{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:55:11Z","timestamp":1792688111835,"version":"4.5.0"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Studying written life stories of patients with personality disorders (PDs) may enhance knowledge of how they understand themselves, others and the world around them. Comparing the construction of their life stories before psychotherapy to their reconstruction after psychotherapy may provide insight in therapeutic changes in the understandings of their lives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>As few studies addressed this topic, the current study explored changes in agency (i.e., perceived ability to affect change in life), and communion (i.e,, perceived connectedness to other persons) in written life stories of 34 patients with various PDs, before and after intensive psychotherapy treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Life stories showed a positive increase in agency from pre- to posttreatment, in particular regarding internal agency, societal success, and occupational success. No significant changes were observed for communion as a whole. However, the perceived number and quality of close relationships revealed a significant positive increase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The increased agency in the reconstruction of patients\u2019 life story after psychotherapy suggests that patients improved their perceived ability to affect change in their own lives. This can be seen as an important step in the treatment of PDs towards further recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1134796","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:36:40Z","timestamp":1678927000000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Life stories of patients with personality disorders before and after treatment: Change and stability in agency and communion"],"prefix":"10.3389","volume":"14","author":[{"given":"Silvia M.","family":"Pol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Schug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Chakhssi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerben J.","family":"Westerhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"ref1","volume-title":"Diagnostic and statistical manual of mental disorders (DSM-5\u00ae)","year":"2013"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1192\/bjp.bp.108.058552","article-title":"DSM-IV personality disorders in the WHO world mental health surveys","volume":"195","author":"Huang","year":"2009","journal-title":"Br J Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.biopsych.2006.09.019","article-title":"DSM-IV personality disorders in the National Comorbidity Survey Replication","volume":"62","author":"Lenzenweger","year":"2007","journal-title":"Biol Psychiatry"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1002\/pmh.1252","article-title":"Personality disorder prevalence in psychiatric outpatients: a systematic literature review","volume":"8","author":"Beckwith","year":"2015","journal-title":"Pers Ment Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e107748","DOI":"10.1371\/journal.pone.0107748","article-title":"A systematic review of economic evaluations of treatments for borderline personality disorder","volume":"9","author":"Brettschneider","year":"2014","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"259","DOI":"10.4088\/JCP.v69n0212","article-title":"The economic burden of personality disorders in mental health care","volume":"69","author":"Soeteman","year":"2008","journal-title":"J Clin Psychiatry"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1002\/jclp.23314","article-title":"Helping patients master core conflictual relationship themes in psychotherapy","volume":"78","author":"Grenyer","year":"2022","journal-title":"J Clin Psychol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"338","DOI":"10.4081\/ripppo.2018.338","article-title":"Metacognitive interpersonal therapy in group: A feasibility study","volume":"21","author":"Popolo","year":"2018","journal-title":"Res. Psychother."},{"key":"ref9","volume-title":"Schema Therapy: A Practitioner\u2019s Guide","author":"Young","year":"2003"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"CD005652","DOI":"10.1002\/14651858.CD005652","article-title":"Psychological therapies for people with borderline personality disorder","volume":"1","author":"Binks","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1016\/j.cpr.2013.08.003","article-title":"The effectiveness of evidence-based treatments for personality disorders when comparing treatment-as-usual and bona fide treatments","volume":"33","author":"Budge","year":"2013","journal-title":"Clin Psychol Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1001\/jamapsychiatry.2016.4287","article-title":"Efficacy of psychotherapies for borderline personality disorder: a systematic review and meta-analysis","volume":"74","author":"Cristea","year":"2017","journal-title":"JAMA Psychiat"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"CD005652","DOI":"10.1002\/14651858.CD005652.pub2","article-title":"Psychological therapies for people with borderline personality disorder","volume":"2012","author":"Stoffers","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.4172\/2161-0487.1000133","article-title":"A systematic review of potential mechanisms of change in psychotherapeutic interventions for personality disorder","volume":"4","author":"Forster","year":"2014","journal-title":"J Psychol Psychother"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1521\/pedi.2018.32.supp.129","article-title":"Mechanisms of change in treatments of personality disorders: commentary on the special section","volume":"32","author":"Gunderson","year":"2018","journal-title":"J Personal Disord"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1521\/pedi.2018.32.supp.134","article-title":"Mechanisms of change in treatments of personality disorders: commentary on the special section","volume":"32","author":"Kealy","year":"2018","journal-title":"J Personal Disord"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1007\/s11920-022-01379-4","article-title":"Future challenges in psychotherapy research for personality disorders","volume":"24","author":"Kramer","year":"2022","journal-title":"Curr Psychiatry Rep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1037\/pst0000172","article-title":"The alliance in adult psychotherapy: a meta-analytic synthesis","volume":"55","author":"Fl\u00fcckiger","year":"2018","journal-title":"Psychotherapy"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s11920-020-01162-3","article-title":"How personality disorders change in psychotherapy: a concise review of process","volume":"22","author":"Kramer","year":"2020","journal-title":"Curr Psychiatry Rep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"698655","DOI":"10.3389\/fpsyg.2021.698655","article-title":"Agency via awareness: a unifying meta-process in psychotherapy","volume":"12","author":"Gorlin","year":"2021","journal-title":"Front Psychol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1353\/sor.2004.0045","article-title":"Life as narrative","volume":"71","author":"Bruner","year":"2004","journal-title":"Soc Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1075\/ni.16.1.04mca","article-title":"The role of narrative in personality psychology today","volume":"16","author":"McAdams","year":"2006","journal-title":"Narrat Inq"},{"key":"ref23","volume-title":"The Art and Science of Personality Development","author":"McAdams","year":"2015"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1080\/10503307.2010.514960","article-title":"Narrative change in emotion-focused therapy: how is change constructed through the lens of the innovative moments coding system?","volume":"20","author":"Mendes","year":"2010","journal-title":"Psychother Res"},{"key":"ref25","article-title":"Narrative therapy and postmodernism","volume-title":"The Handbook of Narrative and Psychotherapy Practice, Theory and Research","author":"Polkinghorn","year":"2004"},{"key":"ref26","volume-title":"Narrative Psychology. 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and criterion validity of a computerized text analysis measure of reflective functioning","volume":"22","author":"Fertuck","year":"2012","journal-title":"Psychotherapy Res"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1037\/cns0000109","article-title":"The structure of past and future events in borderline personality disorder, eating disorder and obsessive-compulsive disorder","volume":"4","author":"Rasmussen","year":"2017","journal-title":"Psychology of Consciousness : Theory, Research, and Practice"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1177\/0020764015589133","article-title":"Personal recovery in personality disorder: systematic review and meta-synthesis of qualitative methods studies","volume":"62","author":"Shepherd","year":"2016","journal-title":"Int J Soc Psychiatry."},{"key":"ref50","volume-title":"Cognitive-Behavioral Treatment of Borderline Personality Disorder","author":"Linehan","year":"1993"},{"key":"ref51","first-page":"750","article-title":"Klinische dialectische gedragstherapie bij borderlinepersoonlijkheidsstoornis: Effect op klachten, coping, hechting en kwaliteit van leven","volume":"59","author":"Oostendorp","year":"2017","journal-title":"Tijdschr Psychiatr"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1037\/pst0000056","article-title":"Inpatient schema therapy for nonresponsive patients with personality pathology: changes in symptomatic distress, schemas, schema modes, coping styles, experienced parenting styles, and mental well-being","volume":"53","author":"Schaap","year":"2016","journal-title":"Psychotherapy"},{"key":"ref53","first-page":"241","article-title":"Inpatient schema therapy in adults with personality disorders: changes in schema modes, attachment style and general psychological functioning","volume":"44","author":"Hazendonk","year":"2018","journal-title":"Tijdschr Psychother"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1515\/TEXT.2008.018","article-title":"Small stories as a new perspective in narrative and identity analysis","volume":"28","author":"Bamberg","year":"2008","journal-title":"Text Talk"},{"key":"ref55","volume-title":"Diagnostic and Statistical Manual of Mental Disorders. Text Revision (DSM-IV-TR)","year":"2001"},{"key":"ref56","first-page":"17","article-title":"Drop-out bij klinisch psychotherapeutische behandeling van persoonlijkheidsproblematiek","volume":"52","author":"Cornelissen","year":"2010","journal-title":"Tijdschr Psychiatr"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"Elo","year":"2008","journal-title":"J Adv Nurs"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual Health Res"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1080\/10503300802326020","article-title":"The narrative reconstruction of psychotherapy and psychological health","volume":"18","author":"Adler","year":"2008","journal-title":"Psychother Res"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"Graneheim","year":"2004","journal-title":"Nurse Educ Today"},{"key":"ref62","volume-title":"Analysis in Qualitative Research","author":"Boeije","year":"2009"},{"key":"ref63","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1988"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1037\/0003-066X.48.12.1181","article-title":"The efficacy of psychological, educational, and behavioral treatment","volume":"48","author":"Lipsey","year":"1993","journal-title":"Conf Meta Anal Am Psychol"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1186\/s12888-018-1739-2","article-title":"The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: a systematic review and meta-analysis","volume":"18","author":"Chakhssi","year":"2018","journal-title":"BMC Psychiatry"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.brat.2011.12.00","article-title":"Changes in natural language use as an indicator of psychotherapeutic change in personality disorders","volume":"50","author":"Arntz","year":"2012","journal-title":"Behav Res Ther"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1080\/10503307.2013.845921","article-title":"Investigating the personality disorder psychotherapy process: the roles of symptoms, quality of affects, emotional dysregulation, interpersonal processes, and mentalizing","volume":"23","author":"Dimaggio","year":"2013","journal-title":"Psychother Res"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2023.1134796\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:36:52Z","timestamp":1678927012000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2023.1134796\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,16]]},"references-count":67,"alternative-id":["10.3389\/fpsyt.2023.1134796"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2023.1134796","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,16]]},"article-number":"1134796"}}