Perceptual and Motor Skills, 1992, 75, 462.
O Perceptual and Motor Skills 1992
DIAGNOSING MPD WITH TWO NEW RORSCHACH SIGNS: ARE
THE SIGNS VALID OR ARE THE MPDS ATYPICAL?' E D W I N E . WAGNER
Forest Institute, Huntsville, Alabama Summary.-The validity of newly developed "Splitting" and "Dissociative" signs on the Rorschach for diagnosing multiple personalicy disorder (MPD) was questioned. It was pointed out that rhe mean number of Rorschach responses for what were osren. sibly patients with M P D was so high as to render the sample atypical. It was huggot ed that perhaps the Splitting and Dissociative signs were diagnostic of either d ~ s s o c ~ a tion in general or MPDs who have experienced d e ~ o m ~ e n s a t i o nleading , to hospitalization. When test data from a group o l patients wich a particular diagnosis differs substanrially from what is expected from previous Lindings, it is prudent to step back and question whether the original diagnosis may be incorrect. Labott, Leavitt, Braun, and Sachs (1992) report on a group of multiple personality disorders (MPDs) with a mean number of rota1 responses of 51.25 on the Rorschach. I have never encountered, either in my own practice or in the literature, multiple who give such a large number of responses. I t is extremely high for any extant scoring system, including Exner's and Piotrowski's. For example, Lovitt and Lefkof (1985), whom these authors cite, report Rs lor chree MPDs of only 16, 13, and 19, respectively. The mean number of responses for the psychiatric controls used in che Labott, et al. study also seems fairly high (44.381, especially when five of the 16 were categorized as depressed. The authors d o not supply any other data on common Rorschach scores except for "movement" responses (which also seem high for both groups), so it is difficult to tell how atypical their samples are or whether there are other psychopathological characteristics which would contraindicate MPD. Insofar as the "Splitting" and "Dissociative" criteria used to differentiate these groups is concerned, it is important to note that "splitting" responses are reportedly common to borderline diagnoses (e.g., Lerner, Albert, & Walsh, 1987). And, since there is no quescion that borderline patients dissociate, one wonders whether what Labott, et al. (1992) have are signs of dissociation which cut across diagnostic groups. An alternative explanation is that hospitalized MPDs may differ substantially from outpatient MPDs, perhaps due to decornpensation. If this is true, then these signs may be more valuable as indices of deterioration than differentially diagnostic of MPD. Therefore, as the authors indicate, these signs must be viewed with caution as potential indicators of MPD. Validation against both inpatient and outpatient samples of MPDs as well as known borderline cases is recommended. REFERENCES LABOTT,S. M., LEAVITT,F,, BRAUN,B. G., & SACI-IS,R. G. (1992) Rorschach indicators of multiple personality disorder. Perceptual and Motor Skillr, 75, 147-158. LEKNER,H., ALBERT,C . , & WMSH, M. (1987) T h e Rorschach assessment of borderline defenses: a concurrent validity study. Journal of Personaliiy Assmmenf, 5 1, 334-348. LOVITT,R., & LEFKOF,G . (1985) Understanding multiple personality with the Comprehensive Rorschach System. Journal of Personaliiy Assessment, 49, 289-294.
Accep~edAugust 18, 1992. 'Correspondence regarding this article should be addressed to Edwin E. Wagner, Dean, Forest Institute, 2611 L e m a n Ferry Rood, I-Iuntsville, AL 35801.
O Perceptual and Motor Skills 1992
DIAGNOSING MPD WITH TWO NEW RORSCHACH SIGNS: ARE
THE SIGNS VALID OR ARE THE MPDS ATYPICAL?' E D W I N E . WAGNER
Forest Institute, Huntsville, Alabama Summary.-The validity of newly developed "Splitting" and "Dissociative" signs on the Rorschach for diagnosing multiple personalicy disorder (MPD) was questioned. It was pointed out that rhe mean number of Rorschach responses for what were osren. sibly patients with M P D was so high as to render the sample atypical. It was huggot ed that perhaps the Splitting and Dissociative signs were diagnostic of either d ~ s s o c ~ a tion in general or MPDs who have experienced d e ~ o m ~ e n s a t i o nleading , to hospitalization. When test data from a group o l patients wich a particular diagnosis differs substanrially from what is expected from previous Lindings, it is prudent to step back and question whether the original diagnosis may be incorrect. Labott, Leavitt, Braun, and Sachs (1992) report on a group of multiple personality disorders (MPDs) with a mean number of rota1 responses of 51.25 on the Rorschach. I have never encountered, either in my own practice or in the literature, multiple who give such a large number of responses. I t is extremely high for any extant scoring system, including Exner's and Piotrowski's. For example, Lovitt and Lefkof (1985), whom these authors cite, report Rs lor chree MPDs of only 16, 13, and 19, respectively. The mean number of responses for the psychiatric controls used in che Labott, et al. study also seems fairly high (44.381, especially when five of the 16 were categorized as depressed. The authors d o not supply any other data on common Rorschach scores except for "movement" responses (which also seem high for both groups), so it is difficult to tell how atypical their samples are or whether there are other psychopathological characteristics which would contraindicate MPD. Insofar as the "Splitting" and "Dissociative" criteria used to differentiate these groups is concerned, it is important to note that "splitting" responses are reportedly common to borderline diagnoses (e.g., Lerner, Albert, & Walsh, 1987). And, since there is no quescion that borderline patients dissociate, one wonders whether what Labott, et al. (1992) have are signs of dissociation which cut across diagnostic groups. An alternative explanation is that hospitalized MPDs may differ substantially from outpatient MPDs, perhaps due to decornpensation. If this is true, then these signs may be more valuable as indices of deterioration than differentially diagnostic of MPD. Therefore, as the authors indicate, these signs must be viewed with caution as potential indicators of MPD. Validation against both inpatient and outpatient samples of MPDs as well as known borderline cases is recommended. REFERENCES LABOTT,S. M., LEAVITT,F,, BRAUN,B. G., & SACI-IS,R. G. (1992) Rorschach indicators of multiple personality disorder. Perceptual and Motor Skillr, 75, 147-158. LEKNER,H., ALBERT,C . , & WMSH, M. (1987) T h e Rorschach assessment of borderline defenses: a concurrent validity study. Journal of Personaliiy Assmmenf, 5 1, 334-348. LOVITT,R., & LEFKOF,G . (1985) Understanding multiple personality with the Comprehensive Rorschach System. Journal of Personaliiy Assessment, 49, 289-294.
Accep~edAugust 18, 1992. 'Correspondence regarding this article should be addressed to Edwin E. Wagner, Dean, Forest Institute, 2611 L e m a n Ferry Rood, I-Iuntsville, AL 35801.
