Associations between the Rorschach Ego Impairment Index and Measures on Intrapsychic and Interpersonal Functioning

Abstract

The Rorschach Ego Impairment Index-2 (EII-2) has shown considerable validity as a measure of personality disturbance. However, few studies have been conducted on the associations between the EII-2 and measures related to ego strength and interpersonal capacities in mood and anxiety disorder patients. This study examined the strength of associations between the EII-2 and its subcomponents with measures of psychological suitability for psychotherapy, personality functioning, and interpersonal problems. A total of 315 outpatients with mood or anxiety disorders were assessed with the Rorschach Comprehensive System (RCS), comprising the EII-2, the Suitability for Psychotherapy Scale (SPS), the Inventory of Interpersonal Problems (IIP-64), and the Quality of Object Relations Scale (QORS), as part of a pre-treatment evaluation. The relatively weak associations found in the study between the EII-2 and the other measures were mostly in the hypothesized direction and often modified by personality pathology. Of the EII-2 subcomponents, the Good Human Representation (GHR) variable was associated with the SPS. The subcomponent Critical Contents were associated with the IIP and the subcomponent WSum6 with the IIP and QORS. Further research is needed to clarify whether the EII-2 has incremental validity in predicting the treatment outcome and alliance in comparison to interview-based and self-report measures.

Ego Impairment Index (EII‐2) as a predictor of outcome in short‐ and long‐term psychotherapy during a 5‐year follow‐up

“…Further, as SPP and SFT were both designed to achieve therapeutic changes within a limited time frame, ego functions-such as capacity to adaptively regulate behavior-may be critical to therapeutic outcome. Previous research has found EII-2 to be relatively weakly associated with both self-report and interview-based methods of pretreatment assessment (e.g., Stenius et al, 2018), which is in line with the meager associations between Rorschach and introspection-based measures, more generally (e.g., Mihura et al, 2013). Given this, the present findings support the incremental utility of the EII-2 in selecting between short-and long-term psychotherapy.…”

“…Also, a study of children in intensive inpatient psychiatric treatment found higher EII-2 values to predict worse long-term treatment outcome (Stokes et al, 2003). In addition, a recent study (Stenius et al, 2018) found the EII-2 to target different phenomena than an interview-based assessment for adult patients, which in turn has been previously…”

“…Also, a study of children in intensive inpatient psychiatric treatment found higher EII‐2 values to predict worse long‐term treatment outcome (Stokes et al, 2003). In addition, a recent study (Stenius et al, 2018) found the EII‐2 to target different phenomena than an interview‐based assessment for adult patients, which in turn has been previously shown to predict the amount (i.e., short‐ vs. long‐term) of psychotherapy that patients needed to recover (Laaksonen et al, 2013). Taken together, these findings indicate the need for further research on the predictive ability of the EII‐2 in choosing between therapies of different lengths or type for adult patients, which is still lacking.…”

Critical review of the use of the Rorschach in European courts

“…Finn, 1996 ) because it goes beyond conscious and behavioural functioning (e.g. Stenius et al., 2018 ). Rorschach supporters believe that it circumvents examinees’ conscious defences because they respond to ambiguous stimuli with a minimum of instructions (see Siipola & Taylor, 1952 ).…”