https://doi.org/10.4081/ripppo.2024.752
Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the Psychodynamic Diagnostic Manual - third edition
Submitted: January 21, 2024
Accepted: March 16, 2024
Published: March 27, 2024
Accepted: March 16, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Depressive disorders in adolescence pose unique challenges for assessment and treatment, particularly due to their high comorbidity with various personality disorders. Moreover, young depressed patients may elicit very intense and difficult-to-manage emotional responses in therapists (in this context, countertransference). This study aimed at empirically identifying specific personality disorders (or subtypes) among adolescents with depressive pathology and exploring distinct countertransference patterns emerging in their psychotherapy: 100 adolescents (58 with depressive disorders; 42 with other clinical conditions) were assessed by their respective clinicians (n=100) using the psychodiagnostic chart-adolescent of the Psychodynamic Diagnostic Manual (PDM) - second edition, and the therapist response questionnaire for adolescents. Results showed that depressed adolescent patients exhibited marked traits of four personality subtypes (i.e., depressive, anxious-avoidant, narcissistic, and borderline) characterized by different levels of mental functioning and personality organization. These subtypes were predictably related to specific clinicians’ emotional responses, even when controlling for the intensity of depressive symptomatology. Patients with depressive or anxious-avoidant personality subtypes evoked more positive countertransference responses, whereas patients with narcissistic or borderline subtypes elicited strong and hard-to-face emotional responses in therapists. Consistent with the next edition of the PDM, the study emphasizes the importance of comprehensive psychodynamic assessment in the developmental age, which frames depressive disorders in the context of accurate emerging personality and mental functioning profiles. This approach, which also relies heavily on the clinician’s subjective experience in therapy, provides crucial information on how to specifically tailor interventions that more effectively meet the needs of adolescents with these heterogeneous and complex clinical conditions.
Alaie, I., Ssegonja, R., Philipson, A., von Knorring, A. L., Möller, M., von Knorring, L., Ramklint, M., Bohman, H., Feldman, I., Hagberg, L., & Jonsson, U. (2021). Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden: a 25-year longitudinal cohort study. Social Psychiatry and Psychiatric Epidemiology, 56(11), 1993-2004. doi: 10.1007/s00127-021-02056-2.
DOI: https://doi.org/10.1007/s00127-021-02056-2
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
DOI: https://doi.org/10.1176/appi.books.9780890425596
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text revision). American Psychiatric Publishing.
DOI: https://doi.org/10.1176/appi.books.9780890425787
Binder, P. E., Holgersen, H., & Høstmark Nielsen, G. (2008). Re-establishing contact: a qualitative exploration of how therapists work with alliance ruptures in adolescent psychotherapy. Counselling & Psychotherapy Research, 8(4), 239-245. doi: 10.1080/14733140802363167.
DOI: https://doi.org/10.1080/14733140802363167
Blatt, S. J. (2004). Experiences of depression: theoretical, clinical, and research perspectives. American Psychological Association Publishing. doi: 10.1037/10749-001.
DOI: https://doi.org/10.1037/10749-000
Bodden, D. H. M., Stikkelbroek, Y., & Dirksen, C. D. (2018). Societal burden of adolescent depression, an overview and cost-of-illness study. Journal of Affective Disorders, 241, 256-262. doi: 10.1016/j.jad.2018.06.015.
DOI: https://doi.org/10.1016/j.jad.2018.06.015
Brøsholen, P., Ulberg, R., Dahl, H. J., & Thorén, A. (2022). Therapists’ emotional responses in individual therapy with depressed adolescents: an evaluation of the data structure of the feeling-word checklist-28. International Journal of Environmental Research and Public Health, 19(15), 9496. doi: 10.3390/ijerph19159496.
DOI: https://doi.org/10.3390/ijerph19159496
Chanen, A. M. (2022). Debate: it is time to stop turning a blind eye to personality disorder in young people. Child and Adolescent Mental Health, 27(2), 194-195. doi: 10.1111/camh.12554.
DOI: https://doi.org/10.1111/camh.12554
Cheek, J., Kealy, D., Joyce, A. S., & Ogrodniczuk, J. S. (2018). Interpersonal problems associated with narcissism among psychiatric outpatients: a replication study. Archives of Psychiatry and Psychotherapy, 20(2), 837-842. doi: 10.12740/APP/90328.
DOI: https://doi.org/10.12740/APP/90328
Cirasola, A., & Midgley, N. (2023). The alliance with young people: where have we been, where are we going?. Psychotherapy, 60(1), 110-118. doi: 10.1037/pst0000461.
DOI: https://doi.org/10.1037/pst0000461
Cirasola, A., Midgley, N., Fonagy, P., IMPACT Consortium, & Martin, P. (2021). The alliance-outcome association in the treatment of adolescent depression. Psychotherapy, 58(1), 95-108. doi: 10.1037/pst0000366.
DOI: https://doi.org/10.1037/pst0000366
Clayborne, Z. M., Varin, M., & Colman, I. (2019). Systematic review and meta-analysis: adolescent depression and long-term psychosocial outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 58(1), 72-79. doi: 10.1016/j.jaac.2018.07.896.
DOI: https://doi.org/10.1016/j.jaac.2018.07.896
Di Giuseppe, M., Gennaro, A., Lingiardi, V., & Perry, J. C. (2019). The role of defense mechanisms in emerging personality disorders in clinical adolescents. Psychiatry, 82(2), 128-142. doi: 10.1080/00332747.2019.1579595.
DOI: https://doi.org/10.1080/00332747.2019.1579595
Feenstra, D. J., Busschbach, J. J. V., Verheul, R., & Hutsebaut, J. (2011). Prevalence and comorbidity of axis I and axis II disorders among treatment refractory adolescents admitted for specialized psychotherapy. Journal of Personality Disorders, 25(6), 842-850. doi: 10.1521/pedi.2011.25.6.842.
DOI: https://doi.org/10.1521/pedi.2011.25.6.842
Freudenstein, O., Valevski, A., Apter, A., Zohar, A., Shoval, G., Nahshoni, E., Weizman, A., & Zalsman, G. (2012). Perfectionism, narcissism, and depression in suicidal and nonsuicidal adolescent inpatients. Comprehensive Psychiatry, 53(6), 746-752. doi: 10.1016/j.comppsych.2011.08.011.
DOI: https://doi.org/10.1016/j.comppsych.2011.08.011
Friborg, O., Martinsen, E. W., Martinussen, M., Kaiser, S., Overgård, K. T., & Rosenvinge, J. H. (2014). Comorbidity of personality disorders in mood disorders: a meta-analytic review of 122 studies from 1988 to 2010. Journal of Affective Disorders, 152-154, 1-11. doi: 10.1016/j.jad.2013.08.023.
DOI: https://doi.org/10.1016/j.jad.2013.08.023
Gabbard, G. O. (2009). Transference and countertransference: developments in the treatment of narcissistic personality disorder. Psychiatric Annals, 39(3), 129-136. doi: 10.3928/00485713-20090301-03.
DOI: https://doi.org/10.3928/00485713-20090301-03
Gander, M., Buchheim, A., & Sevecke, K. (2023). Personality disorders and attachment trauma in adolescent patients with psychiatric disorders. Research on Child and Adolescent Psychopathology, 52(3), 457-471. doi: 10.1007/s10802-023-01141-1.
DOI: https://doi.org/10.1007/s10802-023-01141-1
Gunderson, J. G., Stout, R. L., Shea, M. T., Grilo, C. M., Markowitz, J. C., Morey, L. C., Sanislow, C., Yen, S., Zanarini, M. C., Keuroghlian, A. S., McGlashan, T. H., & Skodol, A. E. (2014). Interactions of borderline personality disorder and mood disorders over 10 years. Journal of Clinical Psychiatry, 75(8), 829-834. doi: 10.4088/JCP.13m08972.
DOI: https://doi.org/10.4088/JCP.13m08972
Ha, C., Balderas, J. C., Zanarini, M. C., Oldham, J., & Sharp, C. (2014). Psychiatric comorbidity in hospitalized adolescents with borderline personality disorder. Journal of Clinical Psychiatry, 75(5), e457-e464. doi: 10.4088/JCP.13m08696.
DOI: https://doi.org/10.4088/JCP.13m08696
Hatkevich, C., Penner, F., & Sharp, C. (2019). Difficulties in emotion regulation and suicide ideation and attempt in adolescent inpatients. Psychiatry Research, 271, 230-238. doi: 10.1016/j.psychres.2018.11.038.
DOI: https://doi.org/10.1016/j.psychres.2018.11.038
Hawes, M. T., Szenczy, A. K., Klein, D. N., Hajcak, G., & Nelson, B. D. (2021). Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychological Medicine, 52(14), 3222-3230. doi: 10.1017/S0033291720005358.
DOI: https://doi.org/10.1017/S0033291720005358
Hennissen, V. C., Meganck, R., Van Nieuwenhove, K., Norman, U. A., Loeys, T., & Desmet, M. (2019). Therapists’ responses toward dependent (Anaclitic) and self-critical (Introjective) depressed outpatients: a multilevel approach. Psychotherapy, 56(2), 193-204. doi: 10.1037/pst0000213.
DOI: https://doi.org/10.1037/pst0000213
Herman, K. C., Ostrander, R., Walkup, J. T., Silva, S. G., & March, J. S. (2007). Empirically derived subtypes of adolescent depression: latent profile analysis of co-occurring symptoms in the treatment for adolescents with depression study (TADS). Journal of Consulting and Clinical Psychology, 75(5), 716-728. doi: 10.1037/0022-006X.75.5.716.
DOI: https://doi.org/10.1037/0022-006X.75.5.716
Huprich, S. K., Defife, J., & Westen, D. (2014). Refining a complex diagnostic construct: subtyping dysthymia with the Shedler-Westen assessment procedure-II. Journal of Affective Disorders, 152–154(1), 186-192. doi: 10.1016/j.jad.2013.09.008.
DOI: https://doi.org/10.1016/j.jad.2013.09.008
Kernberg, O. F. (1967). Borderline personality organization. Journal of the American Psychoanalytic Association, 15(3), 641-685. doi: 10.1177/000306516701500309.
DOI: https://doi.org/10.1177/000306516701500309
Kernberg, O. F. (1984). Severe personality disorders: psychotherapeutic strategies. Yale University Press.
Kernberg, P. F., Weiner, A. S., & Bardenstein, K. K. (2000). Personality disorders in children and adolescents. Basic Books.
Koelen, J. A., Luyten, P., Eurelings-Bontekoe, L. H., Diguer, L., Vermote, R., Lowyck, B., & Bühring, M. E. (2012). The impact of level of personality organization on treatment response: a systematic review. Psychiatry, 75(4), 355-374. doi: 10.1521/psyc.2012.75.4.355.
DOI: https://doi.org/10.1521/psyc.2012.75.4.355
Lamkin, J. (2018). Interpersonal functioning of narcissistic individuals and implications for treatment engagement. In A. D. Hermann, A. B. Brunell, J. D. Foster (Eds), Handbook of trait narcissism: key advances, research methods, and controversies (pp. 463-470). Springer International Publishing.
DOI: https://doi.org/10.1007/978-3-319-92171-6_50
Lampe, L., & Malhi, G. S. (2018). Avoidant personality disorder: current insights. Psychology Research and Behavior Management, 11, 55-66. doi: 10.2147/PRBM.S121073.
DOI: https://doi.org/10.2147/PRBM.S121073
Lingiardi, V., & McWilliams, N. (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). Guilford Press.
Lingiardi, V., & McWilliams, N. (in press). Psychodynamic diagnostic manual, PDM-3 (3rd ed). Guilford Press.
Liotti, M., Milesi, A., Spitoni, G. F., Tanzilli, A., Speranza, A. M., Parolin, L., Campbell, C., Fonagy, P., Lingiardi, V., & Giovanardi, G. (2023). Unpacking trust: the Italian validation of the epistemic trust, mistrust, and credulity questionnaire (ETMCQ). PloS One, 18(1), e0280328. doi: 10.1371/journal.pone.0280328.
DOI: https://doi.org/10.1371/journal.pone.0280328
Loades, M. E., St Clair, M. C., Orchard, F., Goodyer, I., & Reynolds, S. (2022). Depression symptom clusters in adolescents: a latent class analysis in a clinical sample. Psychotherapy Research, 32(7), 860-873. doi: 10.1080/10503307.2022.2030498.
DOI: https://doi.org/10.1080/10503307.2022.2030498
Malberg, N., Malone, J., Midgley, N., & Speranza, M. (2017). Psychodiagnostic chart–adolescent (PDC-A). In V. Lingiardi & N. McWilliams (Eds.), Psychodynamic Diagnostic Manual, 2nd ed. (PDM-2) (pp. 1024-1027). Guilford Press.
Midgley, N., Parkinson, S., Holmes, J., Stapley, E., Eatough, V., & Target, M. (2015). Beyond a diagnosis: the experience of depression among clinically-referred adolescents. Journal of Adolescence, 44, 269-279. doi: 10.1016/j.adolescence.2015.08.007.
DOI: https://doi.org/10.1016/j.adolescence.2015.08.007
Moselli, M., Frattini, C., Williams, R., & Ronningstam, E. (2021). The study of motivation in the suicidal process: the motivational interview for suicidality. Frontiers in Psychiatry, 11, 598866. doi: 10.3389/fpsyt.2020.598866.
DOI: https://doi.org/10.3389/fpsyt.2020.598866
Moselli, M., Casini, M. P., Frattini, C., & Williams, R. (2023). Suicidality and personality pathology in adolescence: a systematic review. Child Psychiatry and Human Development, 54(2), 290-311. doi: 10.1007/s10578-021-01239-x.
DOI: https://doi.org/10.1007/s10578-021-01239-x
Morán, J., Díaz, M. F., Martínez, C., Varas, C., & Sepúlveda, R. P. (2019). The subjective experience of psychotherapists during moments of rupture in psychotherapy with adolescents. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(1), 346. doi: 10.4081/ripppo.2019.346.
DOI: https://doi.org/10.4081/ripppo.2019.346
Mullen, S. (2018). Major depressive disorder in children and adolescents. Mental Health Clinician, 8(6), 275-283. doi: 10.9740/mhc.2018.11.275.
DOI: https://doi.org/10.9740/mhc.2018.11.275
National Institute for Health Care Excellence. (2019). Depression in Children and Young People: Identification and Management. Available from: https://www.nice.org.uk/guidance/ng134. Accessed in: May 2023.
Norcross, J. C., & Lambert, M. J. (2019). Psychotherapy relationships that work: evidence-based therapist contributions (3rd ed.). Oxford University Press. doi: 10.1093/med-psych/9780190843953.001.0001.
DOI: https://doi.org/10.1093/med-psych/9780190843953.001.0001
Normandin, L., Ensink, K., Weiner, A., & Kernberg, O. F. (2021). Transference-Focused Psychotherapy for adolescents with severe personality disorders. American Psychiatric Association Publishing.
DOI: https://doi.org/10.1521/pdps.2021.49.2.215
Ogrodniczuk, J. S., & Kealy, D. (2013). Interpersonal problems of narcissistic patients. In J. S. Ogrodniczuk (Ed.), Understanding and Treating Pathological Narcissism (pp. 113-127). American Psychological Association.
DOI: https://doi.org/10.1037/14041-007
Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63, 539-569. doi: 10.1146/annurev-psych-120710-100452.
DOI: https://doi.org/10.1146/annurev-psych-120710-100452
Ronningstam, E. (2019). Narcissism and its discontents: diagnostic dilemmas and treatment strategies with narcissistic patients. Journal of Psychiatric Practice, 25(3), 239-240. doi: 10.1097/PRA.0000000000000379.
DOI: https://doi.org/10.1097/PRA.0000000000000379
Rost, F., Luyten, P., & Fonagy, P. (2018). The anaclitic-introjective depression assessment: Development and preliminary validity of an observer-rated measure. Clinical Psychology & Psychotherapy, 25(2), 195-209. doi: 10.1002/cpp.2153.
DOI: https://doi.org/10.1002/cpp.2153
Ryan, R., Berry, K., & Hartley, S. (2023). Review: therapist factors and their impact on therapeutic alliance and outcomes in child and adolescent mental health - a systematic review. Child and Adolescent Mental Health, 28(2), 195-211. doi: 10.1111/camh.12518.
DOI: https://doi.org/10.1111/camh.12518
Safran, J. D., & Kraus, J. (2014). Alliance ruptures, impasses, and enactments: a relational perspective. Psychotherapy, 51(3), 381-387. doi: 10.1037/a0036815.
DOI: https://doi.org/10.1037/a0036815
Satir, D. A., Thompson-Brenner, H., Boisseau, C. L., & Crisafulli, M. A. (2009). Countertransference reactions to adolescents with eating disorders: relationships to clinician and patient factors. International Journal of Eating Disorders, 42(6), 511-521. doi: 10.1002/eat.20650.
DOI: https://doi.org/10.1002/eat.20650
Sekowski, M., Gambin, M., Sumlin, E., & Sharp, C. (2022). Associations between symptoms of borderline personality disorder and suicidality in inpatient adolescents: the significance of identity disturbance. Psychiatry Research, 312, 114558. doi: 10.1016/j.psychres.2022.114558.
DOI: https://doi.org/10.1016/j.psychres.2022.114558
Sharp, C., Cano, K., Bo, S., & Hutsebaut, J. (2022). The assessment of personality function in adolescents. In S. K. Huprich (Ed.), Personality disorders and pathology: integrating clinical assessment and practice in the DSM-5 and ICD-11 era (pp. 109-134). American Psychological Association. doi: 10.1037/0000310-006.
DOI: https://doi.org/10.1037/0000310-006
Sharp, C., & Wall, K. (2018). Personality pathology grows up: adolescence as a sensitive period. Current Opinion in Psychology, 21, 111-116. doi: 10.1016/j.copsyc.2017.11.010.
DOI: https://doi.org/10.1016/j.copsyc.2017.11.010
Sharp, C., & Wall, K. (2021). DSM-5 Level of personality functioning: refocusing personality disorder on what it means to be human. Annual Review of Clinical Psychology, 17, 313-337. doi: 10.1146/annurev-clinpsy-081219-105402.
DOI: https://doi.org/10.1146/annurev-clinpsy-081219-105402
Strandholm, T., Karlsson, L., Kiviruusu, O., Pelkonen, M., & Marttunen, M. (2014). Treatment characteristics and outcome of depression among depressed adolescent outpatients with and without comorbid axis II disorders. Journal of Personality Disorders, 28(6), 853-863. doi: 10.1521/pedi_2012_26_073.
DOI: https://doi.org/10.1521/pedi_2012_26_073
Streiner, D. L. (2003). Being inconsistent about consistency: when coefficient alpha does and doesn’t matter. Journal of Personality Assessment, 80(3), 217-222. doi: 10.1207/S15327752JPA8003_01.
DOI: https://doi.org/10.1207/S15327752JPA8003_01
Tanzilli, A., Colli, A., Gualco, I., & Lingiardi, V. (2018). Patient personality and relational patterns in psychotherapy: factor structure, reliability, and validity of the psychotherapy relationship questionnaire. Journal of Personality Assessment, 100(1), 96-106. doi: 10.1080/00223891.2016.1272050.
DOI: https://doi.org/10.1080/00223891.2016.1272050
Tanzilli, A., Giovanardi, G., Patriarca, E., Lingiardi, V., & Williams, R. (2021). From a symptom-based to a person-centered approach in treating depressive disorders in adolescence: a clinical case formulation using the Psychodynamic Diagnostic Manual (PDM-2)’s framework. International Journal of Environmental Research and Public Health, 18(19), 10127. doi: 10.3390/ijerph181910127.
DOI: https://doi.org/10.3390/ijerph181910127
Tanzilli, A., & Gualco, I. (2020). Clinician emotional responses and therapeutic alliance when treating adolescent patients with narcissistic personality disorder subtypes: a clinically meaningful empirical investigation. Journal of Personality Disorders, 34, 42-62. doi: 10.1521/pedi.2020.34.supp.42.
DOI: https://doi.org/10.1521/pedi.2020.34.supp.42
Tanzilli, A., Gualco, I., Baiocco, R., & Lingiardi, V. (2020). Clinician reactions when working with adolescent patients: the therapist response questionnaire for adolescents. Journal of Personality Assessment, 102(5), 616-627. doi: 10.1080/00223891.2019.1674318.
DOI: https://doi.org/10.1080/00223891.2019.1674318
Tummala-Narra, P. (2014). Cultural identity in the context of trauma and immigration from a psychoanalytic perspective. Psychoanalytic Psychology, 31(3), 396-409. doi: 10.1037/a0036539.
DOI: https://doi.org/10.1037/a0036539
Van, H. L., & Kool, M. (2018). What we do, do not, and need to know about comorbid depression and personality disorders. Lancet Psychiatry, 5(10), 776-778. doi: 10.1016/S2215-0366(18)30260-8.
DOI: https://doi.org/10.1016/S2215-0366(18)30260-8
Westen, D., DeFife, J. A., Malone, J. C., & Dilallo, J. (2014). An empirically derived classification of adolescent personality disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 53(5), 528-549. doi: 10.1016/j.jaac.2013.12.030.
DOI: https://doi.org/10.1016/j.jaac.2013.12.030
Westen, D., Moses, M. J., Silk, K. R., Lohr, N. E., Cohen, R., & Segal, H. (1992). Quality of depressive experience in borderline personality disorder and major depression: when depression is not just depression. Journal of Personality Disorders, 6(4), 382-393. doi: 10.1521/pedi.1992.6.4.382.
DOI: https://doi.org/10.1521/pedi.1992.6.4.382
Williams, R., Casini, M. P., Moselli, M., Frattini, C., & Ronningstam, E. (2021). The road from pathological narcissism to suicidality in adolescence: an empirical study. International Journal of Environmental Research and Public Health, 18(18), 9761. doi: 10.3390/ijerph18189761.
DOI: https://doi.org/10.3390/ijerph18189761
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th revision). Available from: https://icd.who.int/.
World Health Organization. (2022). World mental health report: transforming mental health for all. Available from: https://iris.who.int/bitstream/handle/10665/356119/9789240049338-eng.pdf?sequence=1.
Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B., & Silk, K. R. (2004). Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. American Journal of Psychiatry, 161(11), 2108-2114. doi: 10.1176/appi.ajp.161.11.2108.
DOI: https://doi.org/10.1176/appi.ajp.161.11.2108
How to Cite
Tanzilli, A., Fiorentino, F., Liotti, M., Lo Buglio, G., Gualco, I., Lingiardi, V., … Williams , R. (2024). Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition. Research in Psychotherapy: Psychopathology, Process and Outcome, 27(1). https://doi.org/10.4081/ripppo.2024.752
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