Representational structures and psychopathology: analysis of spontaneous descriptions of self and significant others in patients with different mental disorders.

BACKGROUND The article was designed to contribute to the empirical clarification of representational structures among adult psychiatric patients. According to psychoanalytic concepts, cognitive developmental psychology and attachment theory, various forms of adult psychopathology involve fundamental impairments in representational structures or cognitive-affective schemas. SUBJECTS AND METHOD We conducted a study to research the structural characteristics of representations of self and significant others in patients with different, mostly severe mental disorders according to DSM-IV and Kernberg's structural criteria for personality organizations. The modified Blatt's method for assessment of conceptual levels of object representations, Kernberg's criteria for identity diffusion and some others measures were used in the analysis of spontaneous descriptions of self and significant others in 186 adult psychiatric in- and outpatients and 109 controls of both sexes. RESULTS The results show significant differences in the developmental level of representational structures between different groups of psychiatric patients and healthy controls. Patients (particularly schizophrenic) reached lower scores on the Conceptual Level Scale compared to healthy controls. Patients' descriptions of self and significant others were more preoperational, concrete, one-dimensional, less differentiated and less integrated. They also described significant others and themselves in a more diffuse, contradictory and shallow way in comparison to healthy controls. CONCLUSIONS Results support previous empirical findings and are for the most part in accordance with developmental cognitive and psychoanalytic theories. As mental representation is a central theoretical construct in cognitive science, in developmental and social psychology and also in psychoanalytic theory and research, the studies of representational structures may demonstrate an important contribution in understanding aspects of personality and psychopathology.