Patterns of object relations and reality testing deficits in schizophrenia: Clusters and their symptom and personality correlates

Abstract

Bell Object Relations Reality Testing Inventory (BORRTI) profile scores were used to cluster 222 outpatients with schizophrenia or schizoaffective disorder. An eight-cluster solution was subjected to replication analysis, and six clusters were found valid and replicable. These clusters were sorted into three pairs that were interpreted as follows: Residually Impaired consisted of Sealed-Over Recovery and Integrated Recovery; Socially Withdrawn consisted of Socially Withdrawn and Socially Withdrawn-Autistic; and Psychotically Egocentric consisted of Psychotically Egocentric and Psychotically Egocentric-Severe. Clusters were compared on Positive and Negative Syndrome Scale ratings and on subscales from the Eysenck Personality Questionnaire. MANOVAs indicated significant differences among clusters. These differences provided further interpretations of cluster membership. Implications for the use of BORRTI profiles for treatment and rehabilitation planning are discussed.

Factor Structure of Social Cognition in Schizophrenia: Is Empathy Preserved?

“…It was developed initially for schizophrenia research and has been found to have strong psychometric properties in a wide variety of applications and to have cross-cultural validity [39]. The Alienation scale has been strongly associated with schizophrenia.The Egocentricity scale has been associated with a more autistic understanding of others and linked with measures of social functioning [2, 23]. Higher T -scores on the Alienation and Egocentricity subscale indicate more impairment.…”

“…The Egocentricity scale has been associated with a more autistic understanding of others and linked with measures of social functioning [2, 23]. Higher T -scores on the Alienation and Egocentricity subscale indicate more impairment.…”

“…For that purpose we included two subscales targeting each system. Regarding the Self-Experience of Relatedness construct, we selected measures that previous studies have shown distinguish schizophrenia from other clinical samples and discriminate various patterns of relatedness within schizophrenia samples [2, 22, 23]. …”

The relationship between post‐traumatic symptom severity and object relations deficits in persons with schizophrenia

“…Furthermore, positive symptoms are associated with greater egocentricity and less empathy; Emotional discomfort is associated with feeling socially incompetent and less securely attached to others; conversely, negative symptoms are associated with less insecure attachment suggesting an indifference to having an attachment to another person (Hansen et al ., ). Consistent with these findings, specific object relations deficits have been used to reliably create three profiles of people with schizophrenia describing them as residually impaired, socially withdrawn, or psychotically egocentric (Bell, Conway Greig, Bryson, & Kaplan, ). Object relations deficits are also closely associated with deficits in metacognitive mastery, the ability to use knowledge about oneself and others to solve problems (Lysaker et al ., ).…”

Object Relations, Reality Testing, and Social Withdrawal in Schizophrenia and Bipolar Disorder

“…A profound lack of interest in relationships and increased egocentric investments are indicated to be specific patterns in patients with more negative symptoms (Bell et al, 1992). A cluster analysis has found two groups: socially withdrawn (characterized by lack of basic trust in relationships and experiences of being social inept) and socially withdrawn autistic (with additional deficits in reality testing, such as more hallucinations and distortion in the interpretation of one's own feelings or the feelings of others) (Bell et al, 2001). In addition, we have in a previous study (Hansen et al, 2009) found differences in underlying patterns: passive withdrawal (PANSS PSW) was related to less interest in social engagement (insecure attachment), whereas avoidant behavior (PANSS ASA) was related to reality distortion.…”