Revisiting Rorschach test and Minnesota Multiphasic Personality Inventory-II patterns in Kraepelinian vs. DSM-wise Schizophrenia: How They Differ and What It Means for Diagnosis.

OBJECTIVE: This retrospective chart review study aimed to investigate the differences in the Rorschach test and Minnesota Multiphasic Personality Inventory (MMPI)-II profiles among patients with Kraepelinian schizophrenia, those with DSM-wise schizophrenia, and controls. Kraepelinian schizophrenia is characterised by a chronic, deteriorative disease course and a predominance of negative symptoms. METHODS: Patients with Kraepelinian schizophrenia were selected based on medical record reviews. We then compared their Rorschach test and MMPI-II results with those of the DSM-wise schizophrenia group and the control group. RESULTS: The Rorschach test revealed a significant increase in DV2 score and a decrease in D score in patients with Kraepelinian schizophrenia compared to those with DSM-wise schizophrenia. In the MMPI-II profiles, patients with Kraepelinian schizophrenia exhibited an elevated L relative to those with DSM-wise schizophrenia. CONCLUSION: Our results suggested the value of revisiting psychological tests in clinically delineated subgroups, such as Kraepelinian schizophrenia. Although patients fall under the same diagnostic category of schizophrenia, considering different phenotypes is important when interpreting psychological test outcomes. Additionally, our study indicated that both schizophrenia groups did not show as many abnormalities as expected compared to controls. This highlights the potential value of revisiting established profiles of certain psychological tests and calls for further research on other psychological tests.

Comparative study of adolescents with Rorschach: public and private schools / Estudo comparativo de adolescentes com o Rorschach: escolas públicas e particulares

Abstract Objective This investigation presents a comparison among students from public and private schools in specific variables of the Rorschach test, Comprehensive System. Method One hundred eighteen adolescents from the city of São Paulo participated in the study, aged 13-17 years, from public (N = 49) and private schools (N = 69). Mixed linear effects models were used to test the effect of school, controlled by sex, years of education (fixed effects), and evaluator (random effect). Results Private schools students presented higher values of R (p = 0.015, d = 0.47) and Complexity scores (p = 0.007, d = 0.53). After inserting Complexity as a fixed factor in the model, the only variable that remained significant was Xu% (p = 0.008, d = -0.52), lower in private schools students. Conclusion The small number of differences found in this study indicates, at least for this age range, a trend to equivalent performance when comparing private and public schools. Even though the Rorschach is a method of personality assessment, it is clear that it can also signalize information related to each group's personal experiences.

Resumo Objetivo O estudo apresenta um comparativo dos resultados do Rorschach - Sistema Compreensivo - entre estudantes de escolas públicas e privadas. Método Participaram da pesquisa 118 adolescentes da cidade de São Paulo, 49 de escolas públicas e 69 de escolas particulares, com idade entre 13-17 anos. Os efeitos da escola foram avaliados por modelos lineares mistos controlados por sexo, anos de estudo (fatores fixos) e aplicador (fator aleatório). Resultados As escolas particulares apresentaram maiores valores de R (p = 0,015, d = 0,47) e Complexidade (p = 0,007, d = 0,53). Quando Complexidade também foi inserida no modelo como fator fixo, a única variável que restou significativa foi Xu% (p = 0,008, d = -0,52), menor em escolas particulares. Conclusão Conclui-se que o pequeno número de diferenças indica pouca interferência da origem escolar nos resultados do Rorschach para esta faixa etária. Mesmo se tratando de um instrumento para avaliação de personalidade, foi possível sinalizar algumas informações relativas às experiências pessoais de cada grupo.

Suicidal Ideation in University Students: a Rorschach Assessment / Ideação Suicida em Estudantes Universitários: Avaliação com Rorschach / Ideación Suicida en Estudiantes Universitarios: Evaluación con Rorschach

Abstract University students are particularly susceptible to suicidal ideation and behavior due to issues inherent to this vital lives' moment. The Rorschach test can help to understand these students' suffering. The objective was to evaluate perception, thinking, stress, and distress in the Rorschach test domains in university students attended at a public university mental health service, comparing students with suicidal ideation with those without it. A total of 36 students aged 18 or over were assessed. The instruments were: Rorschach Performance Assessment System (R-PAS), Columbia Suicide Severity Rating Scale (C-SSRS) and Self Report Questionnaire (SRQ-20). Two analyses were performed using Wilcoxon Mann-Whitney test, according to the presence of suicidal ideation in the last 30 days (SRQ-20) and in the last six months (C-SSRS). Statistically significant differences were found in the two analyses, indicative of greater perceptual distortion in students without suicidal ideation and of stress and distress in students with ideation.

Resumo Estudantes universitários são particularmente suscetíveis a ideação e comportamento suicidas decorrentes de problemas inerentes a este momento vital. O método de Rorschach pode contribuir na compreensão do sofrimento destes estudantes. O objetivo do estudo foi avaliar os domínios percepção, pensamento, estresse e angústia no Rorschach de estudantes universitários atendidos em serviço de saúde mental de universidade pública, comparando estudantes com ideação suicida com aqueles sem ideação. Foram avaliados 36 estudantes com 18 anos ou mais. Os instrumentos foram: Rorschach Performance Assessment System (R-PAS), Escala de Avaliação do Risco de Suicídio de Columbia (C-SSRS) e Self Report Questionnaire (SRQ-20). Foram realizadas duas análises com teste de Wilcoxon Mann-Whitney, segundo a presença de ideação nos últimos 30 dias (SRQ-20) e nos últimos 6 meses (C-SSRS). Foram observadas diferenças estatísticas significativas nas duas análises, indicativas de maior distorção perceptiva nos alunos sem ideação suicida e de angústia e estresse nos estudantes com ideação.

Resumen Estudiantes universitarios son particularmente susceptibles a ideación y comportamiento suicida debido a problemas inherentes a este momento vital. El Rorschach puede ayudar a comprender su sufrimiento. El objetivo fue evaluar los dominios percepción, pensamiento, estrés y angustia en el Rorschach de universitarios atendidos en un servicio de salud mental de universidad pública, comparando estudiantes con ideación suicida con aquellos sin esa ideación. Se evaluaron 36 estudiantes de pregrado y posgrado de 18 años o más. Los instrumentos fueron: Rorschach Performance Assessment System, Escala Columbia para Evaluar la Seriedad de la Ideación Suicida (C-SSRS) y Self Report Questionnaire (SRQ-20). Se realizaron dos análisis con Wilcoxon Mann-Whitney test, según la presencia de ideación en los últimos 30 días (SRQ-20) y en los últimos 6 meses (C-SSRS). Hubo diferencias estadísticamente significativas en los dos análisis, indicativas de mayor distorsión perceptiva en estudiantes sin ideación suicida y de angustia y estrés en estudiantes con ideación.

Cognition and psychopathy in incarcerated sexual offenders / Cognição e psicopatia em autores de violência sexual encarcerados

Objective: The objective was to investigate if perpetrators of sexual offenses against children and adolescents with and without psychopathy differ regarding cognitive aspects. Method: A total of 30 male inmates participated in the study, divided into two groups: one that included psychopaths and the other with non-psychopaths. The instruments used were: protocol for collecting information on criminal court records; Rorschach test according to the Performance Assessment System, considering the cognitive variables and the Psychopathy Checklist-Revised Scale. Results: The results indicate that psychopaths exhibit greater impairment in the organization of thoughts, as well as greater vulnerability to the general personality disruption. The best regression model showed that 55% of psychopathy can be explained by a greater propensity to a general personality disorder (EII-3 β: 4.77; p-value < 0.001), associated with the predisposition to be arrested at a young age (β: -0.26; p-value = 0.004). Conclusion: The efficiency of the R-PAS is observed in the identification of cognitive failures in psychopath perpetrators of sexual violence and perpetrators of sexual violence, and its usefulness is enhanced, when associated with other behavioral measures in the identification of this type of personality profile.

Objetivo: O objetivo foi investigar se autores de violência sexual contra crianças e adolescentes, com e sem psicopatia, se diferenciam em relação aos aspectos cognitivos. Método: Participaram do estudo 30 reeducandos cumprindo pena em regime fechado, divididos em dois grupos: um composto pelos psicopatas e outro pelos não psicopatas. Os instrumentos utilizados foram: protocolo de coleta de informações no processo criminal; teste de Rorschach, de acordo com o Sistema de Avaliação por Performance, considerando as variáveis cognitivas, e; a escala Psychopathy Checklist-Revised. Resultados: Os resultados indicaram que o grupo de psicopatas apresentou maiores prejuízos na organização do pensamento, bem como maior vulnerabilidade à desorganização geral da personalidade. O melhor modelo de regressão identificou que 55% da psicopatia pode ser explicada por uma maior propensão ao desajuste geral da personalidade (EII-3 β: 4.77; p-value < 0.001), associada à predisposição a ser preso ainda jovem (β: -0.26; p-value = 0.004). Conclusão: A eficiência do R-PAS é observada na identificação de falhas cognitivas em psicopatas autores de violência sexual e autores de violência sexual, e sua utilidade é potencializada, quando associada a outras medidas comportamentais na identificação desse tipo de perfil de personalidade.

Periculosidade e características da personalidade em autores de violência sexual / DANGEROUSNESS AND PERSONALITY CHARACTERISTICS IN SEXUAL OFFENDERS / PELIGROSIDAD Y CARACTERÍSTICAS DE LA PERSONALIDAD EN AUTORES DE LA VIOLENCIA SEXUAL

The aim of the article was to analyze the dangerousness and personality characteristics of perpetrators of sexual violence (SVA). 69 inmates who participated in this study were serving time for sexual crimes in a closed regime and were divided into two groups: SVA convicted of victimizing children (G1) (n = 41) and SVA convicted of victimizing adolescents and adults (G2) (N = 28 ). The collected data derived from the reading of the criminal case and the application of the Rorschach test in the Performance Assessment System (R-PAS). For data analysis, a variable called dangerousness was created, through the principal component factor analysis, using criminal profile variables, to verify the correlation between the R-PAS variables and the participants' riskiness. Comparisons were also made between the groups. The results showed that the greater the danger, the greater the use of intellectualization as a defense mechanism, in order not to deal directly and realistically with aspects that generate emotional or social anguish. In addition, G2 showed a higher degree of danger.

O objetivo do artigo foi analisar a periculosidade e as características de personalidade de autores de vio-lência sexual (AVS). Participaram deste estudo 69 reeducandos que cumpriam pena por crimes sexuais em regime fechado, divididos em dois grupos: AVS condenados por vitimizar crianças (G1) (n = 41) e AVS con-denados por vitimizar adolescentes e adultos (G2) (N = 28). Os dados coletados derivaram da leitura do processo criminal e da aplicação do teste de Rorschach no Sistema de Avaliação por Desempenho (R-PAS). Para a análise dos dados, criou-se uma variável denominada periculosidade, por meio da análise fatorial de componente principal, mediante variáveis do perfil criminal, para verificar a correlação entre as variá-veis do R-PAS e a periculosidade dos participantes. Também foram realizadas comparações entre os gru-pos. Os resultados apontaram que quanto maior é a periculosidade, maior é o uso da intelectualização como mecanismo de defesa, para não lidar de modo direto e realista com aspectos que geram angústia emocional ou social. Além disso, o G2 revelou maior grau de periculosidade.

El objetivo del artículo fue analizar la peligrosidad y las características de personalidad de autores de vio-lencia sexual (AVS). Participaron de este estudio 69 reeducandos que cumplían condena por crímenes sexuales en régimen cerrado, divididos en dos grupos: AVS que victimizaron niños (G1) (n = 41) y AVS por adolescentes y adultos (G2) (n = 28). Los datos recogidos derivaron de la lectura del proceso criminal y de la aplicación del test de Rorschach en el sistema de evaluación por performance (R-PAS). Para el análisis de los datos, se creó una variable denominada peligrosidad por medio del análisis factorial de componente principal, mediante variables del perfil criminal, para verificar la correlación entre las variables del R-PAS y la peligrosidad de los participantes. También fueron realizadas comparaciones entre los grupos. Los re-sultados apuntaron que, cuanto mayor es la peligrosidad, mayor es el uso de la intelectualización como mecanismo de defensa, para no lidiar de modo directo y realista con aspectos que generan angustia emo-cional o social. Además de eso, el G2 reveló mayor grado de peligrosidad.

Neuroanatomical and psychological considerations in temporal lobe epilepsy.

Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy and is associated with a variety of structural and psychological alterations. Recently, there has been renewed interest in using brain tissue resected during epilepsy surgery, in particular 'non-epileptic' brain samples with normal histology that can be found alongside epileptic tissue in the same epileptic patients - with the aim being to study the normal human brain organization using a variety of methods. An important limitation is that different medical characteristics of the patients may modify the brain tissue. Thus, to better determine how 'normal' the resected tissue is, it is fundamental to know certain clinical, anatomical and psychological characteristics of the patients. Unfortunately, this information is frequently not fully available for the patient from which the resected tissue has been obtained - or is not fully appreciated by the neuroscientists analyzing the brain samples, who are not necessarily experts in epilepsy. In order to present the full picture of TLE in a way that would be accessible to multiple communities (e.g., basic researchers in neuroscience, neurologists, neurosurgeons and psychologists), we have reviewed 34 TLE patients, who were selected due to the availability of detailed clinical, anatomical, and psychological information for each of the patients. Our aim was to convey the full complexity of the disorder, its putative anatomical substrates, and the wide range of individual variability, with a view toward: (1) emphasizing the importance of considering critical patient information when using brain samples for basic research and (2) gaining a better understanding of normal and abnormal brain functioning. In agreement with a large number of previous reports, this study (1) reinforces the notion of substantial individual variability among epileptic patients, and (2) highlights the common but overlooked psychopathological alterations that occur even in patients who become "seizure-free" after surgery. The first point is based on pre- and post-surgical comparisons of patients with hippocampal sclerosis and patients with normal-looking hippocampus in neuropsychological evaluations. The second emerges from our extensive battery of personality and projective tests, in a two-way comparison of these two types of patients with regard to pre- and post-surgical performance.

Inter-rater Reliability and Construct Validity of the Lerner Defense Scale in Clinical and Non-clinical Groups.

The current study investigated the inter-rater reliability and the construct validity of the Rorschach Lerner Defense Scale (LDS). In particular, it aimed to explore the inter-rater reliability, analyzing the most frequent coding mistakes in an attempt to improve the coding guidelines, and to investigate the ability of the scale to distinguish between individuals with neurotic-level and borderline-level personality organization, according to the Psychodynamic Diagnostic Manual-2 (PDM-2), and non-clinical subjects. Eighty clinical subjects and 80 non-clinical ones participated in the study. Among the clinical subjects, 40 have borderline-level personality organization and 40 have neurotic-level personality organization. Non-clinical subjects were drawn from an archival dataset of non-clinical individuals who previously participated in a Rorschach normative study. The LDS showed substantial inter-rater reliability; however, guidelines could be improved, specifically with regard to the threshold for coding Devaluation and Idealization at level 1. Furthermore, more examples should be included in the manual about the coding of Projective Identification and Denial. The LDS distinguished borderline-level subjects from both the non-clinical and neurotic groups with regard to Devaluation and Projective Identification, with borderline-level personality organization subjects reporting higher scores than either of the two other groups. Only the Denial scale discriminated between the non-clinical and neurotic group, with the latter reporting higher scores of high-level Denial.

Psychopathy and stress in child and adolescent's sexual offender / Psicopatia e estresse em autores de violência sexual contra crianças e adolescentes / Psicopatía y estrés en agresores sexuales de niños y adolescentes

The aim of this article was to investigate whether child and adolescent's sexual offender (SO), with and without psychopathy, differ in relation to their ability to manage stress and distress. Thirty prisoners serving time in jail for sexual crimes against children and adolescents participated in the study, which was divided into two groups: G1 SO considered without psychopathy (N = 20; PCL-R <30); and G2 SO with psychopathy (N = 10; PCL-R ≥ 30). The instruments used were: a protocol for collecting information on criminal proceedings; the Rorschach test according to the Performance Assessment System (R-PAS), considering the variables of the stress and distress domain, and the Psychopathy Checklist-Revised (PCL-R). The data were analyzed using Student's t-test and linear regression analysis. The results showed that 16% of psychopathy in SO was explained by a lower level of stress and distress. (AU)

O objetivo deste artigo foi investigar se Autores de Violência Sexual (AVS) contra crianças e adolescentes, com e sem psicopatia, se diferenciam em relação à capacidade de administrar o estresse e distresse. Participaram do estudo 30 reeducandos cumprindo pena em regime fechado por crimes sexuais contra crianças e adolescentes, divididos em dois grupos: G1 AVS considerados sem psicopatia (N = 20; PCL-R < 30); e G2 AVS com psicopatia (N = 10; PCL-R ≥ 30). Os instrumentos utilizados foram: um protocolo de coleta de informações no processo criminal; o teste de Rorschach de acordo com o Sistema de Avaliação por Performance (R-PAS), considerando as variáveis do domínio de estresse e distresse, e o Psychopathy Checklist-Revised (PCL-R). Os dados foram analisados por meio do teste t de student e análise de regressão linear. Os resultados evidenciaram que 16% da psicopatia em AVS foi explicada por menor nível de estresse e distresse. (AU)

Este artículo investiga si agresores sexuales (AS) de niños y adolescente, con y sin psicopatía, se diferencian en relación a la capacidad de administrar el estrés y el distrés. Participaron 30 reeducandos cumpliendo pena en régimen cerrado por crímenes sexuales contra niños y adolescentes, divididos en dos grupos: G1 AS considerados sin psicopatía (N = 20; PCL-R < 30); y G2 AS con psicopatía (N = 10; PCL-R ≥ 30). Instrumentos utilizados: protocolo de colecta de informaciones en el proceso criminal; test de Rorschach conforme el Sistema de Evaluación por Performance (R-PAS), considerando las variables del dominio de estrés y distrés y Psychopathy Checklist-Revised (PCL-R). Los datos fueron analizados según el test t de student y AS fueron por menor nivel de estrés y distrés. (AU)

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.

Personality Impairment in Children and Adolescents with ADHD / Comprometimento da Personalidade em Crianças e Adolescentes com TDAH / Deterioro de la Personalidad en Niños y Adolescentes con TDAH

Abstract Attention deficit hyperactivity disorder in children and adolescents manifests itself in a heterogeneous manner as regards personality aspects. This study aimed to evaluate, by using the Ego Impairment Index, the personality functioning characteristics of children and adolescents between 9 and 15 years old (to be completed), diagnosed with the disorder (clinical group) and compare them with a non-clinical group. The groups included 42 participants each. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version was used for diagnosis, and the Rorschach Performance Assessment System (R-PAS) was utilized for personality traits. When compared to their peers, the participants in the clinical group showed ability to discern adaptive behaviors through proper judgment, difficulty in keeping thinking and reasoning processes stable, a negative view of themselves and others, in addition to difficulty in establishing cooperative relationships.

Resumo O transtorno da falta de atenção com hiperatividade em crianças e adolescentes manifesta-se de forma heterogênea com relação aos aspectos de personalidade. O presente estudo teve por objetivo avaliar, por meio do Índice de Enfraquecimento do Ego, características do funcionamento da personalidade de crianças e adolescentes, entre 9 e 15 anos incompletos, com o diagnóstico do transtorno (grupo clínico) e compará-las com um grupo não-clínico. Os grupos contemplaram 42 participantes cada. Utilizou-se para o diagnóstico a entrevista Kiddie-Sads Referente ao Momento Presente e ao Longo da Vida, e o Sistema de Avaliação por Performance no Rorschach (R-PAS) para as características de personalidade. Os participantes do grupo clínico, quando comparados com seus pares, mostraram capacidade de discernir comportamentos adaptativos por meio de julgamento adequado, dificuldade em manter estáveis os processos de pensamento e raciocínio, visão negativa de si próprios e dos demais, dificuldade para estabelecer relacionamentos cooperativos.

Resumen El trastorno por déficit de atención con hiperactividad es uno de los más encontrados entre las patologías infantiles y se manifiesta de forma no homogénea con relación a los aspectos de personalidad. Este estudio comparó a través de lo Índice de Enflaquecimiento del Ego características de personalidad de niños y adolescentes entre 9 y 15 años incompletos con diagnóstico con un grupo de mismo sexo y edad sin diagnóstico. Cada grupo estaba compuesto por 42 participantes. Se utilizó la entrevista Kiddie-Sads sobre el momento presente y al largo de la vida para el diagnóstico y el Sistema de Evaluación por Performance en el Rorschach (R-PAS), para las características de personalidad. El grupo clínico mostró capacidad para discernir conductas adaptativas a través del juicio adecuado, dificultad para mantener estables los procesos de pensamiento y razonamiento, visión negativa de sí mismos y de los demás, dificultad para establecer relaciones de cooperación.