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F Leichsenring

Publications and source records attributed to F Leichsenring.

18 recordsLinked to original sources
PubMed2001

Comparative effects of short-term psychodynamic psychotherapy and cognitive-behavioral therapy in depression: a meta-analytic approach.

UNLABELLED: This article reviews the efficacy of short-term psychodynamic psychotherapy (STPP) in depression compared to cognitive-behavioral therapy (CBT) or behavioral therapy (BT). In this review, only studies in which at least 13 therapy sessions were performed have been included, and a sufficient number of patients per group were treated (N > or = 20). With regard to outcome criteria, the results were reviewed for improvements in depressive symptoms, general psychiatric symptoms, and social functioning. Six studies met the inclusion criteria. RESULTS: In 58 of the 60 comparisons (97%) performed in the six studies and their follow-ups, no significant difference could be detected between STPP and CBT/BT concerning the effects in depressive symptoms, general psychiatric symptomatology, and social functioning. Furthermore, STPP and CBT/BT did not differ significantly with regard to the patients that were judged as remitted or improved. According to a meta-analytic procedure described by R. Rosenthal (1991) the studies do not differ significantly with regard to the patients that were judged as remitted or improved after treatment with STPP or CBT/BT. The mean difference between STPP and CBT/BT concerning the number of patients that were judged as remitted or improved corresponds to a small effect size (post-assessment: phi = 0.08, follow-up assessment: phi = 0.12). Thus, STPP and CBT/BT seem to be equally effective methods in the treatment of depression. However, because of the small number of studies which met the inclusion criteria, this result can only be preliminary. Furthermore, it applies only to the specific forms of STPP that were examined in the selected studies and cannot be generalized to other forms of STPP. Further studies are needed to examine the effects of specific forms of STPP in both controlled and naturalistic settings. Furthermore, there are findings indicating that 16-20 sessions of both STPP and CBT/BT are insufficient for most patients to achieve lasting remission. Future studies should address the effects of longer treatments of depression.

Adult↗
PubMed2000

[When does a study of different therapies allow comparisons of their relative efficacy?].

UNLABELLED: Psychotherapy research is a form of evaluation research. Among many others, two types of evaluation can be distinguished: "comparative" and "non-comparative" evaluation studies. This differentiation, though its consequences are often neglected, is fundamental, since a study designed to answer a question concerning the non-comparative or "isolated" efficacy of a therapy cannot simultaneously serve to answer the question concerning the relative efficacy of two or more therapies aiming at the same goals or objectives--and vice versa. In this article, a small part of psychotherapy research, the 22 studies which have already been used by Grawe et al. (1994) in their comparisons of behaviour therapies and short-term psychodynamic therapies, is reanalyzed with respect to the two types of evaluation and to some consequences of this differentiation. RESULTS: On the whole, it is not possible to draw conclusions about the comparative efficacy of behaviour therapies and short-term psychodynamic therapies with regard to their specific goals, even if only some consequences of the distinction between two types of evaluation are taken into account. Among other reasons, this is due to the fact that the studies have not consequently been planned and executed as comparative evaluations. Only amelioration of the 22 studies can be regarded--with certain restrictions--as comparative outcome studies with respect to amelioration of certain symptoms. A further analysis of these studies shows that there is no evidence of a "highly significant" superiority of behaviour therapies over short-term psychodynamic therapies.

Cognitive Behavioral Therapy↗
PubMed1999

[Dimensions of bizarre, idiosyncratic thinking. Relationship between thought disorders and affect].

In the present study disorders of thinking were studied in normals, patients with neurotic disorders, borderline patients and both acute and chronic schizophrenics. Disorders of thinking were assessed by the Holtzman Inkblot Technique. By a factor analysis, different dimensions of disordered thinking characteristic of the different diagnostic groups could be identified. Among others two dimensions of schizophrenic thought disorder and one of borderline thought disorder could be identified. This latter dimension showed high correlations with anxiety and hostility. This was true for a dimension of productive schizophrenics thought disorders, but not for a dimension of negative schizophrenics thought disorders.

Acute Disease↗
PubMed1999

Primitive defense mechanisms in schizophrenics and borderline patients.

In this study, patients with neurotic disorders, borderline patients, acute schizophrenics, and chronic schizophrenics were studied with regard to primitive defense mechanisms. Primitive defense mechanisms were assessed by means of the Lerner Defense Scale (LDS). In this study, the LDS was applied to the Holtzman Inkblot Technique. With the exception of primitive idealization, borderline patients used all primitive defense mechanisms significantly more frequently than patients with neurotic disorders, that is, splitting, projective identification, primitive denial, and primitive devaluation. Compared with both acute and chronic schizophrenics, borderline patients used primitive devaluation at a significantly higher degree of frequency. Both acute and chronic schizophrenics differed from patients with neurotic disorders by using splitting and projective identification significantly more frequently. However, there were differences concerning primitive devaluation and idealization. The defense structure of chronic schizophrenics was heterogenous. Except for primitive idealization, all primitive defense mechanisms correlated significantly with self-report measures of identity diffusion and impaired reality testing, which is consistent with theoretical assumptions. By a discriminant analysis, 90% of the borderline patients, 80% of the patients with neurotic disorders, 76% of the acute schizophrenics, and 92% of the chronic schizophrenics were classified correctly.

Acute Disease↗
PubMed1999

Development and first results of the Borderline Personality Inventory: a self-report instrument for assessing borderline personality organization.

This article reports the development of a short 53-item true-false self-report instrument, the Borderline Personality Inventory (BPI). The BPI is based on Kernberg's (1984) concept of borderline personality organization. However, the diagnostic criteria are compatible with both the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) and Gunderson's (Gunderson & Kolb, 1978) concept of borderline personality disorder (BPD). The BPI contains scales for assessing identity diffusion, primitive defense mechanisms, and reality testing. Another scale refers to the fear of closeness. The construction of the scales is based on the results of a factor analysis. As a result of several studies, a cutoff score is proposed to make the diagnosis of a BPD. Thus, the BPI combines dimensional and categorical models of BPD. The BPI was tested in several studies. According to the results, internal consistency and retest reliability are satisfactory (Cronbach's alpha = .68-.91, rtt = .73-.89). Results for sensitivity are .85 to .89, and results for specificity .78 to .89. The BPI identifies borderline patients in high agreement with Kernberg's criteria of borderline personality organization, Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) criteria of BPD and Gunderson's criteria of BPD. The BPI is recommended as a screening instrument for borderline personality organization and BPD and for dimensional research of borderline features in Axis I and Axis II disorders.

Adult↗
PubMed1999

[Internalized object relations in schizophrenics].

In the present study, schizophrenic persons were studied with regard to internalised object relations. A rating method developed by Urist was applied to the Holtzman Inkblot Technique, a modification of the Rorschach-Test. A sample of acute schizophrenic patients (n = 25) and a sample of chronic schizophrenics (n = 25) were studied and compared to a sample of borderline patients (n = 30) with regard to ratings of internalised object relations. According to the results, borderline patients showed significantly higher ratings of object relations in which one figure was tortured, damaged, or devoured by another. Furthermore, it could be demonstrated that severe forms of primary process thinking correlated significantly with ratings of primitive object relations not only in borderline patients, but also in acute schizophrenics and chronic schizophrenics. The results are discussed with regard to Kernbergs's theory of primary process thinking.

Adult↗
PubMed1999

Splitting: an empirical study.

In this study, the Rorschach scoring system for splitting developed by Lerner, Sugarman, and Gaughran (1981) was applied to the Holtzman Inkblot Technique (HIT). Normal individuals (n = 30), patients with neurotic disorders (n = 30), patients with borderline personality disorder (n = 30), patients with acute schizophrenia (n = 25), and patients with chronic schizophrenia (n = 25) were studied with respect to their use of splitting. Sufficient interrater reliability was demonstrated for the scoring of splitting in the HIT. Significant differences between borderline patients, acute schizophrenic patients, and chronic schizophrenic patients, on the one hand, and patients with neurotic disorders, on the other hand, were demonstrated. Furthermore, it was shown that the indicators of splitting were associated with measures of identity diffusion, primitive defense mechanisms, and other measures of psychopathology. The Lerner indicator of splitting proved to be multidimensional. Different forms of splitting seem to be characteristic of borderline patients and schizophrenic patients. The application of the Lerner criteria of primitive defenses to the HIT appears to be promising.

Acute Disease↗
PubMed1998

[Psychotherapy research--how it should (not) be done. An expert reanalysis of comparative studies by Grawe et al. (1994)].

22 psychotherapy outcome studies used in the Bernese meta-analysis by Grawe, Donati and Bernauer (1994) for a treatment comparison between behavioural and psychoanalytic-psychodynamic treatment concepts were reanalysed by 12 expert psychotherapy researchers independent of each other. Three clinical criteria served as basic criteria for the assessment of the methodological quality of the 22 comparative studies: treatment dosage, therapists' competence or expertise, and an adequate realisation of the intended treatment concept. The expert ratings were then compared with an evaluation of an assessment of a research team from the University of Ulm and with the one from the Bernese research team. Contrary to the Bernese meta-analysis, both the experts and the Ulm research group conclude that only 5 or 8 of the 22 studies, respectively, could be accepted for a relatively fair comparison between the treatments under study. Out of the 5/8 studies, none could be considered fully suitable for a treatment comparison, at the most only moderately suitable. These remaining 5 or 8 studies, respectively, do not prove superiority of one treatment over the other. Hence, the "Dodo Bird Verdict" stands up under scrutiny.

Behavior Therapy↗
PubMed1994

[Reducing ambiguity: semantic statistical studies of "normal" probands, neurotic patients, borderline patients and schizophrenic patients].

The present study tries to answer three questions: 1.) Do patients with neurotic disorders differ from normals by a stronger tendency to avoid or reduce ambiguity? 2.) Does the tendency to avoid or reduce ambiguity increase with increasing ambiguity of the stimulus? 3.) Does the avoidance or reduction of ambiguity increase with affects of anxiety and hostility? In order to answer these questions, Ertel's dogmatism-dictionary was applied to the answers of 30 normals, 30 patients with neurotic disorders, 30 borderline-patients, 25 acute and 25 chronic schizophrenics in the Holtzman Inkblot Technique (HIT). According to the results, (1) patients with neurotic disorders do not differ from normals by a stronger tendency to avoid or reduce ambiguity. 2.) The tendency to avoid or reduce ambiguity increases with measures of increasing stimulus ambiguity of the HIT cards in all diagnostic groups studied with the exception of chronic schizophrenics. As far as response ambiguity (variability of interpretation) is concerned, only in chronic schizophrenics the tendency to avoid or reduce ambiguity decreases with increasing response ambiguity. 3.) The avoidance or reduction of ambiguity increases with affects of anxiety and/or aggression assessed by HIT-measures in all diagnostic groups studied with the exception of normals and chronic schizophrenics. In both normals and chronic schizophrenics, the reduction of ambiguity decreases significantly with increasing anxiety, in chronic schizophrenics the reduction of ambiguity decreases significantly with an increase of low levels of aggression.

Adult↗
PubMed1993

[Empirical findings on the personality structure of borderline patients].

In the present study the question of personality structure in borderline patients is studied empirically. The "Diagnostic Interview for Borderlines" of Gunderson and Kolb is used to classify the patients. In an inpatient sample of borderline patients (n = 26) the clinical diagnoses of personality structure according to psychoanalytic criteria are investigated and compared to those of an inpatient sample of patients with neurotic disorders (n = 24). According to the results most of the borderline patients (88%) had received a diagnosis of a schizoid personality structure according to psychoanalytic criteria, in contrast to the neurotic patients. The results are compared to those of studies using descriptive psychiatric criteria.

Borderline Personality Disorder↗
PubMed1992

[Cognitive style of schizophrenic patients: ambiguity avoidance and decreased abstract thinking].

The hypothesis of specific cognitive dynamics in schizophrenics is derived and tested in this study. This cognitive style should be characterized by a reduction of cognitive ambiguity and could be demonstrated in borderline patients in a previous study. This hypothesis is tested by applying Ertel's (1972) DOTA-dictionary to responses of 25 acute and 25 chronic schizophrenics in the Holtzman Inkblot Technique. Furthermore the level of abstractness of the responses is investigated with the method of Günther and Groeben (1978). According to the results both groups of schizophrenics had a significantly higher "Dogmatismus-Quotient" (Ertel, 1972) than a sample of neurotics, but did not differ from borderline patients. Both acute and chronic schizophrenics used significantly less abstract nouns than borderline patients and neurotics. In contrast to borderline patients the reduction of cognitive ambiguity in schizophrenics is not connected with strong affects of anxiety and hostility.

Adult↗
PubMed1991

Primary process thinking, primitive defensive operations and object relationships in borderline and neurotic patients.

In the present paper Kernberg's hypothesis concerning the connection between primary process thinking on the one hand and primitive defense mechanisms and modes of object relationships on the other hand were tested empirically in a sample of 30 hospitalized borderline and 30 hospitalized neurotic patients. The diagnoses of the patients were given according to the 'Diagnostic Interview for Borderlines' of Gunderson and Kolb, the functions mentioned above were assessed on the basis of the Holtzman Inkblot Technique applying scoring systems of Lerner and coworkers for primitive defense mechanisms and of Urist for the scoring of object relationships to the Holtzman Inkblot Technique. According to the results the hypothesis derived from assumptions of Kernberg could be corroborated. Primary process thinking in borderline patients seems to be closely connected with high levels of anxiety and hostility, projective identification/projection, primitive denial and sadomasochistic relationships. A model for the coming about of primary process thinking in borderline patients is proposed.

Borderline Personality Disorder↗
PubMed1991

Discriminating schizophrenics from borderline patients: study with the Holtzman Inkblot technique.

The present study tried to discriminate acute (n = 25) and chronic schizophrenics (n = 25) from borderline patients (BLP; n = 30) on the basis of deviant verbalizations as assessed by the Holtzman Inkblot Technique (HIT). A 30-card version of the HIT was used. It was possible to separate BLPs and schizophrenics with quite good results: 77% of the BLPs, 80% of the acute schizophrenics and 92% of the chronic schizophrenics could be classified correctly based on the less severe deviant verbalizations (DVs) which were more frequent in the BLPs and based on the most severe forms of DVs, i.e. Incoherence, neologism and Perseveration (which were more frequent in the schizophrenic patients). Furthermore, it could be demonstrated that BLPs can be separated from neurotics using the 30-card version of the HIT, the resulting scores being nearly as high as those on the basis of the 45-card version. In another comparison, neurotics (n = 30) were discriminated from normals (n = 35) using the less severe DVs, which were more frequent in the neurotics: here, 74% of the normals and 73% of the neurotics could be classified correctly.

Acute Disease↗
PubMed1990

Discriminating borderline from neurotic patients. A study with the Holtzman Inkblot Technique.

The present study tried to separate 30 hospitalized borderline and 30 hospitalized neurotic patients by indicators of deviant thinking. Kolb and Gunderson's diagnostic interview for borderlines and the Holtzman Inkblot Technique (HIT) were applied as diagnostic instruments. It was possible to separate the two groups by the more severe degrees of deviant thinking with relatively high values for sensitivity and specificity (83 and 93%). If these results can be corroborated in cross-validations with independent samples, the HIT would be a very useful instrument for the discrimination of the two diagnostic groups.

Adult↗
PubMed1990

[Primary and secondary process thinking in normal probands, neurotic and borderline patients].

In the present paper normals, neurotics and borderline patients were compared with respect to primary and secondary process thinking. The Holtzman Inkblot Technique was used to assess the different modes of functioning. As it was expected, normals had more indicators of the most severe levels of primary process thinking than neurotics, but less than borderline patients. On the other hand it could be demonstrated that in normals the reality testing ability and synthetic functioning were not impaired compared to neurotics. In the contrary, the normals exceeded the neurotics concerning indicators of abstractive abilities. The results are discussed with regard to the hypothesis of a continuum of normal and deviant thinking and with regard to the concept of adaptive regression in the service of the ego.

Borderline Personality Disorder↗
PubMed1989

[Aspects of object relations in borderline and neurotic patients: an empirical study using the Holtzman Inkblot technic].

In the present study hospitalized borderline and neurotic patients were compared concerning certain aspects of object relations. The diagnosis of a borderline disorder was given on the basis of the "Diagnostic Interview for Borderlines" (Gunderson u. Kolb 1978). Certain aspects of object relations were assessed by applying the 7-point scale developed by Urist (1977) to responses in the Holtzman Inkblot Technique. According to the results the two diagnostic groups differ with regard to 5 of the 7 scale levels which are connected with the following interpersonal themes: Being supplied and guided; controlling; sucking out, devouring and damaging; engulfing and overwhelming. The results are interpreted referring to object relation theory. Furthermore hit rates were assessed on the basis of the Urist scale data with relatively good results for sensitivity and specifity.

Adult↗