Advancement in the child attachment interview and the child and adolescent reflective functioning scale using a PDM-2 framework: case reports

open5siThe Child Attachment Interview (CAI) is a well-established semi-structured interview, widely used to identify attachment representations in middle childhood and adolescence. The application of the Child and Adolescent Reflective Functioning Scale (CRFS) to CAI narratives allows for an assessment of child mentalization, considered a strong predictor of attachment security. The 2nd edition of the Psychodynamic Diagnostic Manual (PDM-2) includes CAI and CRFS as valid and reliable assessment measures in order to assess the dominion of the Mental Functioning axis. The aim of the present paper is to investigate the informative power of CAI and CRFS for the overall understanding of mental functioning and personality in a PDM-2 framework. The present report includes the discussion of two clinical cases of school-aged children in applying the Psychodiagnostic Chart-Second Edition (PDC-2) to the CAI transcript. The first case concerns a young male, aged 10, suffering from Oppositional-Provocative Disorder (externalizing disorder), while the second case concerns a young female, aged 15, suffering from Somatic Symptoms Disorder (internalizing disorder). PDC-2 for children and adolescents was used. Data from the scoring of CAI and CRFS were combined with a systematic evaluation of the qualitative contents emerging from CAI transcripts. A detailed analysis suggests that both the CAI and CRFS are useful attachment-oriented measures, able to explore a child's mental states, and together with the application of PDC-2 they provide an essential contribution in the understanding of developmental psychopathology. Implications of this innovative approach for clinical assessment, treatment design, and interventions are further discussed.openBizzi, Fabiola; Locati, Francesca; Parolin, Laura; Shmueli-Goetz Yael; Brusadelli, EmanuelaBizzi, Fabiola; Locati, Francesca; Parolin, Laura; Shmueli-Goetz, Yael; Brusadelli, Emanuel

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