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Akın A, Reichel PM, Weber EC, Kluge G, Goth K, Obbarius A, Seiffge-Krenke I, Sarrar L. [Associations between Personality Structure, Psychodynamic Conflicts and Defense Styles in Adolescents with Mental Health Problems]. Psychother Psychosom Med Psychol 2024; 74:157-164. [PMID: 38580307 DOI: 10.1055/a-2255-3572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
OBJECTIVES An exploration of the interrelationships between central psychodynamic constructs in adolescents with mental health problems was conducted. METHODS 230 adolescents (Mage=18.0±1.9) were assessed using the Structure and the Conflict Questionnaire of the Operationalized Psychodynamic Diagnosis System in Childhood and Adolescence and the Defense Style Questionnaire for Adolescents. RESULTS Controlling for the influence of gender, age, and socioeconomic status, low to moderate associations were revealed between increased psychodynamic conflict levels and immature defense styles (r=0.20 to 0.39, p<0.05 to 0.001) as wells as deficits in the personality structure and increased psychodynamic conflict levels (r=0.15 to 0.55, p<0.05 to p<0.001) or immature defense styles (r=0.30 to 0.69, p<0.001). Psychodynamic conflicts as well as defense styles could be predicted by the structural dimensions as well as age and sex (R2=0 .04 to 0.49, p<0.05 to 0.001). CONCLUSIONS Theory-compliant correlations were demonstrated. The findings are particularly relevant against the background of the revision of the classification of personality functioning (ICD-11) in childhood and adolescence.
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Affiliation(s)
- Aslı Akın
- Abteilung für Psychosomatik, Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum der Charité, Charité Universitätsmedizin Berlin
| | | | | | - Greta Kluge
- Psychologie, MSB Medical School Berlin GmbH, Berlin
| | - Kirstin Goth
- Kinder- und Jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Schweiz
- Kinder- und Jugendpsychiatrische Forschungsabteilung, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg
| | - Alexander Obbarius
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité Universitätsmedizin Berlin
| | | | - Lea Sarrar
- Psychologie, MSB Medical School Berlin GmbH, Berlin
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2
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Juen F, Reiffen-Züger B, Lehmhaus D, Prentl S, Moisl S, Züger M, Rexroth I, Marton MA, Maurer MH. [The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2024. [PMID: 38323523 DOI: 10.1024/1422-4917/a000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability Abstract: Objective: The OPD-CA2 manual for assessing psychodynamic aspects in children and adolescents is well established in clinical practice. However, publications regarding its reliability and validity are limited to (1) adolescents, (2) the structure of the first version of the manual and not to the comprehensive revision of the OPD-CA2, (3) the axes "structure" and (partly) "conflict" but not the axis "relationship," and (4) missing applicability in everyday clinical practice. Methodology: The present study comprised 42 children aged 6-12 years (age level 2 of the OPD-CA2), with and without mental illness, and assessed them using two randomly assigned raters. We assessed them using a low-structured diagnostic symbol game with miniature figurines and objects based on videotapes. We also tested the interrater reliability of the OPD-CA2 axes. Results: The overall assessment of structure and the assessment of the four subdimensions succeeded with good to very good agreement. We could also determine the presence of relevant conflict dynamics with very high agreement, while not recognizing specific conflicts in the clinical sample. Our assessment of the items of the relationship axis shows a low level of agreement. Conclusions: Overall, we can confirm the reliability of the OPD-CA2 for everyday clinical assessment in the younger age groups. Finally, we discuss which factors contribute to the heterogeneous picture.
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Affiliation(s)
| | - Bertke Reiffen-Züger
- Ärztliche Akademie für Psychotherapie von Kindern und Jugendlichen e. V. - München, Deutschland
| | - Dagmar Lehmhaus
- Ärztliche Akademie für Psychotherapie von Kindern und Jugendlichen e. V. - München, Deutschland
| | - Sabine Prentl
- Ärztliche Akademie für Psychotherapie von Kindern und Jugendlichen e. V. - München, Deutschland
| | - Sibylle Moisl
- Ärztliche Akademie für Psychotherapie von Kindern und Jugendlichen e. V. - München, Deutschland
| | - Markus Züger
- Ärztliche Akademie für Psychotherapie von Kindern und Jugendlichen e. V. - München, Deutschland
| | - Iris Rexroth
- Ärztliche Akademie für Psychotherapie von Kindern und Jugendlichen e. V. - München, Deutschland
| | | | - Martin H Maurer
- Institut für Physiologie und Pathophysiologie, Universität Heidelberg, Deutschland
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3
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Dixius A, Möhler E. Effects of a Standardized DBT-A Program on Identity Development in Adolescents. Brain Sci 2023; 13:1328. [PMID: 37759929 PMCID: PMC10526514 DOI: 10.3390/brainsci13091328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Identity diffusion plays a central role in the onset of borderline personality disorders. Dialectical Behavioral Therapy for Adolescents (DBT-A) is a treatment program for adolescents with emotional instability and dysregulation. The interest of this study is to examine the potential effects of a standardized and certified DBT-A therapy program on the identity development of adolescents in an inpatient setting. METHODS A total of 138 adolescents aged 13 to 18 years with symptoms of severe emotional instability were assessed before and after a certified and standardized 12-week in-patient DBT-A program targeting emotional regulation with the following standardized instruments: the Assessment of Identity Development in Adolescence (AIDA), Scale of the Experience of Emotions (SEE), and Symptom Checklist (SCL-90-R). RESULTS The results indicate a significant change in identity development, emotion regulation, and general symptoms of psychopathology after treatment with DBT-A. CONCLUSIONS In this large sample of adolescents, DBT-A significantly improved identity development and reduced identity diffusion, however, without a treatment-as-usual control group as a limitation. Nevertheless, our results may become clinically relevant for the prevention of chronic impairment in emotionally unstable adolescents.
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Affiliation(s)
- Andrea Dixius
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrucken, Germany;
- SHG Clinic for Child and Adolescent Psychiatry, 66119 Saarbrucken, Germany
| | - Eva Möhler
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrucken, Germany;
- SHG Clinic for Child and Adolescent Psychiatry, 66119 Saarbrucken, Germany
- Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany
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4
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Akın A, Goth K, Seiffge-Krenke I, Obbarius A, Winter SM, Sarrar L. Operationalized Psychodynamic Diagnostic of Adolescents in Light of the New ICD-11 Model of Personality Functioning: Personality Structure, Psychodynamic Conflicts, and Mental Health Problems. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1095. [PMID: 37508592 PMCID: PMC10378630 DOI: 10.3390/children10071095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023]
Abstract
The International Classification of Diseases and Related Health Problems, 11th Revision introduced a fully dimensional approach to personality disorders which conceptionally converges with the long-standing psychodynamic understanding of psychopathology through underlying intra- and interpersonal impairments. In this study, the diagnostic contributions of the two psychodynamic concepts of personality structure and psychodynamic conflicts were investigated through the comparison of self-report data of 189 adolescents with mental health problems and 321 mentally healthy controls. The study results reveal that adolescents with mental health problems show significantly higher impairments in all four domains of personality structure and significantly higher levels of several psychodynamic conflicts. Further, adolescents with different mental health problems significantly differ regarding the impairments in the personality structure domains and several levels of psychodynamic conflicts. While higher structural impairments are shown in adolescents with eating and anxiety disorders, higher levels of the passive self-worth conflict persist in adolescents with depressive disorders, and higher levels of the passive identity conflict are affecting adolescents with eating disorders. The findings suggest that a standardized diagnostic assessment of personality structure and psychodynamic conflicts in adolescent patients could contribute to a deeper understanding of mental health problems and appropriate treatment planning through the detection of underlying intra- and interpersonal impairments.
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Affiliation(s)
- Aslı Akın
- Unit for Psychosomatic Medicine, Institute of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité-Medical Heart Center of Charité and German Heart Institute Berlin, 13353 Berlin, Germany
- Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, 4002 Basel, Switzerland
- Department of Child and Adolescent Psychiatry, University Clinics Saarland, 66421 Homburg, Germany
| | | | - Alexander Obbarius
- Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany
| | - Sibylle M Winter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Lea Sarrar
- Department of Psychology, Faculty of Sciences, MSB Medical School Berlin, 14197 Berlin, Germany
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5
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Sarrar L, Goth K. Defense Mechanisms Reloaded in the Light of Impaired Personality Functioning: An Attempt of Clarification and Simplification Resulting in the DSQ-22-A for Adolescents. Front Psychiatry 2022; 13:866837. [PMID: 35722566 PMCID: PMC9198968 DOI: 10.3389/fpsyt.2022.866837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
With the upcoming ICD-11, the diagnostic guidelines for personality disorders will change fundamentally to a dimensional severity concept, including the evaluation of several domains of personality functioning. Moreover, the lifetime perspective will allow this diagnosis even in early adolescence, providing the opportunity for early detection and intervention. In psychodynamic understanding, defense mechanisms are considered to be a part of the "personality structure", which is one axis in the related diagnostic system (OPD) and showed great similarities to the concept of personality functioning. The most common inventory to assess defense mechanisms is the Defense Style Questionnaire, especially the DSQ-40, which has unfortunately not been specifically adapted to younger ages yet. Using an age-adapted version of the DSQ-40 with simplified formulations, a thorough empirical item analyses and selection was performed, including a face-validity check of the items by experienced therapists and assessments for item correlations, factor structure, reliability, construct and clinical validity in a german clinical and school sample containing 396 adolescents. Though several improvements, similar problems as reported for the adult DSQ versions concerning face-validity and coherence of the item pairs (2-item-method) to represent the single defense mechanisms were obtained. Thus, not all item pairs could be kept and a shortened version DSQ-22-A for adolescents with good psychometric properties was build. The three resulting defense categories adaptive, neurotic and maladaptive showed acceptable scale reliabilities (0.63, 0.56, 0.68), sound factor structure and convincing convergent and clinical validity in terms of highly significant correlations with impaired personality structure according to the OPD-CA2-SQ as well as with PHQ-D depression and somatic symptoms, especially for the maladaptive defense category (0.75, 0.44, 0.34). Likewise, the maladaptive defense category differed highly significant (p = 0.000) and with a large effect size of d = 0.9 standard deviations between adolescents from the school and the clinical sample. The DSQ-22-A can be recommended for use in adolescents for research, diagnostics and therapy planning, especially with regard to personality functioning and structure. Possible fundamental changes concerning some basic operationalization's of the defense mechanisms and the 2-item-method were suggested for international discussion.
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Affiliation(s)
- Lea Sarrar
- Department of Psychology, Faculty of Sciences, Medical School Berlin (MSB), Berlin, Germany
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Base, Basel, Switzerland
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Seiffge-Krenke I, Hau S. The Operationalized Psychodynamic Diagnostic for Children and Adolescents (OPD-CA-2): a new diagnostic method to determine psychodynamic constructs. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2021.2012107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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7
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Rosén T, Hau S. Operationalized psychodynamic diagnosis in childhood and adolescence (OPD-CA-2)—A useful tool for improving diagnoses of psychological illnesses. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2021.2001677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Stephan Hau
- Department of Psychology, Stockholm University, Stockholm, Sweden
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8
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Seiffge-Krenke I, Escher F. [Psychodynamic conflicts: Development of a questionnaire for the assessment by patients and their therapists]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2021; 49:361-376. [PMID: 34503361 DOI: 10.1024/1422-4917/a000822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Psychodynamic conflicts: Development of a questionnaire for the assessment by patients and their therapists Abstract. The OPD-CA conflict questionnaire represents a means of recording modes of coping with unconscious conflicts according to the Operationalized Psychodynamic Diagnostics (OPD-CA) for patients and their therapists. To select the items for the conflict questionnaire, we combined the expert ratings and psychometric quality criteria using a sample of 427 adolescents (53.6 % patients) and 44 therapists. The short version contains 28 items, which include 7 intrapsychic conflicts and their active and passive coping modes (total ICC = .855; p < .001). We found expected differences between healthy and clinically abnormal adolescents with a higher level of conflicts among outpatients. A comparison of the therapist's version with two different methods (assessment according to the sheet in OPD-CA and the conflict questionnaire) produced consistent assessments of the same patient both in the expert assessment (total ICC = .861; p < .001) and from the point of view of 52 participants in two OPD-KJ training courses (total ICC = .825; p < .001).
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9
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[Changes in the Level of Conflict through Psychodynamic Psychotherapy: The Perspective of Adolescent Patients and their Therapists]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:423-444. [PMID: 34187340 DOI: 10.13109/prkk.2021.70.5.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Changes in the level of structure and conflict are, in addition to alleviating of symptoms, central goals of psychodynamic therapies. This study examines this question with a focus on intrapsychic development-impairing conflicts in the sense of the OPD-CA on a sample of 121 adolescents and their 46 therapists. At the beginning, in the middle and at the end of the M = 73.27 hours (SD = 17.40) therapy, they assessed the level of conflict and structure from the patients' and the therapists' perspectives. The results show large effect sizes with regard to the reduction of the overall conflict level from the point of view of the therapists (η2 = .33). While the therapists reported higher initial values in almost all intrapsychic conflicts and significant linear decreases over time, the therapy tended to sensitize the patients to the existence of an intrapsychic development-impairing conflict. With regard to the structural level, which was already quite good at the start of treatment, there were no significant changes over time. However, the overall structural level and the conflict scales contributed to the explanation of the variance in the severity of symptoms at the end of therapy.
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10
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Cropp C, Claaßen B. [Reliability and validity of the OPD-CA Conflict Questionnaire in an adolescent inpatient sample]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2021; 49:377-385. [PMID: 34128699 DOI: 10.1024/1422-4917/a000809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Reliability and validity of the OPD-CA Conflict Questionnaire in an adolescent inpatient sample Abstract. Abstracts: The OPD-CA Conflict Questionnaire (OPD-CA-CQ) assesses intrapsychic conflicts according to the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence (OPD-CA-2) in a simple and time-efficient way. The questionnaire exists in two versions: as a self-report measure for adolescents and as an informant-report measure for therapists. We examined the psychometric criteria of the questionnaire (internal consistency, construct validity, convergent validity) in a sample of adolescent inpatients. Overall, results were heterogeneous: Some scales of the questionnaire seem to be suitable for assessing the corresponding intrapsychic conflicts, while others require a critical review. Particularly the conflict scales closeness vs. distance and submission vs. control need revision.
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Affiliation(s)
- Carola Cropp
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Asklepios Fachklinikum Tiefenbrunn.,Institut für Psychologie, Universität Kassel
| | - Bastian Claaßen
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Asklepios Fachklinikum Tiefenbrunn
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11
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Seiffge-Krenke I, Posselt M. [Quality measurement in psychodynamic psychotherapy: Diagnosis-specific courses, the influence of different informants, and their view of moderators of change]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 49:19-35. [PMID: 33170099 DOI: 10.1024/1422-4917/a000760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Quality measurement in psychodynamic psychotherapy: Diagnosis-specific courses, the influence of different informants, and their view of moderators of change Abstract. This study uses a naturalistic design to assess the course and effectiveness of long-term psychodynamic therapies from the perspective of adolescent patients and their mothers. It looks at the context of different moderators of change, including the characteristics of the patient, the therapist, and the therapy. Assessments of the internalizing, externalizing, and overall symptom burden using the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL) were collected on 161 patients and their mothers at three timepoints - the beginning, middle, and end of therapy. The assessments of both informants showed a decrease in symptoms over the course of therapy with similar effect sizes (η2 = .25 for the patients, η2 = .31 for their mothers). The adolescents differentiated more between the diagnosis groups, reported higher symptom intensities at the beginning, and saw fewer changes in the second half of the therapy than their mothers. Psychodynamic long-term therapy was particularly effective for internalizing disorders according to both parents and patients. Both informants differed, however, in their evaluation of short-term therapy. An examination of the moderators of change in the mothers' evaluation (difference value of the total symptom burden between the beginning and end) showed that the therapist and therapy characteristics predicted change, whereas for adolescents, the patient characteristics have the greatest influence.
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12
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[Associations Between Personality Structure, Unconscious Conflicts, and Defense Styles in Adolescence]. Prax Kinderpsychol Kinderpsychiatr 2020; 69:666-683. [PMID: 33146087 DOI: 10.13109/prkk.2020.69.7.666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Associations Between Personality Structure, Unconscious Conflicts, and Defense Styles in Adolescence According to the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence, associations between personality structure, unconscious conflicts, and defense styles are postulated. So far, an empirical investigation of these associations in mentally healthy adolescents is missing. The present study aims to contribute to the understanding of unconscious conflicts as well as the unconscious defense of conflicts by elucidating intrapersonal factors within a normative sample. Furthermore, the aim of this study is to analyse the extent to which sex, age, and socioeconomic status are related to personality structure, unconscious conflicts, and defense styles. A total of 175 adolescents (Mage = 16.98 ± 1.83) participated in the study. Measurement instruments were the Structure and the Conflict Questionnaire of the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence as well as the Defense Style Questionnaire for Adolescents and Young Adults. Sex-specific differences were found for the passive identity conflict. Regarding the personality structure, unconscious conflicts or defense styles, associations with age or socioeconomic status of adolescents were not found. The associations between personality structure, unconscious conflicts, and defense styles as postulated by OPD-CA-2 were empirically proven regarding the passive self-worth, guilt, and identity conflict as well as the active guilt conflict. Overall, this study indicates the low presence of unconscious conflicts in mentally healthy adolescents and the possibility of elucidating these conflicts by means of personality structure and defense styles.
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13
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Seiffge-Krenke I, Schmeck K. [Operationalized Psychodynamic Diagnosis in Childhood and Adolescence: Findings on the axes interpersonal relations and structure]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 47:385-387. [PMID: 31495323 DOI: 10.1024/1422-4917/a000659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Klaus Schmeck
- Lehrstuhl für Kinder- und Jugendpsychiatrie, Universitäre Psychiatrische Kliniken (UPK), Abteilung für Kinder- und Jugendpsychiatrische Forschung, Basel
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14
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Bock A, Huber E, Müller S, Henkel M, Sevecke K, Schopper A, Steinmayr-Gensluckner M, Wieser E, Benecke C. [Levels of structural integration in adolescents and the relationship to later mental disorders - A longitudinal study]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 47:400-410. [PMID: 30939974 DOI: 10.1024/1422-4917/a000656] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Levels of structural integration in adolescents and the relationship to later mental disorders - A longitudinal study Abstract. Objective: Psychological disorders frequently manifest during adolescence. Because of the multifactorial influencing factors, the courses of the diseases are heterogeneous, from relapsing-remitting to chronic. This study investigated whether the level of structural integration of the Operationalized Psychodynamic Diagnostics in Childhood and Adolescence (OPD-CA) correlates with later symptomatic burden. Method: This long-term study assessed the levels of structural integration according to the OPD-CA of 60 adolescents (mean age = 15.6; SD = 0.9). Seven years later, we then measured symptomatic burden (SCID axis I and II) and overall burden (GAF, BSI-GSI) (73.3 % follow-up participation rate). Results: The results showed high correlations between deficient structural integration in adolescence and later symptoms and overall burden in early adulthood. Conclusion: The follow-up examination after a 7-year time period showed significant correlations, which argue for the predictive value of structural integration. This suggests that early specific treatment, e.g., in the form of intensive psychotherapy, be urgently recommended in order to influence this course.
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Affiliation(s)
- Astrid Bock
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Hall in Tirol, Österreich
| | - Eva Huber
- Institut für Psychologie, Universität Innsbruck, Österreich
| | - Steffen Müller
- Institut für Psychologie, Universität Kassel, Deutschland
| | - Miriam Henkel
- Institut für Psychologie, Universität Kassel, Deutschland
| | - Kathrin Sevecke
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Hall in Tirol, Österreich.,Universitätsklinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Medizinische Universität Innsbruck, Österreich
| | - Alexander Schopper
- Institut für Psychologie, Universität Innsbruck, Österreich.,Klinik für Kinder- und Jugendpsychiatrie und Psychosomatik, DRK-Kinderklinik Siegen , Deutschland
| | - Maria Steinmayr-Gensluckner
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Hall in Tirol, Österreich
| | - Elke Wieser
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Hall in Tirol, Österreich
| | - Cord Benecke
- Institut für Psychologie, Universität Kassel, Deutschland
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