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.