Recent theoretical formulations emphasize the importance of the quality of interpersonal relationships in personality development and psychopathology and have resulted in the construction of methods for assessing the representation of interpersonal experiences. The Urist Mutuality of Autonomy (MOA) Scale is one of the most frequently used methods for assessing the quality of interpersonal relationships by evaluating interactions portrayed on the Rorschach between people, animals, and/or things. This study of the relationship of the MOA scale to independent assessments of interpersonal relationships and clinical symptoms in a group of seriously disturbed adolescents and young adults recently admitted to a long-term, open, residential treatment facility revealed that the average quality of interactions portrayed on the Rorschach relates significantly to the severity of clinical symptoms and the presence of thought disorder, but not to the quality of interpersonal relations. In addition, the portrayal of at least one intensively malevolent and destructive interaction on the Rorschach is correlated primarily with measures of thought disorder and impaired reality testing, whereas not giving at least one mutual and benevolent interaction response is correlated with impaired capacity for social adaptation (e.g., inappropriate interpersonal behavior and unmodulated affect). The relative failure to give at least one mutual and benevolent response is also correlated with the severity of clinical symptoms. Though the MOA scale was developed to assess object relations, it seems more consistently to assess aspects of psychopathology, such as the severity of clinical symptoms and the extent of thought disorder, and only secondarily the quality of interpersonal relationships.