Development and psychometric evaluation of a screening instrument for cognitive perceptual disruption (Copeds) in psychotherapy patients.

Objective: Cognitive perceptual disruption (CPD) is an emotion regulation mechanism described in intensive short-term dynamic psychotherapy (ISTDP) that distinguishes fragile patients from resistant ones. CPD functions as an involuntary avoidance-based mechanism that prevents engagement with distressing emotions, making its identification crucial for guiding treatment. Currently, CPD assessment relies solely on clinical psychodiagnostic evaluation, with no available psychometric instruments. This study introduces a cognitive perceptual disruption screening instrument (Copeds), a self-report measure designed to identify CPD and assist in treatment planning for emotion-focused therapies.

Method: A cross-sectional study was conducted to develop Copeds, evaluate its ability to distinguish between fragile and resistant patients, and examine its preliminary psychometric properties. 112 outpatients underwent clinical psychodiagnostic evaluation and completed Copeds. Regularized regression techniques, receiver operating characteristic (ROC) analysis, and analyses of internal consistency and sensitivity/specificity were performed.

Results: The final instrument contained 19 psychometric items that strongly discriminated between fragile and resistant patients. ROC analysis yielded an area under the curve (AUC) value of 0.88. Sensitivity was 91.4%, and specificity was 76.4%.

Conclusion: The study provides promising initial evidence for Copeds as a reliable instrument with strong classification accuracy, supporting its potential use in clinical assessment and treatment planning for emotion-focused therapies.