MMPI and Rorschach indices of schizophrenic and depressive diagnoses among adolescent inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

Neuromotor microalterations in subjects with spasmophilia symptoms: a preliminary study

Spasmophilia is a relatively unknown condition characterized by perturbations of the neuromuscular system. We hypothesized that spasmophilia may negatively affect neuromotor functions in subtle ways. Three tests including tremor, rapid pointing movements, and alternating movements were quantified in a group of subjects with spasmophilia symptoms (SS) (n = 10) and a healthy control group (n = 10). Most of the characteristics used to evaluate motor functions in these three tests revealed no significant differences between the two groups except for two characteristics in alternating movements and two characteristics in rapid pointing movements. In terms of variances, a dissociation between voluntary movements and involuntary movements was observed for the two groups. Control subjects had significantly higher variances in involuntary movements such as tremor, while subjects with SS had significantly higher variances in voluntary movements such as alternating and rapid pointing movements. A significant increase in asymmetry in hand laterality was also noted for some characteristics in subjects with SS.     

A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model

In the present study, we used a top-down approach to examine perfectionism and loneliness as additive sociocognitive predictors of depressive and anxious symptoms in a sample of 121 Latina college students. Consistent with expectations, we found perfectionism and loneliness to be associated with both depressive and anxious symptoms. In addition, results of conducting hierarchical regression analyses indicated that certain dimensions of perfectionism, especially doubts about actions, accounted for significant variance in both depressive and anxious symptoms. Moreover, the inclusion of loneliness as a predictor was found to predict additional unique variance in both depressive and anxious symptoms beyond what was accounted for by perfectionism. Implications of the present findings for future research on negative affective conditions in Latinas are discussed.     

The reliability of Rorschach variables for inpatients presenting symptoms of depression and/or helplessness

Fifty newly admitted patients presenting symptoms of depression and/or helplessness were recruited to participate in a study concerning depression and randomized into two groups. Rorschachs were administered shortly after admission and then three or four days later. The subjects in the experimental group were instructed to give responses different than they had in the first test. Approximately two-thirds of the responses given by the experimental group in test 2 were different from those in test 1, whereas the control subjects repeated 66% of their test 1 answers in test 2. Retest correlations for 28 variables critical to interpretation show that the two groups differed significantly for four. The retest correlations for four of five variables often used as indices of depressive features were significantly high for both groups. Unusual findings are noted in the retest correlations for FM and m for the Control group and questions are raised concerning the modest retest correlations for CF and C + Cn versus the more commonplace summation of CF + C.     

Learning capacities during sleep: A preliminary study in a group of schizophrenic inpatients

The relationship between sleep and learning processes is analysed in a sample of schizophrenic patients, starting from more recent hypotheses about the function of REM sleep in learning and memory processes. This is done by means of two experiments: in the first AA. evaluate the possibility to elicit a simple motor conditional reflex acquired during daytime in different sleep stages. With the second experiment daytime learning performances are evaluated with and without a reinforcement administered during REM sleep. Results for the first experiment underline a qualitative difference between REM and nREM sleep in a reflexological perspective. In nREM sleep the conditional response is better maintained than in REM sleep. The second experiment confirms the possibility to improve daytime learning performances after an additional presentation of learning material in REM. The joint study of sleep abnormalities and learning and cognitive impairment in schizophrenic patients is finally suggested.     

Changes in self-perceptions in children with ADHD: a longitudinal study of depressive symptoms and attributional style

This study examined positive self-perceptions in relation to depressive symptoms and attributional style in a sample of 88 boys with attention-deficit/hyperactivity disorder (ADHD) assessed at baseline and at a 2- to 3-year follow-up. Change in boys' self-perceptions of competency in the scholastic, social, and behavioral domains was examined as a predictor of changes in depressive symptoms and depressive attributional style. Additionally, teacher-rated perceptions of competency at baseline and follow-up were considered as unique predictors. Results indicated that across all three domains, a reduction in children's self-perceptions of competency over time predicted greater depressive symptoms at follow-up, even when controlling for teacher-rated competency. Analyses also suggested that a reduction in self-perceptions in the social domain was the strongest relative predictor of later depressive symptoms and also predicted greater depressive attributional style at follow-up. In contrast, teacher-rated competency was not a significant predictor of depressive symptoms or attributional style at follow-up. Results support a protective function of positive self-perceptions in regards to depressive cognitions over a 2- to 3-year period for children with ADHD. However, literature suggesting risks for other negative outcomes also is discussed.     

The four-factor model of depressive symptoms in dementia caregivers: a structural equation model of ethnic differences

Previous studies have suggested that 4 latent constructs (depressed affect, well-being, interpersonal problems, somatic symptoms) underlie the item responses on the Center for Epidemiological Studies Depression (CES-D) Scale. This instrument has been widely used in dementia caregiving research, but the fit of this multifactor model and the explanatory contributions of multifactor models have not been sufficiently examined for caregiving samples. The authors subjected CES-D data (N = 1,183) from the initial Resources for Enhancing Alzheimer's Caregiver Health Study to confirmatory factor analysis methods and found that the 4-factor model provided excellent fit to the observed data. Invariance analyses suggested only minimal item-loading differences across race subgroups and supported the validity of race comparisons on the latent factors. Significant race differences were found on 3 of the 4 latent factors both before and after controlling for demographic covariates. African Americans reported less depressed affect and better well-being than White caregivers, who reported better well-being and fewer interpersonal problems than Hispanic caregivers. These findings clarify and extend previous studies of race differences in depression among diverse samples of dementia caregivers.     

Personality in panic disorder with agoraphobia: a Rorschach study.

In this study, we tested several hypotheses derived from self psychology (Diamond, 1987) regarding personality features of patients suffering from panic disorder and agoraphobia (PDA). PDA patients are thought to suffer from a deficit in negative affect-regulating capacity, surrounded by defenses such as avoidance, repression, denial, and reaction formation against dependency needs. These defenses are thought to lead to a greatly impoverished affective life. The Rorschach Comprehensive System was used to assess the personality features of avoidance, restricted affective life, and reaction formation against dependency needs. We found evidence for the presence of a highly avoidant information-processing style (86% of protocols had lambda [L] greater than .99) and a constricted affective life (low weighted sum color [WSumC] and low affective ratio [Afr]). Our results were consistent with the hypothesis of reaction formation against dependency needs (low food content [Fd]). Findings are discussed in light of studies that found a high incidence of avoidant personality disorder in PDA patients.     

Preliminary examination of sex differences in depressive symptoms among adolescent psychiatric inpatients: the role of anxious symptoms and generalized negative affect.

Assessed the emerging view that generalized negative affect and anxious symptoms are important in understanding sex differences in depressive symptoms. Sixty-three adolescent psychiatric inpatients (32 boys, 31 girls), ages 12 to 16 (M = 13.87, SD = 1.36), completed measures of positive and negative affect and anxious and depressive symptoms. Results demonstrated, as predicted, that depressive and anxious symptoms were more highly associated in adolescent girls than boys. Furthermore, girls with depressive symptoms were more likely to have comorbid anxious symptoms than boys with depressive symptoms. Sex differences were not found for adolescents with specific depressive symptoms and specific anxious symptoms (i.e., the absence of comorbidity). Our findings supported the possibility that sex differences in pure forms of depression are overestimated and that comorbid internalizing conditions may be more prevalent in adolescent girls than boys.     

Satisfaction with social support and depressive symptoms: a panel analysis

The literature suggests that persons who are dissatisfied with the amount of social support that has been provided to them may subsequently suffer from psychological disorder. At the same time, there is evidence that individuals who initially suffer from emotional disorder may consequently be less satisfied with their social support systems than may persons who enjoy better mental health. The purpose of this study was to test these competing hypotheses with panel data from a community survey of older adults. The findings indicate that changes in satisfaction with support tend to precede changes in depressive symptoms. A number of issues in the analysis of longitudinal data are discussed.     

Social support, social stressors at work, and depressive symptoms: testing for main and moderating effects with structural equations in a three-wave longitudinal study

This study investigated the moderating effects of social support by supervisors and colleagues relative to social stressors at work and depressive symptoms using a structural equations approach in a 3-wave longitudinal study over 1 year. The analyses were based on a randomly drawn sample (N = 543) of citizens in the area around Dresden in the former East Germany. LISREL analysis with latent moderating effects revealed a moderating effect for supervisor support. This applied only if the time lag was 8 months, but not for longer or shorter lags. Under low-support conditions depressive symptoms were increased by social stressors, whereas, contrary to expectations, social stressors reduced subsequent depressive symptoms under high-support conditions. No moderating effect for colleague support was found. Several mechanisms are discussed that may explain the results.     

Dampening and brooding jointly link temperament with depressive symptoms: A prospective study

Integrated affective-cognitive models of depression suggest that the effects of trait temperament (low positive affectivity (PA) and high negative affectivity (NA)) on depressive symptoms may be mediated by maladaptive cognitive strategies. Research and theory suggest that the effect of NA on depression is mediated by brooding and the effect of PA on depression is mediated by dampening. Despite correlations among these constructs, no studies have examined joint contributions of PA, NA, brooding, and dampening on depression. The present study examined the effects of NA and PA on prospective increases in depressive symptoms, and whether effects were mediated by brooding and dampening. Hypotheses were tested in an eight-week study of 333 young adults; depressive symptoms were assessed at weeks one and eight. Participants reported their use of dampening and brooding in response to ideographically identified weekly events in weeks two through seven. Results suggest that the effect of PA on increases in depressive symptoms was mediated by use of dampening and the effect of NA on increases in depressive symptoms was mediated by use of both brooding and dampening. Future research should consider temperament traits and cognitive strategies jointly to understand the development and maintenance of depression.     

Relationships between Rorschach variables as relevant to the interpretation of structural data

The protocols of 100 adult nonpatients who had been administered the Rorschach twice in a long term temporal consistency study were used in this study. Separate intercorrelational matrices were calculated for each testing with R partialed. Means of the pairs of partial correlations were calculated, the square root of which is considered the best available estimate of the correlation between each pair of variables. Fifteen of the 120 partial correlations are considered to be significant. The findings are discussed in terms of their potential relevance for configurational interpretation of structural data.     

Screening detoxifying inpatients with substance-related disorders for a major depressive disorder

The Beck Depression Inventory-Fast Screen for Medical Settings (BDI-FS; [Beck, Steer, & Brown, 2000]) and the Mood Module (MM) from the Primary Care Evaluation of Mental Disorders [Spitzer, Williams, Kroenke, Linzer, deGruy, III, Hahn, & Brody, 1995] were used to screen 100 inpatients detoxifying from alcohol, illicit substances, or both for a major depressive disorder (MDD). Receiver operating characteristic (ROC) analyses indicated that both tests were highly and comparably effective in differentiating patients who were and not diagnosed with a MDD; the ROC areas-under-curves for the BDI-FS and MM were, respectively, .87 and .84. A BDI-FS cut-off score of 10 and above had 90% sensitivity and 78% specificity rates, and a MM cut-off score of 7 and above had 90% sensitivity and 72% specificity rates for discriminating patients with and without a MDD. The clinical advantages and disadvantages of both instruments for rapidly screening detoxifying inpatients for clinical depression were discussed.     

Brooding as moderator of depressive symptoms after a work accident: A longitudinal study

This study analyzes the relationship between having experienced a work accident and developing depressive symptoms six months later, considering the subjective severity of accidents, the use of both positive and negative religious coping strategies, and brooding as predictors variables. Fifty seven women and 187 men were evaluated during the month following their accident (T1) and six months later (T2). The results show that after controlling for initial depressive symptoms, all predictors showed a statistically significant relationship with depression at six months, including the interaction between brooding and subjective severity of accident. Forty nine percent of resilient participants exhibited low symptoms at T1 and T2, 22% of recovered individuals showed high symptoms at T1 and low symptoms afterwards, 20% of depressive individuals had high symptoms at T1 and T2, and 8% exhibited high symptoms only at T2. High severity, brooding and religious coping at T1 differentiated those who exhibited stable symptoms from those who were resilient. Resilience was specifically predicted with a negative coefficient by the interaction of brooding with subjective severity of accident. We conclude that brooding is a variable that moderates the relationship between subjective severity of accident and the development and maintenance of depressive symptoms. Subjective severity of accident, brooding and negative religious coping are risk factors, while positive religious coping is not a sufficient protection factor.     

Predictors and consequences of childhood depressive symptoms: a 5-year longitudinal study.

A 5-year longitudinal study investigated the interrelationships among children's experiences of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 years. Depressed children consistently showed helpless behaviors in social and achievement settings.     

Assessment of Rorschach dependency measures in female inpatients diagnosed with borderline personality disorder

The psychometric properties and predictive validity of the Dependency Index (DI; Hilsenroth & Bornstein, 2002) and the Rorschach Oral Dependency Scale (ROD; Masling, Rabie, & Blondheim, 1967) were examined to determine if these implicit measures of dependency predict observable attachment-seeking behavior in 66 female inpatients diagnosed with borderline personality disorder. Results indicate that both scales produce excellent reliability estimates. The DI and ROD yield adequate base rates, and the distributions of scores approximate normal distributions. The DI was predictive of nursing staff observation of positive attachment/treatment compliance (r = .28, p = .02) but not excessive isolation. By contrast, the ROD predicted positive attachment/treatment compliance (r = .38, p = .002) and excessive isolation (r = -.35, p = .004). Texture responses predicted excessive isolation (r = -.25, p = .05). Discriminant validity was supported when neither dependency measure predicted hostile interactions or self-destructive behaviors. Hierarchical regression analyses revealed that the ROD demonstrated incremental validity over the DI and select Comprehensive System (Exner, 1993) variables associated with dependency.     

Cigarette smoking and depressive symptoms: a longitudinal study of adolescents and young adults

Cigarette smoking and depressive symptoms have been shown to be related in previous research. This paper examined the relationship between cigarette smoking and depressive symptoms in a longitudinal sample of 688 adolescents and young adults through surveys conducted over 13 yr. The results indicate that a history of earlier cigarette smoking in adolescence predicts later depressive symptoms in the late twenties. The study also suggests that depressive symptoms during adolescence predict cigarette smoking in the late twenties but not above and beyond prior smoking. These results help clarify and expand current knowledge on the links between cigarette smoking and depression. The results point to several clinical implications for treatment of both cigarette smoking and depressive symptoms among both adolescents and young adults.     

Assessment of depressive symptoms in old visually-impaired people: a study of the Geriatric Depression Scale

This study has two main purposes: (a) to assess the functioning of the Geriatric Depression Scale in its Spanish version in old visually-impaired people, and (b) to assess the relevance of measuring depressive symptoms within a comprehensive assessment of psychological adjustment related to vision impairment in that population. Respondents were 329 people affiliated to the ONCE who were a representative sample of the target population. The assessment of the first goal let us to establish two cut-off points, and led to new methodological developments that combine Item Response Theory and Classical Test Theory. The results indicated that the scale is particularly useful in the target population and that it is very relevant in the assessment of psychological adjustment related to visual impairment in old people.