Am J Psychiatry 1996; 153:1189-1194
Copyright © 1996 by American Psychiatric Association
Assessment of object relations and reality testing in methadone patients
MJ Rutherford, JS Cacciola, AI Alterman and JR McKay
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
OBJECTIVE: The authors studied methadone maintenance patients to determine
the degree of their impairment in object relations and reality testing and
the relationship of such impairment to comorbid axis I and axis II
disorders. It was expected that deficits in object relations and, to a
lesser degree, reality testing would be exhibited by the group as a whole
and that they would be related to the presence of comorbid disorders.
METHOD: The self-report Bell Object Relations Reality Testing Inventory was
administered to 240 methadone maintenance patients. The subjects were first
divided into groups on the basis of number of comorbid axis I disorders and
then on the basis of number of comorbid axis II disorders. Finally, the
subjects were placed into one of four groups on the basis of the combined
presence or absence of axis I and axis II disorders. RESULTS: The methadone
patients exhibited some specific impairments in object relations, but not
in reality testing. Bell inventory scores did not significantly differ
according to the number of comorbid axis I disorders, but they did
significantly differ according to number of axis II disorders diagnosed.
The scores were poorest for those with axis II disorders only, while
subjects with only axis I disorders had scores similar to those with
neither axis I nor II disorders. CONCLUSIONS: Comorbid axis II disorders,
more than axis I disorders, may be associated with problems in object
relations and reality testing in methadone patients.
