Machine learning detects predictors of symptom severity and impulsivity after dialectical behavior therapy skills training group in borderline personality disorder
Por:
Jimenez, Said, Angeles-Valdez, Diego, Rodriguez-Delgado, Andres, Fresan, Ana, Miranda, Edgar, Alcala-Lozano, Ruth, Duque-Alarcon, Xochitl, Arango de Montis, Ivan, Garza-Villarreal, Eduardo A.
Publicada:
1 jul 2022
Resumen:
Only 50% of the patients with Borderline Personality Disorder (BPD)
respond to psychotherapies, such as Dialectical Behavioral Therapy
(DBT), this might be increased by identifying baseline predictors of
clinical change. We use machine learning to detect clinical features
that could predict improvement/worsening for severity and impulsivity of
BPD after DBT skills training group. To predict illness severity, we
analyzed data from 125 patients with BPD divided into 17 DBT
psychotherapy groups, and for impulsiveness we analyzed 89 patients
distributed into 12 DBT groups. All patients were evaluated at baseline
using widely self-report tests; similar to 70% of the sample were
randomly selected and two machine learning models (lasso and Random
forest [Rf]) were trained using 10fold cross-validation and compared
to predict the post-treatment response. Models' generalization was
assessed in similar to 30% of the remaining sample. Relevant variables
for DBT (i.e. the mindfulness ability ``non-judging'', or
``non-planning'' impulsiveness) measured at baseline, were robust
predictors of clinical change after six months of weekly DBT sessions.
Using 10-fold cross-validation, the Rf model had significantly lower
prediction error than lasso for the BPD severity variable, Mean Absolute
Error (MAE) lasso - Rf = 1.55 (95% CI, 0.63-2.48) as well as for
impulsivity, MAE lasso - Rf = 1.97 (95% CI, 0.57-3.35). According to Rf
and the permutations method, 34/ 613 significant predictors for severity
and 17/613 for impulsivity were identified. Using machine learning to
identify the most important variables before starting DBT could be
fundamental for personalized treatment and disease prognosis.
Filiaciones:
Jimenez, Said:
Facultad de Psicología, Universidad Nacional Autónoma de México, México City, Mexico
Univ Nacl Autonoma Mexico, Fac Psicol, Mexico City, DF, Mexico
Angeles-Valdez, Diego:
Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
Univ Nacl Autonoma Mexico, Inst Neurobiol, Campus Juriquilla, Queretaro, Mexico
Rodriguez-Delgado, Andres:
Clínica de Trastorno Limite de la Personalidad, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Mexico City, Mexico
Inst Nacl Psiquiatria Ramon Fuente Muniz, Clin Trastorno Lumite Personalidad, Mexico City, DF, Mexico
Fresan, Ana:
Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
Inst Nacl Psiquiatr Ramon Fuente Muniz, Subdirecc Invest Clin, Mexico City, DF, Mexico
Miranda, Edgar:
Clínica de Trastorno Limite de la Personalidad, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Mexico City, Mexico
Inst Nacl Psiquiatria Ramon Fuente Muniz, Clin Trastorno Lumite Personalidad, Mexico City, DF, Mexico
Alcala-Lozano, Ruth:
Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
Inst Nacl Psiquiatr Ramon Fuente Muniz, Subdirecc Invest Clin, Mexico City, DF, Mexico
Duque-Alarcon, Xochitl:
Clinica de Especialidades en Neuropsiquiatria, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
Inst Seguridad & Serv Sociales Trabajadores Estad, Clin Especialidades Neuropsiquiatria, Mexico City, DF, Mexico
Arango de Montis, Ivan:
Clínica de Trastorno Limite de la Personalidad, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Mexico City, Mexico
Inst Nacl Psiquiatria Ramon Fuente Muniz, Clin Trastorno Lumite Personalidad, Mexico City, DF, Mexico
Garza-Villarreal, Eduardo A.:
Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
Univ Nacl Autonoma Mexico, Inst Neurobiol, Campus Juriquilla, Queretaro, Mexico
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