A transdiagnostic conflict-square algorithm

A four-node computational framework for psychotherapy and functional diagnosis

Datos Bibliográficos

ID15524907
AutoresEik Niederlohmann (Klinik für Psychosomatik, autor de correspondencia)
Año2026
Volumen17
Páginas1687372-1687372
Fecha de publicación2026-03-16
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaFrontiers in Psychiatry (JOURNAL)
Identificadores de la revistaISSN: 1664-0640 • E-ISSN: 1664-0640
EditorialFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2026.1687372
PMID41918586
OpenAlexW7136224888
IdiomaEN
Citas recibidas1
Referencias citadas40

Clinical services need more than categorical labels to guide safe dosing, maintain alliance, and plan functional recovery. The Conflict-Square Algorithm (CSA) offers a compact bedside grammar for moment-to-moment decisions during psychotherapy. Clinicians track four observable signals-defense, anxiety/affect tolerance, progression, and superego/shame-and gate intervention intensity by three safety thresholds (A-C). Each clinically meaningful moment is summarized as one auditable episode line in plain language: trigger, observable response, threshold, action, and expected functional impact (Mini-ICF-APP). To strengthen reproducibility, we provide i) operational threshold definitions with observable markers and common misclassification errors, grounded in established anxiety-channel descriptions [striated muscle, smooth muscle, and cognitive-perceptual disruption (CPD)]; ii) a short scope and contraindication checklist; iii) several consecutive worked micro-episodes demonstrating node shifts, threshold transitions, and dose modulation over time; and iv) a minimal machine-readable schema plus a threshold-gating state diagram. As a proof-of-concept feasibility demonstration, we report aggregate coding statistics from three published psychotherapy training videos distributed by the ISTDP Institute (transcribed for analysis with written permission; N = 2,809 speaker turns) using a three-label therapist intervention mapping (invite progression/defense work/anxiety regulation) aligned with CSA nodes. CSA is presented as a teachable, testable decision framework-not as a validated diagnostic instrument-and we outline a pragmatic validation program (rater agreement, safety-rule adherence, usability, and functional outcomes) and future multimodal extensions (e.g., optional physiological monitoring for biofeedback and threshold detection)

Categorical variable · Coding (social sciences · Contraindication · Intervention (counseling · Mindfulness · Schema (genetic algorithms · Emotion and Mood Recognition · Mental Health Research Topics · Psychotherapy Techniques and Applications