Predicting Psychotherapy Utilization for Patients With Borderline Personality Disorder

Abstract

The purpose of this study was to create hypotheses that would serve as predicting variables in the planning of psychotherapeutic treatment for patients with borderline personality disorder (BPD). Twenty psychiatric inpatients were treated with psychoanalytically oriented psychotherapy for 6 weeks with the aim of clarifying, planning, and preparing them for outpatient psychotherapy. The authors investigated anxiety, aggression, interpersonal problems, and self-concept before and after inpatient treatment. Nine patients engaged in further outpatient psychotherapy. Significant predictors for engaging in further treatment were female gender, strong subjective perception of interpersonal problems, and generalized negative self-concept of own capacities. High reactive readiness for aggression and thorough conviction of self-efficacy had predictive value for nonengagement in further psychotherapy. Correlations between aggression and increased capability of one's self and severe interpersonal problems were found only in psychotherapy nonusers. Results emphasize the importance of acknowledging mechanisms of destruction, attachment, and mentalization in initial psychotherapy planning.