Anne Andronikof

A Rorschach stability study in a nonpatient adult sample.

The objective of this study was to provide new primary data on Rorschach Comprehensive System stability levels. To achieve this, we tested 75 French nonpatient adults twice on the Rorschach with a 3-month interval between the tests. Interrater reliability was in the excellent range for most of the variables studied. The overall stability level in a selected set of previously studied variables was below expectations (median r = .53). Personality, cognitive or self/relational variables yielded higher test�retest correlations than emotional and coping variables. Moderators of stability could be identified: (a) overall level of Task Engagement (TE) in F, m, FM + m, a, FC, Sum C′, Sum V, Sum Shd, Fr + rF, INC + FAB, COP, es, Adj es, EGO, and Blends; (b) variations in TE in F, FM, and p; (c) state distress in Zd, m, FM + m, a, C, CF + C, WSumC, FD, and es; (d) variables derived from the number of responses impacted stability in P, Zf, m, FC, CF + C, Sum C′, Sum V, MOR, EA, es, and Blends. These results provide further support for the reliability of several measures. Examiner effects as an influence on productivity and TE were identified as an important area for future research.

Individual psychology of risk-taking behaviours in non-adherence

This paper presents some theoretical considerations based on the theories of risk about non-adherence in the field of health care. Traditional models as the Health Belief Model and the Theory of Reasoned Action are presented and criticized. In order to enable the use of other theoretical frameworks, it is argued that non-adherence can be studied within the general frame of risk-taking. The behavioural decision theory is presented and it is argued that cognitive biases like unrealistic optimism play a major role in non-adherence as in risk-taking. It is also argued that these cognitive biases depend on self-related motivation factors. Results of a pilot study involving 16 patients are presented. These results only partly support the theoretical analysis and underline that it would be necessary to take mood factors into consideration in further research.

Dynamique de l'idéation et des comportements préparatoires dans le passage à l'acte suicidaire: vers une méthodologie qualitative standardisée

Suicidal risk factors are nowadays well known. We often detect many of these risk factors in clinical situations, but their interaction and their writing in the suicidal sequence are still largely unrecognized. Building on narratives from suicidal patients, the authors propose a method for investigating the upstream components of suicide in an attempt to understand how the risk factors and the state of the person interact and converge on the suicidal action better. The interview is divided into the following four sections. (1)The patient is invited to mentally go back to the hours immediately preceding the suicide attempts and reconstruct the sequence of thoughts, feelings and doings of the day. Here, we explore the dynamic progression of his cognitions, emotions, actions and state of consciousness. We also note the social affective context of the suicidal act. (2) Proceeding backwards into the memory, the patient is invited to retrieve all foreshadowing elements, situating them on two axes: behavioural planning, that is, effective or contemplated actions in relation to suicide (stocking drugs, seeking information about substance toxicity, weapon training, etc.). (3) The second axis focuses on the phenomenology of the suicidal ideation, that is, intensity, frequency, proximity/availability of suicidal ideation, etc. These are assessed by means of an analogical rule. Finally, the current attempt is situated in the context of the suicidal history of the patient: previous attempts, severity, operative mode, etc. Our clinical experience using this semi-structured interview has shown that the method gives an insight into the unique combination of factors leading to the suicidal act in a given person and permits to understand and foresee relapses better. A new model of suicide is emerging from our data, suggesting the importance of the preparatory phase, which combines a progressive non-conscious learning of the gestures to accomplish, rumination of suicidal ideations and alteration of consciousness and the sense of self. The method is illustrated through an example. The necessity to further test this interview method is called for.

Study of the correlation between psychiatric and psychological diagnoses in sample offenders.

This study deals with the frequency with which expert psychiatrists and psychologists make structural or nosographic diagnoses within the context of expert assessment. Thus, the rates of concordance between psychiatrists and psychologists in both types of diagnoses will be assessed. To do so, the level of inter-observer agreement on diagnoses between 1990 and 2003 was studied retrospectively in France through psychiatric and psychological assessments of 505 male offenders. The assessment of the correlation rates was carried out using the Kappa coefficient. The results show a range of 0.55 to 0.71 in inter-observer (psychiatrists vs psychologists) agreement for structural diagnoses, and 0.51 to 0.89 for nosographic diagnoses. In addition, a marked correlation between psychiatrists and psychologists may be noted regarding abstention in both structural (k=66) and nosographic (k=73) diagnoses. In fact, recommendations are made for improvement in the consistency of offender assessment in the psycho-legal French context.

Exneriana – II – The Scientific Legacy of John E. Exner, Jr. 1Part of this paper was presented at the XIXth International Congress of Rorschach and Projective Methods, July 22–26, 2008, Louvain, Belgium.

Based on an analysis of John Exner’s peer-reviewed published work from 1959 to 2007, plus a brief comment for an editorial in Rorschachiana, the author draws a comprehensive picture of the scientific work of this outstanding personality. The article is divided into three sections: (1) the experimental studies on the Rorschach, (2) the clinical studies using the Rorschach, and (3) Exner’s “testament,” which we draw from the last paper he saw published before his death (Exner, 2001/2002). The experimental studies were aimed at better understanding the nature of the test, in particular the respective roles of perception and projection in the response process. These fundamental studies led to a deeper understanding of the complex mechanisms involved in the Rorschach responses and introduced some hypotheses about the intentions of the author of the test. The latter were subsequently confirmed by the preparatory sketches and documents of Hermann Rorschach, which today can be seen at the H. Rorschach Archives an...

Complexity, Pseudoscience and Rorschach Performance AssessmentSystem

Objective: Complexity is one of the most important components of the Rorschach Performance Assessment System, R-PAS (the equivalent of general intelligence for IQ test). However Complexity is problematic on conceptual grounds and the objective of this research is to assess the scientificity of this notion. Method: The Belgian adult non-patient reference sample of the RCS was used in this study. (A) Data were analyzed according to R-PAS procedures, (B) protocols were randomly rescored and analyses were repeated; (C) analyses were compared. Results: Complexity main results were replicated with both real and random protocols. In addition, the Complexity of real and random protocols are highly correlated (r=0.82). Conclusions: Complexity is a pseudoscientific notion and the use of the R-PAS in clinical practice is questionable. The nature of the problem of R is discussed, and means to address it are proposed.