Relationship between the Rorschach Perceptual Thinking Index (PTI) and the Positive and Negative Syndrome Scale (PANSS) in psychotic patients: a validity study

Rorschach inkblot test and psychopathology among patients suffering from schizophrenia: A correlational study

BACKGROUND

Rorschach test has been considered a well-known and most widely used projective test for the assessment of personality and diagnostic evaluation in various psychiatric disorders. Schizophrenia is considered to be the major psychiatric illness characterized by gross distortion of reality, the disorganization and fragmentation of perception, thought, emotion, and withdrawal from social interaction. Rorschach provides both specific and general knowledge about the different areas of personality functioning, such as coping style, emotions, managing stress, mediation, ideation, self-perception, and interpersonal relationships along with correlating with the psychopathology of the schizophrenia patients.

AIM

The aim of the present study is to assess the relationship between Rorschach response pattern different symptoms in schizophrenia patients.

METHODOLOGY

After having informed consent, 100 patients of schizophrenia group were included as per the International Classification of Diseases 10th Revision Diagnostic Criteria for Research (ICD-10 DCR) criteria. Information about sociodemographic data and clinical details was collected using the sociodemographic and clinical data sheet from the drawn sample. For the assessment of symptoms of schizophrenia patients, Scale for the Assessment of Positive Symptom and Scale for the Assessment of Negative Symptom have been used. After that Rorschach test was administered individually to all the participants to assess the personality structure of each schizophrenia patients.

RESULTS

The results showed that there is a significant positive and negative correlation among positive, negative schizophrenia symptoms, and different Rorschach variables.

CONCLUSION

Schizophrenia patients having positive and negative symptoms would be giving Rorschach variables indicative of moderate level of cognitive distortions, poorly controlled and disorganized affect, less conventional form of responses, poor perception and loss with reality, poor interpersonal relationships, presence of anxiety, and aggression.

Development and preliminary validation of a brief behavioral measure of psychotic propensity

Extensive research demonstrates that the dimensional assessment of psychotic manifestations is a primary strength of the Rorschach inkblot task, which provides an in vivo sample of problem-solving behavior and normative standards concerning the logic and coherence of thought processes and the typicality of perceptual representations. This article presents foundational research for the Thought and Perception Assessment System (TPAS), a Rorschach-based system designed to assess solely for disordered thinking and perceptual aberrations using either the standard 10-card set of inkblots or alternative 3-, 4-, and 5-card short forms. Using data from three patient samples (ns = 61, 93, and 133) and one nonpatient sample (n = 118), we document the equivalence of mean scores across the full and short-form card sets. We also document satisfactory interrater reliability and validity for the full and short forms, as well as strong part-whole reliability coefficients between the short forms and the full form. Consistent with psychometric theory and the principle of aggregation, each type of coefficient decreased as a function of decreasing the number of cards. We discuss implications and future applications in research and clinical assessment.

Blunted vocal affect and expression is not associated with schizophrenia: A computerized acoustic analysis of speech under ambiguous conditions

INTRODUCTION

Patients with schizophrenia are consistently rated by clinicians as having high levels of blunted vocal affect and alogia. However, objective technologies have often failed to substantiate these abnormalities. It could be the case that negative symptoms are context-dependent.

OBJECTIVES

The present study examined speech elicited under conditions demonstrated to exacerbate thought disorder.

METHODS

The Rorschach Test was administered to 36 outpatients with schizophrenia and 25 nonpatient controls. Replies to separate "perceptual" and "memory" phases were analyzed using validated acoustic analytic methods.

RESULTS

Compared to nonpatient controls, schizophrenia patients did not display abnormal speech expression on objective measure of blunted vocal affect or alogia. Moreover, clinical ratings of negative symptoms were not significantly correlated with objective measures.

CONCLUSIONS

These findings suggest that in patients with schizophrenia, vocal affect/alogia is generally unremarkable under ambiguous conditions. Clarifying the nature of blunted vocal affect and alogia, and how objective measures correspond to what clinicians attend to when making clinical ratings are important directions for future research.

Cognitive-perceptual deficits and symptom correlates in first-episode schizophrenia

Background

Thought disorder and visual-perceptual deficits have been well documented, but their relationships with clinical symptoms and cognitive function remain unclear. Cognitive-perceptual deficits may underscore clinical symptoms in schizophrenia patients.

Aim

This study aimed to explore how thought disorder and form perception are related with clinical symptoms and cognitive dysfunction in first-episode schizophrenia.

Setting

Forty-two patients with a first-episode of schizophrenia, schizophreniform or schizoaffective disorder were recruited from community clinics and state hospitals in the Cape Town area.

Methods

Patients were assessed at baseline with the Rorschach Perceptual Thinking Index (PTI), the Positive and Negative Syndrome Scale (PANSS) and the MATRICS Cognitive Consensus Battery (MCCB). Spearman correlational analyses were conducted to investigate relationships between PTI scores, PANSS factor analysis-derived domain scores and MCCB composite and subscale scores. Multiple regression models explored these relationships further.

Results

Unexpectedly, poor form perception (X- %) was inversely correlated with the severity of PANSS positive symptoms (r = -0.42, p = 0.02). Good form perception (XA%) correlated significantly with speed of processing (r = 0.59, p < 0.01), working memory (r = 0.48, p < 0.01) and visual learning (r = 0.55, p < 0.01). PTI measures of thought disorder did not correlate significantly with PANSS symptom scores or cognitive performance.

Conclusions

Form perception is associated with positive symptoms and impairment in executive function during acute psychosis. These findings suggest that there may be clinical value in including sensory-perceptual processing tasks in cognitive remediation and social cognitive training programmes for schizophrenia patients.

Antipsychotic treatment and the Rorschach Perceptual Thinking Index (PTI) in psychotic disorder patients: Effects of treatment

The Rorschach-based Perceptual Thinking Index (PTI) is used to identify and rate features of psychotic disorders, but effects of antipsychotic treatment on such ratings is not clear. Accordingly, we examined potential effects of antipsychotic drugs on PTI measures in 114 patients with a psychotic or bipolar-I disorder. Use and doses of antipsychotic drugs (as chlorpromazine-equivalent [CPZ-eq] mg/day) were unrelated to PTI total or subscale scores in any diagnostic group. PTI scores were independently and significantly associated with psychotic symptomatic severity (PANSS score) and less with female sex. These findings support the validity and value of the PTI in identifying features of psychosis even in the presence of antipsychotic treatment.

Application of the Rorschach test in psychological diagnosis of personality disorders

<b>Background</b><br /> The paper presents the authors’ own research, which points to the possibility of applying the Rorschach test in the clinical diagnosis of personality disorders.<br /> <br /> <b>Participants and procedure</b><br /> The clinical research was conducted in the years 2010-2013 in the Neurosis Treatment Center and in the Mental Health Outpatient Clinic. The study population comprised individuals with a medical diagnosis of neurotic personality organization as well as patients with more severely disorganized personality structure. The research participants had never undergone psychological evaluation for personality disorders (for instance, they had never taken the Rorschach test), and therefore it seemed rather difficult to verify the accuracy of the medical diagnoses which they had received, concerning the level of personality destabilization. Eighty Polish individuals participated in the research. The study population comprised 38 males (47.50%) and 42 females (52.50%). The mean age of women was 30.40 (SD = 7.67). The men’s mean age was 35.10 (SD = 8.73). The examined females were somewhat younger than the male subjects. Methods: Rorschach test, clinical interview.<br /> <b>Results</b><br /> The statistical procedures applied in the present study allowed us to conduct empirical examination of the indicators of the investigated variables constituting the major psychological criteria for describing psychological functioning of personality, and thus to identify the main characteristics of neurotic as well as borderline level of personality organization. Analysis of the data obtained as a result of this research allowed us to distinguish two significantly different clusters in the group of 80 examined individuals.<br /> <br /> <b>Conclusions</b><br /> The results of the present investigation indicate that despite the fact that the examined individuals displayed symptoms of different medical diagnoses (F40 and F60), the subjects comprising cluster 1 exhibited a higher level of personality structure compared with the study participants belonging to cluster 2.