Associations between patient personality, symptomatic change and therapy dropout

Abstract

Background Studies show that 16% to 77% of psychotherapy patients abandon therapy within the first sessions. The aim of this study is to examine how patient personality variables, specifically the patients' structural integration and the personality traits dependency and self‐criticism, are associated with symptomatic change and therapy dropout. Method We analysed data from 96 patients (age: M = 30.56, SD = 11.39; 78.5% women; 44.6% students, 28.3% employees). A hierarchical logistic regression analysis was carried out to determine whether patients' structural integration (assessed via the OPD‐SQ) and their level of dependency and self‐criticism (DEQ) can predict therapy dropout. In addition, a multiple regression was used to analyse how these variables affect symptomatic change (OQ‐45.2 symptom subscale). Results The interaction of structural integration level and dependency best predicts therapy dropout. For the prediction of symptomatic change, both structural integration and dependency were significant. However, their interaction showed no significant results. Discussion The patient's structural integration was associated to both symptomatic change and dropout. Therapists' training should include techniques addressing patients' structural integration and degree of dependency to prevent patient dropout from therapy.

Changes in mentalization in patients with personality disorders during sequential brief—Adlerian psychodynamic psychotherapy: The role of therapists’ technique and countertransference.

“…The therapeutic and clinical aims of the SB-APP are not only related to symptom reduction, but also to the specific underlying mechanisms of mental processes (Sauer-Zavala et al, 2023). SB-APP posits that therapeutic interventions are related to patient’s personality organization level (Babl et al, 2019; Ferrero et al, 2016; Immel et al, 2022; Stone, 2022). When working with PD patients, for example, psychodynamic expressive interventions such as confrontations or interpretations are used very cautiously.…”

Personality Functioning: An Opportunity for Treatment Personalization

“…Assessing personality functioning through the OPD-SQ to screen for the heterogeneity and complexity of patients can make it possible to derive patient-specific interventions and treatment planning [29,46,47].…”

“…Immel, Dagnino, and Hunger-Schoppe [29] analyzed the data of 96 patients with depression (age: M = 30.56, SD = 11.39; 78.5% women; 44.6% students, 28.3% employees). They explored predictors for therapy dropout and symptomatic change in depressive patients.…”

Measuring personality functioning with the 12-item version of the OPD-Structure Questionnaire (OPD-SQS): reliability, factor structure, validity, and measurement invariance in the general population

“…Higher scores of the OPD-SQ but not a categorical diagnosis of BPD were associated with active negative emotions in psychotherapy inpatients ( Dinger et al, 2021 ). OPD-SQ scores but not depression predicted less success in blood glucose normalization in the treatment of patients with type 2 diabetes mellitus ( Ehrenthal et al, 2019 ), and could be related to gastrointestinal complaints ( Berens et al, 2021 ) and irritable bowel syndrome ( Berens et al, 2021 ), profiles of eating disorders ( Rohde et al, 2019 ), bipolar disorder ( Wagner-Skacel et al, 2020 ), vaginismus and dyspareunia ( Koops et al, 2021 ), and has been applied in different areas of psychotherapy research ( Ehrenthal et al, 2020 ; Nikendei et al, 2020 ; Zeeck et al, 2020 ; Knefel et al, 2021 ; Kraus et al, 2021 ; Immel et al, 2022 ). In addition, the OPD-SQ is highly correlated with state and trait measures of emotional intelligence as well as self-reported levels of personality functioning according to the DSM-5 ( Jauk and Ehrenthal, 2021 ), and it mediates the association between childhood trauma and adult depression ( Dagnino et al, 2020 ).…”