ABSTRACT
In this article we examine the relation between the Rorschach Comprehensive System's Suicide Constellation (S-CON; Exner, 1993; Exner & Wiley, 1977) and lethality of suicide attempts during the course of patients' hospitalization at the Austen Riggs Center (Stockbridge, MA). Patient records were rated as nonsuicidal (n = 37), parasuicidal (n = 37), or near-lethal (n = 30) based on the presence and lethality of self-destructive acts. Diagnostic efficiency statistics utilizing a cutoff score of 7 or more positive indicators successfully predicted which patients would engage in near-lethal suicidal activity relative to parasuicidal patients (overall correct classification rate [OCC] = .79), nonsuicidal inpatients (OCC = .79), and college students (OCC = .89). Although these predictions were influenced by relatively high base rates in the hospital population (14.5%), base rate estimates were calculated for other hypothetical populations revealing different prediction estimates that should be considered when judging the relative efficacy of the S-CON. Logistic regression analysis revealed that an S-CON score of 7 or more was the sole predictor of near-lethal suicide attempts among 9 psychiatric and demographic variables.
Subject(s)
Rorschach Test , Suicide/psychology , Adult , Analysis of Variance , Diagnosis, Differential , Female , Humans , Logistic Models , Male , Reproducibility of Results , Suicide, Attempted/psychology , Time FactorsABSTRACT
Although several investigations have examined the relationship of Rorschach Oral Dependency (ROD; Masling, Rabie, & Blondheim, 1967) scores to Axis I diagnosis, there has been very little research assessing variations in ROD scores across Axis II personality disorders (PDs). In this study, ROD scores were compared in 5 PD groups (borderline PD inpatients, borderline PD outpatients, avoidant-dependent PD outpatients, narcissistic PD outpatients, and antisocial PD outpatients), and 2 non-PD comparison groups (psychotic disorder inpatients and college students). Borderline PD inpatients had significantly higher ROD scores than borderline PD outpatients, antisocial PD outpatients, and college students; no other between-group differences were found. We discuss implications of these results for research on dependency and Axis II psychopathology and offer suggestions for future studies.
Subject(s)
Antisocial Personality Disorder/psychology , Avoidance Learning , Borderline Personality Disorder/psychology , Dependency, Psychological , Interpersonal Relations , Narcissism , Oral Stage , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Rorschach Test/standards , Adult , Analysis of Variance , Antisocial Personality Disorder/diagnosis , Borderline Personality Disorder/diagnosis , Case-Control Studies , Female , Humans , Inpatients/psychology , Interview, Psychological , Male , Outpatients/psychology , Students/psychology , UniversitiesABSTRACT
In this study, we investigate the reliability, validity, and diagnostic efficiency of the Rorschach Schizophrenia Index (SCZI) in relation to the accurate identification of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) schizophrenia or other psychotic disorder (PD) according to the methodological recommendations offered by Wood, Nezworski, and Stejskal (1996). Seventy-eight patients who were found to meet DSM-IV criteria for a PD or Axis II disorder (PD = 33; borderline personality disorder = 23; Cluster A personality disorders = 9; Cluster C personality disorders = 13) and 50 nonclinical participants were compared on the SCZI. The results of this study indicate that the SCZI is internally consistent and can be reliably scored. In addition, the SCZI was used effectively in differentiating PD patients from patients with an Axis II disorder and from the participants in the nonclinical sample. Also, the SCZI variable was found to be empirically related to the presence of a DSM-IV diagnosis of PD. Finally, this variable could be employed for classification purposes in ways that were clinically meaningful in the diagnosis of a PD. Conceptual and methodological issues are discussed in relation to the assessment of psychosis.
Subject(s)
Rorschach Test/statistics & numerical data , Schizophrenia/diagnosis , Schizophrenic Psychology , Adult , Female , Humans , Male , Middle Aged , Patient Admission , Personality Disorders/diagnosis , Personality Disorders/psychology , Psychiatric Status Rating Scales/statistics & numerical data , Psychometrics , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Reference Values , Reproducibility of ResultsABSTRACT
This study was an investigation of the differences between 97 patients who had prematurely terminated psychotherapy (M = 1 session) and 81 who had participated in individual psychotherapy for at least 6 months and 24 sessions (M = 18 months/72 sessions) on selected Minnesota Multiphasic Personality Inventory--2 (MMPI-2) and Rorschach variables. None of the between-group comparisons using the MMPI-2 proved to be significant. However, a multivariate analysis of variance of 9 Rorschach variables in 3 conceptual categories--(a) interpersonal relatedness, (b) psychological resources versus resource demand, and (c) level of psychopathology--proved to be significant at p = .008. The Rorschach scores from the interpersonal-relational category proved to be the most robust in differentiating the 2 groups. The theoretical implications of interpersonal variables are discussed in relation to the termination and continuation of patients in psychotherapy.
