Psychoanalytic Psychology

Cain, Lylli; Diener, Marc J.; Giannopoulos, Evangeline; Bornstein, Robert F.; Szymanski, Kate; Hilsenroth, Mark J.

doi: 10.1037/pap0000595pmid: N/A

This is the first meta-analytic review of the criterion validity of the Social Cognition and Object Relations Scale (SCORS) as applied to Thematic Apperception Test narratives, evaluating whether SCORS ratings significantly correlate with external indices of psychological and behavioral functioning. The primary hypothesis of the present study was that the overall criterion validity of the SCORS with Thematic Apperception Test narratives would yield a small to medium overall weighted effect size, with specific effects aligned with individual study hypotheses. In addition, we developed several secondary hypotheses. We hypothesized that higher SCORS ratings—indicative of more adaptive object relational functioning—would be significantly associated with a range of specific external criterion variables, including (a) membership in nonclinical versus clinical populations; (b) adaptive differences among diagnostic, clinical, and developmental groups; (c) positive psychotherapy process and outcome indicators; (d) lower levels of overall symptom severity or psychopathology; (e) higher ratings of intrapsychic functioning; (f) higher ratings of interpersonal functioning; and (g) greater performance on measures of cognitive functioning. A random effects meta-analysis was conducted on 37 articles representing 32 independent samples (N = 2,399). The primary hypothesis was supported as SCORS ratings demonstrated significant criterion validity, yielding an overall weighted effect size of r = .227 (p < .001). Heterogeneity testing showed no significant between-study variability, Q(31) = 33.210, p = .360, I2 = 7%, suggesting consistency of validity effects across samples. In addition, when effect sizes were classified separately based on their different sources of criterion variables, each of these subgroup meta-analyses yielded significant results (p < .02) consistent with secondary hypotheses. Publication bias analyses were conducted, and two of these suggested some potential risk of bias. However, analyses conducted to correct for any potential risk of bias yielded an overall weighted effect size that remained statistically significant. Interrater reliability of SCORS coding in the original studies included in this meta-analysis was excellent, with an average intraclass correlation coefficient of .847 across 1,676 ratings. Analysis of Thematic Apperception Test card usage indicated that Cards 1, 2, 3BM, 4, and 13MF were most frequently administered (> 70%), supporting their use as a core set for standardized clinical assessment and research protocols. Findings provide robust evidence supporting the SCORS as a psychometrically sound measure of relational and affective functioning, with practical implications for clinical diagnosis, treatment planning, and tracking therapeutic change.

Decker, Line Brotnow; Stob, Victoria; Woolston, Joseph; Conway, C. Andrew; Slade, Arietta

doi: 10.1037/pap0000604pmid: N/A

Parents’ curiosity about and attunement to their child’s mental states significantly predict parenting behaviors and child outcomes. As a result, parental mentalizing is increasingly targeted as a transdiagnostic mechanism of change in evidence-based mental health interventions. In diverse clinical contexts, particularly with highly stressed and underresourced families, reducing parental nonmentalizing has emerged as a key marker of treatment effectiveness. However, effective assessment of mentalizing and nonmentalizing in real-time, high-arousal contexts remains challenging, as gold standard methods require time-consuming coding of transcripts or videos. This study introduces the Short Parental Observation Tool for Mentalizing, developed to assess both parental mentalizing and nonmentalizing during intensive home-based treatment for socially and economically marginalized families with high trauma exposure and psychopathology. The Short Parental Observation Tool for Mentalizing integrates 2 decades of conceptual and empirical findings to structure observations of parental mentalizing and nonmentalizing in both language and behavior. The results support the proposed four-factor structure, indicating that mentalizing and nonmentalizing expressed through language and behavior are related but distinct constructs. The Short Parental Observation Tool for Mentalizing demonstrated good psychometric properties, including sensitivity, internal consistency, and interrater reliability. The study discusses the tool’s strengths, limitations, and implications, offering a practical, reliable method for assessing parental mentalizing in demanding clinical settings.

Witter, Melissa

doi: 10.1037/pap0000603pmid: N/A

This article revisits Wilfred Bion’s concept of K (the emotional link of knowing) to explore a dimension that remains undertheorized in the literature: the question of power. While Bion and his interpreters have emphasized K as a developmental drive toward emotional truth, sustained by the therapist’s capacity for containment and reverie, this article considers whether power is not merely incidental to knowing in the analytic relationship but constitutive of it. Drawing on clinical work with complex trauma, the article explores how the asymmetry between therapist and patient, in which the therapist is structurally positioned as a necessary condition for the patient’s capacity to think their most disturbing thoughts, creates a power differential that structures the relational field. This asymmetry manifests most clearly in what might be called the risk of being known: the patient’s vulnerability in needing another mind to think their most disturbing thoughts. Building on the well-established understanding of defenses as having communicative and relational dimensions, the article considers whether defensive strategies might also be understood as assessments of power—ways of testing the therapist’s capacity to hold structural authority without wielding it destructively. More radically, it asks whether such strategies might constitute a form of primitive K: the patient’s way of knowing the therapist through developmentally early means that carry relational intelligence not yet available to symbolic thought. This reframing has implications for clinical practice, relational theory, and work with populations who have experienced systemic oppression or trauma.