Rorschach movement and color responses and MMPI social extraversion and thinking introversion personality types

Results of an analysis of MMPI profiles and Rorschach protocols scored by the Exner method for 100 psychiatric patients provided partial support for Rorschach's hypotheses that perceptions of color (FC, CF, and C) and movement (M) tap separate personality dimensions. First, the proportion of M responses on a protocol correlated significantly (p < .01) to thinking introversion as defined in terms of a subject's MMPI profile similarity to a prototypic MMPI profile with peak PtSc elevations. Second, the proportion of FC responses correlated negatively (p < .01) to social extraversion defined in terms of MMPI profile similarity to a prototypic MMPI profile with peak PdMa elevations. Hence, use of FC signified a socially reserved, controlled behavior. The findings regarding CF and C were inconclusive. Third, color and movement responses did not correlate significantly with somatization defined in terms of similarity to a prototypic MMPI profile with peak Hs, D, Hy elevations. Finally, the nonsignificant correlations of FC with M and with MMPI thinking introversion plus the nonsignificant correlation of M with color responses and MMPI social extroversion further supported the hypotheses that movement and color responses tap essentially unique personality dimensions.     

Schizophrenia and deliberate self-harm: a systematic review of risk factors

Deliberate self-harm (DSH) is a strong predictor of suicide in schizophrenia. The aim of this review was to identify risk factors for DSH in schizophrenia. This systematic review of the international literature examined cohort and case-control studies of patients with schizophrenia or related diagnoses that reported DSH as an outcome. Studies were identified by searching electronic databases and reference lists, and by consulting international experts. Fourteen studies met the eligibility criteria. Of the 29 variables examined by two or more studies, five (past or recent suicidal ideation, previous DSH, past depressive episode, drug abuse or dependence, and higher mean number of psychiatric admissions) were associated with an increased risk of DSH, and one (unemployment) was associated with a reduced risk. Schizophrenic patients with these risk factors need careful follow-up and monitoring, with treatment of any associated comorbid depression or drug abuse. Large, prospective studies of DSH in schizophrenia are needed to further define risk factors and to build on the findings of this review.     

A Rorschach stability study in a nonpatient adult sample

The objective of this study was to provide new primary data on Rorschach Comprehensive System stability levels. To achieve this, we tested 75 French nonpatient adults twice on the Rorschach with a 3-month interval between the tests. Interrater reliability was in the excellent range for most of the variables studied. The overall stability level in a selected set of previously studied variables was below expectations (median r = .53). Personality, cognitive or self/relational variables yielded higher test-retest correlations than emotional and coping variables. Moderators of stability could be identified: (a) overall level of Task Engagement (TE) in F, m, FM + m, a, FC, Sum C', Sum V, Sum Shd, Fr + rF, INC + FAB, COP, es, Adj es, EGO, and Blends; (b) variations in TE in F, FM, and p; (c) state distress in Zd, m, FM + m, a, C, CF + C, WSumC, FD, and es; (d) variables derived from the number of responses impacted stability in P, Zf, m, FC, CF + C, Sum C', Sum V, MOR, EA, es, and Blends. These results provide further support for the reliability of several measures. Examiner effects as an influence on productivity and TE were identified as an important area for future research.     

Cultural Mistrust and the Clinical Diagnosis of Paranoid Schizophrenia in African American Patients

This study examined agreement between clinical diagnoses and research diagnoses of schizophrenia for a sample of African American patients recently admitted to a psychiatric hospital. It also examined the association of cultural mistrust with disagreement between clinical diagnoses and research diagnoses of the paranoid subtype of schizophrenia. Complete data was available for 118 (77%) of the 154 cases from the original sample. Agreement among the different sources of diagnoses was poor in 5 out of 6 comparisons. The lack of agreement can be attributed, in part, to the fact there were significantly more cases of schizophrenia using clinical diagnoses than those using SCID or best estimate methods. Contrary to the hypothesis, however, level of cultural mistrust did not predict the excess in clinical diagnoses of paranoid schizophrenia. Cultural mistrust was positively associated with the odds of a diagnosis of paranoid schizophrenia by the best estimate method. The implications of the results for the diagnosis and treatment of African American patients are discussed.     

Receiver operating characteristics for the brief symptom inventory depression, paranoid ideation, and psychoticism scales in a large sample of clinical inpatients

A commonly used screening tool for psychopathology, the Brief Symptom Inventory, provides normative data for assessing current mental functioning across multiple domains. Using data from 654 psychiatric inpatients, receiver operating characteristic (ROC) analyses were conducted for three scales, Depression, Paranoid Ideation, and Psychoticism. t ratios identified significant group differences on the Depression scale between patients diagnosed with or without depression but no differences on the Paranoid Ideation and Psychoticism scales between patients diagnosed with or without schizophrenia. Area under the curve for Depression was .65, indicating that the scale improved diagnostic prediction somewhat beyond chance; for Paranoid Ideation, the area was .52 and for Psychoticism, the area was .53, indicating that these two scales did not significantly improve diagnostic prediction beyond chance.     

Coping with Severe Mental Illness: Relations of the Brief COPE with Symptoms, Functioning, and Well-Being

The way patients cope with the experience of having an episode and being hospitalized for psychiatric disorder may relate to symptom severity, social functioning, and psychological well-being. Coping was assessed among 70 psychiatric inpatients diagnosed primarily with schizophrenia, major depressive disorder, and schizoaffective disorder. The Brief COPE—a questionnaire developed in health psychology (C. S. Carver, 1997)—was administered in interviewer-assisted format during patients' stay on the ward. Thirty patients were re-interviewed an average of 6 weeks after discharge. Among patients with schizophrenia, schizophrenia symptom severity correlated inversely with adaptive coping (e.g., acceptance, planning, seeking support) but did not correlate with maladaptive coping (e.g., self-blame, denial). Among those with schizophrenia, deficits in adaptive coping also predicted relative increases in schizophrenia symptoms over time, controlling for intake symptom severity. Among patients without schizophrenia, maladaptive coping correlated concurrently with depressive symptoms. Several hypothesized associations between concurrent coping, functioning, and well-being were also documented.     

Demographic, clinical, and neurocognitive correlates of everyday functional impairment in severe mental illness

Although cognitive deficits often accompany severe mental illness, their implications for everyday functioning remain poorly understood. In this study, an occupational therapist (OT) rated the everyday functioning of 105 adult psychiatric patients. Using demographic, clinical, and cognitive variables, the authors tested alternative models to account for the observed variability in OT ratings. Although age, education, and the presence of schizophrenia each contributed to a model that accounted for 27% of the variation in functional independence, adding terms for auditory divided attention and verbal learning increased the proportion of explained variance to 45% and decreased the beta weights for age and education--but not schizophrenia--to nonsignificant levels. These findings demonstrate the relevance of cognitive performance to everyday functioning in severe mental illness. They are discussed with respect to hypothesized determinants of psychiatric disability.     

A relational interpretation of the Rorschach color determinants

This article presents a contemporary relational interpretation of the Rorschach that is consistent with the empirical features of the Comprehensive System. The specific focus is on color determinants and the FC:CF+C ratio. The approach follows that of Schachtel ( 1959), who argued that how one perceives others reveals the quality of relatedness between oneself and others. Schachtel identified a developmental sequence of relatedness (perceptual-relatedness modes) and linked these levels of perceiving and relating to the Rorschach color determinants. I suggest that this developmental sequence, elaborated in a contemporary context, defines the expected or normative course of relatedness, whether across a lifetime, a particular relationship, or an interpersonal encounter. I further propose that relationships emerge and develop through organized trial-and-error activity, in the sense of Piaget's (1952) trying out (assimilating) and simultaneously modifying (accommodating) one's understanding within a relationship. Relatedness levels and the developmental transitions between them are described in terms of the underlying assimilation and accommodation processes. Within this general approach, the FC:CF+C ratio is defined as reflecting styles of relating to one's interpersonal environment, with each relational style based on normative or on variant relational development. Four fundamental relational styles-healthy, egocentric, veneered egocentric, and defensive-are described and coordinated with the Comprehensive System FC:CF+C potential findings.     

An Approach to Use of Color on the Rorschach through Individual Color Preferences

More must be learned of color and its possible relationships with the Rorschach before its interpretation may be taken with assurance. Twenty Ss were administered the Rorschach and a Color Battery of four tasks chosen to tap color preference. Preferences were analyzed for use of the color on the Rorschach plates; color response scores and form-level scores; relationship with color meaning for the subject. Significances were found between: (1) preference and use of color; (2) preference and CF and C scores; (3) plus form-level and preferences. Color meanings varied with each subject. Color preference may influence the subject's use of color on the Rorschach, as well as scores, regardless of what the preferred color may be or the amount available. Generalizations are not warranted on the basis of color or color use, especially as regards differential diagnosis.     

Adaptation to tempo changes in sensorimotor synchronization: Effects of intention, attention, and awareness

Adaptation to tempo changes in sensorimotor synchronization is hypothesized to rest on two processes, one (phase correction) being largely automatic and the other (period correction) requiring conscious awareness and attention. In this study, participants tapped their finger in synchrony with auditory sequences containing a tempo change and continued tapping after sequence termination. Their intention to adapt or not to adapt to the tempo change was manipulated through instructions, their attentional resources were varied by introducing a concurrent secondary task (mental arithmetic), and their awareness of the tempo changes was assessed through perceptual judgements. As predicted, period correction was found to be strongly dependent on all three variables, whereas phase correction depended only on intention.     

Psychological concomitants of cystic fibrosis in children and adolescents

Thirty cystic fibrosis (CF) and 30 matched control children and their parents were administered several psychiatric inventories including the child (DICA) and parent (DICA-P) versions of the Diagnostic Interview for Children and Adolescents, the Child Behavior Check List, the Hopelessness Scale, and the Piers-Harris Children's Self-Concept Scale. Data analysis revealed few differences in either psychopathological symptoms or psychiatric diagnoses between the CF and control children. The differences which did emerge were either physical in nature (reflecting somatic complaints) or did not depart enough from normal scores to merit the label of high psychopathology. The results are discussed in terms of the growing evidence that CF children do not suffer from greater psychopathology than do normal children.     

On the stability and relevance of the exercise heart rate–music-tempo preference relationship

ObjectivesTo examine the stability of the cubic (two points of inflection) exercise heart rate–music-tempo preference relationship found by Karageorghis et al. (2011) in cycle ergometry using a different exercise modality (treadmill exercise). To advance previous related studies through the inclusion of psychological outcome variables (e.g., state attention and intrinsic motivation) and post-experiment interviews.DesignA mixed-model experimental design was employed with two within-subject factors (exercise intensity and music tempo) and a between-subjects factor (gender). The experiment was supplemented by qualitative data that were analyzed using inductive content analysis.MethodsParticipants (n = 22) exercised at six intensities (40–90% maxHRR) during which they were exposed to music tracks at four tempi and a no-music control. Music preference, affective valence, and perceived activation were assessed during the task. Immediately afterwards, an attentional focus item, the short Flow State Scale-2 and items from the Intrinsic Motivation Inventory were administered. A subsample of participants (n = 8) was interviewed using a schedule of open-ended questions.ResultsResults did not support a cubic relationship but rather a quadratic one (one point of inflection), and there was a weak association between the optimal choice of music tempo and positive psychological outcomes.ConclusionsThe range of preferred tempi for treadmill exercise (123–131 bpm) was narrower than that for cycle ergometry (125–140 bpm). Regardless of its tempo, music reduced the number of associative thoughts by ∼10% across all exercise intensities.     

Clinical Correlates of Co-occurring Psychiatric and Autism Spectrum Disorder (ASD) Symptom-Induced Impairment in Children with ASD

Although psychiatric symptom severity and impairment are overlapping but nevertheless distinct illness parameters, little research has examined whether variables found to be associated with the severity are also correlated with symptom-induced impairment. Parents and teachers completed ratings of symptom-induced impairment for DSM-IV-referenced syndromes, and parents completed a background questionnaire for a consecutively referred sample of primarily male (81 %) 6-to-12 year olds with autism spectrum disorder (ASD) (N?=?221). Some clinical correlates (e.g., IQ?<?70, maternal level of education, pregnancy complications, current use of psychotropic medication, season of birth) were associated with impairment for several disorders, whereas others were correlated with only a few syndromes (e.g., gender, co-morbid medical conditions) or were not related to impairment in any disorder (e.g., family psychopathology). There was little convergence in findings for parents’ versus teachers’ ratings. Some clinical correlates (e.g., season of birth, current psychotropic medication, maternal education) were unique predictors of three or more disorders. Pregnancy complications were uniquely associated with social anxiety and schizoid personality symptom-induced impairment. IQ was a unique predictor of schizophrenia, ASD, oppositional defiant disorder symptom-induced impairment. Children whose mothers had relatively fewer years of education had greater odds for symptom-induced impairment in social anxiety, depression, aggression, and mania and greater number of impairing conditions. Season of birth was the most robust correlate of symptom-induced impairment as rated by teachers but not by parents. Children born in fall evidenced higher rates of co-occurring psychiatric and ASD symptom-induced impairment and total number of impairing conditions. Many variables previously linked with symptom severity are also correlated with impairment.     

Memory for surface features of unfamiliar melodies: independent effects of changes in pitch and tempo

A melody’s identity is determined by relations between consecutive tones in terms of pitch and duration, whereas surface features (i.e., pitch level or key, tempo, and timbre) are irrelevant. Although surface features of highly familiar recordings are encoded into memory, little is known about listeners’ mental representations of melodies heard once or twice. It is also unknown whether musical pitch is represented additively or interactively with temporal information. In two experiments, listeners heard unfamiliar melodies twice in an initial exposure phase. In a subsequent test phase, they heard the same (old) melodies interspersed with new melodies. Some of the old melodies were shifted in key, tempo, or key and tempo. Listeners’ task was to rate how well they recognized each melody from the exposure phase while ignoring changes in key and tempo. Recognition ratings were higher for old melodies that stayed the same compared to those that were shifted in key or tempo, and detrimental effects of key and tempo changes were additive in between-subjects (Experiment 1) and within-subjects (Experiment 2) designs. The results confirm that surface features are remembered for melodies heard only twice. They also imply that key and tempo are processed and stored independently.     

Extending the Validity of the Personality Assessment Inventory's (PAI) Level of Care Index (LOCI) in Multiple Psychiatric Settings

The purpose of this study was to extend the validity and clinical application of the Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI) in 2 independent psychiatric samples. In Study 1 (N = 201), the LOCI effectively differentiated level of care (inpatients from outpatients), and was also meaningfully associated with risk factors for psychiatric admission (e.g., suicidal ideation, self-harming behavior, previous psychiatric admission, etc.), even after controlling for other demographic variables (range of Cohen's ds = 0.57–1.00). Likewise, the LOCI also incremented other risk indicators (suicide and violence history) and relevant PAI indexes (i.e., Mean Clinical Elevation, and Suicide and Violence Potential) in predicting level of care, and explained an additional 6% to 12% of variance in the target variable. Diagnostic efficiency analyses indicated LOCI scores in the range of 15 to 18 optimize positive and negative predictive power, and classification rate. In Study 2 (N = 96), the LOCI was found to be significantly higher in those with a recent psychiatric admission within the past 6 months (d = 0.64), as compared to those without an admission. Similarly, those who were admitted for suicide risk had significantly higher mean LOCI scores as compared to those who did not (d = 0.70). The clinical implications of these findings and potential application of the LOCI are discussed.     

Suicide, schizophrenia, and schizoid-type psychosis: role of life events and childhood factors

The first objective was to identify the provoking events of suicide in patients with schizophrenia or schizoid-type disorder, and to assess the humiliation component of these events. The second objective was to verify if quality of care during childhood is a vulnerability factor for suicide in patients with schizophrenia or schizoid-type psychosis. Thirty-three cases of suicide with a diagnosis of schizophrenia or schizoid-type psychosis were compared with 34 living patients with a similar diagnosis. The psychological autopsy method was used. The assessments were made with the Structured Clinical Interview for the Diagnostic and Statistical Manual for Axis I mental disorders, the Life Events and Difficulties Schedule, and the Child Experiences and Child Abuse Interview. The suicide group (SG) experienced more often a recent severe event, usually of a humiliation nature, than the control group (CG). It also experienced more severe events associated with aggressive behavior or with psychiatric impairment. Contrary to expectations, the CG had worse scores than the SG for quality of care during childhood. In conclusion, suicide in schizophrenia is related both to environmental stress and to psychiatric impairment.     

Poly I:C母体免疫刺激诱导的子代精神分裂症神经发育动物模型研究

精神分裂症是一组病因未明的重性精神障碍,其病理生理学机制极其复杂,建立能够确切模拟精神分裂症的动物模型对于其发病机制的研究及抗精神分裂症药物的研发具有十分重要的意义。本文意在介绍产前母体免疫刺激（聚肌胞苷酸聚肌苷酸-聚胞苷酸,poly-I:C）诱导子代出现精神分裂症样的神经发育动物模型,以及该模型对精神分裂症的病因研究、生物学机制及其治疗和药物研发的重要意义。     

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.     

Cognitive impairments and disordered speech in schizophrenia: thought disorder, disorganization, and communication failure perspectives

This article posits that basic cognitive impairments in schizophrenia are more highly related to speech disorder measured as communication failures than speech disorder measured as thought disorder or disorganization. The author tested 47 schizophrenia patients and 36 control participants for sustained attention, sequencing, and conceptual sequencing ability. Their speech was also rated for communication failures, thought disorder, and conceptual disorganization. Attention and sequencing impairments, examined hierarchically, explained a substantial 38% of the variance in the communication measure of speech disorder but little of the variance in formal thought disorder or conceptual disorganization. The author concludes that (a) impairments in attention and sequencing abilities contribute substantially to schizophrenic communication failures, and (b) it is important to consider lower level cognitive "3rd variables" when examining higher level cognitive associates of speech disorder.     

Systematic Monitoring of the Implementation of a Case Management Model

A systematic approach for monitoring case management service provision and the results obtained when this approach was applied to a program for community-dwelling elders with severe mental illness are presented. A detailed, closed-ended, daily service log was used to collect data on 713 client-contact days. Participants (N = 24) were predominantly female (71%), were White (63%) or African American (37%), and tended to have diagnoses of either schizophrenia (42%) or major depression (21%). Services were delivered most frequently in the client's home (47%), the program office (35%), or by phone (27%); most frequent activities were monitoring psychiatric symptoms/medications (62 %), and monitoring physical symptoms or medications or both (54%). Service characteristics did not differ with regard to demographics but did vary with living situation and psychiatric diagnosis. The findings point to the need for flexible programs capable of meeting diverse service needs as well as the utility of a daily service log in studying case management.