Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample

Abstract Background Since its introduction in the diagnostic manuals DSM-5 and ICD-11, the construct of personality functioning has gained increasing attention. However, it remains unclear which factors might predict improvement in personality functioning. Methods We examined a sample of 648 comple...

Full description

Saved in:
Bibliographic Details
Main Authors: I. Dönnhoff, D. Kindermann, S. Stahl-Toyota, J. Nowak, M. Orth, H.-C. Friederich, C. Nikendei
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S0924933824017802/type/journal_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846166910159290368
author I. Dönnhoff
D. Kindermann
S. Stahl-Toyota
J. Nowak
M. Orth
H.-C. Friederich
C. Nikendei
author_facet I. Dönnhoff
D. Kindermann
S. Stahl-Toyota
J. Nowak
M. Orth
H.-C. Friederich
C. Nikendei
author_sort I. Dönnhoff
collection DOAJ
description Abstract Background Since its introduction in the diagnostic manuals DSM-5 and ICD-11, the construct of personality functioning has gained increasing attention. However, it remains unclear which factors might predict improvement in personality functioning. Methods We examined a sample of 648 completed psychodynamic psychotherapies conducted by 172 therapists at the Heidelberg Institute for Psychotherapy. A machine learning approach was used to filter for variables that are relevant for the prediction of the improvement of personality functioning from a broad data set of variables collected at the beginning of each psychodynamic psychotherapy. Results On average, we found an improvement of 0.24 (SD = 0.48) in the OPD-SQ. This corresponds to a medium effect in the improvement of personality functioning. Patients with initially high impairment experienced particularly large improvements. Overall, we found a large number of variables that proved to be predictive for the improvement of personality functioning. Limitations in social activity due to physical and emotional problems proved to be one of the most important predictors of improvement. Most of the effect sizes were small. Conclusions Overall, the improvement in personality functioning during psychotherapy is determined more by the sum of a large number of small effects than by individual variables. In particular, variables that capture social areas of life proved to be robust predictors.
format Article
id doaj-art-87a82c9122e4461c8972fde994ed2f4a
institution Kabale University
issn 0924-9338
1778-3585
language English
publishDate 2024-01-01
publisher Cambridge University Press
record_format Article
series European Psychiatry
spelling doaj-art-87a82c9122e4461c8972fde994ed2f4a2024-11-15T06:52:39ZengCambridge University PressEuropean Psychiatry0924-93381778-35852024-01-016710.1192/j.eurpsy.2024.1780Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sampleI. Dönnhoff0https://orcid.org/0000-0003-1538-9971D. Kindermann1S. Stahl-Toyota2https://orcid.org/0000-0003-0168-3811J. Nowak3https://orcid.org/0009-0009-9058-4663M. Orth4https://orcid.org/0000-0002-1704-2229H.-C. Friederich5https://orcid.org/0000-0003-4344-8959C. Nikendei6Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, GermanyAbstract Background Since its introduction in the diagnostic manuals DSM-5 and ICD-11, the construct of personality functioning has gained increasing attention. However, it remains unclear which factors might predict improvement in personality functioning. Methods We examined a sample of 648 completed psychodynamic psychotherapies conducted by 172 therapists at the Heidelberg Institute for Psychotherapy. A machine learning approach was used to filter for variables that are relevant for the prediction of the improvement of personality functioning from a broad data set of variables collected at the beginning of each psychodynamic psychotherapy. Results On average, we found an improvement of 0.24 (SD = 0.48) in the OPD-SQ. This corresponds to a medium effect in the improvement of personality functioning. Patients with initially high impairment experienced particularly large improvements. Overall, we found a large number of variables that proved to be predictive for the improvement of personality functioning. Limitations in social activity due to physical and emotional problems proved to be one of the most important predictors of improvement. Most of the effect sizes were small. Conclusions Overall, the improvement in personality functioning during psychotherapy is determined more by the sum of a large number of small effects than by individual variables. In particular, variables that capture social areas of life proved to be robust predictors. https://www.cambridge.org/core/product/identifier/S0924933824017802/type/journal_articlepersonality functioningmachine learningmissing data analysis in machine learningpsychotherapy success
spellingShingle I. Dönnhoff
D. Kindermann
S. Stahl-Toyota
J. Nowak
M. Orth
H.-C. Friederich
C. Nikendei
Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample
European Psychiatry
personality functioning
machine learning
missing data analysis in machine learning
psychotherapy success
title Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample
title_full Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample
title_fullStr Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample
title_full_unstemmed Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample
title_short Predictors for improvement in personality functioning during outpatient psychotherapy: A machine learning approach within a psychodynamic psychotherapy sample
title_sort predictors for improvement in personality functioning during outpatient psychotherapy a machine learning approach within a psychodynamic psychotherapy sample
topic personality functioning
machine learning
missing data analysis in machine learning
psychotherapy success
url https://www.cambridge.org/core/product/identifier/S0924933824017802/type/journal_article
work_keys_str_mv AT idonnhoff predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample
AT dkindermann predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample
AT sstahltoyota predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample
AT jnowak predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample
AT morth predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample
AT hcfriederich predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample
AT cnikendei predictorsforimprovementinpersonalityfunctioningduringoutpatientpsychotherapyamachinelearningapproachwithinapsychodynamicpsychotherapysample