Purpose: Atheoretical and descriptive conceptualizations of eating disorders (EDs) have faced substantial criticism due to their limited ability to assess patients' subjective characteristics and experiences, as needed to determine the most appropriate treatment options. The present article provides an overview of the clinical and empirical literature supporting the potential contribution of the Psychodynamic Diagnostic Manual (PDM-2) to both diagnostic assessment and treatment monitoring.
Methods: Following a discussion of the most relevant shortcomings of current diagnostic models of EDs and a description of the rationale and structure of the PDM-2, evidence supporting the core PDM-2 dimensions of ED patients' subjective experiences (i.
The founding members of the Coalition for Psychotherapy Parity present Clinical Necessity Guidelines for Psychotherapy, Insurance Medical Necessity and Utilization Review Protocols, and Mental Health Parity. These guidelines support access to psychotherapy as prescribed by the clinician without arbitrary limitations on duration or frequency. The authors of the guidelines first review the evidence that psychotherapy is effective, cost-effective, and often provides a cost-offset in decreased overall medical expenses, morbidity, mortality, and disability.
View Article and Find Full Text PDFThis article reviews the theoretical and empirical contributions of Blatt's two-polarities model of personality development and psychopathology to the second edition of the Psychodynamic Diagnostic Manual (PDM-2). First, we briefly provide an overview of the manual's main features and describe the guiding principles of the revision process. We then discuss in more detail how Blatt's model, which is focused on the dialectic interaction between and dimensions in both normal and disrupted personality development, increases the PDM-2's theoretical and empirical comprehensiveness and clinical utility, especially concerning the classification and assessment of personality and overall mental functioning in adult populations.
View Article and Find Full Text PDFThe aim of this study is to explore the relationship between level of personality organization and type of personality disorder as assessed with the categories in the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006) and the emotional responses of treating clinicians. We asked 148 Italian clinicians to assess 1 of their adult patients in treatment for personality disorders with the Psychodiagnostic Chart (PDC; Gordon & Bornstein, 2012) and the Personality Diagnostic Prototype (PDP; Gazzillo, Lingiardi, & Del Corno, 2012) and to complete the Therapist Response Questionnaire (TRQ; Betan, Heim, Zittel-Conklin, & Westen, 2005). The patients' level of overall personality pathology was positively associated with helpless and overwhelmed responses in clinicians and negatively associated with positive emotional responses.
View Article and Find Full Text PDFThe rental of housing units by landlords to participants in Housing First (HF) programs is critical to the success of these programs. Therefore, it is important to understand the experiences of landlords with having these individuals as tenants. The paper presents findings of qualitative interviews with 23 landlords who rented to tenants from a HF program located in a small city and adjoining rural area in eastern Canada and in which approximately 75 % of tenants had been housed for at least six consecutive months at 2 years in the program.
View Article and Find Full Text PDFUnlabelled: Countertransference (CT) awareness is widely considered valuable for differential diagnosis and the proactive management of ethical dilemmas. We predicted that the more practitioners' theoretical orientation (TO) emphasizes insight into the dynamics of subjective mental life, the better they will be at using their CT expectations in differential diagnosis with high-risk patients. To test this hypothesis, we compared psychodynamic therapy (PDT) practitioners who emphasize insight into subjective mental life with practitioners who do not emphasize this epistemology.
View Article and Find Full Text PDFThe author argues that existing research on the outcome of psychoanalysis and the psychoanalytic therapies is sufficient to claim a solid basis in scientific evidence for psychodynamically oriented clinical work. She explores sociocultural trends that increase the probability that analytic therapists and academic researchers will misunderstand one another, and she discusses the problematic status of the randomized controlled trial as the "gold standard" of research. She urges readers to educate themselves about what the outcome research actually shows, to support empirical investigations of psychoanalytic theories and practice, to make alliances with therapists of other orientations, and to try to contribute to changing the terms in which policymakers and the public frame their understanding of mental health and mental suffering.
View Article and Find Full Text PDFThe author argues that research in the idiographic tradition is more conducive to effective clinical work than the uncritical adoption of specific "evidence-based therapies" for discrete symptomatic disorders. She views pressures on therapists to adopt evidence-based therapies without consideration of individual differences and personal subjectivity as the misapplication of a research paradigm to the clinical situation. Reviewing some recent empirical work on individuality and therapeutic process, she critiques efforts to formulate personality diagnosis on the basis of externally observable traits without attention to internal experience, and she contends that intrapsychic themes account for personality differences more powerfully than traits, even when traits are construed dimensionally.
View Article and Find Full Text PDFThis article describes, from the perspective of a participant in the process, the background of and rationale for the development of the Psychodynamic Diagnostic Manual (PDM), a classification system based on both long-standing clinical observation and recent empirical research. It was hoped that the PDM would compensate for some of the unintended negative consequences to practitioners and their clients of uncritical reliance on descriptive psychiatric taxonomies such as the Diagnostic and Statistical Manual of the American Psychiatric Association. A shared and motivating experience of the contributors to the PDM was dismay at how the dominance of a narrow, descriptive-psychiatry model has promoted the decline of the empirically sound and clinically valuable idiographic tradition, in which clients' difficulties are conceptualized in the context of their unique personalities, developmental challenges, and life contexts.
View Article and Find Full Text PDFAustralas Psychiatry
December 2008