Object Relations Schizophrenia

People with schizophrenia experience extreme difficulties in all realms of social functioning. Ordinary daily social situations pose great problems such as speaking with a store clerk, asking for directions, making phone calls, chatting with friends, and selling oneself in a job interview (Blaney & Millon, 2009). Further, many with schizophrenia are unable to keep steady employment. In 2004, Marwaha and Johnson reported that only about 10-20% of patients diagnosed with schizophrenia were employed (Blaney & Millon, 2009).

Medications and neurocognitive approaches do not fully address social dysfunction for people with schizophrenia. Medications, for example, have been shown to address symptoms but do not address social impairment issues

(2014)’s study demonstrated that Post Traumatic Stress Disorder symptoms reported by participants such as feeling separate from others, chronically afraid, and irritable are positively correlated with object relation deficits controlling for schizophrenia symptoms and educational level (Chapleau et al., 2014). In sum, object relations plays a critical role in schizophrenia.

The above studies highlight object relations’ contribution to social dysfunction associated with schizophrenia. Therefore treatments aimed at object relations could prove useful. However, with existing studies the measures used pose limitations. Thus the impact of object relations on people with schizophrenia must be understood with caution.

For example, the BORI (Bell, 1986; Chapleau, 2014), an earlier version of the BORRTI (Hansen, 2013), and the ORI (Prout, 2012) are self-report measures used to assess object relations. Responses on self-report measures are inconsistent over time (Butcher, 2013). Internal validity is subject to instrumentation threats because responses are dependent on context, level of cooperation, demographics, degree of mental health, and so forth. For instance, participants may report more benevolent parental representations during periods of health but more malevolent object relations could be seen during times of decompensation. Additionally, object relations assessed

These include complexity of representations (COM), expectations of others (AFF), ability for intimacy and emotional sharing (EIR), use of abstract thought for morality and compassion (EIM), social causality (SC), control of aggressive impulses (AGG), coherence of self-esteem, self-concept, and self-identity (SE), and level of self-fragmentation and integration (ICS). A factor analysis of the scales identified three factors (Stein, 2012): 1. Relational tone (linked with scales AFF, EIR, EIM, and AGG); 2. Self-affective states associated with relationships and important others (linked with scales SE and ICS); and 3. Cognitive and intellectual functioning (linked with scales COM and SC) (citation). The SCORS-G has strong internal consistency (Stein, 2012). Additionally, as evidence of good construct validity, the SCORS-G factor 1 had strong and positive correlations with the NEO Five-Factor Inventory Short Form, the Personality Assessment Inventory; factor 2 with the Wisconsin Card Sorting Test; and factor three with the WASI, suggesting a strong relationship with intellectual and cognitive abilities (Stein, 2012). The SCORS will be used to code TAT