Vierl Larissa, Juen Florian, Benecke Cord, Hörz-Sagstetter Susanne
Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany.
Department of Psychology, University of Kassel, Kassel, Germany.
Personal Ment Health. 2023 Feb;17(1):40-54. doi: 10.1002/pmh.1559. Epub 2022 Jul 25.
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.
心理动力疗法通过关注潜在的（无意识的）过程而非症状，有效地减轻了症状。然而，心理动力结构与精神病理学之间的确切相互关系仍不明确。本研究使用网络分析来探索这些关联。我们在一个为心理动力门诊治疗登记的341名成年人的自然样本中，计算了心理动力结构（即根据操作性心理动力诊断[OPD]系统的人格功能、人际关系以及心理内部冲突的主动和被动模式）与精神病理学（即抑郁和躯体化）之间的横断面偏相关网络。我们估计了节点中心性、节点可预测性和桥梁症状，并使用了社区检测分析。应用自助法来评估网络稳定性。心理动力结构和精神病理学形成了各自独立但相互连接的集群。人格功能成为网络中最具影响力的节点，并连接着各个集群。该网络被发现具有高度稳定性，从而能够进行可靠的解释。研究结果为心理动力结构与精神病理学之间的关系提供了重要见解，可用于为治疗方法提供参考。研究结果表明，人格功能可能是一个重要的干预靶点。然而，未来的研究需要纳入更广泛的诊断范围。此外，纵向研究可能会阐明因果关系的方向。
