PDM-2 is a diagnostic System of psychic disorders based both on a psychodynamic model and empirical data. It is also based on his predecessor, the first edition of the Manual (published in 2006), which had the aim of “call attention to how much careful research supports psychoanalytic concepts and approaches” (Lingiardi, McWilliams, 2017). Therefore, one of the main goals of this new Manual and of the PDM-2 task force was continuing to inform the psychodynamic theories with constantly updated empirical data. Furthermore, it aims to support and usefully integrate the current nosography of mental disorders, represented by DSM-5 and ICD-10. In this Manual, clinical and personality syndromes are considered as “ideal types”, to which the clinical presentations of actual patients may be approximated to a lesser or greater degree.
The evolutive dimension
One of the nuclear characteristics of this Manual is the focus on an evolutive dimension, which becomes a central feature of the diagnostic process. In fact, the Manual is divided into the various phases of the life cycle. In addition, more recently the PDM-2 task force has focused its attention to deepen the age-range from birth to 18 years, with the publication of the PDM-2 0/18, edited by Lingiardi, McWilliams e Speranza (2020).
The purposes of the Manual
This manual may be employed for clinical diagnosis, research purposes, case formulation and treatment planning. Its multidimensional approach attempts to systematically describe personality functioning, mental functioning (including, e.g., pattern of relating to others, understanding and expressing one’s own feelings, coping with stress and anxiety, etc.), and symptom patterns, including differences in everyone’s personal and subjective experience of symptoms and the possible related experiences of treating clinicians. The PDM-2 also helps the clinician to identify how these characteristics can influence the therapeutic process.
Unlike other nosographic classifications, PDM-2 aspires to be a taxonomy of people rather than a taxonomy of disorders, as it highlights the importance of considering who one is rather than what one has. Therefore, the diagnosis emerges from clinical observation and reasoning, that provide meaning to the individual complexity and overcome the observation of clinical signs and symptoms alone. The subjective experience itself, of how the patient deals with those same symptoms, is the crucial focal point. This Manual also stresses the importance of assessing and bolstering the psychological resources and strengths of each individual, without limiting itself to a mere assessment of the level of compromise and disability.
What has changed since the previous edition of the Manual?
- PDM-2 is organized in 5 Sections: Adulthood, Adolescence, Childhood, Infancy and Early Childhood, Later Life. For the first time, there is a specific section dedicated to elderly people inside a diagnostic system.
- The addition of the VI Section, specifically dedicated to the presentation of assessment measures PDM-2 derived, the presentation of clinical illustration and the discussion of some PDM-2 Profiles. This section is intended to help readers to improve their formulations.
- The revision of all the manual occurred in response to feedback about its strengths and weaknesses and to enhance its empirical rigor and clinical utility. The PDM-2 is based on more systematic and empirical research, including neuroscience. Additionally, there is a more significant integration with both DSM-5 and ICD-10 in the description of symptom patters and its emotional, cognitive, interpersonal, and social components.
- In the evaluation of mental functioning, the PDM-2 also considers strengths, capacity of adaptation, and resources, as well as the subjective experience of the symptoms of the patients. Another innovative aspect interests the deepening of the emotional responses and the subjectivity of the treating clinicians, who responds in a very different way to the different characteristics of the patient’s personality.
- The P Axis includes a psychotic level of personality organization, considering the most recent research that support its utility. A brief description of the “borderline personalities” is also presented.
- The inclusion of a more in-depth definition of the quality of primary relationships between the child and the caregiver, with a greater emphasis on assessing family systems, within the Infancy and Early Childhood Section.
Which other tools can be used alongside the PDM-2?
- The Manual offers specially designed tools for the diagnostic assessment with the PDM-2, like the Psychodiagnostic Chart-2 (PDC-2), with all its versions for different age groups, and the Psychodynamic Diagnostic Prototypes-2 (PDP-2). Additionally, it suggests other assessment measures to improve the assessment of patients according to the specific approach proposed by the PDM-2, among which: The Shedler-Westen Assessment Procedure (SWAP), The Structured Interview of Personality Organization (STIPO), The Karolinska Psychodynamic Profile (KAPP), and so on. Finally, it proposes some self-report and performance-based tools that can be used for the assessment and psychodynamically oriented research, such as the Minnesota Multiphasic Personality Inventory (MMPI-2), the Rorschach Inkblot Test, and the Thematic Apperception Test (TAT).
- A specific software, which was created from the Psychodiagnostic Charts-2, developed for facilitating the assessment of patients, treatment planning, and empirical research.
Vittorio Lingiardi e Nancy McWilliams.
- Adulthood: P Axis, Nancy McWilliams, Jonathan Shedler; M Axis, Vittorio Lingiardi, Robert F. Bornstein; S Axis, Emanuela Mundo, John O’Neil.
- Adolescence: MA Axis, Mario Speranza, Nick Midgley; PA Axis, Johanna Malone, Norka Malberg; SA Axis, Mario Speranza.
- Childhood: MC Axis, Norka Malberg, Larry Rosenberg; PC Axis, Norka Malberg, Larry Rosenberg, Johanna C. Malone; SC Axis, Norka Malberg, Larry Rosenberg.
- Infancy and Early Childhood: IEC Axis 0-3 Anna Maria Speranza, Linda Mayes.
- Later Life, Franco Del Corno, Daniel Plotkin.
- Assessment and Clinical Illustrations: “Assessment within the PDM-2 Framework”, Francesco Gazzillo, Robert M. Gordon, Sherwood Waldron; “Clinical Illustrations and PDM-2 Profiles”, Franco Del Corno, Vittorio Lingiardi, Nancy McWilliams.
- American Academy of Psychoanalysis and Dynamic Psychiatry
- American Association for Psychoanalysis in Clinical Social Work
- American Psychoanalytic Association
- Association Européenne de Psychopathologie de l’Enfant et de l’Adolescent
- Confederation of Independent Psychoanalytic Societies
- Division of Psychoanalysis (39), American Psychological Association
- International Association for Relational Psychoanalysis & Psychotherapy
- International Psychoanalytical Association
- International Society of Adolescent Psychiatry and Psychology
- Italian Group for the Advancement of Psychodynamic Diagnosis