[Knee osteoarthritis and acupuncture].
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Biomedical subjects
Publications and source records attributed to O Heyerdahl.
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Psychoanalytic theory holds that dynamic insight is used for self-observation and self-analysis during and after explorative therapy. Such self-analysis is held to lead to stable dynamic change. Within a sample of 43 moderately disturbed out-patients, pre-treatment level of insight was associated with treatment length, with not being an early or late drop-out, and with receiving additional psychotherapy during a four-year follow-up period. Pre-treatment level of insight turned out to be not directly correlated with outcome two and four years after therapy. However, level of insight was significantly correlated with outcome in interaction with treatment length. Gain of insight measured at two-year follow-up was the strongest predictor of overall dynamic change four years after therapy, compared with all the other outcome assessments made at two-year follow-up.
The clinical proposition that an ideal focus for intensive brief dynamic psychotherapy is an intra-psychic conflict rooted in oedipal pathology with circumscribed effects on personality functioning has been widely accepted a priori, without empirical validation. In this study 4 clinical raters assessed the 'degree of circumscribed conflict' and 'hypothesized psychosexual development level' from a dynamic evaluation interview. The variables were only marginally associated with DSM-III diagnoses. Within a subsample of 22 patients treated with intensive psychoanalytic technique, patients with whom a highly circumscribed conflict could be identified had the most favourable dynamic change 4 years after therapy.
Dynamic change in psychotherapy, as measured by theory-related or mode-specific instruments, have been criticized for being too intercorrelated with symptomatic change measures. In this study, long-term changes after brief dynamic psychotherapy were studied in 45 moderately disturbed neurotic patients by a reliable outcome battery. The factor structure of all the change variables suggested that they tapped 2 distinct and stable sources of variance: dynamic and symptomatic change. The categories of overall dynamic change were different from categories of change on the Global Assessment Scale. A small systematic difference was found between the categories of overall dynamic change and the categories of target complaints change also, due to false solutions of dynamic conflicts.
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