Integrating the Shedler-Westen Assessment Procedure and Rorschach Composite Measures for exploring psychopathological patterns of mental functioning

This study addressed the exploration of a multimethod psychodynamic assessment and its relation to psychopathological patterns. The study applies the Shedler-Westen Assessment Procedure (SWAP; Shedler, J., & Westen, D., 2006, Personality diagnosis with Shedler-Westen Assessment Procedure (SWAP): Bridging the gulf between science and practice. In P. D. M. Task Force (Ed.), Psychodynamic Diagnostic Manual (pp. 573-613). Silver Spring, MD: Alliance of Psychoanalytic Organizations.) and three composite Rorschach measures to a sample of 72 outpatients with various Diagnostic and Statistical Manual of Mental Disorders Axis I diagnoses (American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Washington, DC: Author.): The Ego Impairment Index (EII-2; Viglione, D. J., Perry, W., & Meyer, G. J., 2003, Refinements in the Rorschach Ego Impairment Index incorporating the Human Representational Variable. Journal of Personality Assessment, 81, 149-156. doi:10.1207/S15327752JPA8102_06), measuring maladaptive ego functions; and two derivations of the Reality-Fantasy Scale (RFS; Tibon, S., Handelzalts, J. E., & Weinberger, Y., 2005. Using the Rorschach for exploring the concept of transitional space within the political context of the Middle East. International Journal of Applied Psychoanalytic Studies, 2, 40-57. doi:10.1002/aps.30): the RFS-P, measuring proneness to fantasy (lowered negative scores) as compared to concrete thinking (elevated positive scores); and the RFS-S, measuring dissociative proneness. Consistent with the literature, in this study, the multimethod assessment revealed modest unilinear associations, if any, between each of the Rorschach indices and the SWAP scales. However, regression analyses showed that the joint use of the EII-2 and the RFS-P explained a substantial portion of the variance in the SWAP scales that indicate inhibition and avoidance (obsessive personality disorder score and Avoidant Q factor, respectively). Furthermore, when used with the RFS-S, the EII-2 was able to significantly explain variance in the SWAP scales that indicate interpersonal detachment (schizotypal personality disorder score and Schizoid Q factor). The implications of these results for clinical practice will be discussed.