Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment
Background: A comorbidity between Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD) is common, severely disabling, and hard to treat. The choice of an optimal psychotherapy based on patient characteristics remains challenging.Objective: This study develops models to pred...
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Taylor & Francis Group
2025-12-01
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| Series: | European Journal of Psychotraumatology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20008066.2025.2497161 |
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| author | Jakob Blaß Benjamin Iffland Philipp Herzog Tim Kaiser Thomas Elbert Carolin Steuwe |
| author_facet | Jakob Blaß Benjamin Iffland Philipp Herzog Tim Kaiser Thomas Elbert Carolin Steuwe |
| author_sort | Jakob Blaß |
| collection | DOAJ |
| description | Background: A comorbidity between Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD) is common, severely disabling, and hard to treat. The choice of an optimal psychotherapy based on patient characteristics remains challenging.Objective: This study develops models to predict the outcome of two psychotherapies for comorbid BPD and PTSD.Method: Data from two trials comparing Narrative Exposure Therapy (NET, N = 40) with Dialectical Behavior Therapy-based treatment (DBT-bt, N = 40) was analysed. A cross-validated genetic algorithm was used to detect baseline predictors of change in PTSD symptoms.Results: In the NET group higher education, more baseline PTSD symptoms, more traumatic experiences, fewer baseline BPD symptoms, and not taking antipsychotic medication predicted better treatment outcome. This model (RMSE = 8.98) outperformed the prediction of PTSD symptom reduction with baseline PTSD symptoms alone (RMSE = 10.07) or with all available predictor variables (RMSE = 12.97). Only more baseline PTSD symptoms were selected to predict a better treatment outcome after DBT-bt. This model (RMSE = 9.41) outperformed the prediction of change in PTSD symptoms with all available predictor variables (RMSE = 14.43).Conclusion: Differences in treatment outcome between NET and DBT-bt may be predictable at baseline, to identify which one of both treatments may be most beneficial for individual patients. The small sample size may restrict the generalizability of the results. |
| format | Article |
| id | doaj-art-d481ef2a93dc44738b3690c152e5e93d |
| institution | OA Journals |
| issn | 2000-8066 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj-art-d481ef2a93dc44738b3690c152e5e93d2025-08-20T02:16:02ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2497161Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatmentJakob Blaß0Benjamin Iffland1Philipp Herzog2Tim Kaiser3Thomas Elbert4Carolin Steuwe5Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, GermanyDepartment of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, GermanyDepartment of Psychology, Harvard University, Cambridge, MA, USADepartment of Methods and Evaluation, Freie Universität Berlin, Berlin, GermanyDepartment of Psychology, University of Konstanz, Konstanz, GermanyDepartment of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, GermanyBackground: A comorbidity between Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD) is common, severely disabling, and hard to treat. The choice of an optimal psychotherapy based on patient characteristics remains challenging.Objective: This study develops models to predict the outcome of two psychotherapies for comorbid BPD and PTSD.Method: Data from two trials comparing Narrative Exposure Therapy (NET, N = 40) with Dialectical Behavior Therapy-based treatment (DBT-bt, N = 40) was analysed. A cross-validated genetic algorithm was used to detect baseline predictors of change in PTSD symptoms.Results: In the NET group higher education, more baseline PTSD symptoms, more traumatic experiences, fewer baseline BPD symptoms, and not taking antipsychotic medication predicted better treatment outcome. This model (RMSE = 8.98) outperformed the prediction of PTSD symptom reduction with baseline PTSD symptoms alone (RMSE = 10.07) or with all available predictor variables (RMSE = 12.97). Only more baseline PTSD symptoms were selected to predict a better treatment outcome after DBT-bt. This model (RMSE = 9.41) outperformed the prediction of change in PTSD symptoms with all available predictor variables (RMSE = 14.43).Conclusion: Differences in treatment outcome between NET and DBT-bt may be predictable at baseline, to identify which one of both treatments may be most beneficial for individual patients. The small sample size may restrict the generalizability of the results.https://www.tandfonline.com/doi/10.1080/20008066.2025.2497161Borderline personality disorderposttraumatic stress disorderDialectical Behavior Therapy-based treatmentNarrative Exposure Therapytreatment outcomeprediction models |
| spellingShingle | Jakob Blaß Benjamin Iffland Philipp Herzog Tim Kaiser Thomas Elbert Carolin Steuwe Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment European Journal of Psychotraumatology Borderline personality disorder posttraumatic stress disorder Dialectical Behavior Therapy-based treatment Narrative Exposure Therapy treatment outcome prediction models |
| title | Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment |
| title_full | Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment |
| title_fullStr | Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment |
| title_full_unstemmed | Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment |
| title_short | Predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder: a machine learning approach to predict long-term outcome of Narrative Exposure Therapy vs. Dialectical Behavioral Therapy based treatment |
| title_sort | predicting the outcome of psychological treatments for borderline personality disorder and posttraumatic stress disorder a machine learning approach to predict long term outcome of narrative exposure therapy vs dialectical behavioral therapy based treatment |
| topic | Borderline personality disorder posttraumatic stress disorder Dialectical Behavior Therapy-based treatment Narrative Exposure Therapy treatment outcome prediction models |
| url | https://www.tandfonline.com/doi/10.1080/20008066.2025.2497161 |
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