Premature Termination of Psychotherapy in Patients With Borderline Personality Disorder: A Cluster-Analytic Study

J Nerv Ment Dis. 2018 Apr;206(4):231-238. doi: 10.1097/NMD.0000000000000764.

Abstract

The goal of the present study was to establish profiles of patients with borderline personality disorder (BPD) who dropped out early from an outpatient psychotherapy program. From a sample of 56 BPD patients who dropped out after the first of a three-year program, a TwoStep cluster analysis procedure was performed, using the five factors of the Treatment Attrition-Retention Scale for Personality Disorders (Gamache et al., J Pers Disord 1-21, 2017) and the Global Assessment of Functioning score (Spitzer et al., Global Assessment of Functioning [GAF] Scale. In Sederer LI, Dickey B [Eds], Outcomes assessment in clinical practice [pp 76-78]. Baltimore, MD: Walter and Williams) as clustering variables. Four clusters emerged: Higher-functioning, Narcissistic features/entitlement, Pseudo-normality, and Highly dysfunctional. Differences between the clusters were found on sex, occupational status, and presence of antisocial features. These findings could help both identify BPD patients at potential risk of dropping out of psychotherapy and adjust interventions accordingly to reduce premature termination.

MeSH terms

  • Adult
  • Borderline Personality Disorder / psychology
  • Borderline Personality Disorder / therapy*
  • Cluster Analysis
  • Female
  • Humans
  • Male
  • Patient Dropouts / psychology*
  • Patient Dropouts / statistics & numerical data
  • Personality
  • Psychiatric Status Rating Scales
  • Psychotherapy
  • Risk Factors
  • Sex Factors