Treatment-disrupting behaviors during psychotherapy of @entity1 with XXXX : the predictive power of psychodynamic personality diagnosis.

@entity1 @entity1314 @entity74 @entity146
BACKGROUND: Behavioral dyscontrol and violations of treatment contracts are serious clinical problems during psychotherapy, especially in treating @entity1 with @entity1314 . However, little is known about predictors of these treatment-interfering phenomena. OBJECTIVE: To identify psychodynamic personality characteristics that can interfere with the psychotherapy process as indicated by treatment-disrupting behaviors. METHODS: Sociodemographic characteristics, descriptive psychiatric diagnoses, and psycho-dynamic characteristics were assessed in 89 inpatients with @entity1314 in psychotherapeutic treatment. Psychodynamic characteristics were assessed with the Develop mental Profile (DP). DP variables were used to predict impulsive acts, anger outbursts, para-suicidal behaviors, and contract violations. Incremental value was established. RESULTS: In this sample, 4 out of 5 @entity1 engaged in treatment-interfering behaviors during the first 3 months of therapy. In general, treatment-disrupting behaviors were not predicted by baseline DSM-IV @entity74 . In contrast, @entity146 , anger outbursts, and contract violations were significantly predicted by psychodynamic variables, especially the DP levels Fragmentation and Egocentricity. DP variables accounted for an incremental predictive value of 23% for treatment-disrupting behaviors, over and above demographics and descriptive diagnoses. Para-suicidal gestures were not predicted by either DSM-IV diagnoses or psychodynamic variables. CONCLUSION: Psychodynamic personality variables significantly predicted @entity146 , outbursts of anger, and treatment contract violations during psychotherapeutic treatment. The amount of explained variance and incremental value was substantial. These findings support the relevance of psychodynamic assessment in clinical practice. (Journal of Psychiatric Practice. 2011;17:21-34).
