| Abstract: | In his American Psychologist article, Joseph Lerner (see record 1964-01189-001) kindly ascribed to me words which properly belong to Samuel J. Beck. Beck does refer to my Perceptanalysis (Piotrowski & Lewis, 1957), but not on the same page. His words express my past belief. At present my attitude is more complex. It changed after I checked some "blind" Rorschach diagnoses and clinical psychiatric diagnoses on the same patients (Piotrowski, 1950, p. 363), and read published reviews of the reliability and validity of clinical psychiatric diagnoses. These revealed that a considerable percentage of first admission patients, discharged as psychoneurotics, are rediagnosed as schizophrenics after a re-examination several years later. In fact, some schizophrenic conditions escape detection through clinical observations for as long as 10 years, despite intermittent clinical examinations. The Rorschach test definitely is highly sensitive to schizophrenia even though at times some remitted or much improved schizophrenics produce test records failing to give any indication of the psychosis, let alone of the past acute psychotic episodes Lerner stated that "the Rorschach alone is of little assistance unless it is an integral part of the total evaluation." Well, if the Rorschach is never used as an independent diagnostic criterion, we shall never know how good or bad a diagnostic criterion it is. Using it as a part source of information, is to contaminate it (that is why "blind" diagnoses are important). The second point is: It seems advisable to follow the rule that if clinical observations or the Rorschach test--or both--suggest schizophrenia, this diagnosis is likely to be valid. This rule is compatible with Lerner's conclusion that an evaluation based on all available sources of information is better than one which utilizes only one diagnostic criterion, be it test, anamnesis, or clinical examination. To be certain that the Rorschach test is a dependable diagnostic criterion in neuropsychiatry we must have first highly reliable diagnostic test procedures. A digital computer program of Rorschach interpretation, including numerous diagnostic formulae, has been written to achieve objective and perfectly reliable application of the diagnostic test rules to individual cases. The computer program will be submitted to a stringent test of validity. We shall then be in possession of a test which will yield independent and uncontaminated diagnoses. These, in turn, will be available for use independently or as part of a "total evaluation." (PsycINFO Database Record (c) 2010 APA, all rights reserved) |
