Clinician reports of personality pathology of patients beginning and patients ending psychoanalysis

The purpose of this work was to use a clinician Q-sort procedure to describe the personality pathology and adaptive functioning of patients beginning and ending psychoanalysis.

With a cross-sectional design, we compared a group of patients beginning and a group of patients ending psychoanalysis.

Twenty-six psychoanalysts described a patient beginning psychoanalysis and 26 described a patient ending psychoanalysis using the Shedler-Westen Assessment Procedure 200 (SWAP-200). Each clinician also completed questions about themselves, the patient, and the treatment. The most characteristic SWAP-200 items describing patients beginning and patients ending psychoanalysis provide a meaningful picture of the two groups.

Among patients at the end of psychoanalysis, scores were significantly lower on the SWAP-200 Paranoid, Schizotypal, Borderline, Histrionic, and Dependent scales and scores were significantly higher on the SWAP-200 High functioning scale and the DSM-IV GAF scale. Common characteristics of patients beginning psychoanalysis were anxiety, guilt, and shame. Common characteristics of patients ending psychoanalysis were conscientiousness and responsibility, striving to live up to moral and ethical standards, and enjoyment of challenges.

The findings demonstrate the usefulness of a clinician report measure for the study of psychoanalytic psychotherapy and psychoanalysis.