Diagnosis in infancy and childhood: towards a Psychodynamic assessment

Diagnosis during infancy and childhood represents a 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 a consideration of specific characteristics for this age group. The aim of this work is to present the assessment process in infancy conducted on the basis of the Second Edition of Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood (IEC 0-3) of the Psychodynamic Diagnostic Manual (PDM-2 Task Force,in press). Description of work: 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 offers a comprehensive and multi-axial approach to the diagnosis, which integrates the description of symptom patterns with their underlying dynamics and the individual’s subjective experience,relational patterns, and emotional functioning. Furthermore, this section has been expanded with the introduction for each axis of clinician-friendly assessment scales whereby the clinician could formulate a clinical relevant profile of the infant or child. Moreover, most relevant assessment tools for clinical use complete each axis. A Psychodiagnostic Chart that summarizes the outcome of the assessment process will be illustrated. The Chart includes: functional emotional developmental capacities (Axis II), regulatory-sensory processing capacity (Axis III), relational patterns and disorders (Axis IV), and other medical and neurological diagnoses (Axis V) as determinant components of a multi-axial diagnosis to infant disorders (Axis I). Conclusion: The IEC of the PDM-2 represents a great improvement in the diagnosis and treatment of mental disorder in infancy and provides significant advantages to the assessment from a psychodynamic perspective. Further example of the assessment process in infancy are needed since they show great utility for the clinicians.