Relationship between the Social Cognition and Object Relations Scale (SCORS) and attachment style in a clinical sample

The relationship between attachment styles, psychopathology and quality of social interaction: A study on a clinical sample

The aim of this study is to examine the differences between four attachment styles in relation to symptoms of psychopathology and the quality of social interaction, as well as to determine the role of attachment and psychopathology in predicting positive and negative social exchange. A total of 57 participants from the neuropsychiatric department of the Service for Specialist-Consultative Health Activities of the Health Centre in Novi Sad took part in the research. Respondents were mostly female (61%), aged 17 to 68 (M=40.13, SD=12.35). The Relationship Questionnaire (RQ) was used for attachment styles assessment. Psychopathological symptoms were measured using the Cornell Index (CI-N4), and the quality of social relationships was evaluated via the Network of Relationship Inventory (NRI). The highest rate of symptoms was detected in subjects with a preoccupied style, followed by those whose style was identified as fearful. The same two styles showed the least positive social exchange. Statistically significant differences on most scales from CI-N4 were found mainly between the secure and preoccupied subjects, while subjects with the avoidant pattern did not demonstrate significant differences in psychopathology and social functioning compared to secure participants. Secure affective attachment and low aggressive-antisocial indicators (impulsiveness, aggression, and paranoia) were the most important predictors of positive social exchange. Understanding psychopathological manifestations of different insecure attachment styles can contribute to the efficiency of psychodiagnostic and psychotherapeutic processes. Furthermore, the fact that insecure attachment and aggressive-antisocial factor predominantly compromise positive social interaction can facilitate goal setting during psychological treatment within the clinical spectrum.

RELATIONSHIPS BETWEEN ATTACHMENT DIMENSIONS AND AFFECT IN ADULTHOOD

This research was conducted during the state of emergency in response to coronavirus pandemic with the aim to further examine the relationships between attachment dimensions – attachment anxiety and attachment avoidance – and affect and to test the mediating role of psychological flexibility in these relationships. The sample which was obtained by using the snowball sampling method consists of 1515 adults from the Republic of Srpska, entity of Bosnia and Herzegovina (70.4% females) aged between 18 and 65 who filled an online questionnaire battery. Attachment dimensions were measured by the Relationship Questionnaire (RQ), affect by the Negative and Positive Affect Scale (NAPAS), and psychological flexibility by the Acceptance and Action Questionnaire (AAQ-II). The results indicate that attachment anxiety and attachment avoidance correlate positively with the negative affect and correlate negatively with the positive affect. Furthermore, the results showed that the relationships between attachment dimensions and negative affect can be explained through psychological flexibility – higher values of attachment dimensions contribute to lower psychological flexibility, which then leads to higher negative affect. The obtained findings have been considered in the light of theoretical and practical importance.

Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization

PURPOSE OF REVIEW

The concept of personality functioning (Alternative DSM-5 Model of Personality Disorders) has led to increased interest in dimensional personality disorder diagnosis. While differing markedly from the current categorical classification, it is closely related to the psychodynamic concepts of personality structure and personality organization. In this review, the three dimensional approaches, their underlying models, and common instruments are introduced, and empirical studies on similarities and differences between the concepts and the categorical classification are summarized. Additionally, a case example illustrates the clinical application.

RECENT FINDINGS

Numerous studies demonstrate the broad empirical basis, validated assessment instruments and clinical usefulness of the dimensional concepts. Their advantages compared to the categorical approach, but also the respective differences, have been demonstrated empirically, in line with clinical observations. Evidence supports the three dimensional concepts, which share conceptual overlap, but also entail unique aspects of personality pathology, respectively.

Emotion regulation in adolescents: Influences of internal representations of relationships - An ERP study

Emotion regulation (ER) strategies can decrease the intensity or modify the experience of emotions. Deficits in emotion regulation are implicated in a wide range of psychopathologies. It is argued that interpersonal, socio-cognitive, and developmental variables play an important role in ER. This is the first study to explore the contribution of individual differences in internal representations of relationships (IRR) to neural correlates of ER in a sample of adolescents. Event related potentials of 53 adolescents (12 to 17 years old) were collected while performing an ER task. IRR was assessed with the social cognition and object relations scale (SCORS-G; Westen, 1995) coding of narratives from interviews. Results show that individual differences in IRR significantly predicted the modulation of emotional responses by expressive suppression in adolescents, accounting for 48% of the variance of changes in occipital late positive potentials (LPP). Thus, it appears that IRR are implicated in an individual's ability to regulate emotions. The clinical implications of the findings are discussed.

SCORS-G and Card Pull Effect of TAT Stories: A Study With a Nonclinical Sample of Children

Previous research has shown that stimulus pull is one of the contributory factors influencing Thematic Apperception Test (TAT) responses. In recent years, there has been a resurgence of studies examining this. In particular, the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) has been employed to examine stimulus pull in adult clinical and nonclinical samples. The present study is the first attempt to examine this issue in a nonclinical sample of children. Ninety-eight children from Italian elementary (1st to 5th grade) and middle (6th to 8th grade) schools provided narratives to six TAT cards (1, 2, 3BM, 4, 8BM, and 16). Some important findings with regard to variance within scales replicate prior findings from other studies. Furthermore, some findings regarding the specific nature of pull for particular TAT cards (1, 2, 3BM, and 4) replicate prior work. Given that Cards 8BM and 16's SCORS-G stimulus properties have not been previously studied, the pull of these cards is explored. Last, SCORS-G differences/similarities across these two age groups are highlighted. Suggestions for further research in this field are also provided, particularly concerning the use of SCORS-G and TAT for clinical assessment.

Validation of a 16-Item Short Form of the Czech Version of the Experiences in Close Relationships Revised Questionnaire in a Representative Sample

The aim of this study was to create a shorter Czech version (ECR-R-16) of the Revised Experiences in Close Relationships (ECR-R) questionnaire and to assess its psychometric properties. Data from a representative sample of the Czech population from 15 to 90 years old (N = 1000, M age = 46.0 years, SD = 17.3) were collected using a face-to-face structured interview in 2014. The developed short form of the Czech version of the ECR-R showed good internal consistency (alphas varied from .84 to .90), and both exploratory and confirmatory factor analyses replicated the two-dimensional model. The results also demonstrated concurrent validity with measures of neuroticism, self-esteem, and positive and negative affect. People living with a partner and people with higher educational levels had significantly lower Avoidance scores than people living alone and people with lower educational levels. It was concluded that the ECR-R-16 questionnaire has good psychometric properties and is a valid assessment method in the Czech cultural context, suitable for research and clinical studies, when the shorter form of a measure is desirable.

Dimensional assessment of self- and interpersonal functioning in adolescents: implications for DSM-5's general definition of personality disorder

Central to the proposed DSM-5 general definition of personality disorder (PD) are features of self- and interpersonal functioning. The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a coding system that assesses eight dimensions of self- and relational experience that can be applied to narrative data or used by clinically experienced observers to quantify observations of patients in ongoing psychotherapy. This study aims to evaluate the relationship of SCORS-G dimensions to personality pathology in adolescents and their incremental validity for predicting multiple domains of adaptive functioning. A total of 294 randomly sampled doctoral-level clinical psychologists and psychiatrists described an adolescent patient in their care based on all available data. Individual SCORS-G variables demonstrated medium-to-large effect size differences for PD versus non-PD identified adolescents (d = .49-1.05). A summary SCORS-Composite rating was significantly related to composite measurements of global adaptive functioning (r = .66), school functioning (r = .47), externalizing behavior (r = -.49), and prior psychiatric history (r = -.31). The SCORS-Composite significantly predicted variance in domains of adaptive functioning above and beyond age and DSM-IV PD diagnosis (ΔR(2)s = .07-.32). As applied to adolescents, the SCORS-G offers a framework for a clinically meaningful and empirically sound dimensional assessment of self- and other representations and interpersonal functioning capacities. Our findings support the inclusion of self- and interpersonal capacities in the DSM-5 general definition of personality disorder as an improvement to existing PD diagnosis for capturing varied domains of adaptive functioning and psychopathology.

Clinical validity of a dimensional assessment of self- and interpersonal functioning in adolescent inpatients

The Social Cognition and Object Relations Scale-Global Version (SCORS-G) is a clinical rating system assessing 8 domains of self- and interpersonal relational experience that can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943], early memories narratives) or oral data (e.g., psychotherapy narratives, relationship anecdotal paradigms). In this study, 72 psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS-G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating-disordered behavior, and history of nonsuicidal self-injury. SCORS-G composite ratings achieved an acceptable level of interrater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy, history of nonsuicidal self-injury). SCORS-G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS-G with adolescents.

Object relations and reality testing in schizophrenia, bipolar disorders, and healthy controls: differences in profiles and clinical correlates

OBJECTIVE

Deficits in object relations (OR) and reality testing (RT) functions are found in schizophrenia but have never been investigated in bipolar disorder. In the current study, we examine if there are OR and RT differences in schizophrenia and bipolar disorder compared to healthy controls and to what extent differences in clinical characteristics mediates the putative effect of diagnosis.

METHODS

We used the Bell Object Relation and Reality Testing Inventory (BORRTI) to measure OR and RT in schizophrenia (n = 55), bipolar disorder (n = 51) and healthy controls (n = 158). Diagnoses and the life time presence of psychotic symptoms were evaluated based on the Structured Clinical Interview for DSM-IV. We used the Positive And Negative Symptom Scale to measure current symptoms.

RESULTS

Analyses of variance with post hoc tests showed statistically significant differences in OR and RT between the Schizophrenia (SCZ), Bipolar Disorder (BD), and Healthy Control (HC) groups. Multiple regression analyses indicated that a lifetime history of psychotic symptoms contributed significantly to the variance in one BORRTI subscale (Social Incompetence) while Positive And Negative Symptom Scale components (either the positive component and emotional discomfort component) contributed significantly to the variance in all BORRTI subscales except one (Uncertainty of Perception).

CONCLUSIONS

OR and RT deficits are present both in SCZ and BD, but differences appears to be mediated by differences in current positive and depressive symptoms.