Psychological precursors of disorders: a thought-provoking observation

While still in medical school at The Johns Hopkins University, participants in the Precursors Study, a longitudinal study of the precursors of coronary artery disease and other disorders, were given the Rorschach test along with other psychological and physical tests. In the present study, we looked at a cohort of 41 participants who, 8 to 24 years after having finished medical school, could be classified into five disorder groups: coronary, hypertension, mental illness, suicide, or malignant tumor. Using stepwise discriminant analysis, we found that participants' Rorschach test scores differed significantly among disorder groups. Since the Rorschach scores considerably predated the appearance of the disorders, this finding implies that the Rorschach scores were predictive of the subsequent development of the various disorders. The Rorschach scores were especially good at predicting mental illness. If this finding is not spurious, it suggests that a given Rorschach profile would be predictive long before mental illness became apparent. Consequently, it offers the possibility that some intervention might be undertaken which could either result in mental illness not occurring or, at perhaps a minimum, lessen its severity. Since the Precursors Study results discussed in this paper are some years old, it is likely that another cohort of participants have developed the various disorders. Therefore, the authors recommend that the discriminant functions derived from this effort be validated with another cohort from that study who had not yet exhibited one of the five disorders when the current analysis was undertaken. Were that not possible, we would recommend that this study simply be replicated with another cohort.