Diagnosis in infancy and childhood: towards a psychodynamic assessment

Diagnosis during infancy and childhood represents one of the most difficult issues for clinicians: relational and developmental features of child psychopathology, as well as specificity of symptomatology, interweave with the complexity of individual and family functioning, requiring the consideration of specific characteristics for this age group. The aim of this paper is to present the assessment process conducted on the basis of the classification of mental health and developmental disorders of the PDM-2. The second edition of the Psychodynamic Diagnostic Manual (PDM Task Force, 2006) represents a great improvement in the diagnosis and treatment of mental disorders, which provides significant advantages to the assessment and diagnosis from a psychodynamic perspective. The special section dedicated to mental health disorders in infancy and early childhood (IEC) proposes a diagnostic system grounded on a biopsychosocial developmental model, specifically focused on 0 to 3 years olds. This section, as well as older children (4-10) section, has been expanded and provided with clinician-friendly and assessment-relevant tools, integrating the description of symptom patterns with their underlying dynamics and the individual’s subjective experience, relational patterns, and emotional functioning. The paper offers an example of an assessment process of a three-and-half-year- old boy based on this multi-axial approach, considering also the importance of integrating information with the PDM-2 section dedicated to older children, 4-10. Clinical implications for treatment will be discussed, in order to highlight the strengths and advantages of the PDM-2 as well as its utility for clinicians.