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Research applications of measures


Public school children

A slightly modified version of the PROQ2 was used to examine the possibility that there may be (negative) relating differences between boarders and non-boarders at a co-educational, English, public school. The study was carried out by a school counsellor (June Thomason), and the children studied were sixth formers, that is, they were in their late teens. The underlying hypothesis was that boarding, particularly when it occurs from an early age, is likely to affect a child's ability to form close relationships, that is that boarders would have higher, mean, negative distance scores than non-boarders. This turned out not to be the case, but what did emerge from the study was that the children studied, irrespective of their boarding status, differed in certain significant respects from non-public school children. This issue is being pursued, and the findings have not so far been published.

Psychotherapy research

The most important application of the PROQ2 has been in the field of psychotherapy research. From the section (and the book) on Relating in Psychotherapy , it will be seen that one way of viewing psychotherapy is the elimination of negative modes of relating and the reinforcement of positive modes of relating. Since the PROQ2 is a measure of negative modes of relating it has proved to be a useful pre-therapy indicator of the psychotherapy patient's areas of negative relating. The PROQ2 may be repeated at stages through the therapy as an indicator of where improvements have been made and where work still needs to be done. It may also be repeated at the end of therapy and at follow-up.


Over a number of years, the PROQ2 has been routinely administered in three English, NHS psychotherapy departments (Canterbury, Northampton and Redhill), before and after a course of therapy. Data from these departments are now available on several hundred patients. In one of these departments, the PROQ2 was also administered, for subsamples of patients, (1) at the time of assessment for therapy - approximately nine months before the start of therapy - and (2) three to six months after the end of therapy. The therapy involved both individual and group therapy, and was predominantly psychodynamic. The duration of therapy ranged from less than 20 sessions (29.7%) to 60 or more sessions (16.0%). A study of 219 patients who had completed the PROQ2 at the beginning and at the end of therapy (Birtchnell, submitted) shows that significant drops in mean scores were recorded on six out of eight scales and on the sum of the scale scores (the scales showing no significant drop being upper close and upper distant). The study further showed no significant change in mean scores over the period of waiting for therapy and a slight increase in mean scores over the period of follow-up. The study demonstrates that therapy does not need to be directed towards the elimination of negative relating, for significant drops in negative relating to be recorded.


The question of whether relatively brief forms of psychotherapy are effective in reducing PROQ2 scores has been addressed. A preliminary study of sixteen patients receiving, sixteen session, cognitive analytic therapy at Guy's Hospital, London, showed no significant improvement; but a study of 32 patients receiving the same form of treatment, by Farouk Okhai and Chess Denman at Addenbrooke's Hospital, Cambridge, showed significant improvement on the three lower scales (LC, LN and LD) and on the sum of the scale scores (a mean of 122.3, sd 27.1 at start of therapy dropping to mean of 104.4, sd 26.2 at end of therapy). A study of patients receiving another short form of therapy, cognitive behavioural therapy, by Lee Brosan, also at Addenbrooke's Hospital, will hopefully start soon.


The PROQ2 is being administered as part of a test battery to patients in a trial of the psychoanalytic treatment of resistant depression at the Tavistock Clinic, London, directed by Jo-anne Carlyle.


Research on the therapeutic community treatment of severe personality disorders

Most of the ten DSM-IV personality disorders can be defined in terms of negative relating, and predicted positions of these disorders within the octagon were made in Birtchnell, 1997. The study of Birtchnell & Shine (2000) was intended to be a test of these predictions. In Birtchnell & Bourgherini (1999) the treatment of dependent personality disorder was described; and the treatment of other personality disorders was described in Birtchnell, 1999.


The PROQ2 is being routinely administered to admissions to Arnold Lodge, a secure unit for the treatment of personality disorders in Leicester, and is being repeated at stages throughout treatment and at follow-up. (Conor Duggan, University of Leicester).


Hallucination research

Mark Hayward (2001) of the University of Leicester, compared scores on the PROQ2 with scores on the YTV (You to Voice) questionnaire (adapted from the MS measure of the CREOQ) in a series of 27 hallucinating psychiatric patients. The object of the study was to determine whether the way the patients related to their voices corresponded with the way they related to people in general.


PROQ2a and PROQ3

These shorter questionnaires are being introduced into the on-going study of psychotherapy research described under the PROQ2. Canterbury is using the PROQ2a, Northampton is using the PROQ3 and Redhill is continuing to use the PROQ2.


The PROQ3 is being included as part of a test battery for the study of a series of psychotherapy patients in West Kent (Invicta Community NHS Trust) conducted by Nick Riding, Rob Leiper & Sheila Butler (University of Kent).


The PROQ3 is been used, together with the IPIP, a questionnaire to measure the Big Five personality traits, in a community survey in Cork, Ireland, by Sean Hammond (University College, Cork). The PROQ3 will subsequently be introduced into a sex offender assessment project.


The PROQ3, together with the ORB, is being administered to a series of admissions to Grendon Underwood. Both measures will be repeated after nine months and eighteen months until a sample of 100 prisoners who have completed an eighteen months course of treatment has been amassed. Prisoners who drop out of treatment, or who are taken off the treatment, will have the same assessments at the time of stopping treatment. The object of the study is to determine whether significant changes in PROQ3 and ORB scores are registered over the course of treatment.



Couple therapy research

The CREOQ was administered to a series of 92 couples seeking psychoanalytic, couple therapy at the Tavistock Institute of Marital Studies, London (Director Chris Clulow). The intention was to administer it also at the termination of treatment, but in the event, only seventeen couples got retested. Very few of these showed significant improvement. With the small number of couples I have treated, despite obvious improvements in the relationship, the changes in CREOQ scores have been surprisingly slight. Further studies of this kind are needed, but it may be that established patterns of interrelating between partners are extremely difficult to change, and that improvements that occur are due to the couple gaining insights into how they behave towards each other and making allowance for it.



Research on young, adult schizophrenics and their parents

The development of the FCMQ and the FCCMQ was prompted by the interest of Argyroula Kalaitzaki at the University of Crete at Rethymnon, in the interrelating between young, adult schizophrenics and their parents. She extended this work to compare the interrelating of schizophrenics and their non-schizophrenic sibling with their parents. For this she was awarded a PhD at the University of Crete. She has also used the FCMQ to compare the interrelating of young, adult schizophrenics before and after psychotherapy. To date, none of this work has been published.



Birtchnell, J. (1997) Personality set within an octagonal model of relating. In Plutchik, R. & Conte, H.R. (Eds.) Circumplex Models of Personality and Emotions. American Psychological Association Press: Washington, D.C.

Birtchnell, J. (1999) Relating in Psychotherapy: The Application of a New Theory. Westport, Con.: Praeger.

Birtchnell, J. (submitted) Psychotherapy and the interpersonal octagon.

Birtchnell, J. & Bourgherini, G. (1999) Interpersonal theory and treatment of dependent personality disorder. Maffei, C. (Ed.) Treatment of Personality Disorders. Plenum Press: New York.

Birtchnell, J . & Shine, J. (2000) Personality disorders and the interpersonal octagon. British Journal of Medical psychology, 73, 433-448.

Hayward, M. (2001) Interpersonal processes and auditory hallucinations. Poster to the Fourth International Conference on Psychological Treatments for Schizophrenia. Cambridge, September.

Thomason, J. (2001) The boarding school self. Successful dissertation for the degree of MA at the University of Kent.