Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition
Depressive disorders in adolescence pose unique challenges for assessment and treatment, particularly due to their high comorbidity with various personality disorders. Moreover, young depressed patients may elicit very intense and difficult-to-manage emotional responses in therapists (in this conte...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2024-03-01
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| Series: | Research in Psychotherapy |
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| Online Access: | https://www.researchinpsychotherapy.org/rpsy/article/view/752 |
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| author | Annalisa Tanzilli Flavia Fiorentino Marianna Liotti Gabriele Lo Buglio Ivan Gualco Vittorio Lingiardi Carla Sharp Riccardo Williams |
| author_facet | Annalisa Tanzilli Flavia Fiorentino Marianna Liotti Gabriele Lo Buglio Ivan Gualco Vittorio Lingiardi Carla Sharp Riccardo Williams |
| author_sort | Annalisa Tanzilli |
| collection | DOAJ |
| description |
Depressive disorders in adolescence pose unique challenges for assessment and treatment, particularly due to their high comorbidity with various personality disorders. Moreover, young depressed patients may elicit very intense and difficult-to-manage emotional responses in therapists (in this context, countertransference). This study aimed at empirically identifying specific personality disorders (or subtypes) among adolescents with depressive pathology and exploring distinct countertransference patterns emerging in their psychotherapy: 100 adolescents (58 with depressive disorders; 42 with other clinical conditions) were assessed by their respective clinicians (n=100) using the psychodiagnostic chart-adolescent of the Psychodynamic Diagnostic Manual (PDM) - second edition, and the therapist response questionnaire for adolescents. Results showed that depressed adolescent patients exhibited marked traits of four personality subtypes (i.e., depressive, anxious-avoidant, narcissistic, and borderline) characterized by different levels of mental functioning and personality organization. These subtypes were predictably related to specific clinicians’ emotional responses, even when controlling for the intensity of depressive symptomatology. Patients with depressive or anxious-avoidant personality subtypes evoked more positive countertransference responses, whereas patients with narcissistic or borderline subtypes elicited strong and hard-to-face emotional responses in therapists. Consistent with the next edition of the PDM, the study emphasizes the importance of comprehensive psychodynamic assessment in the developmental age, which frames depressive disorders in the context of accurate emerging personality and mental functioning profiles. This approach, which also relies heavily on the clinician’s subjective experience in therapy, provides crucial information on how to specifically tailor interventions that more effectively meet the needs of adolescents with these heterogeneous and complex clinical conditions.
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| first_indexed | 2024-04-24T17:41:35Z |
| format | Article |
| id | doaj.art-42c8169741334a678a1305dbb536b15a |
| institution | Directory Open Access Journal |
| issn | 2499-7552 2239-8031 |
| language | English |
| last_indexed | 2024-04-24T17:41:35Z |
| publishDate | 2024-03-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Research in Psychotherapy |
| spelling | doaj.art-42c8169741334a678a1305dbb536b15a2024-03-27T23:34:49ZengPAGEPress PublicationsResearch in Psychotherapy2499-75522239-80312024-03-0127110.4081/ripppo.2024.752Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third editionAnnalisa Tanzilli0Flavia Fiorentino1Marianna Liotti2Gabriele Lo Buglio3Ivan Gualco4Vittorio Lingiardi5Carla Sharp6Riccardo Williams 7Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of RomeDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of RomeDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of RomeDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of RomeCenter for Individual and Couple Therapy, GenoaDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of RomeDepartment of Psychology, University of Houston, TXDepartment of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome Depressive disorders in adolescence pose unique challenges for assessment and treatment, particularly due to their high comorbidity with various personality disorders. Moreover, young depressed patients may elicit very intense and difficult-to-manage emotional responses in therapists (in this context, countertransference). This study aimed at empirically identifying specific personality disorders (or subtypes) among adolescents with depressive pathology and exploring distinct countertransference patterns emerging in their psychotherapy: 100 adolescents (58 with depressive disorders; 42 with other clinical conditions) were assessed by their respective clinicians (n=100) using the psychodiagnostic chart-adolescent of the Psychodynamic Diagnostic Manual (PDM) - second edition, and the therapist response questionnaire for adolescents. Results showed that depressed adolescent patients exhibited marked traits of four personality subtypes (i.e., depressive, anxious-avoidant, narcissistic, and borderline) characterized by different levels of mental functioning and personality organization. These subtypes were predictably related to specific clinicians’ emotional responses, even when controlling for the intensity of depressive symptomatology. Patients with depressive or anxious-avoidant personality subtypes evoked more positive countertransference responses, whereas patients with narcissistic or borderline subtypes elicited strong and hard-to-face emotional responses in therapists. Consistent with the next edition of the PDM, the study emphasizes the importance of comprehensive psychodynamic assessment in the developmental age, which frames depressive disorders in the context of accurate emerging personality and mental functioning profiles. This approach, which also relies heavily on the clinician’s subjective experience in therapy, provides crucial information on how to specifically tailor interventions that more effectively meet the needs of adolescents with these heterogeneous and complex clinical conditions. https://www.researchinpsychotherapy.org/rpsy/article/view/752Depressive disorderspersonality disorderscountertransferenceadolescencePDM |
| spellingShingle | Annalisa Tanzilli Flavia Fiorentino Marianna Liotti Gabriele Lo Buglio Ivan Gualco Vittorio Lingiardi Carla Sharp Riccardo Williams Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition Research in Psychotherapy Depressive disorders personality disorders countertransference adolescence PDM |
| title | Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition |
| title_full | Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition |
| title_fullStr | Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition |
| title_full_unstemmed | Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition |
| title_short | Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition |
| title_sort | patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders toward the i psychodynamic diagnostic manual i third edition |
| topic | Depressive disorders personality disorders countertransference adolescence PDM |
| url | https://www.researchinpsychotherapy.org/rpsy/article/view/752 |
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