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Journal of Psychotherapy Practice and Research 4: 205-213, 1995
Copyright © 1995 American Psychiatric Association, Inc.

Predictors of Dropout in Psychodynamic Psychotherapy of Borderline Personality Disorder

THOMAS E. SMITH M.D.1, HAROLD W. KOENIGSBERG M.D.1, FRANK E. YEOMANS M.D.1, JOHN F. CLARKIN PH.D.1, and MICHAEL A. SELZER M.D.1

1 Department of Psychiatry, Cornell University Medical College, and the New York Hospital, Westchester Division, New York.

Dr. Smith, The New York Hospital-Westchester Division, 21 Bloomingdale Road, White Plains, NY 10605.

This study aimed to identify patient factors that predict early dropout from psychodynamic psychotherapy for borderline personality disorder (BPD). Thirty-six BPD patients began an open-ended course of twice per week psychodynamic psychotherapy that was defined in a treatment manual and supervised. Dropout rates were 31% and 36% at 3 and 6 months of therapy, respectively. Survival analysis techniques demonstrated that age and hostility ratings predicted early dropout, with continuers more likely to be older and expressing lower levels of hostility than dropouts. Many variables hypothesized to predict dropout failed to do so. Both the positive and negative findings are discussed relative to the literature.

Submitted on April 18, 1994
Revised on August 11, 1994
Accepted on August 23, 1994




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