Rorschach Ego Impairment Index: The Analysis Of Validity And Its Influencing Factors

Objectives: To examine the validity of Rorschach Ego Impairment Index (EII-2) inChinese sample, and analysis its influencing factors, especially the influence ofalexithymia, as well as the reliability and validity of The Rorschach Alexithymia Scale(RAS).Methods： A total of36non-patients and123psychiatric patients were administered theRorschach, the TAS-20,the SCL-90,the HAMA, the HAMD, and the BPRS. TheRorschach test was administered and scored according to the Comprehensive System.Results:1.The ICC of the EII-2which scored by two researchers is0.848.2.There were difference between the non-patients and patients, the non-patients andpatient with schizophrenia, as well as with major depression disorder and anxiety disorder,on the mean of EII-2.(P<0.05)3.The diagnostic efficiency of EII-2to distinguish patients with psychiatric disorders isat the middle level. The sensitivity, specificity, Youden Index and the area underreceiver operating characteristic (ROC) curve were91%,35%,26%and0.748.4. There were linear correlation between EII-2and the raw sores of BPRS, as well asHAMA and HAMD (r=0.425,0.194,0.277, P<0.05).5. There were linear correlation between EII-2and the total average score(r=0.191,P<0.05) and positive item average score(r=0.199,P<0.05) of SCL-90,as well asthe factor sores of compulsion-obsession,depression,hostility,paranoid ideation psy-chosis (r=0.176,0.216,0.184,0.215.0.229, P<0.05).6. Between the group of missed diagnosis and the group of correct diagnosis,there were no difference on the total score and factor scores of HAMA,as well asHAMD and TAS-20(P>0.05). The patients with missed diagnosis have a higherSores of The Rorschach Alexithymia Scale (P<0.05), as well as a higher F%(P<0.05) and Pop (P<0.05). 7. The patient with Alexithymia have a higher omission diagnostic rate（P<0.05）and moredefensive short records(P<0.05), the R of that is between14and16and the lambda ofthat is greater than1.8. The ICC of the RAS which scored by two researchers is0.914. No linear correlationbetween RAS and the TAS-20was found in this study（P<0.05).Conclusion：1.The EII-2have a good inter-scorer reliability and considerable discriminant validity.Itcan differentiate patients with psychiatric disorders from non-patients,and patients withdifferent degree of ego function impairment. The EII-2have a correlation with psychoticsymptoms as well as depression,anxiety and other mental symptoms. But thecorrelation with psychotic symptoms is closer.2.The diagnostic efficiency of EII-2to distinguish patients with psychiatric disorders isat the middle level. Many patients with major depressive disorder and anxiety disorderwere missed the diagnosis.There are several reasons for missed diagnosis.First, comparedwith schizophrenic, the ego impairment of patients with major depressive disorders andanxiety disorders is less serious.Second, EII-2has a more close correlation with thoughtdisturbance than depression, anxiety and other symptoms. The third, the ego functionimpairment measured by the EII-2is the impairment of underlying psychologicalstructure,whose correlation with symptom is limited. At last but not least the patientsmissed diagnosis may have alexithymia.Therefore, they tend to be more defensive on theRorschach.3.The RAS have a good inter-scorer reliability and some construct validity.But no linercorelation between RAS and TAS-20was found in this study. The validity of RAS isworthy to be further explored.