The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G)

A comprehensive guide for clinicians and researchers

Michelle Stein, Jenelle Slavin-Mulford

• Publisher: Routledge
• Year: 2017
• eBook ISBN: 9781351801232
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a clinician rated measure that can be used to code various forms of narrative material. It is comprised of eight dimensions which are scored using a seven-point Likert scale, where lower scores are indicative of more pathological aspects of object representations and higher scores are suggestive of more mature and adaptive functioning. The volume is a comprehensive reference on the 1) validity and reliability of the SCORS-G rating system; 2) in depth review of the empirical literature; 3) administration and intricacies of scoring; and 4) the implications and clinical utility of the system across settings and disciplines for clinicians and researchers.

PART I

History and Empirical Research

1
INTRODUCTION

Aims

The Social Cognition and Object Relations Scale (SCORS) rating system (Westen et al., 1985/1987/1988/1989/1990; Westen et al., 1988/1990; Westen, 1993, 1995a, 1996a, 2002) has become one of the most commonly used measures to code object-relational content via narrative material. There have been three versions of the scale since its inception (SCORS, SCORS-Q sort, and SCORS-Global Rating Method (SCORS-G)), with the SCORS-G being the most recent edition. The SCORS and SCORS-G are the two versions that have been most represented in the empirical literature. The main differences between the SCORS and SCORS-G are as follows. First, the SCORS-G has eight dimensions, whereas the SCORS only has four. Second, the SCORS-G is based on a 7-point scale as opposed to the 5-point Likert scale. Finally, the SCORS-G can be applied to any type of narrative data, whereas with the SCORS, there are two versions of the scale based on the type of narrative data used. That is, there is one version used to rate Thematic Apperception Test (TAT) narratives (Murray, 1943) and a different version of the scale used to rate interview data. These differences allow the SCORS-G to capture underlying dimensions of object relations in a more comprehensive way than the original version of the SCORS. As such, this book will focus on the SCORS-G. However, since there have been a number of important studies using the original version of the SCORS that lay the foundation for future SCORS-G studies, Chapter 2 will provide an overview of all versions of this rating system (SCORS, SCORS-Q, and SCORS-G).

To date, the SCORS-G has been used predominantly for clinical research. Following in Drew Westen et al.’s footsteps, Hilsenroth, Stein, and Pinsker (2007) created a scoring manual for clinicians and researchers to use in establishing inter-rater reliability. There have been updated editions, with the most recent being Stein et al. (2011). Although the manual has been successful in providing a basic framework for using the SCORS-G and teaching clinicians and researchers how to establish inter-rater reliability in a step-by-step fashion, it is limited in scope. That is, while it provides a number of narrative-based protocols (Early Memory (EM) and TAT narratives) with ratings, it does not provide scoring rationale, nor does it represent all dimensional anchor points. The clinician and/or researcher is required to intuit the reasons for scoring as opposed to providing more comprehensive guidelines. In addition, none of the versions of the manual discuss how this measure has been used in the empirical literature (beyond references and a brief overview). Lastly, in contrast to how this measure can be used in the context of clinical research (i.e., to assess change, aspects of personality, and psychopathology), there is a relative dearth of information in the literature describing other clinical applications. As such, the purpose of this book is to provide a comprehensive textbook for clinicians and researchers. With this goal in mind, it will provide information regarding (1) validity and reliability of the SCORS-G system, (2) the variety of ways this measure has been used and subsequent findings, (3) administration and scoring, and (4) the implications and clinical utility of the system across settings and disciplines. By doing this, we hope to increase the clinician’s and researcher’s understanding of this scale and the ratings of individual dimensions. Also, we aim to enlighten readers on the ways this measure can be used as a conceptual framework within the psychotherapy and supervisory process, as well as in the context of formal intake and psychological assessment.

In this introduction, we will provide the theoretical background as well as the development of the SCORS system. Then, we will describe the uses and psychometric properties of this measure. Strengths and criticisms of this measure will also be discussed. The last portion of this introduction will be a synopsis of the sections and chapters of this book.

Theoretical Background

While the majority of this book focuses on research and clinical applications of the SCORS rating system, we feel it is prudent to discuss the theoretical framework, which led to the conceptualization and development of this measure. In this section, we summarize how Westen integrated principles from object relations and social-cognitive theory to create the dimensions associated with the SCORS rating system. However, we do not go into detail, as Westen et al. have already written extensively about this (i.e., commonalities, differences, strengths, and vulnerabilities within each theoretical/experimental framework; the integration of these two theories; and relevant theorists and experimental researchers). Instead, we provide a short summary describing how each dimension incorporates both approaches. Then, we provide a list of references. This is not an exhaustive list. Instead, our aims are to direct readers to resources that provide a comprehensive review of the theoretical underpinnings of this measure and are easily accessible.

Conceptually, Westen sought to create a measure that was multidimensional (as object relations are a multidimensional construct), sensitive to fluctuations in functioning (a variety of object-relational processes vary across circumstances), and could be applied to an array of data sources (object-relational processes manifest differently across different situations/environments). In addition, he wanted the measure to assess underlying psychological processes that are less within one’s conscious awareness, and, as such, more challenging to assess via self-report (Westen, 1995a, p. 6).

Globally, the SCORS rating systems integrate “clinically based object relations theories” with experimentally generated theories in cognitive science, particularly social cognition (Westen, 1995a, p. 4). Object-relational theorists

have examined from a clinical perspective, the nature and development of representations of self and others and the affective processes brought to bear on those representations. Their focus has been on pathological object relations (that is, problematic patterns of thought, feelings, and motivation that underlie interpersonal functioning in intimate relationships), particularly in personality disorders. Social cognition researchers have explored mechanisms of social information processing largely in normal subjects, using experimental methods.

(Westen, 1995a, p. 2)

To help the reader understand the theoretical underpinnings more specifically, we will now provide a brief summary related to each dimension individually.

Complexity of Representations of People (COM)

For COM, Westen (1995a) described that within most object-relational theories, there are three key points all related to development. First, representations of self and other should become increasingly differentiated as children mature. Second, object representations should become more complex and integrated over time. Third, as part of this integration and complexity, splitting should decrease with a greater tolerance for ambiguity and conflict. Importantly, the social-cognitive developmental research largely supports these tenets.

Affective Quality of Representations (AFF)

For AFF, psychoanalytic clinicians conceptualize this dimension as the “affective coloring of the object world” (Westen et al., 1985, p. 17). Similarly, social-cognitive researchers have explained this as the extent to which an individual expects relationships to be painful and threatening versus pleasurable and enriching.

Emotional Investment in Relationships (EIR) and Emotional Investment in Values and Moral Standards (EIM)

EIR and EIM are discussed in terms of maturational processes. Specifically, Westen et al. (1985, 1995a) discuss how these dimensions capture the growing capacity throughout development to invest both in moral values and in others for their unique qualities. This is as opposed to very early development in which decisions are based solely on one’s own needs and others are used for self-gratification. In psychoanalytic language, one can see how these dimensions capture superego development. Westen et al. (1985) and Westen (1995a) also reviewed the social-cognitive research and described how these processes can be examined via friendship, convention, moral development, pro-social behavior, authority, and justice.

Understanding of Social Causality (SC)

For SC, social-cognitive research shows that throughout development, there are a number of important shifts in how children infer causality in the social realm. Specifically, as children develop, they understand social events with increasing complexity in which they are able to utilize their own internal psychological processes to make sense out of events as opposed to solely relying on surface-level observations. Similarly, from a clinical perspective, individuals with severe personality disorders tend to make highly idiosyncratic and illogical conclusions, whereas healthier individuals form more accurate attributions regarding others’ intentions (Westen 1995a; Westen et al., 1985).

Experience and Management of Aggressive Impulses (AGG)

Interestingly, Westen has written the least about the dimension AGG. One of the reasons for this may be because it was not part of the original version of the SCORS rating system. Though, theoretically, aspects of AGG can be targeted through AFF. AGG is associated with the patient’s management of anger (self in relation to others) and how this is regulated and expressed. AFF is generally associated with the general affective valence of relationships (malevolent/hostile to benevolent) and how other people are perceived. This variable focuses on how “others” regulate and display AFF and how this subsequently impacts the “self.” Regardless, regulation and the adaptive expression of aggressive impulses have been highlighted by psychoanalytic clinicians beginning with Sigmund Freud and later by object-relational theorists (e.g., Otto Kernberg and Melanie Klein). With regard to the inclusion of this dimension, Kernberg and Caligor (2005) emphasized “a normal personality structure includes the capacity to successfully channel aggressive impulses into expressions of healthy, self-assertion, to withstand attacks without excessive reaction, to react protectively, and to avoid turning aggression against the self” (p. 122). Further, “in severe personality disorders, we see the predominance of a very intense, poorly integrated, and poorly modulated form of aggression … which is a confluence of constitutional and environmental factors” (pp. 129–130). Likewise, in the social-cognitive field, anger has been studied via the following modal processes: hostile attributions, anger rumination, proactive and reactive aggression, social information processing (cognitive and emotional processes that lead to aggression), self/emotion regulation, effortful control, and hot cognitions (Kunda, 1999).

Self-Esteem (SE) and Identity and Coherence of Self (ICS)

Lastly, with regard to SE and ICS, Westen (1992) posited that both the psychoanalytic and social-cognitive self are affective, multidimensional, and interpersonal. Both theories also highlight the degree of fluctuation versus stability in how a person views himself (i.e., how reactive one’s sense of self is to the environment) as well as to the level of integration in self-concept. The SCORS rating system attempts to integrate these clinical and experimental paradigms. Whereas the other dimensions of this rating system focus on the interplay between self and other, Westen (1995a) added SE and ICS to the SCORS-G, allowing clinicians and researchers to more specifically assess aspects of self in relation to others. Specifically, the SCORS helps to assess the self as a complex construct by taking into account the different processes, functions, and dimensions of the self. That is, patients could exhibit struggles in one area of self-structure, but not another. Thus, the SCORS attempts to provide an additional measure of the self to compliment more traditional self-report measures.

Suggested Readings (in No Particular Order)

For those interested in further increasing their understanding of the theory behind this rating system, we make several suggestions for additional reading. Many of these references include reviewing Westen’s manuals on the SCORS (Westen, et al., 1985/1987/1988/ 1989/1990; Westen, et al., 1988/1990) and SCORS-Q (Westen, 1995a, 1996a, 2002), as he goes into extensive detail regarding the conceptualization of the SCORS rating system as it relates to object relations and social-cognitive theory. There are also a series of papers that he wrote around the same time, which highlight the theoretical underpinning of this rating system (Westen, 1991a, 1991b; Westen, 1992). In Westen (1991a, 1991b), he discusses the four original dimensions. In Westen (1992), he speaks about both the cognitive and psychoanalytic self. Interestingly, while SE and ICS were not part of the rating system at the time, it provides a framework for these two dimensions for the SCORS-G. Kernberg and Caligor (2005) wrote a book chapter that is both well written and summarizes psychoanalytic and object-relational theory as it pertains to normal and disrupted personality organization. The authors clearly discuss the role of AGG in personality development and also provide useful references. We encourage readers to start with these papers.

If after these readings and the references embedded within these materials, you find yourself wanting more, then below are additional articles that we have also found relevant to understanding the theories behind this rating system. Specifically, for those interested in the conceptualization and assessment of personality organization, not specific to the SCORS rating system, we encourage reading Westen (1995b, 1996b). Similarly, Westen (1990) focuses on psychological underpinnings of narcissism using SCORS rating system language. In this paper, Westen writes about underlying processes both as separate phenomena, but also discusses the interplay between various processes. In Westen (1989), he discusses the developmental role of object relations and how theory and empirical research converge and diverge as it relates to severe character pathology. Lastly, Kunda (1999) is a textb...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgments
• Foreword
• PART I History and Empirical Research
• PART II Scoring
• PART III Clinical Applications
• Appendix A SCORS-G Scoring Criteria
• Appendix B Table of Empirical Research
• Index