AACES - MST evaluation study 3 on the effectiveness of mentalization-supporting therapy

Mentalization Supporting Therapy (Sulz 2021a, b), 2022a-c, 2023) is a metacognitive therapy approach (Sulz 2017a-c) for the treatment of Axis I and Axis II disorders. Anxious patients have no access to their ability to mentalize in a fearful situation. This is exactly where the anxiety therapy of Mentalization Supporting Therapy (MST) comes into play. This paper deals with the question of the effectiveness of AACES training in the context of Mentalization Supporting Therapy. This will be tested first with a non-clinical sample in a pilot study. 21 test subjects (students who were offered online anxiety management training over five evenings) received AACES (Mindfulness, Acceptance, Commitment, Exposure, Self-reinforcement) training on five evenings, which was first practiced in dry runs and then applied between sessions in the fearful situation. Anxiety symptoms (VDS90-anxiety) improved significantly after AACES training. The effect size is high. The decrease in clinical anxiety/anxiety symptoms (VDS90) is also associated with a decrease in trait anxiety (VDS28) (-VDS90-anxiety). Individuals with higher neuroticism scores showed more clinical anxiety (VDS90-anxiety) and more trait anxiety (VDS28) prior to the training. The more pronounced the overall mentalization and the mentalization of the world are, the more do the anxiety symptoms subside (pre-post difference VDS90-anxiety). The correlation analyses suggested that neuroticism had a negative impact on the effect of anxiety training, while the ability to mentalize led to a better outcome. In the moderation analyses, we also found a moderating effect for neuroticism: Neuroticism decreases the reduction in anxiety symptoms. Likewise, the moderating effect of attachment insecurity was a decrease in anxiety reduction through AACES training. The result encourages us to take the next step: controlled randomized trials with a clinical sample. Until then, the statements cannot be generalized.