Deliberate self-harm in female patients with affective disorders: investigation of personality structure and affect regulation by means of operationalized psychodynamic diagnostics.

This study investigated psychodynamically relevant dimensions in female depressive patients with and without deliberate self-harm (DSH). DSH is often observed in depressive patients and frequently shows a correlation with personality disorders. Forty female depressive patients with and without DSH were investigated after recovery from acute depressive pathology by means of "operationalized psychodynamic diagnostics" (OPD). Patients with DSH had a significantly lower level of integration in the OPD dimension "structure," and their "interpersonal relationships" showed dysfunctional interaction patterns. They also had a significantly higher rate of personality disorders. These results underline the significance of aspects of personality structure in female depressive patients with DSH, and enable a deeper understanding of their dysfunctional defense strategies, the connections with underlying disturbed affect regulation, and vicious circles in the therapeutic transference-countertransference relationship. OPD has been shown to be a useful tool for empirical research into therapeutically relevant dimensions of personality.

[Automutilistic behaviour in female patients with affective disorders: investigation of personality structure and affect regulation by means of Operationalized Psychodynamic Diagnostics (OPD)]. / Automutilistisches Verhalten bei Patientinnen mit affektiven Störungen: Untersuchung der Persönlichkeitsstruktur und Affektregulation mittels Operationalisierter Psychodynamischer Diagnostik (OPD).

UNLABELLED: Automutilistic behaviour is frequently correlated with personality disorders and should be differentiated from suicidal behaviour during acute episodes of affective disorders. The aim of the study was to investigate psychotherapeutically and psychodynamically significant personality traits and affect regulation. The dimensions "relationship", "conflict" and "structure" were examined by means of Operationalized Psychodynamic Diagnostics. SAMPLE: 20 female patients with depression and automutilistic behaviour and 20 age-matched female subjects with a similar educational background, suffering from depression without automutilistic behaviour. RESULTS The female patients with depression and automutilistic behaviour could be differentiated from the control group in all categories in the OPD dimension "structure". They showed an "isolated" and "disclosed" self-image. This negative self-perception corresponded with a negative countertransference. There were no differences between the patients with automutilistic behaviour and the control group regarding the OPD dimension "conflict". Low and moderate levels of integration were prominently correlated with the autonomy-dependence conflict. CONCLUSION The results underline the significance of aspects of personality structure in automutilistic behaviour seen in female patients with depression. Operationalized Psychodynamic Diagnostics can reveal therapeutically relevant personality dimensions for empirical research.