Do gender and level of relational functioning influence the long-term treatment response in dynamic psychotherapy?

Gender as a moderator of long-term treatment effects has to a very little extent been explored in individual psychotherapy. We have previously reported a short-term difference in treatment-response to transference interpretations between women with poor relational functioning (low Quality of Object Relations Scale; low QOR) and men with good relational functioning (high QOR). The present study focuses on whether there also is a sustained difference in treatment-response between those two subgroups.

In the First Experimental Study of Transference-interpretations (FEST), patients (n=100) were randomized to receive dynamic psychotherapy over 1 year with either a moderate level of transference interpretations or no transference interpretations. Assessments were made at pre-treatment, mid-treatment, post-treatment, and at 1- and 3-year follow-ups. The outcome measures used were the Psychodynamic Functioning Scales (PFS), Inventory of Interpersonal Problems (IIP-C), Global Assessment of Functioning (GAF) and Symptom Checklist-90 (GSI). Change was assessed using linear-mixed models.

In the moderator analyses, women with low QOR showed a significant positive long-term treatment effect of transference interpretation (P=0.005), while men with high QOR responded equally well to both therapies.

Women with poor relational functioning and men with good relational functioning showed sustained different treatment-response to transference interpretations.