Patterns of inner change and their relation with patient characteristics and outcome in a psychoanalytic hospitalization‐based treatment for personality disordered patients

This study investigated whether different clusters of patients with personality disorders in a psychoanalytic hospitalization-based treatment were associated with: (a) different changes in personality organization (PO); (b) different pre-treatment variables; and (c) different associations between changes in PO and outcome. K-means clustering analysis identified two clusters of patients, which showed different changes in PO and mainly differed in terms of levels of anaclitic and introjective personality features, respectively. Both clusters showed a significant decrease in symptoms and an improvement in personality functioning during treatment and at 3-month follow-up. Clinical implications of these findings are discussed. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Psychoanalytic hospitalization-based treatment for patients with personality disorders is associated with changes in different aspects of personality organization such as representations of self and others, mentalization and felt safety. • Patients show different trajectories of change in personality organization, which are associated with patient characteristics such as introjective and anaclitic personality dimensions as defined by Blatt (2004). • Two identified trajectories of change during psychoanalytic hospitalization-based treatment lead to improvement in outcome, i.e., symptom reduction and improvement in personality functioning. • Therapists should tailor treatment to individual patient characteristics in treating personality disorders.