Alternative Model of Personality Disorders (DSM-5) Predicts Dropout in Inpatient Psychotherapy for Patients With Personality Disorder.
- Busmann M Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- Wrege J Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- Meyer AH Department of Psychology, University of Basel, Basel, Switzerland.
- Ritzler F Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- Schmidlin M Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- Lang UE Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- Gaab J Department of Psychology, University of Basel, Basel, Switzerland.
- Walter M Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- Euler S Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.
- 2019-05-23
Published in:
- Frontiers in psychology. - 2019
Alternative Model of Personality Disorders
dropout
personality disorders
personality functioning
therapeutic alliance
English
Objective
Criterion A serves as the fundamental diagnostic criterion of the Alternative Model of Personality Disorders in section III of the Diagnostic and Statistical Manual 5. Consisting of a self- and an interpersonal dimension, it defines the construct of personality functioning as a general and dimensional factor of personality disorders. This study aimed to explore criterion A along with well-established treatment dropout predictors, e.g., sociodemographic factors, personality disorder diagnosis, symptom severity, and the therapeutic alliance.
Methods
The sample consisted of 132 patients diagnosed with personality disorder in a psychotherapeutic inpatient treatment. Cox proportional hazard regression models and a lasso model were applied.
Results
28% of the sample prematurely discontinued treatment. The risk for dropout was 2.3 times higher for patients with high impairments in self-functioning as assessed with criterion A. Moreover, a positive therapist-rated therapeutic alliance was associated with a lower dropout risk.
Conclusion
The study suggests criterion A is a useful clinical indicator by identifying patients with personality disorder with a higher risk for dropout. An individualized therapeutic approach for such patients might be required.
Criterion A serves as the fundamental diagnostic criterion of the Alternative Model of Personality Disorders in section III of the Diagnostic and Statistical Manual 5. Consisting of a self- and an interpersonal dimension, it defines the construct of personality functioning as a general and dimensional factor of personality disorders. This study aimed to explore criterion A along with well-established treatment dropout predictors, e.g., sociodemographic factors, personality disorder diagnosis, symptom severity, and the therapeutic alliance.
Methods
The sample consisted of 132 patients diagnosed with personality disorder in a psychotherapeutic inpatient treatment. Cox proportional hazard regression models and a lasso model were applied.
Results
28% of the sample prematurely discontinued treatment. The risk for dropout was 2.3 times higher for patients with high impairments in self-functioning as assessed with criterion A. Moreover, a positive therapist-rated therapeutic alliance was associated with a lower dropout risk.
Conclusion
The study suggests criterion A is a useful clinical indicator by identifying patients with personality disorder with a higher risk for dropout. An individualized therapeutic approach for such patients might be required.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.3389/fpsyg.2019.00952
- PMID 31114528
- Persistent URL
- https://sonar.ch/global/documents/250465
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