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Adult Depression

How does CBT Reduce Neuroticism? Considering the Role of CBT Skills

(PS3-17) How Does CBT Reduce Neuroticism? Considering the Role of CBT Skills

Friday, November 15, 2024
11:30 AM – 12:30 PM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Research has shown that cognitive behavioral therapy (CBT) is an effective treatment for depression. However, it is much less clear whether and how personality changes through CBT treatment. Psychotherapy studies have demonstrated that neuroticism (and extraversion) change during treatment (Sauer-Zavala et al., 2021; Tang et al., 2009), but little is known regarding the mechanism of this change. Vittengl and colleagues (2020) found that increased CBT skills related to larger decreases in negative temperament. Using data from our recent trial, we examine change in personality dimensions and the relation of these changes with CBT skill acquisition. In the trial, 150 individuals were randomized to either standard CBT or skill-enhanced CBT (a treatment with a special focus on the development of coping skills). Personality was measured with the NEO Personality Inventory (NEO-FFI; Costa & McCrae, 1992) at intake and posttreatment (at week 12). Skills were measured with Competencies of Cognitive Therapy Scale-Client Reported (CCTS-SR) and Ways of Responding Scale (WOR; Barber & DeRubeis, 1992). Four of five personality traits significantly changed from intake to post-treatment (all but openness). Neuroticism decreased (d = 1.17), while extraversion (d = -.69), agreeableness (d = -.35), and conscientiousness (d = -.49) all significantly increased. In addition, CBT skills also significantly increased from intake to posttreatment (CCTS: d = -1.57; WOR quality: d = -1.39).  We then examined the relation of regressed change in CBT skills and regressed change in personality variables. Only change in agreeableness was significantly related to improvement in WOR-assessed coping skill quality (B = .25, p = .009). Reductions in neuroticism (B = -.50) were associated with greater change in skill use as reported on the CCTS. Neither of these relationships with skill quality were accounted for by depressive symptom change. These relationships did not differ across treatments nor did treatments yield differential change in personality dimensions. Thus, our results suggest that greater use of CBT skills may play a role in the reduction of neuroticism in CBT. Nonetheless, our effort to promote greater skills via CBT-SE did not result in greater personality change. Although more research is needed, it may be that skill promoting elements shared across CBT and CBT-SE play a role in neuroticism reduction.