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I066<0%_!H>_!"2B3*0%_!Q>_!FB7##0$9_!=_!@T*(0_!">L>_!Q(267#_!@>_!0(!2<>![+,--^>!;*&$Y$&B2<$C0&!2*&!7<$*$72<<4!&0%$Y0&! 6($9B<$!27($Y2(0!<$93$7!6(%B7(B%06!$*!&01%066$)*?!=*!:@5;!Q(B&4>!/A)Q!Na'!g[-^?!0-.d-+>!! I066<0%_!H>_!Q(267#_!@>_!G!8$0%1M2_!@>![+,-P^>!N10%2($)*2<$C0&!1647#)&4*29$7!&$2D*)6$6!26!2*!$*6(%B90*(!()! (%2*6:0%!1647#)&4*29$7!7)*6(%B7(6!$*()!*0B%)67$0*70>!L%)*($0%6!$*!HB92*!a0B%)67$0*70!d?d-b>! "2B3*0%_!Q>_!I066<0%_!H>!G!K$6Z0&0_!O![+,-P^>!a0B%2!L%)*($0%6!$*!HB92*!a0B%)67$0*70!d?b-+> & ON;?-,>PPb\u:*#B9>+,-P>,,b-+! K$6Z0&0_!O>_!"2B3*0%_!Q>_!FB7##0$9_!=>_!@T*(0_!">L>_!Q(267#_!@>_!0(!2<>![+,-]^!"%27M$*D!:B*7($)*2!/A)Q!Na'!\[-,^?! 0-,\,Pd>! Operationalized Psychodynamic Diagnosis (OPD-2) served as a tool to investigate complex intrapsychic processes in a reliable way by constructing core conflict formulations that were presented to the patients in the scanner. Kessler et al. (2013) provides the foundation and rationale of this procedure. H&2*Y#! 18 unmedicated patients with recurrent major depressive disorder were confronted with individualized and clinically derived stimuli in a functional MRI experiment before (T1) and after eight months (T2) of psychodynamic therapy. A control group of 17 healthy subjects was also tested twice without intervention. The experimental stimuli were sentences describing each participant’s dysfunctional interpersonal relationship patterns derived from clinical interviews based on OPD (Kessler et al., 2011; Wiswede et al., 2014). ;&2-5.2! At T1 patients showed enhanced activation compared to controls in several limbic and subcortical regions, including amygdala and basal ganglia, when confronted with OPD sentences. At T2 the differences in brain activity between patients and controls were no longer apparent. Concurrently, patients had improved significantly in depression scores. Using ecologically valid stimuli, this study supports the model of limbic hyperactivity in depression that normalizes after treatment. Additionally, this study provides empirical evidence that the application of individualized stimuli is a powerful method to investigate complex intrapsychic processes as well as deepen our understanding of depression and its neural correlates. Taubner et al. (2013) studied subgroups within the sample of chronically depressed patients. Using empirically derived personality syndroms with the Shedler-Westen-Assessment-Procedure, two personality factors could be distinguished: depressive or emotional-hostile-externalizing personality respectively. The degree to which patients score on the second correlated with relatively higher activity in three key areas involved in emotion processing, evaluation of reward/ punishment, negative cognitions, and social knowledge.
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