title: Pattern destabilization and emotional processing in cognitive therapy for personality disorders.
abstract: Clinical trials of treatments for personality disorders can provide a medium for studying the process of therapeutic change with particularly entrenched and self-perpetuating systems and might reveal important principles of system transition. We examined the extent to which maladaptive personality patterns were destabilized in a trial of cognitive therapy personality disorders (CT-PD) and how destabilization was associated with emotional processing and treatment outcomes. Dynamic systems theory was used as a theoretical framework for studying change.
  
  
  METHODS
  Participants were 27 patients diagnosed with Avoidant or Obsessive Compulsive Personality Disorder (AVPD or OCPD), who completed an open trial of CT-PD. Raters coded treatment sessions using a coding system that operationalizes emotional processing, as well as cognitive, affective, behavioral, and somatic components of pathological (negative) and more adaptive (positive) patterns of functioning. Pattern destabilization (dispersion) scores during the early phase of treatment (phase 1: session 1-10) and the schema-focused phase (phase 2: session 11-34) were calculated using a program called GridWare.
  
  
  RESULTS
  More pattern destabilization and emotional processing in the schema-focused phase of CT-PD predicted more improvement in personality disorder symptoms and positive pattern strength at the end of treatment, whereas these variables in phase 1 did not predict outcome.
  
  
  CONCLUSIONS
  In addition to illustrating a quantitative method for studying destabilization and change of patterns of psychopathology, we present findings that are consistent with recent updates of emotional processing theory and with principles from dynamic systems theory.
authors.affiliation: Department of Psychological and Brain Sciences, University of Delaware Newark, DE, USA.
authors.forename: Adele M
authors.initials: AM
authors.lastname: Hayes
authors.affiliation: Department of Psychological and Brain Sciences, University of Delaware Newark, DE, USA.
authors.forename: Carly
authors.initials: C
authors.lastname: Yasinski
keywords: associative networks; cognitive therapy; dynamic systems; personality disorders; psychotherapy research