The last aim of this study was to investigate whether different clusters of patients were differentially related to outcome. Indeed, some studies have suggested that patients with PDs not only show different trajectories of change during treatment, but that these different trajectories are also associated with different outcomes. For instance, that introjective patients changed primarily in higher levels of thought disorder, whereas anaclitic patients changed more in the more pathological forms of thought disorder. To the best of our knowledge, this is the first study to directly investigate possible associations between different trajectories of change and outcome in the psychoanalytic treatment of PDs. In line with findings of earlier studies, the results of this study showed that the psychoanalytic hospitalization-based treatment for PDs is indeed associated with changes in different aspects of PO, including representations of self and others, mentalization and felt safety. In addition, this study extends previous studies in that two different clusters of patients could be identified, which showed a distinct pattern of change in PO during and after treatment. On one hand, one cluster consisted of patients who showed a more fluctuating and thus less stable pattern of changes in PO during treatment and at follow-up. The other cluster consisted of patients showing more consistent improvement in PO both during and after treatment. Importantly, further analyses showed that these two clusters showed substantial differences in terms of pre-treatment personality features as assessed by the SCID-II. More specifically, results showed that the more fluctuating cluster seemed to be mainly characterized by anaclitic features as described by Blatt (2004, 2008), as was shown in higher scores on dependent, borderline, avoidant and depressive characteristics compared with patients from the stable cluster. Patients from the more stable cluster, in turn, tended to have higher scores on SCID-II narcissistic PD features, which is in line with Blatt’s suggestion that higher level personality disordered patients with introjective features are mainly characterized by narcissistic characteristics (Blatt, 2004, 2008). @)15-1.*$# This study including a longitudinal, multi-wave design as well as multi-trait, multi-method approach lends further support to the assumption that psychoanalytic hospitalization-based treatment of PD is associated with changes in PO. Finally, results of this study also suggest that different types of patients may differentially respond to different treatment factors, adding to the growing evidence for the importance of considering patient–treatment interactions in psycho-therapy research towards PO. G$#.1/.\! Prof. Rudi Vermote. University Psychiatric Centre, University of Leuven, Campus Kortenberg Leuvense-steenweg 517, 3070 Kortenberg, Belgium E-mail: rudi.vermote@uc-kortenberg.be, Website: www.uc-kortenberg.be
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