Research

The Columbia Psychoanalytic Center has an outstanding, multidisciplinary research group led by Steven P. Roose, M.D. If you are interested in learning about research conducted at the Center, please contact Dr. Roose at (212) 543-5749 or spr2@columbia.edu.

CURRENT RESEARCH

A Study of Psychopharmacologic Management by Psychoanalytic Candidates

Primary Researcher: Bret Rutherford, M.D.

The role of medications in psychoanalysis has been debated for decades, and the optimal use of pharmacological agents in the analytic situation remains difficult. Studies show patients entering psychoanalysis have extremely high rates of affective and anxiety disorders, and more than a third of analytic patients are prescribed medication. While there is extensive literature examining the possible effects of medication on psychoanalytic treatment, strikingly little information exists on how psychoanalysis affects the delivery of psychopharmacologic treatment. The few studies available underscore the challenges to delivering optimal psychopharmacologic treatment in the psychoanalytic situation, while recent developments in the pharmacology of depression point to its increasing complexity.

We plan to investigate whether psychopharmacologic management of training cases in psychoanalysis can be improved by means of an educational intervention. Patients accepted for psychoanalysis at the Columbia University Center for Psychoanalytic Training and Research who are already taking psychotropic medications or for whom the prescription of medications is being considered will be followed in this study. Treating candidates will be randomized to either treatment as usual or an experimental condition, which is the provision of psychopharmacologic consultations to the candidate and supervisor at baseline, three, and six months following the start of analysis. Patients will be assessed on a battery of self-assessment procedures at baseline, three, six, and twelve months following entry into the study. The primary outcome measures are change in depressive symptoms as measured by a standardized rating scale and remission of depression according to predefined criteria. Secondary outcome measures are the number and type of medications used at twelve months, adequacy of psychopharmacologic documentation as measured by chart review at three and twelve months, drop out rates of patients in each study cell, and effects on the candidate’s education. The data will be analyzed at one year after the start of analysis, but patients will continue to be followed over time.

Comparative Outcomes of Psychotherapy and Psychoanalysis Study

Primary Researchers: Steven Roose, M.D., Robert Glick, M.D., Andrew Gerber, M.D.,
Eve Caligor, M.D., and Bret Rutherford, M.D.

The proposed COPPS study recently received positive reviews from the Fund for Psychoanalytic Research of the American Psychoanalytic Association, and will be submitted for approval in January 2008. The study aims to measure and compare the effects of cognitive behavioral therapy, supportive-expressive psychotherapy, and psychoanalysis as treatment for chronic, complicated depression. Primary outcomes will be assessed with a variety of instruments measuring symptom level, global functioning, and interpersonal relationships. Utilizing expert researchers in each of the various fields, the COPPS study has garnered support from other institutions and should ultimately yield unprecedented findings.

Assessment of Personality Organization, Depression and Anxiety in Patients Evaluated for Psychoanalysis

Primary Researcher: Eve Caligor, M.D.

This study examines the factors that contribute to patients being accepted or rejected for analytic treatment. There is also an observation of the fate of psychiatric symptoms and personality traits during analysis. Patients are administered structured intake interviews such as but not exclusive to the SCIDs, Hamiltons, and STIPOs as well as self-report questionnaires at baseline, and follow-up self-reports at 3, 6 and 12 months. Patients, candidates, and supervisors are surveyed on their impressions of the effect the research study has on the integrity of the analysis.

Imaging Study for Persons in Psychoanalysis and a Control Group

Primary Researcher: Bradley Peterson, M.D.

Dr. Peterson’s imaging study is currently recruiting new subjects and continuing procedure with enrolled subjects. From the study abstract: “Patients in psychoanalysis presumably experience a specific type of learning that focuses on internal psychological processes. This learning produces significantly greater self-regulation of affective states and behavior, greater creativity and awareness of internal mental states, and altered processes of representing the interaction between self and others. We hypothesize that a brain imaging study of patients in psychoanalysis will reveal neuroplastic changes in the brain structures that subserve self-regulatory functions, including increased volume of the prefrontal cortex, amygdala, and hippocampus, as well as altered activation of self-regulatory circuits. We will use Magnetic Resonance Imaging (MRI) to measure regional volumes, quantify functional activation, measure neurometabolite concentrations, and trace fiber tracts in these brain regions. We further hypothesize that educational learning differs from psychoanalytic learning and that educational learning will therefore not produce comparable changes in volume and activity in these areas. The groups of subjects who will participate in this study include psychoanalytic candidates entering training before they begin psychoanalysis, patients entering psychoanalysis as training cases for psychoanalytic candidates, and a control group matched for age, gender, and educational background, who are participating in an intense program of non-psychological educational experiences.”

Structured Interview for Personality Organization: Test-retest Reliability and Temporal Stability

Primary Researcher: Barry Stern, Ph.D.

The Structured Interview of Personality Organization (STIPO) was developed to provide a dimensional assessment of features that, according to modern object relations theory, are thought to underlie personality disorders. The purpose of Dr. Stern’s study is to assess the reliability properties of the STIPO, specifically, scale internal consistency, inter-rater reliability, 4-week test-retest reliability, and 4-month temporal stability. The constructs operationalized in the STIPO are hypothesized as deriving from mental representations of self and others that are presumed to be stable over time. Repeated measurements of the STIPO domains over a relatively brief period of time would therefore provide an assessment of measurement error in the interview itself; re-assessment, as proposed at 4 months, would provide an estimate of temporal stability for the constructs assessed in the STIPO. The protocol was approved by the NYSPI IRB in September 2007, and the study is now in the recruitment/research phase.

Career Paths after Psychoanalytic Training: A Longitudinal Study

Primary Researcher: Sabrina Cherry, M.D.

Continuing her longitudinal study of analyst development, Dr. Cherry has collected a fifth year of data from graduates of the Columbia University Center for Psychoanalytic Training and Research. Supported by the Developing Psychoanalytic Practice and Training Project of the International Psychoanalytic Association, the study was presented this summer at the IPA Conference in Berlin. Addressing the pressing issue of a recent decline in patients seeking psychoanalysis, the study collected information regarding experience in analytic training, experience with mentoring, experience in training analysis, current practice characteristics, and immediate and long-term career goals. Of note is an apparent decrease after graduation in the desire to become a certified supervising and training analyst. The data collected in Dr. Cherry’s study aims to recognize and modify current aspects of analytical training and post-graduate support in order to increase interest in psychoanalysis in both patients and graduates.

COMPLETED PROJECTS

Supervision Project:

Cabaniss, D., Glick, R., Roose, S. (2001). Data from the Dyad: The Columbia Supervision Study, J. Amer. Psychoanal. Assn., 49 (1), 235-267

Progression Project:

Cabaniss, D., Schein, J.W., Rosen, P., Roose, S.P. (2003). Candidate progression in analytic institutes: A multi-center study, The International Journal of Psychoanalysis, 84 (1 ), 77-94.

Conversion Project:

Caligor E, Hamilton , M, Schneier H, Donovam J, and Roose, S. (2003). Converted patient and clinic patients as control cases: A comparison with implications for psychoanalytic training. Journal of the American Psychoanalytic Association, vol. 51

Adjusting Analytic Technique after 9/11 (WTC project):

Cabaniss, D., Forand, N., Roose, S. (2004).Conducting Analysis After September 11: Implications for Psychoanalytic Technique. Journal of American Psychoanalytic Association, 52 (3).

Columbia Psychodynamic Psychotherapy Skills Test:

Mullen, L., Rieder, R., Glick, R. (2004). Testing Psychodynamic Psychotherapy Skills Among Psychiatric Residents: The Psychodynamic Psychotherapy Competency Test. American Journal of Psychiatry, 161:9, 1658-1664.

Post-Termination Contact Project: (Presented as a poster at the Winter meetings of the American Psychoanalytic Association)

Yang S, Caligor E, Cabaniss D, Luber B, Donovan J, Rosen P, Forand N and Roose S: Post-Termination Contact: A survey of prevalence, characteristics and analyst attitudes. Poster session, American Psychoanalytic Association, January 2003.

Personal Psychiatric Treatment in Psychiatric Residents Project: (in preparation)

Emerich, S., Cabaniss, D., Caligor, E., Forand, N., Roose, S., A Survey of Personal Psychiatric Treatment Among Psychiatric Residents in Manhattan .

Graduation from Psychoanalytic Training Project:

Cherry, S.,Cabaniss, D., Forand, N., Roose, S. (2004) The impact of graduation from psychoanalytic training. The Journal of the American Psychoanalytic Association. 52:851-871

Premature Termination From Psychoanalysis:

Cooper, E., Hamilton, M., Gangure, D., & Roose, S. (2004). Premature termination from psychoanalysis: An investigation of factors contributing to early endings (abstract). Journal of the American Psychoanalytic Association, 52, 1233-1234.

Psychoanalytic Practice in Early Postgraduate Years:

Cherry, S., Cabaniss, Haywood, D. Forand, N., Roose,S. (2004) Psychoanalytic Practice in the Early Postgraduate Years. TheJournal of the American Psychoanalytic Association. 52:833-849.

Post Graduate Study:

Cherry, S., Cabaniss, D., Haywood, D., Nicholas, F., Roose, S (2004).
Psychoanalytic Practice in the Early Postgraduate Years. Journal of the
American Psychoanalytic Association. 52:851-871.