Internet-Delivered Affect Phobia Therapy for Neuroticism: Results from an Uncontrolled Pilot Study with 6-Month Follow-Up.

Objective

Trait neuroticism both correlates with and predicts mental and physical health outcomes and has been characterized as a transdiagnostic risk factor for mental health problems. No previous studies have investigated if internet-delivered psychodynamic therapy (IPDT) can reduce levels of neuroticism. The aim of the present study was to investigate the preliminary effect of affect-focused IPDT on trait neuroticism in a sample with mixed anxiety and depressive symptoms.

Methods

In total, 30 participants were included and assigned to 10 weeks of therapist-supported IPDT. Self-reported levels of neuroticism measured with the IPIP-NEO 300 were used as the primary outcome measure. Secondary measures of depression, anxiety, quality of life, neuroticism, treatment satisfaction, emotion regulation, and defense mechanism adaptiveness were also included.

Results

Levels of neuroticism were significantly reduced following the intervention, Cohen's d = 0.64, [.19, 1.1], and these reductions were maintained at the 6-month follow-up. Significant effects were also found across the secondary outcome measures. Changes in defense mechanism adaptiveness significantly predicted changes in neuroticism, β =.63. Discussion: The results indicate that affect-focused IPDT shows promise in reducing trait neuroticism and that changes in defense mechanism adaptiveness may account for a substantial part of the observed effect. These results need to be replicated using a randomized controlled trial design.