A method for the definition of a self-awareness behavior dimension with clinical subjects: a latent trait analysis.

The main scope of the present study was to devise a method in order to define a dimension characteristic of self-awareness behaviors with clinical subjects. To do so, I adopted a latent trait methodological approach. I studied the way patients expressed their treatment requests through their behaviors, both during their admission to a medical center in Northern Italy and after a period of treatment that involved an integrated (psychoanalytical and pharmacological) approach. The subjects were 48 females suffering from affective disorders, often combined with personality disorders. Five self-awareness indicators were identified, based both on interviews conducted with the patients and on the literature on the subject. The data gathered were analyzed by means of the many-facet Rasch model (Linacre, 1989). The results confirmed the existence of a self-awareness dimension characterized by the five indicators. Moreover, there was evidence that an improvement in self-awareness occurred during the pretreatment to posttreatment time period for both the affective disorders with personality problems patients and the affective disorders without personality problems patients. The estimation of bias/interactions showed the existence of specific behavioral differences between the two groups of patients. This study demonstrates the appropriateness of the methodological tool adopted, opening new expectations with regard to the integration of two approaches-psychoanalytical and pharmacological ones-in the treatment of psychiatric subjects.