The overall aim of the present proposal is to test the validity of a new method for assessing psychodynamic change resulting from psychotherapy. The method requires an initial psychodynamic interview and a two stage rating procedure that yields first, an idiopathic conflict formulation, and second, scores on a predefined list of conflicts using the Psychodynamic Conflict Rating Scales. Dynamic change is assessed at one and two years of follow-up using a modification of the initial procedure. This method will be tested in a naturalistic study of 60 neurotic, depressive, or personality disordered outpatients entering psychotherapy in both clinic and private practice settings. Symptom and dynamic status will be independently measured over a two year follow-up period. Assessment procedures will include the course of any DSM-III axis I disorder, problems with impulse control, and psychosocial role functioning. Dynamic assessments will compare the new method with improvement in defenses and coping with prospectively gathered life events.
The specific aims are methodological and clinical. The methodological aims include testing the reliability and stability of both initial and outcome psychodynamic assessment procedures, as well as comparing them with the CCRT method of Luborsky. The clinical aims include determining the relationship between select diagnoses and dynamic conflicts at intake and determining the relationship between symptomatic and dynamic improvement. Dynamic status at one year will be used to predict lasting recovery at two years, over and above what symptom status at one year predicts. This will help answer the question of whether clinicians should attend to issues of dynamic recovery beyond attending to symptomatic improvement. 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. It will advance the study of psychodynamic treatments.
| 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 |
