8<$*$7$2*!%01)%(6!):!10%6)*2<$(4!12(#)<)D4!):!12($0*(6!30D$**$*D!2*&! 12($0*(6!0*&$*D!1647#)2*2<46$6!
8)D2*_!5>_!/)%70%0<<$_!i>H>![+,,.^>!8<$*$7$2*!%01)%(6!):!10%6)*2<$(4!12(#)<)D4!):!12($0*(6!30D$**$*D!2*&!12($0*(6! 0*&$*D!1647#)2*2<46$6>! '(A?-"B"LA&@+*&'(A?-",-%#@:A^&1-%"#AO&3%(%@#?-&@+*&'#@?,)?%O&be _!+P.E+]b>! Q#0&<0%_!i>_!G!K06(0*_!O>![-\\b^>!50:$*$*D!(#0!9026B%090*(!):!=c$6!;;?!=!fE6)%(!1%)70&B%0!:)%!266066$*D! 10%6)*2<$(4!12(#)<)D4>! /((%(($%+, _!._!PPPhP.P>! >-001(3! The purpose of this work was to use a clinician Q-sort procedure to describe the personality pathology and adaptive functioning of patients beginning and ending psychoanalysis. With a cross-sectional design, Cogan and Porcerelli compared a group of patients beginning and a group of patients ending psychoanalysis. This was the first comprehensive assessment of the personality of patients beginning and patients ending psychoanalysis with a measure that (a) is consistent with Axis II of DSM-IV, (b) includes commonly observed Axis I symptoms which often co-occur with Axis II psychopathology, (c) draws on the expertise of clinicians; and (d) has been psychometrically evaluated in published studies of reliability and validity. Twenty-six psychoanalysts described a patient beginning psychoanalysis and twenty-eight described a patient ending psychoanalysis using the Shedler–Westen Assessment Procedure 200 (SWAP-200). The SWA-200 is clinically sensitive, reliable, and valid measure of personality disorders, traits, and strengths which harnesses clinician judgments about patients and is consistent with DSM-IV personality disorder categories (Shedler & Westen 1998). Each clinician also completed questions about themselves, the patient, and the treatment. The most characteristic SWAP-200 items describing patients beginning and patients ending psychoanalysis provide a meaningful picture of the two groups. Among patients at the end of psychoanalysis, scores were significantly lower on the SWAP-200 Paranoid, Schizotypal, Borderline, Histrionic, and Dependent scales and scores were significantly higher on the SWAP-200 High functioning scale and the DSM-IV GAF scale. At the beginning of psychoanalysis, of the 15 most descriptive items, 10 items concerned internal struggles (afraid of rejection or abandonment, guilty, feels inadequate, unhappy, self critical, anxious, competitive,ashamed, submissive, and creates situations that lead to unhappiness). In contrast, at the end of psychoanalysis, of the 15 most descriptive items, four concerned positive aspects of work (satisfaction in pursuing long-term goals, pleasure in accomplishing things, able to use talents effectively, and contentment in life’s activities), three concerned positive relationships with others (fulfilment in mentoring, empathic, able to assert appropriately), and three concerned resilience (resolution of painful experiences from the past; can hear and benefit from hearing emotionally threatening information, and able to recognize alternative viewpoints even when strong feelings are involved). @)15-1.*$#! The findings demonstrate the usefulness of a clinician report measure for the study of psychoanalytic psychotherapy and psychoanalysis. The SWAP-200 allows for the assessment of personality pathology and strengths and also allows for a rank ordering of both pathological and adaptive characteristics.
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