Varieties of "disordered" thinking on the Rorschach: Findings in schizophrenic and nonschizophrenic patients.

Assessed 71 schizophrenic and nonschizophrenic hospitalized patients on 3 scales for aspects indicative of a thinking disorder on the Rorschach: disruption of logical thought, irrelevant or personalized associations, and elaboration in affective terms. Each scale could be reliably scored according to the criteria described. The scales correlated significantly with other Rorschach scores suggestive of thought disorder. All 3 scales were significantly higher in schizophrenic Ss than in depressed Ss (p     

Development of the quality of life in epilepsy inventory

We developed an instrument to measure health-related quality of life (HRQOL) in epilepsy. A 99-item inventory was constructed from the RAND 36-Item Health Survey (generic core), with 9 additional generic items, 48 epilepsy-targeted items, and 6 other items concerning attitudes toward epilepsy and self-esteem. We administered the 99-item inventory to 304 adults with epilepsy at 25 epilepsy centers. Patients and patient-designated proxies completed the inventory and were retested 1-91 days later. A multitrait scaling analysis of these data led to retention of 86 items distributed in 17 multiitem scales (Cronbach's alpha ranged from 0.78 to 0.92). Factor analysis of the 17 multiitem scales yielded four underlying dimensions of health: an epilepsy-targeted dimension, a cognitive factor, mental health, and physical health. Construct validity was supported by significant patient-proxy correlations for all scales and correlations between neuropsychologic tests and self-reported emotional and cognitive function (all p values < 0.05). There were significant negative correlations between the four factor scores derived from the HRQOL scales and neurotoxicity, systemic toxicity, and health care utilization (except for the correlation between mental health factor and health care utilization; all p values < 0.05). Patients who were seizure-free in the preceding year reported better HRQOL for the overall score, three of the four factor scores, and 8 of the 17 scale scores than did patients with a high frequency of seizures. Relative validity analysis showed that the epilepsy-targeted factor and three of its four component scales were more sensitive to categorization of patients by severity of seizure frequency and type than scales tapping physical health, mental health, or cognitive function. These cross-sectional data support the reliability and validity of this measure of HRQOL in epilepsy. The addition of an epilepsy-targeted supplement to the generic core improved the sensitivity to severity of epilepsy. The 86 items included in the field testing were supplemented by three additional items to form the Quality of Life in Epilepsy (QOLIE-89) inventory.     

Dimensions of the Rorschach: A matter of preference.

Obtained similarity judgments among all possible pairs of the 10 Rorschach inkblots from a normative group of 15 psychiatric patients. A multidimensional scaling analysis was then performed for 2 groups of Ss: 20 clinical psychologists, and 49 state hospital psychiatric patients. 4 dimensions emerged for each group, and these were related to independently obtained preferences for the 10 inkblots by various S groups (psychotics, neurotics, normals) and to various stimulus calibrations (e.g., evaluation and meaningfulness) of the blots. Both S groups perceived a dimension that correlated with preference ratings made by both a psychotic and neurotic group; the patients split this dimension into psychotic and neurotic preference. The psychologists' judgments reflected a dimension not present in the patient group involving the difficulty of an inkblot in eliciting a response. It is argued that a multidimensional scaling analysis of the Rorschach provides a possible alternative method for the development of new scoring categories that would be based on Ss' own psychophysical perceptions of the blots. (33 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires

A self-report questionnaire module consisting of 24 items, comprising 5 scales and 7 single items, has been developed for measuring health-related quality of life in patients with brain cancer. Module development proceeded through several stages, including a listing of patient, family and health care professional concerns, the writing of items, field testing in 105 patients with brain cancer and subsequent item reduction and scale construction after multitrait scaling analysis and assessment of internal consistency (Cronbach's coefficient alpha). The final version of the module exhibits reasonable test-retest stability over a period of one week. Differences in the responses between patients with recently-diagnosed and recurrent cancer and between patients with a Karnofsky Performance Score (KPS) of 50-70 and 80-100 were in the expected direction, indicating that the module of questions is responsive to differing conditions. Patients with either mental confusion, motor deficit or dysphasia indicated problems in several domains and single items as compared to patients without these neurological deficits. Thus, differences in the responses to the items in the brain cancer module appear to reflect differences in neurological status. In addition, deteriorating neurological status was accompanied by a marked increase in emotional distress, future uncertainty and motor dysfunction. A comparison of the responses in the module with the KPS and with a modified Barthel Activities of Daily Living Index (BADLI) shows moderate correlations, primarily with scales and items that pertain to motor dysfunction, while other scales (such as emotional distress, visual disorder and communication deficit) and most single items are not associated with the KPS or BADLI. Since the emotional distress scale of the module was found to be highly correlated with the emotional function scale of the EORTC QLQ-C30, it could be omitted when the module is used in combination with the QLQ-C30. This would reduce the module to a total of 20 items with four scales and seven single items. The intention is to combine this module of questions with other core or general quality-of-life questionnaires when studying patients with brain cancer in clinical trials.     

Review of The clinical interaction: With special reference to the Rorschach.

Reviews the book "The clinical interaction: With special reference to the Rorschach," by Seymour B. Sarason (see record 1955-00896-000). Clinical psychologists who use the Rorschach technique have been sorely criticized by their more experimentally oriented colleagues for failing to take into account the numerous Rorschach research studies. The use of the Rorschach as a psychodiagnostic instrument still seems to be based upon the original, preexperimental statements of Rorschach and some of his disciples, with little or no attention paid to those investigations that have attempted to validate such statements. Sarason's effort to handle this problem of integrating research findings with the clinical use of the Rorschach will help answer these criticisms and will bring the Rorschach closer to the main body of contemporary empirical psychology. The author's pro-Rorschach bias occasionally leads him to conclusions that others might find unacceptable. This bias is clearly seen in the treatment of the Rorschach indices of performance under stress. Despite the criticisms, the present volume represents a significant contribution to the literature of the Rorschach and general clinical psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competence-enhancing communication by parents of high-risk children.

Examined parental competence-enhancing communication (CEC), which is transactional behaviors that may facilitate healthy child development. A set of coding categories was applied to Rorschach protocols from both parents of 61 10-yr-old boys who were at risk for the development of psychopathology; a parent in each family had previously been hospitalized for a mental disorder. Teacher and peer ratings of the children were also obtained. On the individual Rorschach, parents of well-adjusted children made clear transitions to each new percept and gave responses freely. These features of parental CEC were independent of parental psychopathology. CEC, symptomatic, and pathogenic communication seem to be separate domains of parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The concept of mental health as related to sex of person perceived.

Investigated the generalizability of the I. K. Broverman et al. (see record 1970-06951-001) findings that there is a difference between the male and female conception of mental health. 117 male and 138 female undergraduates rated a mentally healthy male and female using the Broverman et al. sex-role stereotypic scale. Results were correlated with those from C. A. Poe and R. A. Matias's semantic differential scale. Results from both instruments support the hypothesis; moreover, they indicate that a rating of mental health does measure concepts other than male and female stereotypes. The significant rater difference (p     

Mothers' fantasy representations and infant security of attachment: A Rorschach study of first pregnancy.

Studied the relationship between pregnant women's fantasy representations on the Rorschach test and later attachment status of their 1-yr-olds. The Manual for Assessing Primary Process Manifestations in Rorschach Responses (R. R. Holt, 1968) was used to score Rorschach protocols gathered from 25 women during their 1st pregnancies. Later, the 1-yr-olds and their mothers were videotaped in the Strange Situation to assess infant attachment behaviors. Findings support the hypothesis that primary process integration during pregnancy is significantly and positively related to infant security of attachment. Results also suggest a relation between empathic maternal behaviors and dimensions of mothers' unconscious mental representations measurable prior to the infant's birth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Language impairment and psychopathology in infants, children, and adolescents.

Reviews the book, Language impairment and psychopathology in infants, children, and adolescents by Nancy J. Cohen (see record 2001-05782-000). Approximately half of the children referred to mental health clinics for social-emotional problems have, on testing, been shown to have co-occurring language impairment. Conversely, about the same percentage of children originally seen for difficulties with language are later diagnosed with social-emotional problems. It is this overlap that Nancy Cohen explores in this concise and immensely readable book. We view this book as a broad and integrative first step that ought to be followed with more depth in specific areas. Thus, although much remains to be done, this book provides an excellent overview of a complex literature and will encourage interesting new clinical and research endeavours. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, depression, and comorbid PTSD/depression in a community sample of Latina immigrants.

Trauma exposure is frequently overlooked as a risk factor for psychiatric morbidity among studies with Latinos. The purpose of this study was to examine the relationships among trauma history, immigration-related factors, and mental health status among Latina immigrants. The current study used baseline data from a randomized clinical trial for the treatment of depression of 64 women with comorbid posttraumatic stress disorder and depression, 69 with depression-only, and 61 with no Axis I mental disorder. Sixty-four percent of the sample was Central American and 75% reported trauma exposure. Multinomial logit analysis suggested fewer years in the United States was associated with worse mental health status. Having a nonmarried marital status was also associated with worse mental health. Reporting four or more types of traumatic events was associated with an increase in the probability of comorbidity. These findings have important implications for future research and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Isolation, cloning and characterization of a putative type-1 astrocyte cell line

The high prevalence of cholesterol gallstone disease in hypertriglyceridemic patients may be associated with frequent metabolic defects in cholesterol and bile acid syntheses and in the concomitant formation of bile supersaturated with cholesterol. This study had the two aims: 1) to assess whether the defects as well as the degree of biliary cholesterol supersaturation in patients with hyperlipoproteinemia (HLP) can be estimated by the simultaneous determination of plasma mevalonate (MVL) and 7alpha-hydroxy-4-cholesten-3-one (C4); and 2) to assess the possible application of an estimated cholesterol saturation index ([CSI]E) as a means of evaluating the clinical effects of simvastatin on biliary lipid composition. Biliary cholesterol supersaturation was observed in patients with both IIa and IV HLP types. Consistent with the high activity and steady-state messenger RNA level of 3-hydroxy-3 methylglutaryl coenzyme A (HMG-CoA) reductase, plasma MVL was significantly higher in 86 patients with HLP (38 type IIa, 44.1 +/- 2.4 nmol/L and 48 type IV, 56.7 +/- 2.3; P < .01) than in 41 normolipidemic subjects (34.2 +/- 1.5), closely correlating with the molar percentage of cholesterol in bile (r = .61, P = .0001; n = 86). On the other hand, consistent with the high activity and messenger RNA level of cholesterol 7alpha-hydroxylase, plasma C4 was significantly higher in patients with HLP (type IIa, 28.8 +/- 2.3 nmol/L and type IV, 38.3 +/- 2.7; P < .01) than in normolipidemic subjects (17.4 +/- 1.5). Plasma C4 was closely correlated with plasma MVL (r = .40, P = .0001; n = 86), but was inversely correlated with the molar percentage of bile acids in bile (r = .49, P = .0001; n = 86). Assuming that cholesterol supersaturation in patients with HLP may be governed by both an enhanced cholesterol secretion (closely reflected by plasma MVL) and a decreased secretion of bile acids (closely reflected by plasma C4), the multivariate linear regression-analyses revealed that an index defined as estimated CSI ([CSI]E) (%) in patients with HLP was given by the following equation using plasma MVL and C4 (nmol/L): [CSI]E = 1[MVL] + 0.7[C4] + 44.4. Biliary cholesterol supersaturation in patients treated with simvastatin improved in a manner parallel to the time course of decreases in plasma MVL and C4. The [CSI]E before and at the end of treatment were correlated with biliary CSI. These results indicate that defects of hepatic cholesterogenesis, and bile acid synthesis, and the degree of biliary cholesterol supersaturation in patients with HLP can be estimated exactly by the simultaneous determination of plasma MVL and C4; furthermore [CSI]E may be adopted for clinical use as a convenient index of biliary CSI.     

Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey

Cross-sectional data from a representative sample of the general population in Japan were analyzed to test the validity of Japanese SF-36 Health Survey scales as measures of physical and mental health. Results from psychometric and clinical tests of validity were compared. Principal components analyses were used to test for the hypothesized physical and mental dimensions of health and the pattern of scale correlations with those components. To test the clinical validity of SF-36 scale scores, self-reports of chronic medical conditions and the Zung Self-Rating Depression Scale were used to create mutually exclusive groups differing in the severity of physical and mental conditions. The pattern of correlations between the SF-36 scales and the two empirically derived components generally confirmed hypotheses for most scales. Results of psychometric and clinical tests of validity were in agreement for the Physical Functioning, Role-Physical, Vitality, Social Functioning, and Mental Health scales. Relatively less agreement between psychometric and clinical tests of validity was observed for the Bodily Pain, General Health, and Role-Emotional scales, and the physical and mental health factor content of those scales was not consistent with hypotheses. In clinical tests of validity, the General Health, Bodily Pain, and Physical Functioning scales were the most valid scales in discriminating between groups with and without a severe physical condition. Scales that correlated highest with mental health in the components analysis (Mental Health and Vitality) also were most valid in discriminating between groups with and without depression. The results of this study provide preliminary interpretation guidelines for all SF-36 scales, although caution is recommended in the interpretation of the Role-Emotional, Bodily Pain, and General Health scales pending further studies in Japan.     

Thought disorder and boundary disturbances in psychosis.

Based on developmental cognitive and psychoanalytic theory, 3 types of thought disorder on the Rorschach (contaminations, confabulations, and fabulized combinations) were conceptualized as indicating different degrees of disruption of boundaries. 11 groups of 10 patients each who illustrated each of the types of boundary disruptions were compared on a wide range of psychological test data and reports of clinical course. Consistent and significant differences were found between level of thought disorder based on degrees of boundary disruption and impairments of complex cognitive functions, deterioration of reality testing, indications of difficulty with affect modulation, distorted human representations on the Rorschach, involvement in interpersonal relationships, and the response to therapeutic intervention. Degrees of boundary disruption appear to be useful criteria for assessing the extent of pathology, particularly within the psychotic range. (64 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality characteristics of mental health professionals who have engaged in sexualized dual relationships: a Rorschach investigation

This study is the first to empirically investigate the psychological characteristics of mental health professionals who have engaged in sexualized dual relationships. Twenty mental health professionals were administered the Rorschach as part of a comprehensive evaluation to assess rehabilitation potential during or after a disciplinary hearing. The Rorschach protocols were scored according to Exner's (1993) Comprehensive System. Results included a total of seven scores that differed by more than 3 standard deviations from the normative mean. These included measures of distress (especially interpersonal longing, helplessness, and generalized dysphoria), primitive sexualization, and idiosyncratic reality contact. Other indicators differing by 2 standard deviations from the normative mean included measures of vulnerable self-boundaries and long-standing, characterological dysphoria. These characteristics and vulnerabilities are consistent with previous observations emphasizing long-standing conflicts involving interpersonal longing and deprivation, anxiety regarding body integrity or self-boundaries, primitive sexualization of anxiety-provoking issues, and depression (Celenza, 1995b). Awareness of such vulnerabilities may represent useful guidelines to supervisors and educators as a focus of concern in an individual's training and personal development.     

Construct validation of the Rorschach Reality-Fantasy Scale in alexithymia.

The study applies Winnicott's conceptualization of potential space to the alexithymia construct by using a new Rorschach index, the Reality-Fantasy Scale (RFS). The scale uses variables derived from the Rorschach Comprehensive System (Exner, 2000, 2001) to detect different types of psychopathological manifestations conceptualized as forms of collapse of potential space. Following previous research, the present study further evaluates the construct validity of the RFS in a sample of 92 patients with inflammatory bowel disease, categorized on the basis of the Toronto Alexithymia Scale (TAS-20) as alexithymic, indeterminate alexithymia, and nonalexithymic groups. As hypothesized, the RFS significantly correlated with the TAS-20, discriminated among the 3 groups, and showed incremental validity in detecting alexithymia over isolated Rorschach markers. The study supports the exploration of psychoanalytic ideas by empirical, statistically based methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Schizophrenic intelligence, symptoms, and release from the hospital.

Used the WAIS and Inpatient Multidimensional Psychiatric Scale to assess changes in intelligence and symptoms over a 1-yr period in 64 male chronic schizophrenics (an additional 32 Ss were assessed only at the end of the 1-yr period). Hospital status 6 yr. later identified Ss who had been discharged successfully and those still hospitalized. Ss who improved in symptoms gained in test scores. Short-term symptomatic improvement showed no significant relationship to discharge within the next 6 yr., whereas short-term gains in intelligence predicted subsequent discharge to a highly significant degree (p     

Faking good and faking bad on the Personality Inventory for Children—Revised, shortened format.

Examined the detection of faking good and faking bad on the Personality Inventory for Children—Revised (PIC—R) with a sample of 6–16 yr old outpatients in a mental health clinic. The PIC—R was administered twice to both Ss and their mothers, and faking instructions to fake good or bad were administered in the 2nd testing session. Results show that faking influenced all 12 clinical scales and the 4 broad-band scales. Detection of faking good is recommended by the use of the Lie scale and the Adjustment scale. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of foreknowledge of death in the assessment from case history material of intent to die.

Investigated the differential assessment of intent to kill oneself expressed in previous nonfatal suicidal acts by having 23 professional mental health personnel rate on a 7-point scale the intent to kill oneself expressed in case history episodes of persons whom they were informed either later died a natural death or later committed suicide. Even though the Ss were informed that none of the persons died as a result of their actions described in the case history episode, foreknowledge that the person later committed suicide resulted in a greater assessment of intent to kill oneself expressed in his previous nonfatal suicide attempt than foreknowledge that the person later died a natural death. Empirical evidence demonstrated the risk of retrospective distortion in the study of suicides after the fact, and suggested that the percentages of prior suicide attempts reported for nonhospitalized or formerly hospitalized persons known to have committed suicide may be at least partially due to the differential likelihood of retrospective distortion in studies employing these 2 populations. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some relationships between manifest anxiety, authoritarian tendencies, and modes of reaction to frustration.

The relationship between authoritarianism and mental health was studied; authoritarianism was measured by the F scale, anxiety by the Taylor Scale, and reactions to frustration by the Child-Waterhouse scale. All intercorrelations of the scales were low but statistically significant. Correlations of authoritarianism and anxiety with each other, and each with intra- and extrapunitive tendencies were in the positive direction, and both correlated negatively with constructive resolutions of frustrating situations. 15 refs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)