The authors investigated incidence, impact, and methods of coping with patient suicide during the training years of Psychology graduate students. All 54 interns in clinical psychology at the Boston VA in 1983-1988 were surveyed. 1 in 6 Ss had experienced a patient's suicide at some time during their training. The group who experienced a patient^ suicide and a group who experienced a patient's suicide attempt both reported high levels of stress on the Impact of Event Scale. Trainees with patient suicides reported stress levels equivalent to that found in patient samples with bereavement and higher than that found with professional clinicians who had patient suicides. Trainees most frequently turned to supervisors for both support and formulation of the suicide. Preparatory efforts at suicide education were found to be minimal and inadequate. Recommendations for assisting the trainee who experiences a patient's suicide are discussed.In their literature reviews on psychotherapists who had had a patient who committed suicide, Goldstein and Buongiorno (1984) and Brown (1987aBrown ( , 1987b noted therapists' reactions of disbelief, denial, shame, guilt, anger, failure, and loss of selfconfidence. Dealing with such feelings and reactions is a difficult and complicated matter. There are reports of anxiety about clinical, ethical, and legal responsibility for a death. Attitudes about death itself, particularly death that is self-inflicted, proba-PHILLIP M. KLEESPIES received his PhD from Clark University in 1971. He serves as a Clinical Psychologist on an acute inpatient psychiatry

Factor analysis of the Bell Object Relations Inventory items produced four subscales interpreted to be underlying dimensions of object relations. Replication factor analysis confirmed the factor structure. Subscales had high internal consistency and were free of age, sex, or social desirability response bias. Subscales had low intercorrelations with Brief Psychiatric Rating Scale (BPRS) sum scores, Global Assessment Scale scores, and most BPRS symptoms. Subscales appear to represent common features of personality and to sample a domain that is distinct from symptomatology, but related to variations in psychopathology. Percentage of high scoring subjects and subscale mean values are compared for seven criterion groups. High scores were least frequent among community active adults and most frequent among borderlines. Selected findings from the group comparisons are discussed to illustrate the potential of the instrument for empirical examination of theoretical assumptions about the object relations ego function and its components.

Two types of bulimic (purging and restricting) and two types of non‐bulimic (binging or normal) eating patterns were reported by 547 undergraduate women who also were assessed for ego function deficits on the four subscales of the Bell Object Relations Inventory. As predicted by psychoanalytic theory, the two bulimic subgroups appeared significantly more pathological on the Insecure Attachment subscale, which identifies ambivalent interpersonal relations and fear of object loss. When the four groups were ranked according to severity of type of eating disorder, a linear increase in group means and in the proportion of high scoring subjects was found on Insecure Attachment and also on the Egocentricity subscale, which indicates suspicious and manipulative attitudes towards others. Results are interpreted to support theories that relate eating disorder to disturbances in object relations ego functioning.

Factor analysis of the Bell Reality Testing Inventory items produced three subscales interpreted as dimensions of the reality testing ego function. Replication factor analysis confirmed the factor structure. Subscales were assessed for internal consistency and for age, gender, and social desirability biases. Two subscales, Reality Distortion and Uncertainty of Perception, had low correlations with most Brief Psychiatric Rating Scale (BPRS) symptom scales. The third, Hallucinations and Delusions, correlated significantly with the Hallucinatory Behavior and Unusual Thought Content scales of the BPRS and with BPRS sum scores and Global Assessment Scale scores. Seven criterion groups are compared for percentage of high-scoring subjects and subscale mean values. Schizophrenics, schizoaffectives, and borderlines were most pathological on Reality Distortion and on Hallucinations and Delusions. Borderlines were highest on Uncertainty of Perception. Discriminant analysis differentiated inpatient schizophrenics from inpatients with major affective disorders with 92% classification accuracy. Subscales appear sensitive to variations in psychopathology and may further investigations involving reality testing ego functioning.

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