{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T17:06:49Z","timestamp":1789405609302,"version":"build-2803163510"},"reference-count":68,"publisher":"Guilford Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychodynamic Psychiatry"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>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\u2019s 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, \u03b2 =.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.<\/jats:p>","DOI":"10.1521\/pdps.2026.54.3.511","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:44:04Z","timestamp":1789404244000},"page":"511-531","source":"Crossref","is-referenced-by-count":0,"title":["Internet-Delivered Affect Phobia Therapy for Neuroticism: Results from an Uncontrolled Pilot Study with 6-Month Follow-Up"],"prefix":"10.1521","volume":"54","author":[{"given":"Tomas","family":"Lindegaard","sequence":"first","affiliation":[{"name":"Department of Behavioural Sciences and Learning, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilda","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"K\u00e4ll","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning and Department of Biomedical and Clinical Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lockman","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edvin","family":"Sch\u00f6nberg","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bj\u00f6rklund","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J.","family":"Frederick","sequence":"additional","affiliation":[{"name":"Center for Courageous Living, Los Angeles, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning and Department of Biomedical and Clinical Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"377","reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s44192-025-00181-x","volume":"5","author":"Ajele K. W.","year":"2025","journal-title":"Discover Mental Health"},{"issue":"6","key":"ref2","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1159\/000339371","volume":"81","author":"Andersson G.","year":"2012","journal-title":"Psychotherapy and Psychosomatics"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Attkisson, C. C. & Zwick, R. (2016). Client Satisfaction Questionnaire-8 [Data set]. https:\/\/doi.org\/10.1037\/t50119-000","DOI":"10.1037\/t50119-000"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.paid.2018.11.025","volume":"139","author":"Bara\u0144czuk U.","year":"2019","journal-title":"Personality and Individual Differences"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1177\/2167702613505532","volume":"2","author":"Barlow D. H.","year":"2014","journal-title":"Clinical Psychological Science"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s10862-015-9514-x","volume":"38","author":"Bjureberg J.","year":"2016","journal-title":"Journal of Psychopathology and Behavioral Assessment"},{"issue":"9","key":"ref7","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1176\/appi.ajp.161.9.1665","volume":"161","author":"Bond M.","year":"2004","journal-title":"American Journal of Psychiatry"},{"issue":"6","key":"ref8","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1037\/0022-3514.93.6.1080","volume":"93","author":"Connor-Smith J. K.","year":"2007","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1521\/pdps.2015.43.4.523"},{"key":"ref10","volume-title":"Intensive short-term dynamic psychotherapy","author":"Davanloo H.","year":"2000"},{"issue":"19","key":"ref11","doi-asserted-by":"crossref","first-page":"12690","DOI":"10.3390\/ijerph191912690","volume":"19","author":"Di Giuseppe M.","year":"2022","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"870","DOI":"10.3389\/fpsyt.2020.00870","volume":"11","author":"Di Giuseppe M.","year":"2020","journal-title":"Frontiers in Psychiatry"},{"issue":"4","key":"ref13","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1037\/a0024406","volume":"26","author":"Eaton N. R.","year":"2011","journal-title":"Psychology and Aging"},{"issue":"1","key":"ref14","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/0191-8869(85)90026-1","volume":"6","author":"Eysenck S. B.","year":"1985","journal-title":"Personality and Individual Differences"},{"issue":"6","key":"ref15","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1037\/ccp0000044","volume":"83","author":"Fernandez E.","year":"2015","journal-title":"Journal of Consulting and Clinical Psychology"},{"key":"ref16","volume-title":"The transforming power of affect: A model for accelerated change","author":"Fosha D.","year":"2000"},{"issue":"5","key":"ref17","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/1467-6494.695161","volume":"69","author":"Goldberg L. R.","year":"2001","journal-title":"Journal of Personality"},{"issue":"7","key":"ref18","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1017\/S0033291709991449","volume":"40","author":"Griffith J. W.","year":"2010","journal-title":"Psychological Medicine"},{"issue":"3","key":"ref19","doi-asserted-by":"crossref","first-page":"823","DOI":"10.2466\/pr0.1993.72.3.823","volume":"72","author":"Hosokawa T.","year":"1993","journal-title":"Psychological Reports"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.7717\/peerj.102","volume":"1","author":"Johansson R.","year":"2013","journal-title":"PeerJ"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1521\/pdps.2013.41.4.513"},{"issue":"4","key":"ref22","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1037\/pst0000147","volume":"54","author":"Johansson R.","year":"2017","journal-title":"Psychotherapy (Chicago, Ill.)"},{"issue":"1","key":"ref23","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/dar.12522","volume":"37","author":"Kelly P. J.","year":"2018","journal-title":"Drug and Alcohol Review"},{"issue":"7","key":"ref24","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/j.brat.2006.11.011","volume":"45","author":"Kotov R.","year":"2007","journal-title":"Behaviour Research and Therapy"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3389\/fpsyg.2012.00044","volume":"3","author":"Kraha A.","year":"2012","journal-title":"Frontiers in Psychology"},{"issue":"7","key":"ref26","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/S0191-8869(00)00106-9","volume":"30","author":"Krueger R. F.","year":"2001","journal-title":"Personality and Individual Differences"},{"issue":"4","key":"ref27","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1037\/a0015309","volume":"64","author":"Lahey B. B.","year":"2009","journal-title":"American Psychologist"},{"issue":"3","key":"ref28","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/0149-7189(79)90094-6","volume":"2","author":"Larsen D.L.","year":"1979","journal-title":"Evaluation and Program Planning"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1521\/pdps.2020.48.4.437"},{"issue":"1","key":"ref30","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1186\/s12888-021-03297-w","volume":"21","author":"Lindegaard T.","year":"2021","journal-title":"BMC Psychiatry"},{"issue":"3","key":"ref31","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1080\/16506073.2016.1143526","volume":"45","author":"Lindner P.","year":"2016","journal-title":"Cognitive Behaviour Therapy"},{"issue":"3","key":"ref32","doi-asserted-by":"crossref","first-page":"e18047","DOI":"10.2196\/18047","volume":"22","author":"Lindqvist K.","year":"2020","journal-title":"Journal of Medical Internet Research"},{"issue":"3","key":"ref33","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","volume":"46","author":"L\u00f6we B.","year":"2008","journal-title":"Medical Care"},{"issue":"1","key":"ref34","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S0165-0327(03)00198-8","volume":"81","author":"L\u00f6we B.","year":"2004","journal-title":"Journal of Affective Disorders"},{"key":"ref35","volume-title":"Individual psychotherapy and the science of psychodynamics","author":"Malan D.","year":"1995"},{"issue":"4","key":"ref36","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1037\/pas0000004","volume":"26","author":"Maples J. L.","year":"2014","journal-title":"Psychological Assessment"},{"key":"ref37","volume-title":"Treating affect phobia: A manual for short-term dynamic psychotherapy","author":"McCullough L.","year":"2003"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/978-1-59745-444-5_11","volume-title":"Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice","author":"McCullough L.","year":"2009"},{"issue":"8","key":"ref39","doi-asserted-by":"crossref","first-page":"e594","DOI":"10.1016\/S2589-7500(22)00095-4","volume":"4","author":"Mechler J.","year":"2022","journal-title":"The Lancet. Digital Health"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"671","DOI":"10.3389\/fpsyt.2020.00671","volume":"11","author":"Mechler J.","year":"2020","journal-title":"Frontiers in Psychiatry"},{"key":"ref41","volume-title":"Mplus user\u2019s guide","author":"Muth\u00e9n L. K.","year":"2017","edition":"8"},{"key":"ref42","volume-title":"Theory and practice of experiential dynamic psychotherapy","author":"Osimo F.","year":"2012"},{"issue":"9","key":"ref43","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1176\/appi.ajp.2012.11091403","volume":"169","author":"Perry J. C.","year":"2012","journal-title":"American Journal of Psychiatry"},{"issue":"2","key":"ref44","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/j.1530-0277.2006.00295.x","volume":"31","author":"Reinert D. F.","year":"2007","journal-title":"Alcoholism, Clinical and Experimental Research"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.psychres.2017.04.042","volume":"254","author":"Rheker J.","year":"2017","journal-title":"Psychiatry Research"},{"issue":"2","key":"ref46","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1037\/bul0000088","volume":"143","author":"Roberts B. W.","year":"2017","journal-title":"Psychological Bulletin"},{"issue":"3","key":"ref47","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1080\/16506073.2015.1008033","volume":"44","author":"Rozental A.","year":"2015","journal-title":"Cognitive Behaviour Therapy"},{"issue":"6","key":"ref48","doi-asserted-by":"crossref","first-page":"e0157503","DOI":"10.1371\/journal.pone.0157503","volume":"11","author":"Rozental A.","year":"2016","journal-title":"PLoS One"},{"issue":"5","key":"ref49","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1017\/S1352465819000018","volume":"47","author":"Rozental A.","year":"2019","journal-title":"Behavioural and Cognitive Psychotherapy"},{"issue":"1","key":"ref50","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1027\/1614-0001\/a000151","volume":"36","author":"Sala M. N.","year":"2015","journal-title":"Journal of Individual Differences"},{"issue":"14","key":"ref51","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1017\/S0033291720000975","volume":"51","author":"Sauer-Zavala S.","year":"2021","journal-title":"Psychological Medicine"},{"issue":"3","key":"ref52","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1037\/per0000224","volume":"8","author":"Sauer-Zavala S.","year":"2017","journal-title":"Personality Disorders"},{"issue":"6","key":"ref53","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","volume":"88","author":"Saunders J. B.","year":"1993","journal-title":"Addiction (Abingdon, England)"},{"issue":"2","key":"ref54","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1037\/1082-989X.7.2.147","volume":"7","author":"Schafer J. L.","year":"2002","journal-title":"Psychological Methods"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1037\/a0018378","volume":"65","author":"Shedler J.","year":"2010","journal-title":"American Psychologist"},{"issue":"5","key":"ref56","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0924-9338(97)83297-X","volume":"12","author":"Sheehan D.","year":"1997","journal-title":"European Psychiatry"},{"key":"ref57","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1146\/annurev.clinpsy.2.022305.095257","volume":"2","author":"Smith T.W.","year":"2006","journal-title":"Annual Review of Clinical Psychology"},{"issue":"1","key":"ref58","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/jopy.12081","volume":"83","author":"Soto C. J.","year":"2015","journal-title":"Journal of Personality"},{"issue":"18","key":"ref59","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1001\/jama.282.18.1737","volume":"282","author":"Spitzer R. L.","year":"1999","journal-title":"JAMA"},{"issue":"10","key":"ref60","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"Spitzer R. L.","year":"2006","journal-title":"Archives of Internal Medicine"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1521\/pedi.2018.32.supp.58","volume":"32","author":"Starrs C. J.","year":"2018","journal-title":"Journal of Personality Disorders"},{"issue":"6","key":"ref62","doi-asserted-by":"crossref","first-page":"e186","DOI":"10.1192\/bjo.2021.1025","volume":"7","author":"Strauss B.","year":"2021","journal-title":"BJPsych Open"},{"key":"ref63","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9798894550190","volume-title":"mechanisms of defense: A guide for clinicians and researchers","author":"Vaillant G. E.","year":"1992"},{"key":"ref64","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.invent.2016.09.006","volume":"6","author":"Vlaescu G.","year":"2016","journal-title":"Internet Interventions"},{"key":"ref65","doi-asserted-by":"crossref","first-page":"109725","DOI":"10.1016\/j.paid.2019.109725","volume":"156","author":"Wimmelmann C. L.","year":"2020","journal-title":"Personality and Individual Differences"},{"key":"ref66","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.jad.2020.01.086","volume":"265","author":"Yang J.","year":"2020","journal-title":"Journal of Affective Disorders"},{"key":"ref67","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1177\/2167702615618162","volume":"4","author":"Zinbarg R. 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