A Multidimensional Assessment of Therapeutic Outcomes: Toward a Psychodynamic Diagnostic Manual (PDM-2)-Oriented Approach to Psychotherapy Research

• Published in: Psychoanalytic psychology 2023-04, Vol.40 (2), p.128-133
• Main Authors: Patriarca, Eleonora, Tanzilli, Annalisa, Brusadelli, Emanuela, Lingiardi, Vittorio, Grenyer, Brin F. S.
• Format: Article
• Language: English
• Subjects: Borderline Personality Disorder; Diagnostic and Statistical Manual; Female; Human; Integrative Psychotherapy; Male; Psychodynamics; Psychotherapy; Treatment Outcomes
• ISSN: 0736-9735; 1939-1331
• DOI: 10.1037/pap0000455

The Psychodynamic Diagnostic Manual-2nd edition (PDM-2) stresses the importance of putting the complex person back at the center of the diagnostic, therapeutic, and research process, fostering the integration between categorical and dimensional classifications, and emphasizing both individual variations and commonalities. Accordingly, the manual aims to promote a new impetus in the psychotherapy research field, trying to bridge the gap between empirical and clinical perspectives. In the present study, a sample of 12 patients diagnosed with borderline personality disorder (BPD), who underwent 1 year of transference-focused psychotherapy, was interviewed using the Adult Attachment Interview (AAI) at baseline and after treatment. The Psychodiagnostic Chart-2 (PDC-2) of the PDM-2 was applied to AAIs, specifically focusing on the level of personality organization and mental functioning capacities (M-Axis). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Axis II Personality Disorders was also used to provide a categorical measure of therapeutic outcomes. As expected, a significant reduction in the DSM BPD criteria number was observed after treatment. More importantly, there were improvements in terms of overall level of personality severity in almost all PDC-2 M-Axis domains. To the best of our knowledge, this is the first study to show psychodynamic therapeutic outcomes using the PDM-2 framework. Findings underline the importance of promoting a multidimensional approach that integrates descriptive and functional understandings of treatment outcomes, highlighting the relevant contribution of the clinically sensitive and diagnostically accurate PDM-2 approach. ⟪心理动力学诊断手册-2⟫第2版(PDM-2)强调了将复杂的人重新置于诊断、治疗和研究过程中心的重要性,促进了分类和维度分类之间的整合,并同时强调了个体的差异和共性。因此,该手册旨在促进心理治疗研究领域的新动力,试图弥合实证和临床观点之间的差距。在本研究中,对12名被诊断患有边缘型人格障碍(BPD)的患者进行了抽样调查,他们接受了一年的移情焦点心理治疗(TFP),在基线时和治疗后,使用成人依恋访谈(AAI)进行了访谈。心理动力学诊断手册-2版的心理诊断图表-2(PDC-2)被应用于AAI,特别关注人格组织和心理功能能力水平(M轴)。DSM-5 Axis II型人格障碍(SCID-II)的结构化临床访谈也用于提供治疗结果的分类测量。正如预期的那样,在治疗后观察到DSM BPD标准数显著减少。更重要的是,几乎所有PDC-2 M轴域的人格严重程度的总体水平都有所改善。据我们所知,这是第一项使用PDM-2 M轴框架显示心理动力学治疗结果的研究。研究结果强调了促进多维方法的重要性,该方法整合了对治疗结果的描述性和功能性理解,强调了临床敏感和诊断准确的PDM-2方法的相关贡献。