Personal growth Initiative: A robust and malleable predictor of treatment outcome for depressed partial hospital patients

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Background: Current methods for treating depressive disorders ineffectively treat large portions of patients. We need to identify malleable factors that predict treatment outcome and can be modified prior to or concurrently with treatment to enhance outcomes. We examined personal growth initiative (PGI) as a malleable predictor of treatment outcome for depressed patients in partial hospital treatment. Methods: Archival data were extracted from medical records of 521 adult patients with depression diagnoses (67.2% women) in a partial hospital program (2008 – 2010). Demographic data and admission and discharge scores for depression and PGI were extracted. ANCOVA assessed the extent to which reliable or clinically significant change in PGI predicted level of depression at discharge, controlling for admission depression levels. Results: PGI and depression were significantly correlated at admission. PGI scores increased significantly from admission to discharge. Reliable and clinically significant improvement in PGI each significantly, uniquely, and negatively predicted depression at discharge, adjusting for admission depression. Limitations: The correlational nature of the longitudinal design precludes definitive statements regarding causality. A large portion of the initial sample was dropped due to substantial missing data, yielding the final N = 521. Dropped patients had higher levels of depression at discharge and increased likelihood of leaving treatment against medical advice, raising concerns about potential other, unmeasured differences. Conclusions: Our findings confirm the utility of PGI as a malleable predictor of treatment outcome for depressed patients in partial hospital treatment and may have implications for using PGI-based interventions to enhance treatment outcomes.

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