Metacognitive Interpersonal Therapy in Group Versus TAU plus Waiting List for Young Adults with Personality Disorders: Randomized Clinical Trial

Young adults presenting with personality disorders (PDs) featuring overcontrol and social inhibition urgently require effective psychological interventions to help them navigate important life transitions. metacognitive interpersonal therapy-group (MIT-G) is a time-limited group program designed to enable individuals to find adaptive solutions to their social difficulties. A small randomized clinical trial (RCT) of MIT-G versus treatment as usual (TAU) was conducted with the primary outcomes of improvements in social and interpersonal functioning and global psychological symptoms. Secondary outcomes were specific symptoms of anxiety and depression and changes in alexithymia and emotion dysregulation. From 40 participants, 20 were randomized to 16 weekly sessions of MIT-G, plus 3 individual sessions and 20 to TAU + waiting list. All 20 patients allocated to MIT-G completed treatments, while 2 dropped-out in the TAU arm. Patients in the MIT-G arm reported significant improvements on primary outcomes of functioning, interpersonal problems and global symptoms of medium magnitude, medium effect sizes for changes in depression and anxiety, and large magnitude changes for alexithymia. However, other than alexithymia no significant differences were observed between groups at treatment end. A Time x Condition interaction, indicated that MIT-G was associated with more rapid and larger magnitude improvements in functioning and alexithymia. MIT-G is a well-tolerated treatment option for young adults with overcontrolled PD. Further effectiveness studies in larger samples are underway.