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Violent and nonviolent suicide attempts--a controlled Rorschach study.

E Rydin1, M Asberg, G Edman

  • 1Department of Psychiatry and Psychology, Karolinska Institute, Stockholm, Sweden.

Acta Psychiatrica Scandinavica
|July 1, 1990
PubMed
Summary
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Violent suicide attempters show distinct Rorschach test patterns, including paranoia and impaired reality testing. These Rorschach findings can help identify individuals at high risk for completed suicide.

Area of Science:

  • Psychiatry
  • Psychological Assessment
  • Forensic Psychology

Background:

  • Distinguishing between different types of suicide attempts is crucial for risk assessment.
  • The Rorschach test is a projective psychological test used to assess thought, emotion, and other personality characteristics.

Purpose of the Study:

  • To compare Rorschach records of violent suicide attempters with nonviolent attempters and psychiatric controls.
  • To identify Rorschach indicators predictive of completed suicide.

Main Methods:

  • Rorschach records from 20 violent attempters, 20 nonviolent attempters (drug overdose), and 20 psychiatric controls were analyzed.
  • Ego function ratings and response patterns were compared across groups.
  • Follow-up data was used to identify completed suicides within the violent attempter group.

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Main Results:

  • Violent attempters exhibited higher paranoia, poorer coping with conflict, reduced capacity to handle dysphoric affect, and impaired reality differentiation compared to controls.
  • Violent attempters showed lower cognitive maturity and produced responses indicative of cognitive slippage and pathological object relations.
  • Nonviolent attempters did not differ significantly from controls.
  • Six patients from the violent group completed suicide; they displayed less tolerance for dysphoric affect and greater decline in developmental level on Rorschach cards compared to survivors.
  • Rorschach findings identified completers with 55% sensitivity and 93% specificity.

Conclusions:

  • The Rorschach test can reveal significant differences in ego functioning and cognitive processes between violent suicide attempters and other psychiatric patients.
  • Specific Rorschach response patterns and ego function deficits are associated with increased risk of completed suicide.
  • The Rorschach test demonstrates potential utility in identifying individuals at high risk for suicide completion.