The WAIS and Rorschach Test in Diagnosing Borderline Personality

Abstract

This study assesses the degree to which indicators from the Rorschach and the WAIS discriminate between the two groups of psychiatric inpatients diagnosed as having either borderline or psychotic personality organization by means of Kernberg's structural interview. A combination of WAIS scores focusing on the Picture Completion subtest, and Rorschach form level proved to be discriminators. These were interpreted as primarily reflecting reality testing. A linear combination of WAIS scale scores was identified that discriminated at least as well as the clinical WAIS-Rorschach comparisons.

A review of recent research addressing the utility of the Rorschach.

“…There is evidence of discriminative validity among the subtypes of cognitive disturbance scores. Findings, taken together, reveal that only individuals with schizophrenia, and to a lesser extent those with schizoaffective disorder or relatives of individuals with schizophrenia, have produced the most severe types of TDI responses (Arboleda & Holzman, 1985;Edell, 1987;Harris, 1993;Harrow & Quinlan, 1977;Holzman et al, 1974;Hymowitz, Hunt, Carr, Hurt, & Spear, 1983;Salwen, Reznikoff, & Schwartz, 1989;Wilson, 1985). Bipolar patients in the manic phase elevate the less severe types of thought disorder scores and produce relatively more combinatory (equivalent to CS incongruous and fabulized combination responses) and positively affectively toned or jocular responses, when compared with schizophrenic individuals (Holzman, Shenton, & Solovay, 1986;Khadivi, Wetzler, & Wilson, 1997).…”

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

“…or some other disorder (Lerner, Albert, & Walsh, 1987;Lerner & Lerner, 1983;Lerner & St. Peter, 1984a, 1984bLerner, Sugarman, & Barbour, 1985;Lerner, Sugarman, & Gaughran, 1981;Lerner & Lerner, 1980;Wilson, 1985). We also eliminated any study that (c) used Kernberg's (1975Kernberg's ( , 1976 criteria for borderline personality organization (Hymowitz, Hunt, Carr, Hurt, & Spear, 1983;Murray, 1985), because these criteria encompass a much broader diagnostic concept than the DSM criteria for BPD, and assess not only BPD, but also a variety of both non-BPD personality disorders and Axis I disorders (Kullgren, 1987;Kullgren & Armelius, 1990). Thus, we retained only studies that used either (d) the diagnostic criteria for BPD set forth in the third or later editions of the DSM (American Psychiatric Association, 1980Association, , 1987Association, , 1994, or (e) Gunderson, Kolb, and Austin's (1981) Diagnostic Interview for Borderlines (DIB), which is closely related to the DSM criteria (Armelius, Kullgren, & Renberg, 1985;McManus, Lerner, Robbins, & Barbour, 1984).…”

Object relations and social cognition in borderlines, major depressives, and normals: A Thematic Apperception Test analysis.

“…Nearly all of those studies have compared borderline patients (often diagnosed with unreported or marginal reliability and validity) with schizophrenics. By and large, borderlines typically score higher than schizophrenics on overall developmental level as measured on Blatt's Rorschach measure for object relations (Blatt, Brenneis, & Shimek, 1976), though findings on particu-lar subscales have been less consistent (Gartner, Hurt, & Gartner, 1989;Hymowitz, Hunt, Carr, Hurt, & Spear, 1983;Lerner & St. Peter, 1984;Spear & Sugarman, 1984). Lerner and St. Peter (1984) and Stuart et al (1990) found that borderlines tend to produce malevolent, idiosyncratic, but cognitive-developmentally advanced representations of people's intentions on the Rorschach.…”