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Changes in personality functioning following psychotherapy: Utilizing machine learning to identify predictors in a
I Dönnhoff1, D Kindermann1, S Stahl-Toyota1
1Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
Summary
Personality functioning improvements after psychotherapy generally remain stable. However, factors like childhood adversity and strong initial gains can influence long-term outcomes in personality development.
Area of Science:
- Psychiatry and Psychology
- Psychotherapy Research
Background:
- Personality functioning is a key area in psychodynamic tradition, with renewed interest from DSM-5 and ICD-11.
- Limited understanding exists regarding the long-term course and predictors of personality functioning post-psychotherapy.
Purpose of the Study:
- To investigate the stability of personality functioning changes after outpatient psychodynamic psychotherapy.
- To identify predictors influencing personality functioning trajectories in the 1-year follow-up period.
Main Methods:
- Analysis of 1208 completed outpatient psychodynamic psychotherapy cases with 1-year follow-up.
- Machine learning employed to identify potential predictors from 227 variables for changes in personality functioning.
Main Results:
- Personality functioning improvements were stable for most patients post-psychotherapy.
- Fourteen predictors identified, including psychotherapy length, adverse childhood experiences, PTSD/recurrent depression diagnoses, improved interpersonal/symptom functioning, and therapeutic alliance stability.
- Significant initial improvements may paradoxically predict subsequent declines in personality functioning.
Conclusions:
- Psychotherapy-induced gains in personality functioning are typically maintained long-term.
- Numerous small effects, often related to interpersonal experiences, influence personality functioning changes.
- Understanding these predictors can inform treatment and patient management strategies.
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