL power analysis SCHEMA therapy FORENSIC psychology HUMAN research subjects PATIENT participation RESEARCH methodology BORDERLINE personality disorder NARCISSISTIC personality disorder VIOLENCE EVIDENCE-based medicine INTERVIEWING SYMPTOM Checklist-90-Revised REGRESSION analysis TREATMENT effectiveness RANDOMIZED controlled trials INTER-observer reliability DESCRIPTIVE statistics QUESTIONNAIRES STATISTICAL sampling CLASSIFICATION of mental disorders ANTISOCIAL personality disorders STATISTICAL models PARANOIA |
| Zdroj: | Psychological Medicine; Jan2023, Vol. 53 Issue 1, p88-102, 15p |
| Abstrakt: | Background: Violent criminal offenders with personality disorders (PD's) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods: We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise-specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results: Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F (5308) = 9.40, p < 0.001; unsupervised leave, treatment*time: F (5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*time: t (1387) = −2.85, p = 0.005). Conclusions: These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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