Cohen David
Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, CNRS UMR 7222, Institut des Systèmes Intelligents et Robotiques, GH Pitié-Salpétrière, AP-HP, Paris, France.
J Physiol Paris. 2011 Dec;105(4-6):211-9. doi: 10.1016/j.jphysparis.2011.09.010. Epub 2011 Sep 29.
The question of whether a psychodynamic view is compatible with experimental research is still a challenging issue-especially for child and adolescent psychopathology-despite the influence of psychoanalytic theory in this field until the 1980s. In this article, is explored the relationship between psychodynamic theory and experimental research using examples of evidence-based studies in the fields of (i) psychotherapeutic intervention assessment, (ii) placebo response in children and adolescents, (iii) unconscious lasting traumatic effects in children and adolescents, (iv) psychodynamic-oriented psychological testing. There are now a sufficient number of evidence-based studies to support the use of psychodynamic therapy in mental disorders, particularly in personality disorder and anxious/depressive disorder. In addition, placebo responses in children and adolescents with internalizing disorders are significantly higher in major depression compared to obsessive-compulsive disorder or other anxiety disorders, which highlights differential psychopathologies regarding the experience of loss. Also, using an experimental task, psychoanalysts are able to identify, without explicit knowledge and above the level of chance, healthy adults whose siblings had experienced cancer during childhood. This experiment suggests that implicit information regarding a participant's history is conveyed in interpersonal exchanges that can be intuitively perceived by judges experienced in listening to free associations from a psychodynamic perspective. Finally, psychodynamic-oriented psychological testing may predict the transition to schizophrenia in adolescents with a history of manic/mixed episodes. It can be concluded that there are no discrepancies between psychodynamic views and experimental data, whether one tests psychotherapeutic approaches, discusses data from other fields such as psychopharmacology, or designs experiments based on psychodynamic theory.
尽管直到20世纪80年代精神分析理论在该领域都有影响，但心理动力学观点是否与实验研究兼容的问题仍然是一个具有挑战性的问题——尤其是对于儿童和青少年精神病理学而言。在本文中，我们将通过以下领域基于证据的研究实例来探讨心理动力学理论与实验研究之间的关系：（i）心理治疗干预评估；（ii）儿童和青少年的安慰剂反应；（iii）儿童和青少年无意识的长期创伤影响；（iv）以心理动力学为导向的心理测试。现在有足够数量的基于证据的研究支持在精神障碍中使用心理动力学疗法，特别是在人格障碍和焦虑/抑郁障碍中。此外，与强迫症或其他焦虑障碍相比，患有内化障碍的儿童和青少年在重度抑郁症中的安慰剂反应明显更高，这突出了在丧失体验方面的不同精神病理学特征。而且，通过一项实验任务，精神分析学家能够在没有明确意识且高于随机水平的情况下，识别出其兄弟姐妹在童年时期经历过癌症的健康成年人。该实验表明，关于参与者历史的隐含信息在人际交流中得以传达，而从心理动力学角度倾听自由联想有经验的评判者能够直观地感知到这些信息。最后，以心理动力学为导向的心理测试可能预测有躁狂/混合发作史的青少年向精神分裂症的转变。可以得出结论，无论是测试心理治疗方法、讨论来自心理药理学等其他领域的数据，还是基于心理动力学理论设计实验，心理动力学观点与实验数据之间都不存在差异。
