Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Peter Lilliengren, Stockholm University, Sweden
- Second opponent: Assistant Professor Ellen Driessen, Radboud University, Netherlands
- Third member and chair of the evaluation committee: Associate Professor Marit Haram, University of Oslo
Chair of the Defence
Associate Professor Emeritus Pål Zeiner, University of Oslo
Principal Supervisor
Associate Professor Pål Gunnar Ulvenes, University of Oslo
Summary
Chronic depression (CD) is difficult to treat, with many patients experiencing limited benefit from standard approaches. The aims of the thesis were to increase our knowledge of psychotherapy for CD patients and to examine whether Intensive short-term dynamic psychotherapy (ISTDP)’s distinction between fragile and resistant patients based on how they manage emotional distress, can be operationalized through a screening instrument.
Five research questions were addressed: (1) whether an intensive (high-dose, high-frequency) inpatient psychotherapy program improves outcomes for CD; (2) whether fragile and resistant patients psychometrically differ on symptom and interpersonal measures; (3) whether a newly developed ISTDP screening instrument can classify patients into these subgroups; (4) whether the instrument has predictive validity to identify unique subgroups of fragile and resistant patients in a CD patient sample; and (5) whether the instrument’s items reflect distinct intrapsychic mechanisms.
Three naturalistic, quantitative studies were conducted using inpatient and outpatient samples. Analyses included multilevel modeling, t-tests, discriminant and ROC analysis.
Results showed that the intensive program significantly reduced depressive symptoms compared to a waitlist condition. Fragile patients reported more severe symptoms and interpersonal difficulties than resistant patients. The screening tool accurately distinguished between groups and predicted treatment response—fragile patients were more symptomatic at baseline and showed less improvement. Finally, half of the instrument’s items significantly differentiated the two subgroups even after controlling for symptom severity, suggesting they may represent markers of underlying psychological mechanisms.
These findings support the use of intensive inpatient psychotherapy for CD and highlight the potential of a psychodiagnostic screening instrument to guide more precise, tailored treatment.
Additional information
Contact the research support staff.