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Robert M. Gordon
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Gordon, R.M. (2010). The Psychodynamic Diagnostic Manual (PDM). In I. Weiner and E. Craighead,
(Eds.) Corsinis Encyclopedia of Psychology (4th ed., volume 3, pp.1312-1315), Hoboken, NJ:
John Wiley and Sons.
on the P axis with different traits. The PDM classifies a depressive personality disorder
with the subtypes of introjective (self critical), anaclitic (high reactivity to loss and
rejection) and the converse manifestation: hypomanic personality disorder (high energy,
counter-depressive, fear of closeness). The PDM also makes treatment suggestions when
there is sufficient data. The introjective type tends to respond better to interpretations and
insight, while the anaclitic type tends to respond better to the actual therapeutic
relationship. The hypomanic type often flees from commitment and therefore does not
stay long enough in treatment. The PDM suggests emphasizing that the commitment to
the treatment is important to improvement. People with hypomanic personality disorders
are most likely to be at the borderline level favoring defenses such as idealization of self
and the devaluation others, as compared to those with depressive personalities who favor
defensives such as devaluation of self and the idealization of others.
Profile of Mental Functioning- M Axis
The second PDM dimension, the M axis- Mental Functioning is a detailed look at the
capacities that contribute to an individual's personality and overall level of psychological
health or disturbance. These are: the capacity for regulation, attention, and learning; the
capacity for relationships (including depth, range, and consistency); the quality of
internal experience (level of confidence and self-regard); the capacity for affective
experience, expression, and communication; the level of defensive patterns; the capacity
to form internal representations; the capacity for differentiation and integration; the selfobserving capacities (psychological-mindedness); and the capacity for internal standards
and ideals, that is a sense of morality.
Symptom Patterns: The Subjective Experience- S Axis
Lastly, the PDM considers the S axis- Manifest Symptoms and Concerns. These are the
DSM-IV-TR symptom patterns, but with an emphasis on the patients subjective
experience of the symptoms. The patient may evidence a few or many patterns, which
may or may not be related. The PDM does not regard them as highly demarcated
biopsychosocial phenomena. These symptom patterns should be seen in the context of the
person's personality (P axis) and mental functioning (M axis).
Next, the PDM looks at the emerging patterns of personality tendencies. These emerging
personality styles that may change or remain relatively stable throughout the course of
life. As with adults, we are asked to first assess the level of severity: normal emerging
personality patterns, moderately dysfunctional emerging personality patterns, and
severely dysfunctional emerging personality patterns. Then the PDM asks us to consider
the specific dysfunctional personality patterns: fearful of closeness/intimacy (schizoid);
suspicious/distrustful; sociopathic (antisocial); narcissistic; impulsive/explosive; selfdefeating; depressive; somatizing; dependent; avoidant/constricted, subtypecounterphobic; anxious; obsessive-compulsive; histrionic; dysregulated; and mixed/other.
Child and Adolescent Symptom Patterns: The Subjective Experience- SCA Axis
Finally, the PDM considers the SCA axis- child and adolescent symptom patterns and
subjective experience. The SCA axis looks at symptom patterns in a developmental,
dynamic context and the fact that each childs subjective experience of his or her
symptoms is unique. These include discerning healthy responses, developmental crises,
situational crises, and disorders of affect. The main symptoms categories are: anxiety
disorders; somatization (somatoform) disorders; affect/mood disorders (such as:
prolonged mourning/grief reaction, depressive disorders, bipolar disorders and
suicidality); disruptive behavior disorders; reactive disorders (such as: psychic trauma
and posttraumatic stress disorder); disorders of mental functioning (such as: psychotic
disorders and neuropsychological disorders); psychophysiologic disorders;
developmental disorders; and other disorders.
The Classification of Mental Health and Developmental Disorders in Infancy and Early
Childhood
The PDM classification of infant and early childhood disorders is unique and appropriate
to this age group. The primary diagnoses include the interactive disorders that involve
symptom patterns such as anxiety, depression and disruptive behaviors. Secondly, the
regulatory-sensory disorders which involve such symptoms regarding inattention, over
and under reactivity and sensory seeking. Thirdly are the neurodevelopmental disorders
of relating and communicating including the autism spectrum disorders.
References
Clemens, N. A. (2007). The psychodynamic diagnostic manual: A review. Journal of
Psychiatric Practice, 13(4), 258-260.
Ekstrom, S. (2007). Review of Psychodynamic Diagnostic Manual. The Journal of
Analytical Psychology, 52(1), 111-114.
Gordon, R.M. (2008). Early reactions to the PDM by Psychodynamic, CBT and Other
psychologists. Psychologist-Psychoanalyst, XXVI, 1, Winter, p.13.
Migone, P. (2006). La diagnosi in psicoanalisi: Present azione del PDM (Psychodynamic
Diagnostic Manual). [The psychoanalytic diagnosis: Presentation of the
Psychodynamic Diagnostic Manual (PDM).]. Psicoterapia e scienze umane,
40(4), 765-774.
PDM Task Force (2006). Psychodynamic Diagnostic Manual. Silver Spring, MD:
Alliance of Psychoanalytic Organizations.
Silvio, J. R. (2007). Review of Psychodynamic diagnostic manual. The Journal of the
American Academy of Psychoanalysis and Dynamic Psychiatry, 35(4), 681-685.