Table of Contents

Part I - Classification of Adult Mental Health Disorders

Introduction to Part 1

Personality Patterns and Disorders – P Axis


Differential Diagnosis of Personality Disorders as a Class
Level of Organization (Severity of Personality Disorder)
Healthy Personalities (Absence of Personality Disorder)
Neurotic-Level Personality Disorders
Borderline-Level Personality Disorders
Implications of the Severity Dimension for Psychotherapy
Types of Personality Disorders
P101. Schizoid Personality Disorders
P102. Paranoid Personality Disorders
P103. Psychopathic (Antisocial) Personality Disorders
  P103.1  Passive/Parasitic
  P103.2  Aggressive
P104. Narcissistic Personality Disorders
  P104.1  Arrogant/Entitled
  P104.2  Depressed/Depleted
P105. Sadistic and Sadomasochistic Personality Disorders
  P105.1  Intermediate Manifestation: Sadomasochistic Personality Disorders
P106. Masochistic (Self-Defeating) Personality Disorders
  P106.1  Moral Masochistic
  P106.2  Relational Masochistic
P107. Depressive Personality Disorders
  P107.1  Introjective
  P107.2  Anaclitic
  P107.3  Converse Manifestation: Hypomanic Personality Disorder
P108. Somatizing Personality Disorders
P109. Dependent Personality Disorders
  P109.1  Passive-Aggressive Versions of Dependent Personality Disorders
  P109.2  Converse Manifestation: Counterdependent Personality Disorders
P110. Phobic (Avoidant) Personality Disorders
  P110.1  Converse Manifestation: Counterphobic Personality Disorders
P111. Anxious Personality Disorders
P112. Obsessive-Compulsive Personality Disorders
  P112.1  Obsessive
  P112.2  Compulsive
P113. Hysterical (Histrionic) Personality Disorders
  P113.1  Inhibited
  P113.2  Demonstrative or Flamboyant
P114.  Dissociative Personality Disorders (Dissociative Identity Disorder/Multiple Personality Disorder)
P115.  Mixed/Other


Profile of Mental Functioning -  M Axis

Capacity for Regulation, Attention, and Learning
Capacity for Relationships (Including Depth, Range, and Consistency)
Quality of Internal Experience (Level of Confidence and Self-Regard)
Affective Experience, Expression, and Communication
Defensive Patterns and Capacities
Capacity to Form Internal Representations
Capacity for Differentiation and Integration
Self-Observing Capacities (Psychological-Mindedness)
Capacity for Internal Standards and Ideals: A Sense of Morality
Summary of Basic Mental Functioning
M201.  Optimal Age- and Phase-Appropriate Mental Capacities
M202.  Reasonable Age- and Phase-Appropriate Mental Capacities
M203.  Age- and Phase-Appropriate Capacities
M204.  Mild Constrictions and Inflexibility
  M204.1  Encapsulated character formations
  M204.2  Encapsulated symptom formations
M205. Moderate Constrictions and Alterations in Mental Functioning
M206. Major Constrictions and Alterations in Mental Functioning
M207. Defects in Integration and Organization and/or Differentiation of Self- and Object Representations
M208. Major Defects in Basic Mental Functions

Symptom Patterns: The Subjective Experience -  S Axis

Introduction
Symptom Patterns
S301. Adjustment Disorders
S302. Anxiety Disorders
  S302.1  Psychic Trauma and Posttraumatic Stress Disorder
  S302.2  Phobias
  S302.3  Obsessive-Compulsive Disorders
S303. Dissociative Disorders
S304. Mood Disorders
  S304.1  Depressive Disorders
  S304.2  Bipolar Disorders
S305. Somatoform (Somatization) Disorders
S306. Eating Disorders
S307. Psychogenic Sleep Disorders
S308. Sexual and Gender Identity Disorders
  S308.1  Sexual Disorders
  S308.2  Paraphilias
  S308.3  Gender Identity Disorders
S309. Factitious Disorders
S310. Impulse Control Disorders
S311. Addictive/Substance Abuse Disorders
S312. Psychotic Disorders
S313. Mental Disorders Based on a General Medical Condition

Case Illustrations of PDM Profile with Adult Mental Health Disorders



Part II - Classification of Child and Adolescent Mental Health Disorders


Introduction to Part II


Profile of Mental Functioning for Children and Adolescents - MCA Axis

Capacity for Regulation, Attention, and Learning
Capacity for Relationships (Including Depth, Range, and Consistency)
Quality of Internal Experience (Level of Confidence and Self-Regard)
Affective Experience, Expression, and Communication
Defensive Patterns and Capacities
Capacity to Form Internal Representations
Capacity for Differentiation and Integration
Self-Observing Capacities (Psychological-Mindedness)
Capacity for Internal Standards and Ideals: Sense of Morality
Summary of Child and Adolescent Mental Functioning
MCA201. Optimal Age- and Phase-Appropriate Mental Capacities
MCA202. Reasonable Age- and Phase-Appropriate Mental Capacities
MCA203. Age- and Phase Appropriate Capacities with Phase-Specific Conflicts
MCA204. Mild Constrictions and Inflexibility
  MCA204.1 Encapsulated character formations
  MCA204.2 Encapsulated symptom formations
MCA205. Moderate Constrictions and Alterations in Mental Functioning
MCA206. Major Constrictions and Alterations in Mental Functioning
MCA206. Defect in Integration and Organization and/or Differentiation of Self and Object Representation
MCA208. Major Defects in Basic Mental Functions
Definition of Terms of Mental Functioning

Child and Adolescent Personality Patterns and Disorders - PCA Axis

Emerging Personality Styles in Children and Adolescents
   “Normal” Emerging Personality Patterns
   Mildly Dysfunctional Emerging Personality Patterns
   Moderately Dysfunctional Emerging Personality Patterns
   Severely Dysfunctional Emerging Personality Patterns
Developmental Aspects of Emerging Personality Patterns
   Normal Range of Patterns
   Dysfunctional Personality Patterns
PCA101. Fearful of Closeness/Intimacy (Schizoid) Personality Disorders
PCA102. Suspicious/Distrustful Personality Disorders
PCA103. Sociopathic (Antisocial) Personality Disorders
PCA104. Narcissistic Personality Disorders
PCA105. Impulsive/Explosive Personality Disorders
PCA106. Self-Defeating Personality Disorders
PCA107. Depressive Personality Disorders
PCA108. Somatizing Personality Disorders
PCA109. Dependent Personality Disorders
PCA110. Avoidant/Constricted Personality Disorders
  PCA110.1 Counterphobic Personality Disorders
PCA111. Anxious Personality Disorders
PCA112. Obsessive-Compulsive Personality Disorders
PCA113. Histrionic Personality Disorders
PCA114. Dysregulated Personality Disorders
PCA115. Mixed/Other

Child and Adolescent Symptom Patterns: The Subjective Experience - SCA Axis

Healthy Response
Developmental Crises
Situational Crises
Disorders of Affect
Anxiety Disorders
SCA301. Anxiety Disorders
SCA302. Phobias
SCA303. Obsessive-Compulsive Disorders
SCA304. Somatization (Somatoform) Disorders
Affect/Mood Disorders
SCA305. Prolonged Mourning/Grief Reaction
SCA306. Depressive Disorders
SCA307. Bipolar Disorders
SCA308. Suicidality
Disruptive Behavior Disorders
SCA309. Conduct Disorders
SCA310. Oppositional-Defiant Disorders
SCA311. Substance Abuse Related Disorders
Reactive Disorders
SCA312. Psychic Trauma and Posttraumatic Stress Disorder
SCA313. Adjustment Disorders (other than developmental)
Disorders of Mental Functioning
SCA314. Motor Skills Disorders
SCA315. Tic Disorders
SCA316. Psychotic Disorders
SCA317. Neuropsychological Disorders
  SCA317.1  Visual-Spatial Processing Disorders
  SCA317.2  Language and Auditory Processing Disorders
  SCA317.3  Memory Impairments
  SCA317.4  Attention Deficit/Hyperactivity Disorder (AD/HD)
  SCA317.5  Executive  Function Disorders
  SCA317.6  Severe Cognitive Deficits
SCA318. Learning Disorders
  SCA318.1  Reading Disorders
  SCA318.2  Mathematics Disorders
  SCA318.3  Disorders of Written Expression
  SCA318.4  Nonverbal Learning Disabilities
  SCA318.5  Social-Emotional Learning Disabilities
Psychophysiologic Disorders
SCA319. Bulimia
SCA320. Anorexia
Developmental Disorders
SCA321. Regulatory Disorders
SCA322. Feeding Problems of Childhood
SCA323. Elimination Disorders
  SCA323.1  Encopresis
  SCA323.2  Enuresis
SCA324. Sleep Disorders
SCA325. Attachment Disorders
SCA326. Pervasive Developmental Disorders
  SCA326.1  Autism
  SCA326.2  Asperger’s Syndrome
  SCA326.3  Pervasive Developmental Disorder (PDD) Not Otherwise Specified
Other Disorders
SCA327. Gender Identity Disorders

Case Illustrations of PDM Profile with Child and Adolescent Mental Health Disorders

Special Section on Infancy and Early Childhood Mental Health Disorders

Introduction
Overview of Primary Mental Health Diagnoses in Infancy and Early Childhood
Overview of the Multi-Axial Approach to Infant and Early Childhood Mental Health and Developmental Disorders
Disorders of Infancy and Early Childhood – Axis I - Primary Axis
IEC100 Series- Interactive Disorders
IEC101. Anxiety Disorders
IEC102. Developmental Anxiety Disorders
IEC103. Disorders of Emotional Range and Stability
IEC104. Disruptive Behavior and Oppositional Disorders
IEC105. Depressive Disorders
IEC106. Mood Dysregulation: A Unique Type of Interactive and Mixed Regulatory-Sensory Processing Disorder Characterized by Bipolar Patterns
IEC107. Attentional Disorders
IEC108. Prolonged Grief Reaction
IEC109. Reactive Attachment Disorders
IEC110. Traumatic Stress Disorders
IEC111. Adjustment Disorders
IEC112. Gender Identity Disorders
IEC113. Selective Mutism
IEC114. Sleep Disorders
IEC115. Eating Disorders
IEC116. Elimination Disorders

IEC200 Series - Regulatory-Sensory Processing Disorders (RSPD)
Clinical Evidence and Prevalence of Regulatory-Sensory Processing Differences
Sensory Modulation Difficulties (Type I)
IEC201. Overresponsive, Fearful, Anxious Pattern
IEC202. Overresponsive, Negative, Stubborn Pattern
IEC203. Underresponsive, Self-Absorbed Pattern
  IEC203.1  Self-Absorbed and Difficult-to-Engage Type
  IEC203.2  Self-Absorbed and Creative Type
IEC204. Active, Sensory Seeking Pattern
Sensory Discrimination Difficulties (Type II) and Sensory-Based Motor Difficulties (Type III)
IEC205. Inattentive, Disorganized Pattern
  IEC205.1  With Sensory Discrimination Difficulties
  IEC205.2  With Postural Control Difficulties
  IEC205.3  With Dyspraxia
  IEC205.4  With Combinations of All Three
IEC206. Compromised School and/or Academic Performance Pattern
  IEC206.1  With Sensory Discrimination Difficulties
  IEC206.2  With Postural Control Difficulties
  IEC206.3  With Dyspraxia
  IEC206.4  With Combinations of All Three
Contributing Sensory Discrimination and Sensory-Based Motor Difficulties
IEC207. Mixed Regulatory-Sensory Processing Patterns
  IEC207.1  Attentional Problems
  IEC207.2  Disruptive Behavioral Problems
  IEC207.3  Sleep Problems
  IEC207.4  Eating  Problems
  IEC207.5  Elimination Problems
  IEC207.6  Selective Mutism
  IEC207.7  Mood Dysregulation, including Bipolar Patterns
  IEC207.8  Other Emotional and Behavioral Problems Related to Mixed Regulatory-Sensory Processing Difficulties
  IEC207.9  Mixed Regulatory-Sensory Processing Patterns where Behavioral or Emotional Problems Are Not Yet In Evidence

IEC300 Series - Neurodevelopmental Disorders of Relating and Communicating
IEC301. Type I: Early Symbolic, with Constrictions
IEC302. Type II: Purposeful Problem-Solving, with Constrictions
IEC303. Type III: Intermittently Engaged and Purposeful
IEC304. Type IV: Aimless and Unpurposeful
Other Neurodevelopmental Disorders (Including Genetic and Metabolic Syndromes)
Summary Tables of Neurodevelopmental Disorders of Relating and Communicating (NDRC)



Part III - Conceptual and Research Foundations of a Psychodynamically Based Classification System for Mental Health Disorders


Introduction to Part III

Historical and Conceptual Foundations

Psychoanalytically Based Nosology: Historic Origins
R. S. Wallerstein
Suitability and Indications for Psychoanalytical Psychotherapy
A. Braconnier, N. Guedeney, B. Hanin, F. Sauvagnat, J. M. Thurin, and D. Widlöcher
A Developmental Framework for Depth Psychology and a Definition of Healthy Emotional Functioning
S. I. Greenspan and S. G. Shanker
The Contribution of Cognitive Behavioral and Neurophysiological Frames of Reference to a Psychodynamic Nosology of Mental Illness
H. Shevrin

Research Foundations

Psychoanalytic Therapy Research: Its History, Present Status, and Projected Future
R. S. Wallerstein
Evaluating Efficacy, Effectiveness, and Mutative Factors in Psychodynamic Psychotherapies
S. J. Blatt, J. S. Auerbach, D. C. Zuroff, and G. Shahar
Personality Diagnosis with the Shedler-Westen Assessment Procedure (SWAP): Bridging the Gulf Between Science and Practice
J. Shedler and D. Westen
Psychic Structure and Mental Functioning: Current Research on the Reliable Measurement and Clinical Validity of Operationalized Psychodynamic Diagnostics (OPD) System
R. Dahlbender, G. Rudolf, and the OPD Task Force
Overview of Empirical Support for the DSM Symptom-Based Approach to Diagnostic Classification
A. Herzig and J. Licht
The Empirical Status of Empirically Supported Psychotherapies: Assumptions, Findings, and Reporting in Controlled Clinical Trials
D. Westen, C. Novotny, and H. Thompson-Brenner
Evidence-Based Psychodynamic Psychotherapies
P. Fonagy
A Review of Meta-Analyses of Outcome Studies of Psychodynamic Therapy
F. Leichsenring