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社会认知和客体关系量表-全球评定方法的维度评定、评分范围以及临床样本中叙述的“平淡”的纵向稳定性。

Longitudinal stability of Social Cognition and Object Relations Scale-Global Rating Method dimensional ratings, score ranges and narrative 'blandness' in a clinical sample.

机构信息

Erikson Institute for Education and Research, Austen Riggs Center, Stockbridge, Massachusetts, USA.

Department of Behavioral Sciences, University of Michigan-Dearborn, Dearborn, Michigan, USA.

出版信息

Clin Psychol Psychother. 2022 Jul;29(4):1447-1456. doi: 10.1002/cpp.2729. Epub 2022 Mar 2.

Abstract

While understanding how internalized representations of others (i.e., object relations) change over the course of treatment is essential for treatment planning and evaluation of progress, few studies have examined the nature of these changes through repeated psychological assessments. In this study, we applied the SCORS-G to Thematic Apperception Test narratives for 61 adult patients with complex psychiatric problems undergoing residential treatment over an 18-month period. Over the course of treatment, patient representations of self and others became more complex, indicating improvements in mentalization. Further, an analysis of default ratings (i.e., an aspect of story 'blandness') suggested that certain shifts in SCORS-G dimensional scores over time were accounted for by greater degree of scorable content across time points, rather than changes specific to the dimensions themselves. Findings from novel exploratory analyses aimed at evaluating the test-retest reliability of both default rating proportion and several emerging alternative scoring approaches (including changes in minimum, maximum and range of scores on individual dimensions) are reported. While the magnitude of change across mean dimensional scores was found to be lower compared to those previously found in outpatient populations, our results suggest that the SCORS-G remains capable of detecting changes in mentalization capacities in individuals contending with longstanding, severe psychiatric impairment and personality-based psychopathology. Implications for treatment, assessment and future research are discussed.

摘要

虽然了解他人的内在表现(即客体关系)如何在治疗过程中发生变化对于治疗计划和评估进展至关重要,但很少有研究通过重复的心理评估来检查这些变化的性质。在这项研究中,我们对 61 名接受住院治疗的复杂精神问题成年患者的主题统觉测验叙述应用了 SCORS-G。在治疗过程中,患者对自我和他人的表现变得更加复杂,表明心理化程度有所提高。此外,对默认评分(即故事“平淡”的一个方面)的分析表明,SCORS-G 维度得分随时间的某些变化是由于在不同时间点的可评分内容的程度增加所致,而不是维度本身的变化。报告了旨在评估默认评分比例和几种新兴替代评分方法(包括单个维度得分的最小值、最大值和范围的变化)的测试-再测试可靠性的新型探索性分析的结果。虽然跨平均维度得分的变化幅度低于先前在门诊人群中发现的变化幅度,但我们的结果表明,SCORS-G 仍然能够检测到长期、严重的精神障碍和基于人格的精神病理学个体的心理化能力的变化。讨论了治疗、评估和未来研究的意义。

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