The Rorschach Schizophrenia Index (SCZI): An Examination of Reliability, Validity, and Diagnostic Efficiency

Abstract

In this study, we investigate the reliability, validity, and diagnostic efficiency of the Rorschach Schizophrenia Index (SCZI) in relation to the accurate identification of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) schizophrenia or other psychotic disorder (PD) according to the methodological recommendations offered by Wood, Nezworski, and Stejskal (1996). Seventy-eight patients who were found to meet DSM-IV criteria for a PD or Axis II disorder (PD = 33; borderline personality disorder = 23; Cluster A personality disorders = 9; Cluster C personality disorders = 13) and 50 nonclinical participants were compared on the SCZI. The results of this study indicate that the SCZI is internally consistent and can be reliably scored. In addition, the SCZI was used effectively in differentiating PD patients from patients with an Axis II disorder and from the participants in the nonclinical sample. Also, the SCZI variable was found to be empirically related to the presence of a DSM-IV diagnosis of PD. Finally, this variable could be employed for classification purposes in ways that were clinically meaningful in the diagnosis of a PD. Conceptual and methodological issues are discussed in relation to the assessment of psychosis.

Association of Rorschach and MMPI Psychosis Indicators and Schizophrenia Spectrum Diagnoses in a Russian Clinical Sample

“…Compared to Meyer's (as cited in Jørgensen et al, 2000; n = 158) sample, there was a small effect size difference of d = -0.39. There was a large effect size difference between the mean SCZI score found in my sample versus the two small samples for which Cohen's d could be computed (Hilsenroth, Fowler, & Padawer, 1998; n = 33, d = -1.11; Netter & Viglione, 1994; n = 20, d = -0.84). In three of these four comparisons, the value of d is negative, indicating that my sample appeared less disturbed than the other samples.…”

The Rorschach test in clinical diagnosis: A critical review, with a backward look at Garfield (1947)

“…Finally, we eliminated studies that assigned diagnoses based entirely or in part on chart reviews (with possible criterion contamination) rather than on structured or clinical interviews (Carlson et al, 1997;Coonerty, 1986;Farris, 1988;Hilsenroth et al, 1998;Hilsenroth et al, 1997;Salwen, Reznikoff, & Schwartz, 1989). …”

Relationship between the Rorschach Perceptual Thinking Index (PTI) and the Positive and Negative Syndrome Scale (PANSS) in psychotic patients: A validity study

“…The Rorschach Inkblot Method is a multi-scale, multi-purpose performance test used to conduct personality assessments that might also be useful in differentiating between psychotic and nonpsychotic patients (Exner et al, 1985;Exner, 1986;Perry et al, 1992;Hilsenroth et al, 1998;Jorgensen et al, 2000;Exner, 2002;Kumar, Khess (2005)). The Rorschach test has demonstrated the ability to detect underlying psychotic processes even before they are evident in the clinical presentation (Frank, 1990;Kleiger, 1999).…”

“…Although many studies have shown the Rorschach Schizophrenia Index (SCZI) (Exner, 1993) to be useful in differentiating psychotic patients from other clinical groups (Ganellen, 1996a;Ganellen, 1996b;Hilsenroth et al, 1998;Ilonen et al, (1999); Jorgensen et al, 2000;Stokes et al, (2001). ), an alternative index has recently been emphasized as a new possibility for detecting psychosis and thought disorder: the Perceptual Thinking Index (PTI) (Exner, 2003;Hilsenroth et al, 2007).…”