RESEARCH PAPER
Temperamental traits as predictors of effectiveness of psychotherapy (prolonged exposure) for PTSD in a group of motor vehicle accident survivors
 
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Online publication date: 2014-02-23
 
Current Issues in Personality Psychology 2013;1(1):43–50
 
KEYWORDS
ABSTRACT
Background
The aim of the study was to analyze demographic (age, gender and education), temperamental (briskness and emotional reactivity) and psychopathological (severity of the disorder, comorbid symptoms of personality disorders) predictors of effectiveness of psychotherapy (Prolonged Exposure; PE) of posttraumatic stress disorder (PTSD). It was expected that temperamental traits – briskness (BR) and emotional reactivity (ER) (involved in arousing and change of PTSD symptoms) – would predict the post-treatment
diagnosis of PTSD, regardless of severity of PTSD and symptoms of personality disorders.

Participants and procedure
The logistic regression done on findings obtained in the com­bined sample of 123 motor vehicle accident (MVA) survivors, participating in PE within randomized and non-randomized trials.

Results
A significant effect of severity of pre-treatment PTSD (lower rate of remission in subjects with more severe PTSD), briskness (higher rate of remission in high BR subjects) and interaction between ER and time after MVA (lower rate of remission in high ER subjects treated in a longer period after MVA) were observed. The effect of personality disorders was not significant due to the remarkable correlations with other predictors.

Conclusions
In the discussion the possible mechanisms of the impact
of temperamental traits on recovery from PTSD under psychotherapy are suggested, including behavioral plasticity (briskness) and the relationship between subjects’ moti­vation for treatment and the opportunity of successful recovery (determined by comorbid personality disorders), explaining the interactional effect of emotional reactivity.
 
REFERENCES (28)
1.
Beck, A.T., Butler, A.C., Brown, G.K., Dahslgaard, K.K., Newman, C.F. & Beck, J.S. (2001). Dysfunctional beliefs discriminate personality disorders. Behavioral Research and Therapy, 39, 1213-1225.
 
2.
Brewin, C. (2005). Implications for psychological in­tervention. In: J. Vasterling & C. Brewin (eds.). Neuropsychology of PTSD: biological, cognitive and clinical perspectives (pp. 271-290). New York: Guilford Press.
 
3.
Cloninger, C.R., Svrakic, D.M. & Przybeck, T.R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50, 975-990.
 
4.
First, M.B., Spitzer, R.L., Gibbon, M. & Williams, J.B.W. (1997). Structured Clinical Interview for DSM-IV Axis I disorders. Washington, DC: American Psychiatric Press.
 
5.
Foa, E.B., Hembree, E.A. & Rothbaum, B.O. (2007). Prolonged exposure therapy for PTSD. Oxford: Oxford University Press.
 
6.
Hembree, E.A., Cahill, S.P. & Foa, E.B. (2004). Impact of personality disorders on treatment outcome for female assault survivors with chronic posttraumatic stress disorder. Journal of Personality Disorders, 18, 117-127.
 
7.
Hornowska, E. (2003). Temperamentalne uwarunowania zachowania. Badania z wykorzystaniem kwestionariusza TCI R.C. Cloningera [Temperamental influences on behaviour. Studies with TCI R.C. Cloninger’s inventory]. Poznań: Bogucki Wydaw­nictwo Naukowe.
 
8.
Jacobson, N. & Truax, P. (1991). Clinical significance:.
 
9.
A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.
 
10.
Jahng, S., Trull, T.J., Wood, P.K., Tragesser, S.L., Tomko, R., Grant J.D., Bucholz, K.K. & Sher, K.J. (2011). Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity. Journal of Abnormal Psychology, 120, 656-669.
 
11.
Joyce, P., McKenzie, J., Carter, J., Rae, A., Luty, S., Frampton, C. & Mulder, R. (2007). Temperament, character and personality as predictors of response to interpersonal psychotherapy and cognitive-behavioural therapy for depression. The British Journal Of Psychiatry: The Journal Of Mental Science, 190, 503-508.
 
12.
Lehner, M., Wisłowska-Stanek, A. & Płaźnik, A. (2009). Wygaszanie reakcji emocjonalnej jako nowy cel farmakoterapii zaburzeń lękowych. Psychiatria Polska, 18, 639-654.
 
13.
Livesley, W.J. & Jang, K.L. (2000). Toward an empirically based classification of personality disorder. Journal of Personality Disorders, 14, 137-151.
 
14.
Lommen, M., Engelhard, I., Sijbrandij, M., van den Hout, M. & Hermans, D. (2013). Pre-trauma individual differences in extinction learning predict posttraumatic stress. Behaviour Research and Therapy, 51, 63-67. doi:10.1016/j.brat.2012.11.004.
 
15.
Nęcka, E. & Hławacz, T. (2013). Who has an artistic temperament? Relationships between creativity and temperament among artists and bank officers. Creativity Research Journal, 25, 182-188. doi: 10.1080/10400419.2013.783744.
 
16.
National Institute for Health and Clinical Excellence, NICE (2005). NICE Treatment Guideline: PTSD (2005). London: Author.
 
17.
Popiel, A. & Pragłowska, E. (2008). Psychoterapia poznawczo-behawioralna. Teoria i praktyka [Cognitive-behavioural psychotherapy. Theory and practice]. Warszawa: Paradygmat.
 
18.
Popiel, A., Zawadzki, B., Pragłowska, E. & Teichman, Y. (in preparation to press). A randomized controlled trial of prolonged exposure, paroxetine and combined treatment for PTSD following motor vehicle accident – the “TRAKT” study.
 
19.
Strelau, J. (1998). Temperament: A psychological perspective. New York: Plenum Press.
 
20.
Strelau, J. & Zawadzki, B. (1993). The Formal Chara­cteristics of Behaviour – Temperament Inventory (FCB-TI): Theoretical assumptions and scale construction. European Journal of Personality, 7, 313-336.
 
21.
Strelau, J. & Zawadzki, B. (1995). The Formal Characteristics of Behavior – Temperament Inventory (FCB-TI): Validity studies. European Journal of Personality, 9, 207-229.
 
22.
Strelau, J. & Zawadzki, B. (2004). Trauma and temperament as predictors of posttraumatic stress disorder and its dimensions 3, 15 months and two years after experiencing flood. Polish Psychological Bulletin, 35, 5-13.
 
23.
Strelau, J. & Zawadzki, B. (2011). Fearfulness and anxiety in research on temperament: Temperamental traits are related to anxiety disorders. Personality and Individual Differences, 50, 907-915.
 
24.
Tarrier, N., Sommerfield, C., Pilgrim, H. & Faragher, B. (2000). Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder. Behaviour Research and The­rapy, 38, 191-202.
 
25.
Van Minnen, A., Arntz, A. & Keijsers, G.P.J. (2002). Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout. Behaviour Research and Therapy, 40, 439-457.
 
26.
Weertman, A., Arntz, A., Schouten, E. & Dreessen, L. (2005). Influences of beliefs and personality disorders on treatment outcome in anxiety patients. Journal of Consulting and Clinical Psychology, 73, 936-944.
 
27.
Wessa, M. & Flor, H. (2007). Failure of extinction of fear responses in Posttraumatic Stress Disorder: Evidence from second-order conditioning. American Journal of Psychiatry, 164, 1684-1692.
 
28.
Zawadzki, B. & Popiel, A. (2012). Temperamental traits and severity of PTSD symptoms: The data from longitudinal studies of motor vehicle accidents survivors. Journal of Individual Differences, 33, 257-267.
 
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