Corresponding Author Information: Kate Szymanski

Session Abstract: BACKGROUND AND PURPOSE: Approximately 42 million people worldwide suffer from any form of trauma of cancer, and this number is growing. Research shows that negative interpersonal relationships with physicians, mental health workers and family members correlate with more severe psychopathology and less adherence to treatment for cancer patients (Farin, Gramm & Schmidt, 2012).The current study assessed if negative internal representations of others (i.e. an internalized framework that forms a foundation for experiencing interpersonal relationships through life) increases psychopathology in cancer patients, thus posing a risk for treatment adherence. In order to minimize participants’ self-presentational confounds in reporting perceptions and experiences of others, we used an implicit measure of object representations. SUBJECTS: This archival study employed narratives of 97 women (mean age = 45.2, SD = 8.6) with breast cancer who, as a part of a larger study, wrote brief descriptions of their experiences with the illness. METHODS AND MATERIALS: Three independent judges applied Westen’s (1995) Social Cognition and Object Relations Scale-Revisited (SCORS-R) in coding the narratives. ANALYSES: ICC was calculated to assess inter rater reliability on SCORS-R, and Pearsons’s product-moment correlation was applied to data analysis. RESULTS: ICC = .81-.93 range was obtained. There were significant negative correlations between low Affective Quality of Representation of People scale (SCORS-R) and PTSD (Pearson r = -395, p < .01) and Global Severity (GS) Brief Symptom Inventory (BSI) ( r = -.377, p < .01); and significant negative correlations between low Emotional Investment in Relationships scale (SCORS-R) and PTSD (r = -.317, p < .01) and GS BSI (r = -271, p<.001). CONCLUSONS: These findings show that for women with breast cancer negative internal object representations relate to severe psychopathology. Targeting these malevolent object representations in clinical treatment would likely facilitate a positive alliance with medical personnel thus increasing treatment adherence for these patients.


Kate Szymanski, PhD | Adelphi University, Garden City, NY

Carolyn Springer| Adelphi University, Garden City, NY

Shira Spiel | New York, NY

Dr. Kate Szymanski

Kate Szymanski, Ph.D. is an Associate Professor at the Gordon F. Derner School of Psychology at Adelphi University. She is a clinical and research supervisor in the Ph.D. Program in the Clinical Psychology, and she also teaches in the Postgraduate Program in Psychoanalysis and Psychotherapy. Dr. Szymanski’s interests concentrate on a wide range of acute and chronic traumas, and their impacts on family environments. She is particularly interested in loss, illness, grief, and resilience. Dr. Szymanski has presented her work at a number of national and international conferences, and published numerous journal articles and book chapters. She is co-editor (with Stroinska and Cecchetto) of Expression of the Unspeakable: Narratives of Trauma. She has international clinical experience working with a wide range of populations. Dr. Szymanski has a private practice in Garden City, NY and specializes in trauma.

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