New Read on Rorschach Test Helps Kids
WEDNESDAY, June 5, 2002 (HealthDayNews) -- Assessing mental illness in children, a tricky task, might now be a little more accurate.
In the first study of a new method for assessing the 81-year-old Rorschach Test, researchers at the University of Arkansas have found that an index called the Perceptual-Thinking Index (PTI) resulted in more accurate psychological diagnoses than the existing Schizophrenic Index (SCZI).
"This is a very preliminary study, but what we hope is that the assessment of the Rorschach Test with the PTI will be a more specific indicator of thought disorder in children," says Steven Smith, the lead author of the study who is now a pediatric psychologist at Massachusetts General Hospital in Boston.
Smith, who did the research while a doctoral graduate, and his colleagues at the University of Arkansas recently won an award from the Society for Personality Assessment for their work on the well-known ink blot test.
In mild forms, thought disorders can include the inability to think logically or sequentially. In more severe cases, they can be characterized by hallucinations and delusions, which are associated with the mental illness schizophrenia. The SCZI test, which was devised to identify schizophrenia, often produces false-positive results, especially when applied to children who are bright and creative, Smith says.
"A child [will see an inkblot and] say things that don't make sense, like saying he sees a dog playing a banjo," Smith says, and the SCZI test records the response as being outside the norm and indicative of a severe thought disorder.
"The SCZI tends to be non-specific compared to the PTI," he adds.
For his study, which was published in a recent Journal of Personality Assessment, Smith and colleague Matthew Baity examined 42 children, whose ages ranged from 8 to 18. All had been admitted to a psychiatric hospital for diagnosis and treatment. Each child completed a self-report of his or her symptoms, their parents submitted a behavior rating for the child, and each child took a Rorschach Test.
The researchers analyzed the Rorschach results according to both the SCZI and the PTI indexes and found that there were fewer false positives with the PTI index. The PTI results were also more consistent with the results of the children's self-reporting and the parents' behavior rating.
"If you have a positive PTI, you have a little bit more confidence in the results," Smith says.
Another result of the new test is to restore some luster to the Rorschach Test, he says.
The Rorschach Test was devised by Swiss psychiatrist Hermann Rorschach as a way to assess a variety of psychological traits by having patients look at a series of 10 inkblots and say what they see. The idea is that a patient's subconscious will assert itself when he sees the inkblot, so that when he says, for instance, the inkblot looks like a rabbit, the doctor will have an idea as to the patient's mental state.
Over the years doctors have developed as many as 95 codes and indexes to interpret Rorschach data as objectively and accurately as possible, to give them insight into many aspects of a person's mental state, Smith says. But a criticism of the test is that interpreting the results is very subjective, depending on who looks at the data.
"This potentially increases the diagnostic reliability of the Rorschach Test," Smith says.
The PTI was developed two years ago by Dr. John E. Exner, Jr. of Rorschach Workshops in Ashville, N.C., an expert in interpreting the Rorschach Test.
"Exner is really the standard bearer. His data is based on a very thorough methodological approach and generates a very specific way of correlating the [Rorschach] responses with specific disorders," says Matthew Silvan, a Columbia University psychologist in New York City.
What To Do
Information about the history and use of the Rorschach Test can be found at the International Rorschach Society. For information about diagnosing schizophrenia, you can visit Health Canada.
