Personality disorders have no excessively negative impact on therapist-rated therapy process in the cognitive and behavioural treatment of Axis I anxiety disorders

The impact of DSM-III-R personality pathology on the Axis I therapy process was studied in 70 outpatients who received cognitive and/or behavioural therapy for an Axis I anxiety disorder. The Axis I therapy process was evaluated by the therapist. DSM-III-R personality pathology was assessed first by an independent rater using a semi-structured interview (Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II)) and second by the therapist in the course of treatment. Results showed poor diagnostic agreement between SCID- and therapist-derived personality pathology. SCID-derived personality pathology was only weakly related to a dysfunctional Axis I therapy process, as reported by the therapist. Therapist-derived personality pathology, on the contrary, was strongly related to a dysfunctional Axis I therapy process, as reported by the therapist. Possibly, therapists erroneously attributed Axis I therapy failure to assumed personality pathology. This is the first study on the impact of personality pathology, as assessed by an independent semi-structured interview, on the process of cognitive-behavioural therapy for Axis I anxiety disorders. The findings are consistent with studies that show no negative impact of personality pathology, as assessed by independent semi-structured interviews, on therapy outcome of Axis I anxiety disorders. Copyright © 1999 John Wiley & Sons, Ltd.