Vaughan S C, Spitzer R, Davies M, Roose S
Center for Psychoanalytic Training and Research, Columbia University, New York, NY 10032, USA.
Int J Psychoanal. 1997 Oct;78 ( Pt 5):959-73.
Although analytic process (AP) is a core concept in psychoanalytic theory and practice and has emerged as an important variable in outcome studies, there is no consensus regarding its definition and operationalisation. This paper describes the development and validation of the Columbia Analytic Process Scale (CAPS), a rating scale developed to evaluate the presence or absence of AP in a single psychoanalytic session transcript for purposes of an outcome study. Definitions of interrater reliability and construct validity are reviewed and two studies designed to evaluate these important aspects of the CAPS are presented. The results demonstrate that the CAPS has adequate interrater reliability (kappa = .5). To establish construct validity the plan was to compare the CAPS rating of AP to clinical consensus. However, when a group of ten senior training and supervising analysts at Columbia were asked to rate five psychoanalytic session transcripts, no clinical consensus could be established. Statistical analysis of the pattern of the analysts' clinical ratings showed that the largest portion of the variance was accounted for by the error term of a two-way ANOVA. The implication of this finding is that the construct of AP itself is ill-defined. The results of this study suggest that the commonly used term AP has less consensually held meanings than analysts tend to believe; the impact of lack of definition of key terms on clinical and research pursuits within psychoanalysis is discussed.
尽管分析过程（AP）是精神分析理论与实践中的核心概念，且已成为疗效研究中的一个重要变量，但对于其定义和操作化尚无共识。本文描述了哥伦比亚分析过程量表（CAPS）的开发与验证，该量表是为在疗效研究中评估单个精神分析会话记录中是否存在分析过程而编制的评定量表。回顾了评分者间信度和结构效度的定义，并呈现了两项旨在评估CAPS这些重要方面的研究。结果表明，CAPS具有足够的评分者间信度（kappa = 0.5）。为建立结构效度，计划将CAPS对分析过程的评分与临床共识进行比较。然而，当要求哥伦比亚大学的十位资深培训与督导分析师对五份精神分析会话记录进行评分时，未能达成临床共识。对分析师临床评分模式的统计分析表明，方差的最大部分由双向方差分析的误差项解释。这一发现的含义是，分析过程这一概念本身定义不明确。本研究结果表明，常用术语分析过程的共识性含义比分析师通常认为的要少；文中讨论了关键术语缺乏定义对精神分析临床和研究工作的影响。
