The overall aim of the present proposal is to test the validity of a new method for assessing psychodynamic change resulting from psychotherapy. This study will also delineate the relationships between specific psychodynamic conflicts as measured by the Psychodynamic Conflict Rating Scales and the diagnoses studied. The method to be validated will be tested in a naturalistic study of neurotic, adjustment, depressed or personality disordered outpatients entering psychotherapy in both clinic and private practice settings. The initial subject assessment requires a videotaped psychodynamic interview that is then rated in a two-stage procedure. At the time of the follow-up (outcome) assessment, the subject is reinterviewed and the psychodynamic rating procedure is repeated with some modifications to yield change scores for individual conflicts as well as for global change. This psychodynamic assessment of change will be validated by comparison to concurrent measures from follow-up interviews containing data on symptoms, the course of any axis I syndromes, impulsive behavior, social role and global functioning, and psychodynamic functioning (defensive/coping) in response to actual life events. Subjects will be followed until three months after terminating psychotherapy or until one year, whichever occurs first. To validate this method, the following hypotheses will be tested: 1) three conflicts will be associated with depression; 2) the investigators' previous findings on the relationships of specific conflicts to personality disorders will be replicated; 3) neurotic and adjustment disorders will be associated with fewer and/or more focal conflicts; 4) the test method of assessing psychodynamic change will correlate with concurrent change measures and correlate with global and psychodynamic functioning, especially in healthier subjects where symptom measures will not be useful change measures; 5) the psychodynamic assessment will offer important predictors of change. If this new method is validated, it would make a reliable and valid contribution to future studies of the efficacy of specific types of psychotherapy for specific psychodynamic conflicts or diagnoses, and it would offer a significant methodological advance to the study of psychodynamic functioning.
| Perry, J C (2001) A pilot study of defenses in adults with personality disorders entering psychotherapy. J Nerv Ment Dis 189:651-60 |
| Perry, J C; Augusto, F; Cooper, S H (1989) Assessing psychodynamic conflicts: I. Reliability of the idiographic conflict formulation method. Psychiatry 52:289-301 |
