Rorschach presentation of borderline personality disorder: primary process manifestations

Obtained WAIS and Rorschach protocols for a sample of 21 psychiatric inpatients diagnosed as borderline personality disorder. Responses were analyzed according to Holt's (1977) and Rapaport, Gill, and Schafer's (1945-46) test correlates of primary process thinking and thought disturbance. Results were discussed in the context of Kernberg's (1975) structural and genetic-dynamic analyses of borderline personality organization and seemed to correspond with his characterization of this population as possessing contradictory personality traits, lacking in normal repressive defenses, and regressing toward primary process thinking. Interrater agreement on the assignment of Rorschach responses within the above scoring categories was assessed, with a high degree of concordance found for primary process content variables. It was concluded that the frequency and type of primary process content identified in the present study probably represent highly reliable Rorschach indicators of borderline personality disorder for purposes of differential diagnosis.