Toward a Psychodynamic Diagnostic Manual (PDM–2)-Oriented Approach to Psychotherapy Research

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 one year of TransferenceFocused Psychotherapy (TFP), was interviewed by using the Adult Attachment Interview (AAI) at the baseline and after the treatment. The Psychodiagnostic Chart-2(PDC-2) of the Psychodynamic Diagnostic Manual-2 Edition was applied to AAIs, specifically focusing on the Level of Personality Organization (LPO) and Mental Functioning Capacities (MAxis). The Structured Clinical Interview for DSM–IV Axis II Personality Disorders (SCID-II) was also used at the end of treatment to provide a categorical measure of therapeutic outcomes. Results showed significant improvements in terms of Overall Level of Personality Severity and in almost all M-Axis domains. Moreover, a significant reduction in the BPD criteria number was observed and discussed in light of the overall improvements at the psychic-structures level. To the best of our knowledge, this is the first study assessing therapeutic outcomes by 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.