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Empirical Studies in Psychoanalysis

A. Empirical Studies of Efficacy and Effectiveness in Psychodynamic Treatments:

These studies aim primarily to measure the efficacy (i.e., under carefully controlled conditions) or effectiveness (i.e., under more generalizable conditions) of psychoanalytic treatments, including psychoanalysis and psychoanalytic psychotherapy.

Primary Studies

  1. Wallerstein, R.S. (1989) The Psychotherapy Research Project of the Menninger Foundation: an overview. Journal of Consulting and Clinical Psychology, 57 (2), 195-205.
  2. Kantrowitz, J., Katz, A. & Paolitto, F. (1990) Follow-up of psychoanalysis five to ten years after termination: III. The relation between the resolution of the transference and the patient-analyst match. Journal of the American Psychoanalytic Association, 38, 655-678.
  3. Fonagy, P., & Moran, G. S. (1991). Studies of the efficacy of child psychoanalysis. Journal of Consulting and Clinical Psychology, 58, 684-695.
  4. Blatt, S. J. (1992). The differential effect of psychotherapy and psychoanalysis with anaclitic and introjective patients: The Menninger Psychotherapy Research Project revisited. Journal of the American Psychoanalytic Association, 40, 691-724.
  5. Target, M., & Fonagy, P. (1994). The efficacy of psychoanalysis for children with emotional disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 361-371.
  6. Bateman, A., & Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder - a randomised control trial. American Journal of Psychiatry, 156(10), 1563-1569.
  7. Sandell, R., Blomberg, J., Lazar, A., Carlsson, J., Broberg, J., & Schubert, J. (2000). Varieties of long-term outcome among patients in psychoanalysis and long-term psychotherapy. International Journal of Psychoanalysis, 81, 921-942.
  8. Creed, F., Fernandes, L., Guthrie, E., Palmer, S., Ratcliffe, J., Read, N., et al. (2003). The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome. Gastroenterology, 124(2), 303-317.
  9. Leuzinger-Bohleber, M., Stuhr, U., Ruger, B., Beutel, M. (2003) How to study the quality of psychoanalytic treatments and their long-term effects on patients' well-being: a representative, multi-perspective follow-up study. International Journal of Psychoanalysis 84, 263-290.
  10. Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2004). The Personality Disorders Institute / Borderline Personality Disorder Research Foundation randomized control trial for borderline personality disorder: Rationale, methods, and patient characteristics. Journal of Personality Disorders. 18 (1): 52-72.
  11. Knekt, P., & Lindfors, O. (2004). A randomized trial of the effect of four forms of psychotherapy on depressive and anxiety disorders. Helsinki: Kela.
  12. Leichsenring, F., Biskup, J., Kreische,R., & Staats, H. (2005) The Gottingen study of psychoanalytic therapy: first results. International Journal of Psychoanalysis 86, 433-455.
  13. Vinnars, B., Barber, J. P., Norén, K., Gallop, R., & Weinryb, R. M. (2005). Manualized supportive-expressive psychotherapy versus nonmanualized community-delivered psychodynamic therapy for patients with personality disorders: Bridging efficacy and effectiveness. American Journal of Psychiatry, 162(10), 1933-1940.
  14. Lingiardi, V., Shedler, J. & Gazzillo, F. (2006) Assessing Personality Change in Borderline Personality Disorder using the SWAP-200. Journal of Personality Assessment (86)1, 23-32.
  15. Hilsenroth, M. J. (2007). A programmatic study of short-term psychodynamic psychotherapy: assessment, process, outcome, and training. Psychotherapy Research, 17(1): 31-45
  16. Levy, K. N., Meehan, K. B., Kelly, K. M., Reynoso, J. S., Weber, M., Clarkin, J. F., Kernberg, O. F. (in press) Change in attachment patterns and reflective function in a randomized controlled trial of Transference Focused Psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology.
  17. Milrod, B., Leon, A. C., Busch, F., Rudden, M., Schwalberg, M., Clarkin, J., et al. (in press). The efficacy of psychoanalytic psychotherapy for panic disorder. American Journal of Psychiatry.

Reviews & Meta-analyses

  1. Anderson, E., & Lambert, M. (1995). Short-Term Dynamically Oriented Psychotherapy: A Review and Meta-Analysis. Clinical Psychology Review, 15, 503-514.
  2. Galatzer-Levy, R. M., Bachrach, H., Skolnikoff, A., & Waldron, S., Jr. (2000). Does Psychoanalysis Work? New Haven: Yale University Press.
  3. Fonagy, P., Jones, E. E., Kächele, H., Krause, R., Clarkin, J., Perron, R., Gerber, A., & Allison, E. (2001). An open door review of outcome studies in psychoanalysis (Second ed.). London: International Psychoanalytic Association. (download or order via http://eseries.ipa.org.uk/prev/research/R-outcome.htm)
  4. Leichsenring, F. (2001) Comparative Effects of Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Depression: A Meta-analytic Approach. Clinical Psychology Review, 21, 401-419.
  5. Gottdiener, W. H., & Haslam, N. (2002). The benefits of individual psychotherapy for people diagnosed with schizophrenia: A meta-analytic review. Ethical Human Sciences and Services, 4, 163-187.
  6. Leichsenring, F. & Leibing, E. (2003). The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-analysis. American Journal of Psychiatry, 160, 1223-1232.
  7. Leichsenring, F., Rabung, S., & Leibing, E. (2004). The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: a meta-analysis. Arch Gen Psychiatry, 61(12), 1208-1216.
  8. Fonagy, P., Roth, A., Higgitt, A. (2005). Psychodynamic psychotherapies: Evidence-based practice and clinical wisdom. Bulletin of the Menninger Clinic, 69, 1-58.
  9. Abbass AA, Henderson J, Kisely S., Hancock JT. (2006). Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database Syst Rev. Oct 8;(4):CD004687

Methodological Issues

  1. Gabbard, G. O., Gunderson, J. G., & Fonagy, P. (2002). The place of psychoanalytic treatments within psychiatry. Archives of General Psychiatry, 59 (6), 505-510 + commentaries.
  2. Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004) The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin. 130 (4): 631-663.
  3. Westen and Weinberger (2004). When clinical description becomes statistical prediction. American Psychologist 59(7):595-613.

B. Empirical Studies of Psychoanalytic Process

These studies aim primarily to measure and explore the process of psychoanalytic treatments, at the level of individual interventions, sessions, or over the course of a treatments, and to examine the relationship between therapeutic technique and treatment outcome.

Primary Studies

  1. Dahl, H., & Teller, V. (1994). The characteristics, identification, and applications of FRAMES. Psychotherapy Research, 4(3&4), 253-276.
  2. Shevrin, H., Bond, J. A., Brakel, L. A. W., Hertel, R. K., & Williams, W. J. (1996). Conscious and Unconscious Processes: Psychodynamic, Cognitive, and Neurophysiological Convergences. New York: Guilford Press.
  3. Bucci, W. (1997). Psychoanalysis and Cognitive Science: A Multiple Code Theory. New York: Guilford Press.
  4. Ablon, S. and Jones, E.E. (1998) How expert clinicians' prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychotherapy Research, 8:(71-83).
  5. Luborsky, L., & Crits-Christoph, P. (1998). Understanding Transference: The Core Conflictual Relationship Theme Method (Second ed.). Washington DC: American Psychological Association.
  6. Freedman, N., Hoffenberg, J.D., Vorus, N. & Frosch, A. (1999) The effectiveness of psychoanalytic psychotherapy: The role of treatment duration, frequency of sessions, and the therapeutic relationship. Journal of the American Psychoanalytic Association 47, 741-772.
  7. Barber, J., et al., (2000). Alliance Predicts Patients’ Outcome Beyond In-Treatment Change Symptoms. Journal of Consulting and Clinical Psychology, 68, 1027-1032.
  8. Blatt, S. J., & Shahar, G. (2004). Psychoanalysis - with whom, for what, and how? Comparisons with psychotherapy. Journal of the American Psychoanalytic Association, 52(2), 393-447.
  9. Josephs, L., Andrews, E., Bernard, A., Fatzer, K., & Streich, S. (2004). Assessing change in analysis terminable. Journal of the American Psychoanalytic Association, 52, 1185-1214.
  10. Ablon JS, Jones EE: On Analytic Process. Journal of the American Psychoanalytic Association 2005; 53(2):541-568
  11. Høglend, P., Amlo, S., Marble, A., Bogwald, K. P., Sorbye, O., Sjaastad, M. C., et al. (2006). Analysis of the patient-therapist relationship in dynamic psychotherapy: an experimental study of transference interpretations. Am J Psychiatry, 163(10), 1739-1746.

Reviews

  1. Martin, D.J., Garske, J.P. & Davis, M.K. (2000) Relation of the therapeutic alliance with outcome and other variables: a meta analytic review. Journal of Consulting and Clinical Psychology 68(3): 438-450.
  2. Ackerman, S.J. & Hilsenroth, M.J. (2003) A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review 23, 1-33.

C. Empirical Studies of Psychoanalytic Concepts

These studies aim primarily to measure and explore specific psychoanalytic concepts, such as unconscious processes, defense mechanisms, attachment, and transference.

Primary Studies

  1. Shevrin, H., & Dickman, S. (1980). The psychological unconscious: A necessary assumption for all psychological theory? American Psychologist, 35, 421-434.
  2. Silverman, L. H., & Weinberger, J. (1985). Mommy and I are one. Implications for psychotherapy. Am Psychol, 40(12), 1296-1308.
  3. Andersen, S. M., & Baum, A. (1994). Transference in interpersonal relations: inferences and affect based on significant-other representations. J Pers, 62(4), 459-497.
  4. Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology, 64, 22-31.
  5. Bornstein, Robert F. (1999) Source Amnesia, Misattribution, and the Power of Unconscious Perceptions and Memories. Psychoanalytic Psychology. 16(2):155-178
  6. Wong, Philip S. (1999). Anxiety, signal anxiety, and unconscious anticipation: Neuroscientific evidence for an unconscious signal function in humans. Journal of the American Psychoanalytic Association 47(3).
  7. Shedler J (2002). A new language for psychoanalytic diagnosis. Journal of the American Psychoanalytic Association; 50(2):429-456
  8. Shedler, J., & Westen, D. (2004). Refining DSM-IV Personality Disorder Diagnosis: Integrating science and practice. American Journal of Psychiatry, 161, 1350-1365.
  9. Betan, E., Heim, A. K., Zittel Conklin, C., & Westen, D. (2005). Countertransference phenomena and personality pathology in clinical practice: an empirical investigation. Am J Psychiatry, 162(5), 890-898.
  10. Brakel LAW, Shevrin H: Anxiety, attributional thinking, and the primary process (2005). International Journal of Psychoanalysis; 86(6):1679-1693
  11. Siefert, Caleb J., Hilsenroth, Mark J., Weinberger, Joel, Blagys, Matthew D., Ackerman, Steven J. (2006) The relationship of patient defensive functioning and alliance with therapist technique during short-term psychodynamic psychotherapy. Clinical Psychology and Psychotherapy. 13, 20–33.

Reviews & Meta-analyses

  1. Kline, P. (1972). Fact and fantasy in Freudian theory. London: Methuen & Co.
     
  2. Barron, J. W., Eagle, M. N., Wolitzky, D. L. (Eds.). (1992). Interface of psychoanalysis and psychology. Washington, DC: American Psychological Association.
  3. Fisher, S., & Greenberg, R. P. (1977). The Scientific Credibility of Freud's Theories and Therapy. New York: Basic Books.
  4. Grunbaum, A. (1984). The foundations of psychoanalysis. Berkeley, CA: University of CA Press.
  5. Hardaway RA (1990). Subliminally activated symbiotic fantasies: facts and artifacts. Psychol Bull; 107(2):177-95
  6. Weinberger, J., & Hardaway, R.A. (1990). Separating science from myth in subliminal psychodynamic activation. Clinical Psychology Review. 10(6), 1990, 727-756.
  7. Bornstein, R.F. & Masling, J.M. Series on Empirical Studies of Psychoanalytical Theories. (1993, 1994, 1996, 1998)
  8. Shevrin H (1995). Is psychoanalysis one science, two sciences, or no science at all? A discourse among friendly antagonists. Journal of the American Psychoanalytic Association; 43:963-986
  9. Fisher, S., & Greenberg, R. P. (1996). Freud Scientifically Reappraised: Testing the Theories and Therapy. New York: John Wiley & Sons, Inc.
  10. Stern, D. N. (1998). The process of therapeutic change involving implicit knowledge: Some implications of developmental observations for adult psychotherapy. Infant Mental Health Journal, 19(3), 300-308.
  11. Westen, D. (1998). The scientific legacy of Sigmund Freud: Toward a psychodynamically informed psychological science. Psychological Bulletin, 124, 333-371.
  12. Westen, D., & Gabbard, G. O. (2002). Developments in cognitive neuroscience: I. Conflict, compromise, and connectionism. J Am Psychoanal Assoc, 50(1), 53-98.
  13. Westen, D., & Gabbard, G. O. (2002). Developments in cognitive neuroscience: II. Implications for theories of transference. J Am Psychoanal Assoc, 50(1), 99-134.
Resources

Author:
Andrew J. Gerber, M.D., Ph.D.
with assistance from Caroline Paster

Contributors:
Allan Abbass, M.D.
allan.abbass@cdha.nshealth.ca

J. Stuart Ablon, Ph.D.
sablon@partners.org

William H. Gottdiener, Ph.D.
wgottdiener@jjay.cuny.edu

Mark J. Hilsenroth, Ph.D.
hilsenro@adelphi.edu

Leon Hoffman, M.D.
73542.334@compuserve.com

Falk Leichsenring, D.Sc.
Falk.Leichsenring@NLKH-Tiefenbrunn.Niedersachsen.de

Ken Levy, Ph.D.
klevy@psu.edu

Ray Levy, Psy.D.
rlevy2@partners.org

Patrick Luyten
patrick.luyten@psy.kuleuven.be

Jonathan Shedler, Ph.D.

Joel Weinberger, Ph.D.
weinberg@panther.adelphi.edu

Philip Wong, Ph.D.
philip.wong@liu.edu