Associations between the Rorschach Ego Impairment Index and Measures on Intrapsychic and Interpersonal Functioning

Jaakko Stenius,Risto Antikainen,Paul Knekt,Jarl Wahlström,Olavi Lindfors,Laura Sares-Jäske

doi:10.4236/ojpsych.2018.81001

Abstract

The Rorschach Ego Impairment Index-2 (EII-2) has shown considerable validity as a measure of personality disturbance. However, few studies have been conducted on the associations between the EII-2 and measures related to ego strength and interpersonal capacities in mood and anxiety disorder patients. This study examined the strength of associations between the EII-2 and its subcomponents with measures of psychological suitability for psychotherapy, personality functioning, and interpersonal problems. A total of 315 outpatients with mood or anxiety disorders were assessed with the Rorschach Comprehensive System (RCS), comprising the EII-2, the Suitability for Psychotherapy Scale (SPS), the Inventory of Interpersonal Problems (IIP-64), and the Quality of Object Relations Scale (QORS), as part of a pre-treatment evaluation. The relatively weak associations found in the study between the EII-2 and the other measures were mostly in the hypothesized direction and often modified by personality pathology. Of the EII-2 subcomponents, the Good Human Representation (GHR) variable was associated with the SPS. The subcomponent Critical Contents were associated with the IIP and the subcomponent WSum6 with the IIP and QORS. Further research is needed to clarify whether the EII-2 has incremental validity in predicting the treatment outcome and alliance in comparison to interview-based and self-report measures.

Highlights

The assessment of relatively stable personality characteristics such as ego strength and interpersonal functioning with clinical interviews and self-reported questionnaires has been found to be important when evaluating indications and suitability for psychotherapy [1] [2] [3]
A total of 315 outpatients with mood or anxiety disorders were assessed with the Rorschach Comprehensive System (RCS), comprising the Ego Impairment Index-2 (EII-2), the Suitability for Psychotherapy Scale (SPS), the Inventory of Interpersonal Problems (IIP-64), and the Quality of Object Relations Scale (QORS), as part of a pre-treatment evaluation
Beck depression inventory (BDI) = Beck Depression Inventory; Critical C = Critical Contents; EII-2 = Ego Impairment Index; FQ- = Distorted perceptions; GAF = Global Assessment of Functioning scale; GHR = Good Human Representations; M- = Distorted object representations; PHR = Poor Human Representations; R = Number of Responses; SCL-90-Anx = Symptom Checklist, Anxiety Scale; SCL-90-GSI = Symptom Checklist, Global Severity Index; WSum6 = Disorganized thought. 1Model: The mean Rorschach values in the three SPS categories were adjusted for SCL-90-GSI, SCL-90-Anx, GAF, BDI, and onset of primary psychiatric disorder. 2Test for trend between the Rorschach variables and the continuous SPS index. 3Patients with diagnoses on Axis II. 4Missing values in variables in the analyses ranging from 0 - 11

Summary

Introduction

The assessment of relatively stable personality characteristics such as ego strength and interpersonal functioning with clinical interviews and self-reported questionnaires has been found to be important when evaluating indications and suitability for psychotherapy [1] [2] [3]. The Ego Impairment Index (EII) [6], (EII-2) [7] is a theoretically based composite Rorschach measure, designed to provide data regarding reality testing, reasoning processes, defensive functions, and the quality of object relationships [7]. It measures the underlying ego organization and the capacity to meet internal and external demands and stressors [6]. Relatively little attention has been focused on the more specific associations of the EII-2 with other personality assessment methods used in psychotherapy assessment for this patient group

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