While the Rorschach has been proven useful in assessing severity of thought disorder, the assessment of extent of thought disorder evidenced in any one protocol is made subjectively, that is, on the basis of clinical impression. Objective methods for assessing thought disorder on the Rorschach were reviewed and evaluated. Problems in the development of such methods which have limited their psychometric efficiency were discussed, and possible solutions of these problems were suggested. Since severity of thought disorder relates to prognosis and treatment, the further exploration of more effective ways of assessing thought disorder by the Rorschach seems warranted.
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References
1.
AbramsS. (1964) A validation of Piotrowski's Alpha Formula with schizophrenics varying in duration of illness. American Journal of Psychiatry, 121, 45–47.
2.
AndreasenN. C. (1976) Do depressed patients show thought disorder?Journal of Nervous and Mental Disease, 163, 187–192.
3.
AndreasenN. C. (1979a) Thought, language, and communication disorders. Archives of General Psychiatry, 36, 1315–1321.
4.
AndreasenN. C. (1979b) Thought, language, and communication disorders: II. Diagnostic significance. Archives of General Psychiatry, 36, 1325–1330.
5.
AndreasenN. C. (1986) Scale for the assessment of thought, language and communication (TLC). Schizophrenia Bulletin, 12, 473–482.
6.
AndreasenN. C.GroveW. M. (1986) Thought, language and communication in schizophrenia: Diagnosis and prognosis. Schizophrenia Bulletin, 12, 349–359.
7.
AndreasenN. C.PowersP. S. (1974) Overinclusive thinking in mania and schizophrenia. British Journal of Psychiatry, 125, 452–456.
8.
ArboledaC.HolzmanP. S. (1985) Thought disorder in children at risk for psychosis. Archives of General Psychiatry, 42, 1004–1013.
9.
BannisterD. (1960) Conceptual structure in thought-disordered schizophrenics. Journal of Mental Science, 160, 1230–1249.
10.
BeckS. J. (1944) Rorschach's test: I. Basic processes. New York: Grune & Stratton.
11.
BeckS. J. (1954) The six schizophrenias. New York: American Orthopsychiatric Association.
12.
BinetA.SimonT. (1905) Methodes nouvelles pour le diagnostic du niveau intellectual des anormaux. L'Anneé Psychologique, 11, 193–244.
13.
BlattS. J.BermanW. (1984) A methodology for the use of the Rorschach in clinical research. Journal of Personality Assessment, 48, 226–239.
14.
BlattS. J.RitzlerB. A. (1974) Thought disorder and boundary disturbance in psychosis. Journal of Consulting and Clinical Psychology, 42, 370–381.
15.
BleulerE. (1950) Dementia praecox or the group of schizophrenias. New York: International Universities Press.
16.
BollesM. M. (1937) The basis of pertinence. Archives of Psychology, No. 212.
17.
BollesM.GoldsteinK. (1938) A study of the impairment of ‘abstract behavior’ in schizophrenic patients. Psychiatric Quarterly, 12, 42–65.
18.
BowerP. A.TestinR.RobertsA. (1960) Rorschach diagnosis by a systematic combining of content, thought process, and determinant scalesGenetic Psychology Monographs, 62, 105–183.
19.
BraffD. L.SaccuzzoD. P. (1981) Information processing dysfunction in paranoid schizophrenia: A two-factor deficit. American Journal of Psychiatry, 138, 1051–1056.
20.
BrometE.HarrowM.TuckerG. T. (1971) Factors related to short-term prognosis in schizophrenia and depression. Archives of General Psychiatry, 25, 148–154.
21.
CameronN. (1938) Reasoning, regression and communication in schizophrenics. Psychological Monographs, 50, No. 1 (Whole No. 221).
22.
CameronN. (1939) Schizophrenic thinking in a problem-solving situation. Journal of Mental Science, 85, 1012–1035.
23.
CancroR. (1969) Clinical prediction of outcome in schizophrenics. Comprehensive Psychiatry, 10, 349–354.
24.
ChapmanL. J. (1956) Distractibility in the conceptual performance of schizophrenics. Journal of Abnormal and Social Psychology, 53, 286–291.
25.
ChapmanL. J.TaylorJ. A. (1957) Breadth of deviate concepts used by schizophrenics. Journal of Abnormal and Social Psychology, 54, 1–6.
26.
EdellW. S. (1987) Role of structure in disordered thinking in borderline and schizophrenic disorders. Journal of Personality Assessment, 51, 23–41.
27.
EfronH. Y.PiotrowskiZ. A. (1966) A factor analytic study of the Rorschach Prognostic Index. Journal of Projective Techniques & Personality Assessment, 30, 179–183.
28.
EpsteinS. (1953) Overinclusive thinking in a schizophrenic and a control group. Journal of Consulting Psychology, 17, 384–388.
29.
ExnerJ. E. (1986) The Rorschach: A comprehensive system. Vol. 1. Basic foundations. (2nd ed.) New York: Wiley.
30.
ExnerJ. E. (1991) The Rorschach: A comprehensive system. Vol. 2. Interpretation. (2nd ed.) New York: Wiley.
31.
FrankG. (1975) Psychiatric diagnosis: A review of research. Oxford, UK: Pergamon.
32.
GoldfriedM. R.StrickerG.WeinerI. B. (1971) Rorschach handbook of clinical and research applications. Englewood Cliffs, NJ: Prentice-Hall.
33.
GoldsteinK. (1939) The significance of special mental tests for diagnosis and prognosis in schizophrenia. American Journal of Psychiatry, 96, 575–588.
34.
GuilfordJ. P. (1956) The structure of intellect. Psychological Bulletin, 53, 267–293.
35.
HaimoS. F.HolzmanP. S. (1979) Thought disorder in schizophrenics and normal controls: Social class and race differences. Journal of Consulting and Clinical Psychology, 47, 963–967.
36.
HanfmannE.KasaninJ. (1942) Conceptual thinking in schizophrenia. Nervous and Mental Disease Monographs, No. 67.
37.
HarrowM.AdlerD.HanfE. (1974) Abstract and concrete thinking in schizophrenia during the prechronic phase. Archives of General Psychiatry, 31, 27–33.
38.
HarrowM.BrometE.QuinlanD. (1974) Predictors of posthospital adjustment in schizophrenia. Journal of Nervous and Mental Disease, 158, 25–36.
39.
HarrowM.GrossmanL. S.SilversteinM. L.MeltzerH. Y. (1982) Thought pathology in manic and schizophrenic patients: Its occurrence at hospital admission and seven weeks later. Archives of General Psychiatry, 39, 665–671.
40.
HarrowM.HarkavyK.BrometE.TuckerG. J. (1973) A longitudinal study of schizophrenic thinking. Archives of General Psychiatry, 28, 179–182.
41.
HarrowM.HimmelhochJ.TuckerG.HershJ.QuinlanD. (1972) Overinclusive thinking in acute schizophrenic patients. Journal of Abnormal Psychology, 79, 161–168.
42.
HarrowM.Lanin-KetteringI.ProsenMillerM., J. G. (1983) Disordered thinking in schizophrenia: Intermingling and loss of set. Schizophrenia Bulletin, 9, 354–367.
43.
HarrowM.MarengoJ. T. (1986) Schizophrenic thought disorder at follow up: Its persistence and prognostic significance. Schizophrenia Bulletin, 12, 373–393.
44.
HarrowM.ProsenM. (1978) Intermingling and disordered logic as influences on schizophrenic thought disorders. Archives of General Psychiatry, 35, 1213–1218.
45.
HarrowM.ProsenM. (1979) Schizophrenic thought disorders: Bizarre associations and intermingling. American Journal of Psychiatry, 136, 292–296.
46.
HarrowM.QuinlanD. (1977) Is disordered thinking unique to schizophrenia?Archives of General Psychiatry, 34, 15–21.
47.
HarrowM.TuckerG. J.AdlerD. (1972) Concrete and idiosyncratic thinking in acute schizophrenic patients. Archives of General Psychiatry, 26, 433–439.
48.
HarrowM.TuckerG. J.HimmelhochJ.PutnamN. (1972) Schizophrenic “thought disorder” after the acute phase. American Journal of Psychiatry, 128, 824–829.
49.
HarrowM.TuckerG. J.ShieldP. (1972) Stimulus overinclusion in schizophrenic disorders. Archives of General Psychiatry, 27, 40–45.
50.
HarveyP. D. (1983) Speech competence in manic and schizophrenic psychoses: The association between clinically rated thought disorder and cohesion and reference performance. Journal of Abnormal Psychology, 92, 368–377.
51.
HarveyP. D.Earle-BoyerE. A.WielgusM. S. (1984) The consistency of thought disorder in mania and schizophrenia: An assessment of acute psychosis. Journal of Nervous and Mental Disease, 172, 458–463.
52.
HolzmanP. S. (1986) Thought disorder in schizophrenia: Editor's introduction. Schizophrenia Bulletin, 12, 342–346.
53.
HolzmanP. S.ShentonM. E.SolovayM. R. (1986) Quality of thought disorder in differential diagnosis. Schizophrenia Bulletin, 12, 360–371.
54.
HughesR. M. (1950) A factor analysis of Rorschach diagnostic signs. Journal of General Psychology, 43, 85–103.
55.
JohnstonM. H.HolzmanP. S. (1979) Assessing schizophrenic thinking: A clinical and research instrument for measuring thought disorder. San Francisco, CA: Jossey-Bass.
56.
KasaninJ. S.HanfmannE. (1938a) Disturbance in concept formation in schizophrenia. Archives of Neurology and Psychiatry, 40, 1276–1282.
57.
KasaninJ. S.HanfmannE. (1938b) An experimental study of concept formation in schizophrenia. American Journal of Psychiatry, 95, 35–52.
58.
KettnerN. W.GuilfordJ. P.ChristensenP. R. (1956) A factor-analytic investigation of the factor called general reasoning. Educational and Psychological Measurement, 16, 438–453.
59.
KettnerN. W.GuilfordJ. P.ChristensenP. R. (1959) A factor-analytic study across the domain of reasoning, creativity, and evaluation. Psychological Monographs, 73, No. 9 (Whole No. 479).
60.
KimballA. J. (1950) History of form-level appraisal in the Rorschach. Journal of Projective Techniques, 14, 134–152.
61.
KnightR.SheererM.ShapiroJ. (1977) Iconic imagery in overinclusive and noninclusive schizophrenics. Journal of Abnormal Psychology, 86, 242–255.
62.
KraepelinE. (1902) Clinical psychiatry. New York: Macmillan.
63.
LangP. J.BussA. H. (1965) Psychological deficit in schizophrenia: II. Interference and activation. Journal of Abnormal Psychology, 70, 77–106.
64.
LernerP. M. (1975) The assessment of pathological thinking by means of the Rorschach. In LernerP. M. (Ed.), Handbook of Rorschach scales. New York: International Universities Press. Pp. 55–67.
65.
LovibondS. H. (1954) The Object Sorting Test and conceptual thinking in schizophrenia. Australian Journal of Psychology, 6, 52–70.
66.
MarengoJ.HarrowM. (1985) Thought disorder: A function of schizophrenia, mania, or psychosis?Journal of Nervous and Mental Disease, 179, 35–41.
67.
McGaughranL. S.MoranL. J. (1956) “Conceptual level” vs. “conceptual area” analysis of object-sorting behavior of schizophrenic and nonpsychiatric groups. Journal of Abnormal and Social Psychology, 52, 43–40.
68.
McGaughranL. S.MoranL. J. (1957) Differences between schizophrenic and brain-damaged groups in conceptual aspects of object sorting. Journal of Abnormal and Social Psychology, 54, 44–49.
69.
NeuchterleinK. H.DawsonM. E. (1984) Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophrenia Bulletin, 10, 160–203.
70.
NeuchterleinK. H.EdellW. S.NorrisM.DawsonM. E. (1986) Attentional vulnerability indicators, thought disorder, and negative symptoms. Schizophrenia Bulletin, 12, 408–426.
71.
PayneR. W.MattusekP.GeorgeE. I. (1959) An experimental study of schizophrenic thought disorder. Journal of Mental Science, 105, 627–652.
72.
PiotrowskiZ. A.BergD. (1955) Verification of the Rorschach Alpha diagnostic formula for underactive schizophrenics. American Journal of Psychiatry, 112, 443–450.
73.
PiotrowskiZ. A.BricklinB. (1958) A long-term prognostic criterion for schizophrenics based on Rorschach data. Psychiatric Quarterly Supplement, 32, 315–329.
74.
PiotrowskiZ. A.BricklinB. (1961) A second validation of a long-term Rorschach prognostic index for schizophrenic patients. Journal of Consulting Psychology, 25, 123–138.
75.
PiotrowskiZ. A.EfronH. Y. (1966) Evaluation of outcome in schizophrenia: The long-term prognostic test index. In HochP.ZubinJ. (Eds.), Psychopathology of schizophrenia. New York: Grune & Stratton. Pp. 312–334.
76.
PiotrowskiZ. A.LewisN. D. C. (1952) An experimental criterion for the prognostication of the status of schizophrenics after a three-year-interval based on Rorschach data. In HochP.ZubinJ. (Eds.), Relation of psychological tests to psychiatry. New York: Grune & Stratton. Pp. 51–72.
77.
PopeB.JensenA. R. (1957) The Rorschach as an index of pathological thinking. Journal of Projective Techniques, 21, 54–62.
78.
PowersW. T.HamlinR. M. (1955) Relationship between diagnostic category and deviant verbalization on the Rorschach. Journal of Consulting Psychology, 19, 120–124.
79.
PowersW. T.HamlinR. M. (1958) A comparative analysis of deviant Rorschach response characteristics. Journal of Consulting Psychology, 22, 123–128.
80.
QuinlanD.HarrowM.TuckerG.CarlsonE. (1972) Varieties of “disordered” thinking on the Rorschach: Findings in schizophrenic and nonschizophrenic patients. Journal of Abnormal Psychology, 79, 47–53.
81.
QuirkD. A.QuarringtonM.NeigerS.SlemonA. G. (1962) The performance of acute psychotic patients on the Index of Pathological Thinking and on selected signs of idiosyncracy on the Rorschach. Journal of Projective Techniques, 26, 431–441.
82.
RapaportD. (1947/1967) Psychological testing: Its practical and heuristic significance. In The collected papers of David Rapaport. New York: Basic Books. Pp. 261–275.
83.
RapaportD. (1950/1967) On the psychoanalytic theory of thinking. In The collected papers of David Rapaport. New York: Basic Books. Pp. 313–328.
84.
RapaportD. (1951a/1967) On the organization of thought processes: Implications for psychiatry. In The collected papers of David Rapaport. New York: Basic Books. Pp. 432–439.
85.
RapaportD. (1951b) Toward a theory of thinking. In Organization and pathology of thought. New York: Columbia Univer. Press. Pp. 689–730.
86.
RapaportD. (1952/1967) Projective techniques and the theory of thinking. In The collected papers of David Rapaport. New York: Basic Books. Pp. 461–469.
RapaportD.MenningerK.SchaferR. (1947/1967) The new role of psychological testing in psychiatry. In The collected papers of David Rapaport. New York: Basic Books. Pp. 245–256.
89.
RashkisH. A. (1947) Three types of thinking disorder. Journal of Nervous and Mental Disease, 106, 650–670.
90.
ReillyF.HarrowM.TuckerG.QuinlanD.SiegelA. (1975) Looseness of associations in acute schizophrenia. British Journal of Psychiatry, 127, 240–246.
91.
RorschachH. (1921/1951) Psychodiagnostics. New York: Grune & Stratton.
92.
SchuldbergD.BosterJ. S. (1985) Back to Topeka: Two types of distance in Rapaport's original Rorschach thought disorder categories. Journal of Abnormal Psychology, 94, 205–215.
93.
ShentonM. E.SolovayM. R.HolzmanP. S. (1987) Comparative studies of thought disorder: II. Schizoaffective disorder. Archives of General Psychiatry, 44, 21–30.
94.
ShimkunasA. M.GyntherM. D.SmithK. (1967) Schizophrenic responses to the Proverbs Test: Abstract, concrete, or autistic?Journal of Abnormal Psychology, 72, 128–133.
95.
SolovayM. R.ShentonM. E.HolzmanP. S. (1987) Comparative studies of thought disorder: I. Mania and schizophrenia. Archives of General Psychiatry, 44, 13–20.
96.
SpohnH. E.CoyneL.LarsonJ. M.MittlemanJ. S.HayesK. (1986) Episodic and residual thought pathology in chronic schizophrenics: Effect of neuroleptics. Schizophrenia Bulletin, 12, 394–407.
97.
StorchA. (1924) The primitive archaic forms of inner experience and thought in schizophrenia. Nervous and Mental Disease Monographs, No. 36.
98.
StraussM. E.PrescottC. A.GuttermanD. F.TuneL. E. (1987) Span of apprehension deficits in schizophrenia and mania. Schizophrenia Bulletin, 13, 699–704.
99.
ThurstoneL. L. (1935) The vectors of mind: Multiple-factor analysis for the isolation of primary traits. Chicago, IL: Univer. of Chicago Press.
100.
ThurstoneL. L. (1936) The factorial isolation of primary abilities. Psychometrika, 1, 175–182.
101.
ThurstoneL. L. (1938) Primary mental abilities. Psychometric Monographs, No. 1.
102.
ThurstoneL. L.ThurstoneT. E. (1941) Factorial studies of intelligence. Psychometric Monographs, No. 2.
103.
VigotskyL. S. (1962) Thought and language. Cambridge, MA: MIT Press.
104.
VigotskyL. S. (1978) Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard Univer. Press.
105.
WatkinsJ. G.StauffacherJ. C. (1952) An index of pathological thinking in the Rorschach. Journal of Projective Techniques, 16, 276–286.
106.
WegrockiH. (1940) Generalizing ability in schizophrenia: An inquiry into the disorders of problem thinking in schizophrenia. Archives of Psychology, No. 254.
107.
WeinerI. B. (1966) Psychodiagnosis in schizophrenia. New York: Wiley.
108.
WlinerI. B.ExnerJ. E. (1978) Rorschach indices of disordered thinking in patient and nonpatient adolescents and adults. Journal of Personality Assessment, 42, 339–343.
109.
WildC.SingerM.RosmanB.RicciJ.LidzT. (1965) Measuring disordered styles of thinking. Archives of General Psychiatry, 13, 471–476.
110.
WykesT.LeffJ. (1982) Disordered speech: Differences between manics and schizophrenics. Brain and Language, 15, 117–124.
111.
ZeigarnikB. V. (1965) The pathology of thinking. New York: Consultants Bureau Enterprises.
112.
ZimmermanW. S. (1953) A revised orthogonal rotational solution for Thurstone's original Primary Mental Abilities Test battery. Psychometrika, 18, 77–93.
