Operationalized Psychodynamic Diagnosis (OPD-2) of an Adolescent in Conflict With the Law

Abstract

There is a scientific effort to construct instruments that evaluate the patient's psychodynamic functioning and improve clinical/academic communication. Therefore, the operationalized psychodynamic diagnosis (OPD-2) was created to perform a multiaxial diagnosis based on five axes: experience of illness and prerequisites for treatment (Axis I); interpersonal relationships (Axis II); conflict (Axis III); structure (Axis IV); mental and psychosomatic disorders (Axis V).This study aimed to identify the psychodynamic characteristics from an audio recorded treatment session with an 18-year-old adolescent in conflict with the law, serving detention without the possibility of external activities. In Axis I, median severity of the problem was observed, but with a level of suffering almost absent. In Axis II, he experiences others as controllers, which disqualify and neglect him, thus, he seeks to keep to himself by maintaining distant, to the point where there is uncontrolled impulses, aggression, and exposure to risk.In Axis III, there was a predominance of conflicts: need to for care versus self-sufficiency and self-esteem conflict.The Axis IV showed a median level structure with internalization of negative models and difficulty in mentalization.The Axis V showed that the patient has a diagnosis of International Statistical Classification of Diseasesand Related Health Problems (ICD), which refers to Conduct Disorders, being characterized by persistent patterns (six months or more) of anti-social, aggressive or confrontational conduct. The OPD-2 has been shown to be a useful tool for identifying the psychic characteristics of adolescents in conflict with the law and for therapeutic planning.