Welcome to the COSMO Typical Performance Scoring

Typical Performance Scoring: An Innovative Approach to Clinical Assessment

COSMO’s Typical Performance Scoring section is designed to help professionals gain deeper insights into patients' relational dynamics and emotional defenses by integrating performance-based assessment tools. While self-report tests provide direct information about patients' experiences, performance-based tools such as the Picture Frustration Study (PFS) and the Thurston-Cradock Test of Shame (TCTS) reveal underlying aspects of personality that are often hidden or unconscious.

COSMO’s Coding System for the Rosenzweig Picture Frustration Study | Interact with the COSMO GPT

The Picture Frustration Study (PFS), redefined by COSMO, is a projective-associative tool that uses slightly frustrating everyday situations to assess patients’ relational and problem-solving skills. COSMO’s innovative coding method categorizes responses based on interpersonal and coping strategies, focusing on key dimensions of personality functioning as defined in the DSM-5 Alternative Model of Personality Disorders (AMPD). Responses are mapped into four quadrants reflecting interpersonal style, from friendly/cooperative to hostile/dominant, allowing clinicians to observe adaptive and maladaptive patterns within social interactions. This structured approach enhances the clinical utility of the PFS, making it a powerful tool to identify specific relational styles and coping responses in patients.

The Thurston-Cradock Test of Shame (TCTS)

The TCTS, developed by Dr. Julie Cradock O’Leary, is a performance-based storytelling test that explores the complex, often hidden, dynamics of shame. Participants respond to ambiguous, shame-related images, and their narratives are analyzed for direct and indirect indicators of shame. The test categorizes defenses against shame into three main types—deflation, aggression, and contempt/inflation—alongside the severity of these defenses. This method provides clinicians with unique insights into a patient’s inner experiences, revealing how deeply-rooted feelings of inadequacy may impact their behavior and relationships.

Enhanced Clinical Insight through Typical Performance Scoring

COSMO’s Typical Performance Scoring tools bridge the gap between self-perception and actual behavior in social contexts, providing a 360° view of personality dynamics. These tools are particularly effective within the framework of collaborative assessment, as advocated by Stephen Finn. This approach emphasizes the importance of using assessment as a tool for increasing self-awareness and fostering positive change, achieved through a collaborative relationship between clinician and patient. By combining these performance-based tools with self-report assessments, clinicians can achieve a comprehensive understanding of each patient’s functioning, empowering them to deliver more targeted, effective interventions that align with each patient’s unique therapeutic journey.