Abstract: The nature of psychotherapeutic change was traditionally viewed as personality change. However, in the field of process-outcome research, most studies reported symptom reduction instead of personality change. The proposed relationship between the change of personality variables (e.g., the irrational beliefs) and the symptom reduction (e.g., depression) was not fully tested. Under the framework of attachment theory, the current research intends to find the change process of core interpersonal schema, and the psychotherapeutic outcome assessed not only by symptom reduction, but also by personality change. Core interpersonal schema means the mental representation of self and other across close relationships. Though core interpersonal schema includes both cognitive and emotional elements, it specifically means the emotional response elicited by the recall of a significant figure. The measurement for representations of two or more than two close relationships would be better than measuring only one close relationship in predicting individual’s well-being. Based on this concept, My Feelings in Close Relationships (MFSR-12, Sun, 2011) was developed to measure emotional response elicited by significant figures. Theoretically, the negative emotional responses were the foundation of psychopathological personality structures and the overt symptoms, and the reduction of those negative emotional responses elicited by the significant figures was the exact process of personality change in efficient psychotherapy, accompanying with clinically observed personality change and symptom reduction. The relationships among core interpersonal schema, personality change and symptom reduction were illustrated by a clinical case, XiaoBei, who were initially diagnosed as depression personality disorder (SCID-II, First, Spitzer, Gibbon, &Williams, 1997) and bipolar depression II (SCID-CV, First, Spitzer, Gibbon, & Williams, 1996). My Feelings in Close Relationships (MFSR-12, Sun, 2011), Shedler-Westen Assessment Procedure (SWAP-200, Shedler & Westen, 1998) and Outcome Questionnaire (OQ45.2, Lambert,et.al.,2004) were administrated. Among them, MFSR-12 and SWAP-200 were tested twice, at the beginning stage and the ending stage respectively, and OQ45.2 was tested once per month. The results show that: (1) core interpersonal schema, personality change measured by SWAP-200, and symptom reduction were changed after 52-session psychotherapy; (2) The clinically significant personality change , symptom reduction and the improvement of the global function were observed, accompanying with small changes of core interpersonal schema; (3) The score of symptoms distress was significantly reduced while scores of interpersonal relation and social role keep relatively stable during the period of psychotherapy.

Key words: Core interpersonal schema, personality change, SWAP-200, case study

摘要： 本研究旨在通过一例抑郁症病例的52次心理治疗和效果评估说明核心人际图式改变、人格改变与症状缓解的关系。核心人际图式采用自编我的感受问卷测量，人格改变采用SWAP-200测量，症状采用OQ45.2测量。结果：核心人际图式的变化伴随着临床上可观察的人格改变、症状缓解及当事人总体功能和心理健康水平的提高。症状缓解主要体现为主观困扰的降低，但在社会功能和人际关系质量上改变不明显。结论：核心人际图式、人格障碍轮廓和症状缓解具有共变关系。

关键词: 核心人际图式, 人格改变, SWAP-200, 个案研究