Dissociation Predicts Symptom-Related Treatment Outcome in Short-Term Inpatient Psychotherapy
Abstract
Objective: Previous research has indicated that dissociation might be a negative predictor of treatment outcome in cognitive behavioural therapy for patients with obsessive-compulsive and anxiety disorders. Using a naturalistic design it was hypothesized that higher levels of dissociation predict poorer outcome in inpatients with affective, anxiety and somatoform disorders participating in a brief psychodynamic psychotherapy. Method: A total of 133 patients completed the Symptom Check List (SCL-90), the German short version of the Dissociative Experiences Scale and the Inventory of Interpersonal Problems at the beginning and the end of treatment. The Global Severity Index (GSI) of the SCL-90 was chosen as outcome criterion. Results: A total of 62.4% of study participants were classified as treatment responders, that is, they showed a statistically significant change of their GSI scores. Controlling for general psychopathology, the non-responders had significantly higher baseline dissociation scores than the responders. In a logistic regression analysis with non-response as a dependent variable, a comorbid personality disorder, low baseline psychopathology and high dissociation levels emerged as relevant predictors, but interpersonal problems and other comorbid disorders did not. Conclusions: Dissociation has a negative impact on treatment outcome. It is suggested that dissociative subjects dissociate as a response to negative emotions arising in psychotherapy leading to a less favourable outcome. Additionally, dissociative patients may have an insecure attachment pattern negatively affecting the therapeutic relationship. Thus, dissociation may directly and indirectly influence the treatment process and outcome.
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Dissociation can become maladaptive and possibly interfere with treatment.
“Thereby, dissociation can become maladaptive [10] and possibly interfere with treatment [46–50].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [48]
Dissociation can become maladaptive and possibly interfere with treatment.
“Thereby, dissociation can become maladaptive [10] and possibly interfere with treatment [46–50].”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [50]
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- Authors
- Spitzer, C., Barnow, S., Freyberger, H. J., & Joergen Grabe, H.
- Affiliations
- Universität Greifswald (DE)
- Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt-University, Rostocker Chaussee 70, D-18437, Stralsund, Germany
- Corresponding author
- Spitzer, Carsten
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2007-08
- Volume
- 41
- Issue
- 8
- Pages
- 682-687
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2029488811
- Cited by
- 129
- References
- 35
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 3 · 2023: 8 · 2022: 3 · 2021: 6 · 2020: 10 · 2019: 5 · 2018: 10 · 2017: 14 · 2016: 9 · 2015: 4 · 2014: 8 · 2013: 10 · 2012: 8
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- dissociation, treatment outcome prediction, brief psychodynamic psychotherapy, inpatient psychotherapy, treatment non-responders, mood disorders, anxiety disorders, somatoform disorders, personality disorder comorbidity, psychopathology, insecure attachment, therapeutic relationship
- MeSH terms
- Adult, Anxiety Disorders, Dissociative Disorders, Female, Humans, Male, Obsessive-Compulsive Disorder, Prospective Studies, Psychotherapy, Brief, Surveys and Questionnaires, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome
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