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Considerable advances have been made in recent years in the assessment of mental representations. One of the most reliable and valid measures of mental representations is the Social Cognition and Object Relations Scale (Westen et al. 1990). The present study used data from the Riggs-Yale Project (Blatt and Ford 1994) to assess changes in mental representations following intensive inpatient psychoanalytically oriented treatment of severely disturbed, treatment-resistant patients. 71(.*/*%1#.2!1#'!7($/&'-(&2! The study included 84 patients (mean age = 21). Patients received, on average, 1.5 years of psychoanalytically oriented treatment and had undergone psychological testing at admission and at the end of the study period. Most patients were at least middle-class, with at least average IQs. Approximately 30% were diagnosed with a DSM-III psychotic condition. Object relations were coded from six TAT cards (1, 5, 12 M, 13 MF, 14, 15). The Social Cognition and Object Relations Scale (SCORS) includes four dimensions of object relations, each scored on a 5-point scale with scores of 5 being healthy. Complexity of Representations (CR) assesses degree of differentiation, integration and complexity. Affect-tone of Relationships (AT) assesses malevolence (vs. benevolence) of relationships. Capacity for Emotional Investment (EI) assesses the degree of need-gratifying vs. mutual relatedness. Understanding Social Causality (SC) assesses the degree to which social attributions are logical, accurate, and psychologically minded. H*2/-22*$#! Significant changes in object relations were demonstrated following psychoanalytically oriented inpatient treatment. Following treatment, descriptions of relationships were less malevolent, idiosyncratic, and illogical and showed more mutuality, complexity, and psychological mindedness. Overall, these results suggest structural changes could occur in a population of severely disturbed, treatment-resistant patients following intensive psychoanalytically oriented inpatient treatment. G$#.1/.! John H. Porcerelli, PhD, ABPP. E-mail: jporcer@med.wayne.edu. Professor Director of Behavioral Medicine Director of Clinical Faculty Development Department of Family Medicine & Public Health Sciences Wayne State University School of Medicine !
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