The Psychodynamic Diagnostic Manual (PDM) and the PDM-2: Opportunities to Significantly Affect the Profession

Abstract

In this article, we discuss the development of the Psychodynamic Diagnostic Manual (PDM) and its upcoming revision, the PDM-2. We describe the processes by which the PDM-2 is being developed and highlight important differences across both editions. At the same time, we emphasize the value of assessing internalized experience and how that can be of use toward the diagnostic assessment process.

Acknowledgments

Portions of this article were presented at the 2013 Annual Meeting of the Psychoanalytic Psychodynamic Research Society, New York, NY and at the 2013 Annual Meeting of the Division of Psychoanalysis, Boston, MA.

Notes

¹ The American Psychoanalytic Association, the International Psychoanalytical Association, Division 39 (Psychoanalysis) of the American Psychological Association, the American Academy of Psychoanalysis and Dynamic Psychiatry, and the National Membership Committee on Psychoanalysis in Clinical Social Work (subsequently renamed the American Association for Psychoanalysis in Clinical Social Work).

² Eaton, Krueger, South, Simms, and Clark (2010) argued empirically that personality dimensions are more robust than prototypes; however, they created their prototypes from self-reported ratings of trait dimensions from mostly nonpatients, and not from ratings of patients from practicing clinicians.

³ In revising the PDM, there has been discussion about what the manual should be called. For instance, it has been questioned whether the term Psychodynamic should be replaced with the terms Practitioner or Psychological. The idea behind this possible change is that clinicians with alternative theoretical orientations (e.g., cognitive-behavioral, interpersonal, biological, humanistic, or family-systems) may not take an interest in a manual that is psychodynamic. Furthermore, by removing psychodynamic from the title, the editor would be inviting nonpsychodynamically oriented clinicians and researchers who seek a better diagnostic system. Although this latter point is fraught with potential pitfalls, it has been argued that including individuals of alternative orientations could strengthen the empirical grounding and wider clinical appeal of the manual (Bornstein, 2015; this issue). This issue continues to be discussed by the PDM-2 Work Group.

⁴ P-axis does not consider some traditional DSM personality disorders, such as Schizotypal and Borderline. This arose out of early work with the SWAP in which many patients diagnosed with Schizotypal PD actually were best classified on the Schizoid prototype, and those diagnosed with Borderline PD were on the Histrionic, Emotionally Dysregulated, Dependent, and Masochistic factors.

⁵ Huprich (2009) has provided a comprehensive list of instruments relevant to M-axis assessment.

⁶ However, the field of neuropsychoanalysis is quickly growing—see http://www.neuropsa.org.uk/.

Additional information

Notes on contributors

Steven K. Huprich

Steven K. Huprich, Ph.D., is Professor and Director of Clinical Training for the clinical psychology Ph.D. program at Wichita State University.  He is the Editor of the Journal of Personality Assessment, Associate Editor for the Journal of Personality Disorders, and has authored and edited six professional books on personality disorders, personality assessment, psychodynamic therapy, and clinical psychology.

Nancy McWilliams

Nancy McWilliams, Ph.D., teaches at Rutgers University’s Graduate School of Applied and Professional Psychology and practices in Flemington, New Jersey. Author of Psychoanalytic Diagnosis (1994, rev. ed. 2011), Psychoanalytic Case Formulation (1999), and Psychoanalytic Psychotherapy (2004), and associate editor of the Psychodynamic Diagnostic Manual (2006), she is a former president of Division 39 (Psychoanalysis) of the American Psychological Association. She is one of three psychotherapists chosen by APA Press (2011) to be videotaped for purposes of training in a comparison and contrast of major psychotherapeutic approaches.

Vittorio Lingiardi

Vittorio Lingiardi, M.D., is a psychiatrist and psychoanalyst, and Full Professor and Director of the Clinical Psychology Specialization Program at the Faculty of Medicine and Psychology, Sapienza University, Rome. He is a member of the Society for Psychotherapy Research (SPR Italy) and of the International Association of Relational Psychoanalysis and Psychotherapy (IARPP). Dr. Lingiardi, along with Nancy McWilliams and Robert Wallerstein, comprise the Steering and Scientific Committee of the new edition of the Psychodynamic Diagnostic Manual (PDM-2; Guilford Press, expected for 2015).

Robert F. Bornstein

Robert F. Bornstein, Ph.D., is with the Derner Institute of Advanced Psychological Studies at Adelphi University.

Francesco Gazzillo

Francesco Gazzillo, Ph.D., is at the Department of Dynamic and Clinical Psychology, Sapienza University, Rome.

Robert M. Gordon

Robert M. Gordon, Ph.D., ABPP, is diplomated in Clinical Psychology and in Psychoanalysis, and is in independent practice in Allentown, Pennsylvania.