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Object Relations, Reality Testing, and Social Withdrawal in Schizophrenia and Bipolar Disorder

Hansen, Charlotte Fredslund MA*†; Torgalsbøen, Anne-Kari PhD*; Røssberg, Jan Ivar PhD†‡; Romm, Kristin Lie PhD; Andreassen, Ole Andreas PhD†‡; Bell, Morris D. PhD§; Melle, Ingrid PhD†‡

The Journal of Nervous and Mental Disease: March 2013 - Volume 201 - Issue 3 - p 222–225
doi: 10.1097/NMD.0b013e3182848ae0
Original Articles

In this study, we investigated the relationships between observed social withdrawal (Positive and Negative Syndrome Scale [PANSS] Passive Social Withdrawal and PANSS Active Social Avoidance), subjectively experienced social withdrawal (Social Functioning Scale [SFS] Withdrawal and SFS Interpersonal Behavior), and their associations to the underlying psychological patterns of Object Relations and Reality Testing. Patients with schizophrenia (n = 55) and bipolar disorder (n = 51) from the ongoing Thematically Organized Psychosis project, Oslo University Hospital, Norway, were evaluated using the Bell Object Relations and Reality Testing Inventory, the PANSS, and the SFS. Object relations and reality testing subscales related differentially to PANSS Passive Social Withdrawal and PANSS Active Social Avoidance. These two measures, together with the level of alienation, explained a significant amount of variance in self-experienced social dysfunction. Findings reveal the multidimensional nature of social dysfunction in severe mental disorders.

*Department of Psychology, University of Oslo; †Psychosis Research Unit, Oslo University Hospital; ‡Psychosis Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; and §Yale University, School of Medicine, New Haven, CT.

Send reprint requests to Charlotte Fredslund Hansen, Department of Psychology, University of Oslo, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål, PO Box 4956, 0424 Oslo, Norway. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.