The alliance-outcome association in borderline and obsessive-compulsive personality disorder

Peter Beiling; Susan Schurig; Andrea Keller; Kerstin Weidner; René Noack

doi:10.3389/fpsyt.2023.1094936

The alliance-outcome association in borderline and obsessive-compulsive personality disorder

Front Psychiatry. 2023 Mar 8:14:1094936. doi: 10.3389/fpsyt.2023.1094936. eCollection 2023.

Authors

Peter Beiling¹, Susan Schurig¹, Andrea Keller¹, Kerstin Weidner¹, René Noack¹

Affiliation

¹ TU Dresden, Carl Gustav Carus Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Dresden, Germany.

Abstract

Personality disorders are considered a possible factor affecting the relationship between therapeutic alliance and therapy outcome. The present study investigated the alliance-outcome effect in patient groups with borderline personality disorder (BPD) and obsessive-compulsive personality disorder (OCPD). Data derived from a sample of n = 66 patients, treated in a day care hospital setting with a dialectical-behavioral and schema therapeutic treatment concept. Patients rated their symptom severity at admission, early alliance after 4-6 therapy sessions and symptom severity as well as alliance at discharge. Results showed no significant differences between BPD and OCPD patients regarding symptom severity and alliance. Multiple regression analyses indicated that the alliance was a significant predictor of symptom reduction, however only in the OCPD group. Our results showed an exceptionally strong alliance-outcome relationship in OCPD patients, suggesting that focusing on building a strong alliance and measuring it early in therapy may be especially beneficial for this patient group. For patients with BPD, a more regular screening of the therapeutic alliance might be helpful.

Keywords: borderline personality disorder; obsessive-compulsive personality disorder; prediction; psychotherapy outcome; therapeutic alliance.

Grants and funding

The Article Processing Charge (APC) were funded by the joint publication funds of the TU Dresden, including Carl Gustav Carus Faculty of Medicine, and the SLUB Dresden as well as the Open Access Publication Funding of the DFG.