Do Relational and Self-Definitional Traits Influence Deep Brain Stimulation Device Preference?

• Type of Material: Article
• Authors: Andrea Crowell, Emory University; Stefanie Speanburg, Emory University; Lydia N Denison, Emory University; Helen Mayberg, Emory University; Nadine Kaslow, Emory University
• Language: English
• Date: 2019-10-01
• Publisher: EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019, American Psychological Association
• Final Published Version (URL): http://dx.doi.org/10.1037/pap0000249
• Title of Journal or Parent Work: PSYCHOANALYTIC PSYCHOLOGY
• Volume: 36
• Issue: 4
• Start Page: 313
• End Page: 320
• Grant/Funding Information: This research was supported by grants from the Hope for Depression Research Foundation and the National Institutes of Health (UH3NS103550) to Dr. Mayberg
• Keywords: SUBTYPES; Social Sciences; CONNECTEDNESS; anaclitic; introjective; MEDICATION; Psychology; depression; DEPRESSIVE EXPERIENCES QUESTIONNAIRE; DEPENDENCY; Psychology, Psychoanalysis; D PERSONALITY; CRITICISM; VALIDATION; NEEDINESS; deep brain stimulation; Psychology, Clinical; CONNECTIVITY

Abstract

Personality psychodynamics have been shown to influence individual responses to psychiatric treatments, including medication. Increasingly, neuromodulation therapies have become available for severe and treatment-resistant depression. This study aims to evaluate patient response to an implanted neurostimulator battery within the framework of relational versus self-definitional personality traits. Relational development is interpersonally oriented, and disruptions along this pathway lead to dependency on others for a sense of security and self-worth. Self-definitional development is characterized by autonomy strivings, and disruptions lead to self-critical feelings of failing to meet expectations. Patients drawn from a larger study of deep brain stimulation (DBS) for treatment-resistant depression were switched from a non-rechargeable to a rechargeable battery type to maintain stimulation therapy. This switch entailed taking greater personal responsibility for device maintenance and allowed for fewer battery replacement surgeries. Twenty-six patients completed the Depressive Experiences Questionnaire (DEQ) and a questionnaire surveying their preference for DBS battery type. Results show that the DEQ Dependency subscale, and more specifically the neediness component of the subscale, is associated with patient preference for the non-rechargeable battery. This suggests that individuals with higher relational needs prefer treatment options that increase contact with and need for medical caregivers and may prioritize this aspect of an intervention over alternative considerations. In contrast, individuals with more self-critical personality traits did not have a battery type preference, indicating that self-definitional needs were not predictive of battery preference. The link between an individual's personality psychodynamics and response to biomedical interventions, including neuromodulation and treatments that incorporate medical devices, deserves further attention.