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Research at Riggs

The Austen Riggs Center, through the Erikson Institute, has a strong historical commitment to research. Research at Riggs grows out of our work with our patients and our practice-based learning about complex psychopathology, human development, social processes, and psychoanalytic psychotherapy.

We see research as a two-way endeavor that extends our clinical knowledge into related fields and brings knowledge back into the institution to deepen and refine our understanding and clinical practice.

These investigations involve the use of innovative methods and collaborative partnerships with other health care organizations to better understand the sociocultural, interpersonal, developmental, and biological factors that impact individuals contending with adversity, at the Austen Riggs Center and beyond.

Our current research projects are described below:

Dr. Jane G. Tillman Talks About Research at the Austen Riggs Center

Current Research

 

Addiction and PTSD: Investigating Links between Substance Use and the Intergenerational Transmission of Trauma (IRB# 2019-008)

Principal Investigator: Marilyn Charles, PhD, ABPP

Collaborating Investigators and Institutions: David Neal, PhD, Patrick Kelley (ARC); Karla Gomez, Leslie Thompson, MA (Universidad de Monterrey, Mexico)

This study aims to add to the body of existing research data that has supported psychoanalytic and attachment theories that link the intergenerational transmission of trauma and developmental deficits in relation to affective self-regulation, coping, and reflective capacities. It looks at trajectories over time through analysis of interviews from the Follow Along Study using the Metacognitive Assessment Scale to code these.

Adverse Life Events and Sleep (ALES) - subject screening for participation in studies 2016-001 (EMA) and 2019-006 (NIMH) (IRB# 2019-007)

Principal Investigator: Katie Lewis, PhD

Collaborating Investigators and Institutions: Jane Tillman, PhD, ABPP, Jeremy Ridenour, PsyD (ARC), Fiona Brown (ARC); Nicole Cain, PhD (Rutgers University); Kevin Meehan, PhD (LIU Brooklyn); Michael Roche, PhD (Penn State-Altoona)

This study serves the dual purpose of assisting with determining eligibility of subjects for inclusion in two studies - ARC IRB# 2016-001 and 2019-006. This protocol will additionally enable the collection of important details of diagnosis at time of participation and past adverse life experiences in participants for both studies.

Influence of Daily Disruptions in Sleep and Self-Regulation on Proximal Risk for Suicide (IRB# 2019-006)*

*Rutgers University is IRB of record

Principal Investigator: Nicole Cain, PhD (Rutgers University)

Collaborating Investigators and Institutions: Katie Lewis, PhD (ARC); Kevin Meehan, PhD (LIU Brooklyn)

This study evaluates the hypothesis that disturbed sleep will carry deleterious effects on subsequent days’ interpersonal functioning, leading to proximal increases in suicidal ideation and behavior, as buffered by effortful control. Mobile assessment methods will be used, to allow for more precise temporal resolution and consideration of situational contexts in mapping the interactive role of arousal, self-regulation, interpersonal functioning, and suicidal ideation and behavior unfolding in the real time context of everyday life.

Assessment of Characterological Change over a Year of Treatment (IRB# 2019-005)

Principal Investigator: Katie Lewis, PhD

Collaborating Investigators and Institutions: Jeremy Ridenour, PsyD, Seth Pitman, PhD (ARC); Michael Roche, PhD (Penn State-Altoona)

Case study of a subject who participated in two protocols, 2016-001 and 2018-011 (see below), to cross reference subject's data from both studies. New data will also be gathered at a second time point. The goal is to create a longitudinal study of changes in personality and interpersonal functioning over time.

Ongoing Data Collection on Psychological Assessment for Patients at the Austen Riggs Center (IRB# 2019-004)

Principal investigator: Jeremy Ridenour, PsyD

Collaborating Investigators and Institutions: Katie Lewis, PhD (ARC)

Creating a database of psychological assessment data for all patients treated at ARC. There are three goals: 1) Increase our knowledge about the patients we are treating, 2) Develop "local norms" so we could make finer discriminations between different patient groups and enhance our evaluation and treatment of complex psychiatric patients, 3) Develop a resource that will lay the foundation for future assessment research.

Psychiatry Residents’ Interest in and Barriers to Practicing Psychotherapy after Graduation (IRB# 2019-003)*

*Northwestern University is IRB of Record

Principal Investigator: Joan Anzia, MD

Collaborating Investigators and Institutions: Marina Bayeva, MD, PhD, David Mintz, MD (ARC)

Via survey of graduating fourth-year psychiatry residents in ACGME-accredited U.S. residency programs, goals are: 1) assess graduating psychiatric residents’ interest in practicing psychotherapy after graduation; 2) identify barriers in securing a job supportive of psychotherapy practice; and 3) examine actual job outcomes for graduating residents interested in practicing psychotherapy.

Dissociation and Metacognition: A Mixed Methods Analysis of PTSD and Dissociative Disorder or PTSD with Dissociative Features (IRB# 2019-002)

Principal Investigator: Marilyn Charles, PhD, ABPP

Collaborating Investigators and Institutions: Richard Nalbandian, MA, Nancy Thurston, PhD, ABPP, Mark McMinn, PhD, ABPP (George Fox University)

To further understand psychological trauma and the effectiveness of intensive-four times per week therapy. Before and after individuals go through treatment, examining the subjects' capacity to think about their own and others' thinking and/or mental states. Understanding the specific disruptions in reflective capacity in a population that suffers psychological trauma may illumine important knowledge into the causes and treatment of this particular mental health disorder. Additionally, the study will track themes of psychological disconnection versus connection in both beginning and ending the course of intensive therapy.

The Impact of Object Relations, Personality, and Cognitive Functioning on Changes in Psychotherapy (IRB#2019-001)

Principal Investigator: Steve Ackerman, PhD

Collaborating Investigators and Institutions: Matthew Baity, PhD, Jennifer Balaban, Anna Klauer, Carlos Oliveira (Alliant International University)

Using the Follow Along Study archival data, this study examines if and whether psychological testing data can inform how well a patient does in long-term psychotherapy – i.e., is there information gathered before treatment that can be used to identify patients who might and might not be able to change? The study will examine specific test score data from patients that have completed clinical research assessment tests of interest.

 

Narcissism, Psychopathy, and Addiction (IRB# 2018-009)

Principal Investigator: Marilyn Charles, PhD, ABPP

Collaborating Investigators and Institutions: Kai Naor (Bard College at Simons Rock)

The character/developmental issues often seen in ARC patients makes it difficult for them to benefit from standard treatment regimens for substance abuse. This study asks if this is due to psychosocial constructions that would benefit from psychosocial rather than behavioral interventions. Uses data from 67 subjects with substance abuse disorders. The case abstract will be reassessed to investigate links between psychopathy, narcissism and addiction, reflective function, character development, and substance abuse.

Collecting Social Cognition and Object Relations Scale – Global Method (SCORS-G) Data from the Thematic Apperception Test for Patients Admitted 2015-2017 (IRB# 2018-006)

Principal Investigator: Jeremy Ridenour, PsyD

Collaborating Investigators and Institutions: Seth Pitman, PhD, Dan Knauss, PsyD, Katie Lewis, PhD (ARC); Caleb Seifert, PhD (University of Michigan); Michelle Stein, PhD (Massachusetts General Hospital)

Assembling a database to explore how ARC patients experience interpersonal challenges in comparison to other clinical samples, and also how structural elements of their internalized object representations change over the course of time and treatment. This study is rating all Thematic Apperception Test (TAT) records for patients admitted to the Austen Riggs Center from 2015-2017 using the Social Cognition and Object Relations Scale – Global Method (SCORS-G) as well as ratings collected from newly admitted patients from 2018 onwards. SCORS-G assesses object relations and cognitive and affective dimensions of social cognition which may help indicate a link with risk of engagement in suicidal and self-harming behaviors as well as significant improvements in psychiatric functioning over a five year period. This database will provide a platform for future research.

Presentations

Ridenour, J, Lewis, K., Siefert, C., Stein, M. B. (2019) Card Pull on Complex Psychiatric Patients in a Residential Setting. Presented at Society for Personality Assessment Annual Convention.

A Pilot Study on Natural Language Processing to Differentiate Patients with Psychosis from Those with Mood Disorders and Personality Disorders (IRB# 2018-002)

Principal Investigator: Marilyn Charles, PhD, ABPP

Collaborating Investigators and Institutions:  David Hafner, PhD, Grecia Cardenas, Juan Herrera, Maria Miron, Aldo Salinas (Universidad de Monterrey, Mexico), Alejandro Villegas, PhD (CentroGeo, Mexico), Edwyn Bobadilla, PhD (CINVESTAV, Mexico)

A pilot study into the feasibility of using computational algorithms of Natural Language Processing (NLP) to analyze the free speech of psychiatric patients to detect language-based variables. This first step involves gathering data, the second entails selecting the right NLP techniques, and the third deploying software tools to instantiate metrics and models. The data will be obtained from de-identified information from the Guided Clinical Interview (GCI), the Structured Clinical Interview (SCID) for DSM-IV Axis I Disorders, and the Dynamic Interview, commencing with a pilot study of 12 subjects. The NLP analyses is to be conducted in part at Universidad de Monterrey, CentroGeo and CINVESTAV, three research sites in Mexico.

Metacognitive Changes in Individuals with Severe Mental Illness in Response to Psychoanalytic Theory (IRB# 2017-008)

Principal Investigator: Marilyn Charles, PhD, ABPP

Collaborating Investigators and Institutions:  David Neal, PhD (ARC); Nancy Thurston, PhD, ABPP (George Fox University)

Investigates group differences in metacognition and metacognitive changes over time in response to long-term psychodynamic psychotherapy amidst a population with severe mental illness diagnoses. 30 subjects are selected with dual diagnoses of either narcissistic personality disorder (NPD), or borderline personality disorder (BPD), and either substance use disorder (SUD) or psychosis (PSY). Statistical analysis will assess for group differences and change over time. If studying NPD and BPD patients is inadequate for analysis the investigators will compare BPD patients to another group with concomitant substance use or psychosis, such as groups with severe depression or PTSD. The analyses will be conducted in part at George Fox University.

Follow-Up to the States of Mind Study (IRB# 2017-004)

Principal Investigator: Jane Tillman, PhD, ABPP

Collaborating Investigators and Institutions: Katie Lewis, PhD, Maria Ciarleglio, PhD, Saksham Chandra (Yale School of Public Health)

Follows up on Dr. Tillman’s previous study “States of Mind” to identify potential predictors of suicidal behavior. Dr. Tillman is following up with the original participant cohort of 131 subjects (recruited from the ARC patient population), to have them repeat the original measures and survey and determine any changes in suicidal behavior risk.

Presentations 

Tillman, J (2019). Trajectories of Risk and Resilience: a longitudinal follow-up study of high-risk psychiatric patients. Presented at the American Association of Suicidology Annual Meeting - Winner, Best Poster.

Follow Along Study (FAS) Data Repository (IRB# 2017-001)

Principal Investigator: Marilyn Charles, PhD, ABPP

The Follow Along Study (FAS) was a naturalistic, observational research study of 226 patients admitted to ARC between September 1992 and August 2001. FAS collected data from patients in residential treatment and after discharge, until 2008, a total of 16 years, from in-person and telephone interviews, and clinical tests and surveys, providing multiple time points for the same measure. With IRB oversight, Dr. Charles serves as Principal Investigator of the FAS Archive, which is providing a useful study data set for a number of research studies listed here, and for researchers both within and outside ARC.

Salience and Impact of Interpersonal Experiences on Maladaptive Thoughts and Behaviors: An Object Relations EMA Study (IRB# 2016-001)

Principal Investigator: Katie Lewis, PhD

Collaborating Investigators and Institutions: PI: Jane Tillman, PhD, ABPP, Jeremy Ridenour, PsyD (ARC), Fiona Brown (ARC); Nicole Cain, PhD (Rutgers University); Kevin Meehan, PhD (LIU Brooklyn); Michael Roche, PhD (Penn State-Altoona); Michael Prezioso, PhD (Saratoga County Mental Health Center)

Aims to understand the ebb and flow of self-destructive impulses and suicidal thoughts and behaviors over time. It remains unclear why certain situations may be particularly salient in triggering self-harming impulses in some individuals and not others. This study uses ecological momentary assessment (EMA), a self-reporting tool operating through a phone app, to have ARC patient volunteers report their thoughts, feelings, and behaviors at multiple times over the course of a day and over multiple weeks. Dr. Lewis aims to recruit 150 subjects over 5 years from Riggs patients, and, as of June 2019, from the Saratoga County Mental Health Center.

Publications

  1. Lewis, K., Ridenour, J. (2019). The integration of EMA and single-occasion multimethod assessment data for a complex psychiatric patient. Assessment, Jan 24.

Presentations

  1. Lewis, K., Ridenour, J. (2019). Social cognitive impairments in suicidal and self-harming individuals: preliminary findings from a mixed-methods study. Presented at the American Association of Suicidality Annual Conference.
  2. Lewis, K. (2019). “But I’m not an angry guy:” A multimethod EMA case study of a complex psychiatric patient. Presented at the Society for Personality Assessment Annual Convention.
  3. Lewis, K. (2018). Suicide, psychic pain and interpersonal problems in adults with a history of bullying victimization: a preliminary study using the Brief Bullying Questionnaire. Presented at the American Association of Suicidality Annual Conference.
  4. Lewis, K. (2017). Challenges associated with implementing an ecological momentary assessment protocol in an open residential treatment setting. Presented at Aeschi 9: Suicide Across the Lifespan Conference.

SOM II: Verifying and Expanding the States of Mind Study (IRB# 2015-003)

Principal Investigator: Jane Tillman, PhD, ABPP

Follows up on Dr. Tillman’s previous study “States of Mind” to identify potential predictors of suicidal behavior. Here, in a major study of 305 clinical files, Dr. Tillman is reviewing the clinical records of the original cohort of 131 States of Mind subjects (recruited from the ARC patient population) as well as the records of 174 patients who were in treatment at ARC during the period of the original study but did not participate. The broad goals of this study are to identify further specific factors that link to or are predictive of suicidal ideation or behavior, and to determine if any subjects are now deceased, and if so, if this may be identified as suicide.

Publications from the original states of mind study IRB #2008-002

  1. Lewis, KC, Meehan, KB, Cain, NM, Wong, PS, Clemence, AJ, Stevens, JL, Tillman, JG (2019) Quality of internalized object representations and suicidality in individuals with anaclitic and introjective personality styles. Journal of Personality Disorders, May 14:1-16. DOI: 10.1521/pedi_2019_33_435
  2. Tillman, JG, Clemence, AJ, Hopwood, CJ, Lewis, KC, Stevens, JL (2017). Suicidality in high-risk psychiatric patients: the contribution of protective factors. Psychiatry: Interpersonal and Biological Processes, 80 (4): 357-373. DOI: 10.1080/00332747.2017.1296309
  3. Tillman, JG, Clemence, AJ, Cree, R, Lewis, KC, Stevens, JL, Reiss, DE (2017). The persistent shadow of suicide ideation and attempts in a high risk group pf psychiatric patients: a focus for intervention. Comprehensive Psychiatry, 77: 20-26. DOI: 10.1016/j.comppsych.2017.05.005
  4. Lewis, KC, Meehan, KB, Cain, NM, Wong, PC, Clemence, AJ, Stevens, JL, Tillman, JG (2015). Impairments in object relations and chronicity of suicidal behavior in individuals with borderline personality disorder. Journal of Personality Disorders, 30 (1): 19-34. DOI: 10.1521/pedi_2015_29_178
  5. Lewis, KC, Meehan, KB, Tillman, JG, Cain, NM, Wong, PC, Clemence, AJ, Stevens, JL (2014). Impact of object relations and impulsivity on persistent suicidal behavior. Journal of the American Psychoanalytic Association, 62: 485-494. DOI: 10.1177%2F0003065114539007

 

 

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