Clinical Validity of a Dimensional Assessment of Self- and Interpersonal Functioning in Adolescent Inpatients

Abstract

The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a clinical rating system assessing eight domains of self and interpersonal relational experience which can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943]; early memories narratives) or oral data (e.g., psychotherapy narratives, Relationship Anecdotal Paradigms). In the current study, seventy-two psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS-G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating disordered behavior and history of nonsuicidal self-injury. SCORS-G composite ratings achieved an acceptable level of inter-rater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy; history of nonsuicidal self-injury). SCORS-G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS-G with adolescents.

Dimensional measure of self and interpersonal functioning: Comparisons with treatment alliance and readiness for inpatient psychotherapy

“…All available information including background information and behavioural observations of the patient made by the staff were used in the clinicians' SCORS‐G ratings. Haggerty et al () showed, using the same sample, that the interrater reliabilities of the variables and composite score were found to be in the good range (Shrout & Fleiss, ).…”

“…Consented patients completed the inpatient treatment alliance scale (I‐TAS) at discharge along with other study measures. A description of the study setting, clinical raters, and their reliability training can be found in Haggerty et al (), as this study uses the same dataset.…”

“…Twenty‐three percent of the sample reported a history of nonsuicidal self‐injury and 4% had a history of eating disordered behaviour. The setting, description of clinical raters, and rating procedures have been described previously (Haggerty et al, )…”

“…Second, Haggerty et al () investigated the SCORS‐G reliability and validity on adolescent inpatients. In this study, both the patient's individual and group therapist completed the SCORS‐G scales blind to one another and all other study data.…”

What interpersonal problems are related to different therapeutic techniques early in treatment?

“…The finding that PI interventions correlate positively with clinically significant levels of global interpersonal problems may have important clinical implications, as Haggerty et al (2015) found that better interpersonal functioning was positively correlated with engagement in the therapeutic process. We additionally found that CPPS-PI was significantly positively related to nonassertiveness.…”