Children's Rorschachs as Predictors of Their Later Adjustment.

Abstract

This report describes a follow-up study that links certain aspects of the personality organizations of seventy preadolescent children (58 male, 12 female) with an index of their later adjustment. All the children were deemed seriously enough disturbed to warrant a substantial amount of residential treatment. Half the sample were later rehospitalized for at least six months at some point between discharge and follow-up. The remaining half of the sample had no subsequent psychiatric services. The two sample groups were matched on a wide variety of demographic, family background and treatment variables. Ego-psychoanalytic theorists have argued that the content of an individual's representations of self and other and the manner in which one perceives and organizes reality are two central elements of personality structure. Given the significance of these two aspects of personality organization to the developmental process, it was hypothesized that Rorschach scales explicitly constructed to measure them could effectively predict later adjustment for this population. Each of the children's first Rorschach upon admission to residential treatment was therefore rescored utilizing the Friedman organizational activity scale and an object-relations scale developed by Urist. The two Rorschach scales did significantly distinguish between the two groups in the hypothesized manner, but for the boys only. Male children with more distorted object representations, particularly the depiction of borderline or psychotic-level representational experience were more likely to be rehospitalized as adults. Similarly, male children with lower organizational activity scores were also more likely to be subsequently rehospitalized. Boys with relatively higher scores on these measures were significantly more likely to avoid later rehospitalization. Conjoint application of these two Rorschach scales revealed a solid degree of predictive association between Rorschach scores and later adjustment, again in the hypothesized direction. These findings strongly suggest that object relations and organizational activity indices can be of significant heuristic value in enhancing diagnostic and prognostic acumen. The use of the Rorschach test as a prime medium from which to assess these two aspects of personality structure is also suggested.