Do Practitioners Find A Psychodynamic Taxonomy Useful?

Abstract

What do typical practitioners think of a psychodynamic taxonomy? A sample of mental health practitioners from a wide range of educational backgrounds and theoretical orientations (N= 438) were asked to rate the utility of the Psychodynamic Diagnostic Manual's taxonomy with a recently seen patient. Our survey indicated that the percent rated as "helpful -very helpful" in understanding their patient for each diagnostic taxon were: level of personality organization 75%, personality disorders 62%, mental functioning 67%, and cultural/contextual dimension 41%. Only 30.5% rated symptoms as "helpful-very helpful" in understanding their patient. All differences were statistically significant. These results suggest that our earlier findings with 61, mainly psychodynamic assessment experts are likely to be generalizable to most non-psychodynamic practitioners. The results suggest that a useful taxonomy should include the psychodynamic categories: personality organization (healthy, neurotic, borderline, psychotic), personality syndromes (ex: schizoid, histrionic, narcissistic, etc.), and mental functioning (ex: capacity for intimacy, defensive level, self observing capacity, etc.) in addition to manifest symptoms. Our results are also generalizable to the forth coming PDM-2, which has the same diagnostic categories as the PDM. We recommend teaching the PDM/PDM-2 along with the ICD and DSM.