Patient Change Trajectories Over a Year of Psychoanalytic Therapy and Psychoanalysis

Univariate and multivariate growth curve analysis were conducted to examine the shape of change of 61 patients receiving either long-term psychodynamic therapy (N=43), or psychoanalysis (N=18). Outcome measures were the Beck Anxiety Inventory (BAI), the Quick Inventory of Depressive Symptomatology (QUIDS), the Social Adjustment Scale (SAS), and the Inventory of Interpersonal Relationship (IIP). Results: when variables are examined separately and jointly using the whole sample, one year of psychoanalytic treatment does not produce significant differences in rates of improvement between patients, indicating that the shape of change over the first year can be generalized to the sample. For QUIDS, BAI, and SAS levels, the shape of change can be described as a slightly downward straight line. For IIP levels, there may be some significant up and downturns suggesting a quadratic trajectory. For clinical course (QUIDS with BAI), the shape of change can be described as a straight, horizontal line, whereas for social adjustment (SAS with IIP), the shape of change is best described as a downward line. For social adjustment (SAS with IIP), the dynamic therapy group has more pronounced rates of improvement than the psychoanalysis group, and higher baseline levels are related to steeper slopes in dynamic therapy whereas for psychoanalysis higher initial levels tend to produce flatter. Clinical and conceptual implication as well as limitations of the study design are discussed.