Exploring the associations between psychodynamic constructs and psychopathology: A network approach

Abstract

Psychodynamic therapy effectively reduces symptomatology by focusing on underlying (unconscious) processes instead of symptoms. Nevertheless, the exact interrelationship between psychodynamic constructs and psychopathology remains unclear. This study uses network analysis to explore these associations. We computed a cross‐sectional partial correlation network between psychodynamic constructs (i.e., personality functioning, interpersonal relations, and active and passive modes of intrapsychic conflicts according to the Operationalized Psychodynamic Diagnostics [OPD] system) and psychopathology (i.e., depression and somatization) in a naturalistic sample of 341 adults registering for psychodynamic outpatient therapy. We estimated node centrality, node predictability, and bridge symptoms and used community detection analysis. Bootstrap methods were applied to assess network stability. Psychodynamic constructs and psychopathology resulted in separate but connected clusters. Personality functioning emerged as the most influential node in the network and was bridging the clusters. The network was found to be highly stable, allowing reliable interpretations. The results offer important insights on how psychodynamic constructs relate to psychopathology, which can be used to inform treatment approaches. The findings suggest that personality functioning may be an important intervention target. However, future research is needed to include a broader range of diagnoses. In addition, longitudinal studies may clarify the direction of causality.

How are psychodynamic conflicts associated with personality functioning? A network analysis

“…Additionally, the interview data enabled us to do a more fine-grained analysis of the levels of structural integration through also considering the individual subscales (structural dimensions) instead of only relying on the total score. This allows to detect association patterns between the conflicts and different aspects of structural integration, which had not been possible in a previous study ( Vierl et al, 2023 ).…”

“…Another limitation concerns the assessment of psychodynamic conflicts: we were not able to take the different modes of conflict coping (passive vs. active) into account, since in the OPD-2 interview this information is only rated for the main conflict. This limits the conclusions we can draw from the network, as the study by Vierl et al (2023) highlights the overall importance to differentiate between the modes of conflict coping. Moreover, the guilt conflict and oedipal conflict were less frequent in our sample (see Supplementary Table 1 ), which could have affected the results.…”

“…To the best of our knowledge, only one study so far has explored the association between OPD-2 constructs with the use of network analysis. Vierl et al (2023) have explored how the OPD-2 constructs (i.e., interpersonal relations, active and passive modes of conflict coping, and level of structural integration) are related with each other and with psychopathology (i.e., depression and somatization). The investigated psychodynamic constructs were assessed by the Inventory of Interpersonal Problems (IIP-32; Thomas et al, 2011 ), the OPD conflict questionnaire (OPD-CQ; Benecke et al, 2018 ), and the short version of the OPD structure questionnaire (OPD-SQS; Ehrenthal et al, 2015 ).…”

“…Depression and somatization were assessed with the Patient Health Questionnaire (PHQ; Kroenke et al, 2001 , 2002 ). Vierl et al (2023) used the global scores of each questionnaire as nodes, except for the OPD-CQ, where the active and passive modes of conflict coping were integrated as separate nodes into the network. They found that psychopathology and psychodynamic constructs formed separate clusters that were positively interrelated.…”

“…The aim of the present study was to explore the associations between psychodynamic conflicts and levels of structural integration according to the OPD-2 with the use of network analysis. The study is meant to overcome the methodological shortcomings in the study by Vierl et al (2023) , by using OPD-2 interview data and by including the conflicts and the structural dimensions as separate nodes into the network. The specific objectives of the study were (1) to examine the network structure to explore how conflicts and structural dimensions are inter-connected, (2) to investigate clusters in the network to determine whether the axes are statistically distinct constructs, (3) to identify the most central node(s) in the network and (4) to detect bridge nodes to examine which conflict is most strongly related to structural dimensions and vice versa.…”