The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling

Bierling AL, Doering S, Weidner K, Pape M, Kessler H, Hofmann T, Rose M, Imbierowicz K, Geiser F, Rademacher J, Michalek S, Morawa E, Erim Y, Schneider JS, Teufel M, Hartmann A, Lahmann C, Peters EMJ, Kruse J, von Boetticher D, Herrmann-Lingen C, Nöhre M, de Zwaan M, Dinger U, Friederich HC, Niecke A, Albus C, Zwerenz R, Beutel M, Sattel HC, Henningsen P, Stein B, Waller C, Hake K, Spitzer C, Stengel A, Zipfel S, Weimer K, Gündel H, Herpertz S, Croy I (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 135

Article Number: 152532

DOI: 10.1016/j.comppsych.2024.152532

Abstract

Introduction: While ample data demonstrate the effectiveness of inpatient psychosomatic treatment, clinical observation and empirical evidence demonstrate that not all patients benefit equally from established therapeutic methods. Especially patients with a comorbid personality disorder often show reduced therapeutic success compared to other patient groups. Due to the heterogeneous and categorical personality assessment, previous studies indicated no uniform direction of this influence. This complicates the derivation of therapeutic recommendations for mental disorders with comorbid personality pathology. Methods: Analyzing n = 2094 patients from German university hospitals enrolled in the prospective “MEPP” study, we tested the dynamic interaction between dimensionally assessed personality functioning and psychopathology of anxiety and depression. Results: Longitudinal structural equation modelling replicated the finding that the severity of symptoms at admission predicts symptom improvement within the same symptom domain. In addition, we here report a significant coupling parameter between the baseline level of personality function and the change in general psychopathology - and vice versa. Discussion and conclusion: These results imply that personality pathology at admission hinders the therapeutic improvement in anxiety and depression, and that improvement of personality pathology is hindered by general psychopathology. Furthermore, the covariance between both domains supports the assumption that personality functioning and general psychopathology cannot be clearly distinguished and adversely influence each other. A dimensional assessment of the personality pathology is therefore recommendable for psychotherapy research and targeted therapeutic treatment.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Medizinische Universität Wien Austria (AT) Universitätsklinikum Bonn Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Universitätsklinikum Düsseldorf Germany (DE) Universität Duisburg-Essen (UDE) Germany (DE) Universitätsklinikum Freiburg Germany (DE) Justus-Liebig-Universität Gießen Germany (DE) Universitätsklinikum Göttingen Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Klinikum der Universität München Germany (DE) Paracelsus Medizinische Privatuniversität, Nürnberg Germany (DE) Universitätsmedizin Rostock Germany (DE) Universitätsklinikum Tübingen Germany (DE) Universitätsklinikum Ulm Germany (DE)

How to cite

APA:

Bierling, A.L., Doering, S., Weidner, K., Pape, M., Kessler, H., Hofmann, T.,... Croy, I. (2024). The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling. Comprehensive Psychiatry, 135. https://doi.org/10.1016/j.comppsych.2024.152532

MLA:

Bierling, Antonie Louise, et al. "The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling." Comprehensive Psychiatry 135 (2024).

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