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Changes in Personality Functioning Following Psychotherapy Utilising Machine Learning to Identify Predictors in a Psychodynamic Psychotherapy Sample
Introduction: Although personality functioning has a long psychodynamic tradition and has received renewed interest in psychotherapy research with the DSM-5 and ICD-11, almost nothing is known about its course and influencing factors following psychotherapy.
Methods: In a sample of 1208 completed outpatient psychodynamic psychotherapies, we examined changes in personality functioning in the 1-year follow-up. We then used machine learning to filter out the probable predictors from all 227 possible predictors for changes in personality functioning following psychotherapy.
Results: On average, the improvement in personality functioning remained stable following psychotherapy. However, it was found that patients whose personality functioning worsened during psychotherapy improved again following psychotherapy. Patients who improved particularly well during psychotherapy worsened slightly following psychotherapy. In total, we found 14 predictors for an improvement of personality functioning following psychotherapy.
Discussion: All the influences found suggest that the change in personality functioning following psychotherapy is in part influenced by how well the patient succeeds in internalising the relationship with the therapist or the insights gained during psychotherapy. If the patient is unable to do so, they cannot compensate for the loss of co-regulation by the therapist at the end of therapy and some of the improvements in psychotherapy are lost. For example, our findings suggest that if the patient receives less than 20 sessions of psychotherapy, a decline in personality functioning following psychotherapy is to be expected. From 20 sessions onwards, the improvement remains stable and from 95 sessions onwards, a subsequent improvement can be expected.
Keywords: Personality Functioning, Long Term Effects of Psychotherapy, Psychotherapy Research, Psychodynamic Psychotherapy, Machine Learning
Dönnhoff, Ivo and Kindermann, David and Stahl-Toyota, Sophia and Nowak, Jonathan and Orth, Maximilian and Friederich, Hans-Christoph and Nikendei, Christoph, Changes in Personality Functioning Following Psychotherapy Utilising Machine Learning to Identify Predictors in a Psychodynamic Psychotherapy Sample. Available at SSRN: https://ssrn.com/abstract=5177615 or http://dx.doi.org/10.2139/ssrn.5177615
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