El indice de trastorno perceptivo y de pensamiento en el Rorschach: Estudio descriptivo en una muestra de paciente psicóticos agudo.

Servicio de Psiquiatría. Hospital General Universitario de Murcia; Indice de Percepción y Pensamiento, PALABRAS CLAVE: Rorschach (EXNER), Esquizofrenia; Psicosis Cicloide

ABSTRACT Desde la creación del Test de Rorschach hasta la actualidad se han utilizado diferentes índices para el diagnóstico de las Psicosis. Dentro de ellos se ha venido utilizando el Indice de Esquizofrenia (SCZI) dentro del Sistema Comprehensivo de Exner, con el que se trata de identificar pacientes psicóticos (dentro del espectro esquizofrénico) y diferenciarlos de otros trastornos psiquiátricos. Existen en la literatura reciente estudios que demuestran la fiabilidad, validez y eficacia diagnóstica del Indice de Esquizofrenia (SCZI) (Hilsenroth et al., 1998; Ilonen et al. 1999; Jorgensen et al., 2000), sin embargo otros trabajos, como el realizado en Cataluña por Vera Campo (1993)demuestra que pueden darse diferencias culturales resultando falsos positivos y negativos. El SCZI tiende, en el momento actual a no utilizarse ya que puede dar lugar a falsos positivos por lo que se ha creado uno nuevo, más conservador el Indice de Percepción y Pensamiento PTI.

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    ABSTRACT: This review focuses on the diagnostic efficiency of the new versions of the Rorschach Comprehensive System Depression Index (DEPI) and the Schizophrenia Index (SCZI). Clinical diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders was chosen as the external validation criteria. The sensitivity, specificity, and overall classification rates for the indices were presented from the studies or computed from the data when possible. The positive and negative predictive validity was estimated at three different base rates. As regards the DEPI the results showed a large variation in diagnostic performance as the index seemed to have relatively more success in identifying nonpsychotic and unipolar depression than psychotic and bipolar depression. The DEPI did not successfully identify depression among adolescent patients. As regards the SCZI the results more consistently indicated that the index effectively discriminates between psychotic and nonpsychotic patients and the predictive validity of both a positive and negative SCZI was found to be high.
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    ABSTRACT: A tripartite taxonomy of perceptual-cognitive errors on the Rorschach, abbreviated TRAUT, was reviewed. TRAUT classifies "autisms" as stemming from either an arrant disregard for the blot shapes (HYPO), an inordinate attention to unusual blot areas (HYPER), or an endorsement of counterfactual relationships among blot areas (RELER) included among Exner's Unusual Verbalizations. The scoring of HYPOs and HYPERs and the frequency of their occurrence among thought-disordered groups were determined by examining Rorschachs of inpatient schizophrenics, outpatient schizophrenics, borderline personality disorders, and Cluster A personality disorders. Because HYPOs and HYPERs yielded better differential diagnoses than RELERs among these four groups, it was suggested that such percepts should be scored routinely as a screen for thought disorder.
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    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.
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