Engaging Personality Dimensions in Treatment: A Parsimonious Approach to Precision Medicine

Despite considerable investments in treatment development for psychological conditions, response rates for most interventions are quite modest (30-40%) and the prevalence of mental disorders remains persistently high. A new approach to psychological treatment is clearly needed to move the needle on the disease burden of mental illness. Researchers have demonstrated that a manageable number of personality dimensions (i.e., neuroticism, [low] agreeableness, [low] conscientiousness) can account for a broad range of psychopathology. The goal of the proposed study is to demonstrate determine whether discrete therapy modules each designed to directly address one higher-order personality dimension engage their intended personality targets using multi-modal assessments of clinician-rated, self-report, and behavioral indicators. A single-case experiment to test engagement of each higher-order target (n = 10 in each sub-study) will be conducted. Participants will complete (1) an assessment-only baseline period to establish stability in the targeted personality dimension without treatment, (2) a 6-session intervention phase targeting the personality mechanism in which they demonstrated an elevation, and (3) a 4-week assessment-only followup. We will recruit participants with borderline personality disorder as this disorder is characterized by combinations of high neuroticism, low agreeableness, and low conscientiousness, and frequently co-occurs with a variety of DSM-5 disorders that are accounted for by different personality domains. The findings from the proposed study will provide initial evidence that targeting this limited number of higher-order, personality-based dimensions represents a more potent, parsimonious, and personalized approach to mental healthcare.