[Conflict dynamics at different structural levels - Relationship between conflict and structure in the OPD-3]

The Operationalized Psychodynamic Diagnosis (OPD) system extends the descriptive classification systems (e. g. DSM, ICD) of mental disorders and is well established in psychodynamic research and practice. With the 3rd version published in 2023, the OPD underwent a comprehensive revision, which also includes a stronger linking of the axes. Until OPD-3, the 'conflict' and 'structure' axes were considered separately, which resulted in a fragmentation of psychodynamic understanding. The OPD-3 changes this separation by now assessing conflicts at all levels of structural integration, which enables a more integrative view. In this study, the relationships between the conflicts and their coping modes were analyzed as a function of structural impairment (low vs. severely impaired). The study comprised two clinical subsamples with a total of N=3678 psychotherapy patients (N=1645 inpatients; N=2032 outpatients). Psychodynamic conflicts were assessed using the OPD conflict questionnaire (OPD-CQ), while the OPD structural questionnaire (OPD-SQS) was used to assess structural integration. The sample was divided using a median split on the OPD-SQS (Md=24). There were no group differences for the intraindividual variability measure in the OPD-KF or in the network models (network invariance test). Our results confirm the conceptual extensions of OPD-3: conflicts can be identified and differentiated also in patients with more severe structural impairments and the relationships between the conflicts remain stable regardless of the level of structural integration. These findings have relevant implications for psychodynamic diagnosis and treatment.