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PROCNOSTIC VALUE OF RORSCHACH CRITERIA IN CLINICAL
RESPONSE TO CONVULSIVE THERAPY
ROBERT
L. KAHN, PH.D., and MAX FINK, MD.
ABSTRACT
In this study of the relationship between premorbid personality factors
and clinical responses to convulsive therapy, the Rorschach test was admin—
istered to 87 unselected patients prior to the beginning of EC T. A favorable
clinical response to ECT was observed in subjects whose Rorschach records
revealed a basically conventional and unimaginative personality, generally
lacking in empathy, introspectiveness or facility of verbal communication.
Post-treatment records (of 41 patients) showed no significant changes. It is
therefore concluded that Rorschach patterns reflect basic personality rather
than prevailing mood or type of illness. These results indicate that Rorschach
patterns can be useful adjuncts in the selection of patients for convulsive
therapy.
In a series of studies of convulsive therapy
we have observed marked individual differences in behavioral response. It has been
shown that the induction of a behavioral
change is related to the presence of altered
brain function;5 Yet, among those with
equivalent degrees of physiologic change,
there are still differences in the clinical patterns of behavior. While some patients become hypomanic, others show paranoid reactions, withdrawal, increased somatization or
expressions of fear.3
We have postulated that personality is one
of the significant factors affecting this variability. This hypothesis was tested in a previous study,6 in which each patient’s premorbid personality was evaluated by means of
structured interviews with members of his
family and with the patient himself. We
found that the patients who were rated as
recovered or much improved after electroshock treatment were those with the follow-
From the Department of Experimental Psychiatry,
Hillside Hospital, Glen Oaks, L.I., New York.
'This study was supported in part by Research
Grant M—927 from the National Institute of Mental
Health, US. Public Health Service.
Presented at meeting of the Electroshock Research
Association, San Francisco, May 11, 1958.
ing personality pattern: they were generally
nonempathic, nonintrospective, verbally noncommunicative, highly conventional and
stereotyped, with little imagination or creative capacity.
The concepts derived from these observations lend themselves to study by other methods. In the present study the Rorschach test,
another measure of personality, was used. The
Rorschach technique has particular advantages in that it is both an instrument for testing the patient directly and, at the same time,
a standardized procedure providing data
which can be verified by others.
The specific purpose of the present study
was to determine: (1) the relationship between Rorschach findings and personality aspects previOusly fOund to be significant in
family interviews; and (2) the applicability
of Rorschach criteria in the prognosis of the
clinical response to convulsive therapy.
METHOD
The population consisted of 87 consecutive,
unselected patients referred for convulsive
therapy in a voluntary mental hospital. All
patients received electroconvulsive therapy
(with either unidirectional or alternating-current instruments) three times a week. A mini242
Reprinted from Journal of Neuropsychiatry, Vol. I, No. 5, May—June, 1960
�l
960
mum Of 12 treatments was given, with the
staff psychiatrist in charge of the treatment
determining the final number on the basis of
clinical criteria. The improvement evaluation,
made by the staff psychiatrist, was based on
the patient’s behavior in the hospital setting
during the period of two to four weeks following termination of treatment. In this manner each patient was rated as either much improved, moderately improved Or unimproved.
As previously described,5 patients were
rated “much improved” if they no longer
showed the symptoms which had brought
them into the hospital; if, in addition, their
doctors felt they were better; and if the
nurses’ notes confirmed such aspects as ability
to sleep without medication, better appetite,
and improved capacity to get along with other
patients and participate in hospital activities.
“Moderately improved” patients typically
showed some symptomatic relief (i.e., acute
depressive features might be gone), but not
the dramatic changes so evident in the first
group. Each of these patients continued to
show some noticeable disturbance such as
obsessional thinking, paranoid ideas or somatic preoccupation. In the “unimproved”
patients, change was either not clearly noticeable or only equivocal or transient. Some
showed fluctuations in behavior, at times appearing somewhat improved; but the change
was not sustained, so that by the end of treatment they appeared much the same as before.
The Rorschach test was given to each patient prior to the beginning of electroconvulsive therapy and, in 41 cases, two weeks
after electroconvulsive therapy. The Ror—
schach records were scored according to the
criteria of Klopfer and Kelley.9 Only those
common components were studied, however,
which could be analyzed quantitatively.
These included:
Total number of responses.
2. Per cent whole responses (responses in
which a subject uses all of a card for the formation of a concept).
3. Per cent form responses (responses in
which the shape of the blot is the sole determinant in the concept formation).
1.
243
JOURNAL OF NEUROPSYCHIATRY
Number of content categories included
in the responses.
5. Number of movement responses (references to any action or movement).
6. Per cent popular responses (responses
statistically given most frequently to a particular blot area).
7. Presence or absence of shading responses (responses in which a subject incorporates the darker and lighter aspects of a
blot into his description).
8. Type of movement responses (e.g., human movement, animal movement, etc.).
9. Type of color responses (responses in
which the color in a blot plays a recognizable
role in the concept formation; when form and
color are both significant, color-form [CF] or
form-color [FC] is scored, depending on the
predominant influence).
4.
RESULTS
The relation of the various Rorschach factors to clinical changes following ECT is
shown in Tables I-IV.
In Table I, comparison is made between
those patients who were rated as having a
good clinical response and those whose response was moderate or poor. The much improved patients had significantly fewer total
number of responses, and significantly more
per cent whole and form responses.
TABLE I
RELATION OF RORSCHACH FACTORS TO CLINICAL
RESPONSE IN CONVULSIVE THERAPY
(NUMBER, PER CENT WHOLE, PER CENT FORM
RESPONSES)
Number of Responses
Much Improved (38)
Mean
S.D.
13.0
6.7
Moderate or
Unimproved
(48) 19.5 12.8
Per Cent Whole Responses
Much Improved (38) 87.6 21.0
Moderate or
Unimproved
(48)
Per Cent Form Responses
Much Improved (38)
Moderate or
Unimproved
(48)
Significant at .05 level
** Significant at .01 level
*
24.4
18.2
71.8
19.0
61.9
21.4
Diff.
t,
6.5
2.7 *"
13.
3.0 H
9.9
2.2
*
�244
JOURNAL OF NEUROPSYCHIATRY
An analysis of content categories, move-
ment responses and popular responses (presented in Table II) reveals that there were
significantly fewer content categories and
movement responses, and a greater per cent
of popular responses in the Rorschach records
of the much improved patients, as compared
with the records of the unimproved and mod—
erately improved groups.
As shown in Table III, the much improved
patients were also less likely to have any kind
of shading response. This table also presents
an analysis of the different types Of movement
and color responses. Those patients who gave
human~movement (M) responses had the
TABLE II
RELATION OF RORSCHACH FACTORS To CLINICAL
RESPONSE IN CONVULSIVE THERAPY
(CONTENT CATEGORIES, MOVEMENT AND PER CENT
POPULAR RESPONSES)
t.
Mean
Diff.
SD.
Number of Content Categories
Much Improved (38)
3.8
Moderate or
Unimproved
4.9
(48)
Number of Movement Responses
Much Improved (38)
2.3
Moderate or
Unimproved
4.9
(48)
Per Cent Popular Responses
Much Improved (38) 37.7
Moderate or
Unimproved
(48)
26.6
2.2
2.7
5.1
21.6
poorest clinical responses (28% much improved), while those with no movement of
any kind had the best clinical results (63%
much improved). Patients with animal-movement (FM) or inanimate-movement (In) responses were rated better than those with
human movement but not as well as those
with no movement at all. With respect to
color, those patients with form-color (FC) responses had the poorest results; those with no
color at all, the best—although patients with
CF or C responses did almost as well.
In Table IV the patients are grouped according to combinations of human-movement
(M) and form-color (FC) responses. Of
those who had both M and FC, only 17% were
rated as much improved; 25% were considered
unimproved. In contrast, of those with neither
M nor FC, 66% were much improved and only
3% were unimproved. The
ratings of the group
with one or the other of these determinants
(M or F C) fell in between.
As
2.3
11.1
2.8
14.3
*
Significant at .05 level
"* Significant at .01 level
MAY-JUNE
mentioned, post-treatment records
were obtained from 41 patients. Comparison
of the pre—treatment and post-treatment records of these patients revealed little change
in the types of responses found. With respect
to human movement (M), for example, 34 of
the records showed no change. In four cases
patients with M responses prior to treatment
H showed none afterward; three other patients
with no M response had such response following treatment. These small changes could be
expected on a chance basis.
TABLE III
RELATION OF RORSCHACH FACTORS TO CLINICAL RESPONSE IN CONVULSIVE THERAPY
(SHADING, MOVEMENT AND COLOR)
Total No.
Much Improved
Moderately Improved
Un improved
Shading
46
15 (33%)
20 (43%)
11
(24%)
No Shading
40
23 (58%)
15 (38%)
2 ( 5%)
x2
= 8.12
p<.02
Human Movement (M)
Animal Movement (FM)
and/or Inanimate
Movement (In)
39
11
(28%)
19
(49%)
9
(23%)
29
16
(55%)
9
(31%)
4
No Movement
(14%)
19
12
(63%)
FOrm-Color (FC)
7
(37%)
X2
=
10.49
p<.05
Color-Form (CF)
and/or Pure
Color (C)
34
7
(21%)
18
(53%)
9
(26%)
27
16
(59%)
8
(30%)
3
No Color
(11%)
26
16
(62%)
.
(35%)
1
(
.
_
>
x2
= 14.98
p<.01
4%)
�JOURNAL OF NEUROPSYCHIATRY
I960
TABLE IV
RELATION 0F RORSCHACH FACTORS To CLINICAL
RESPONSE IN CONVULSIVE THERAPY
(HUMAN MOVEMENT AND FORM-COLOR)
Much
Total
Moderately
Human
Improved Unimproved
Movement
(M) and
Form-Color
No.
Improved
(FC)
24
25
4 (17%)
10 (40%)
14 (58%)
9 (36%)
6 (25%)
6 (20%)
38
25 (66%)
12 (32%)
1
FC
Neither M
nor FC
M or
M
and FC vs. M or FC vs. Neither M nor F0:
M
and
X2
WC
vs. Neither M nor FR:
.‘(1’
=
-:
17.82
12.26
(
3%)
p<.01
p<.00]
EPICBISIS
The results of this study confirm the findings previously reported concerning the relationship of personality to clinical response
after convulsive therapy. Patients who had a
good clinical result showed Rorschach records
characterized by few responses and little variety of content, no shading or movement or
color responses, and a high percentage of
whole, form and popular responses. This kind
of record indicates a personality pattern
which is nonempathic, nonintrospective, verbally noncommunicative, highly conventiOnal
and stereotyped and with little manifestation
of imagination or creative capacity. These
characteristics are identical with those described in the previous study based on interviews with family members.6
The prognostic value of the Rorschach as a
clinical instrument is demonstrated by these
data. While there are a number of studies in
the literature on the prognostic value of the
Rorschach in somatic therapy, the results have
not been consistent. Rabin,13 for example,
states that “single Rorschach factors cannot
serve . . . as predictors of improvement.” On
the other hand, Piotrowski12 describes specific prognostic criteria. It is likely that the
difference in point of view, as well as in the
varying criteria offered, reflects differences in
the type of population and the variety of somatic treatment observed. Despite these problems, however, those studies 12’ 14 with the
largest series of patients have obtained results
similar to those of the present study. For ex—
ample, their data show that the absence of
245
human movement (M) is more often associated with a favorable clinical response, and
that patients with form-color (FC) responses
are more likely to have a poor result.14
The significance of our findings might be
questioned on the basis that we have demonstrated a relationship merely between clinical
response and type of illness, rather than between clinical response and personality pattern. This objection would appear to be sup1“
4’10'1‘1
the
studies
ported by
numerous
which have reported that depressed patients.
the most likely candidates for convulsive
therapy, show no human-movement or color
responses. Our observations, however, substantiated by other studies,1’7!8’“’ Show a
constancy of the Rorschach before and after
treatment, and indicate that the response pattern reflects aspects of the basic personality
rather than transient features such as the prevailing mood or type of illness.
REFERENCES
l. Beck,
S. J.: Arch. Neurol. &
1943.
2. Fink, M., and Kahn, R. L.:
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Psychiat. 50:483.
AMA. Arch. Neurol.
i7 Psychiat, 78:516-525, 1957.
Fink, M., and Kahn, R. L.: paper presented at
meeting of A.P.A., New York, 1957.
Cuirdham, A.: Brit. J. Med. Psychol., 16:130—
145, 1936.
Kahn, R. L., Fink, M., and Weinstein, E. A.:
AMA. Arch. Neurol. b Psychiat, 76:23—29.
1956.
Kahn, R. L., and Fink, M.: I. Neurop.sychiat., 1:
45-50, 1959.
Kelley, D. M., Margolis, H., and Barbera, S. E.:
Rorsch. Res. Exch., 5:35-43, 1941.
Kisker, C. W.: I. Aim. (J Soc. Psychol., 37:120—
124, 1942.
Klopfer, B., and Kelley, D.: The Rorschach
Technique, World Book Co., New York, 1942.
Levy, D. M., and Beck, S. J.: Am. J. Orthopsy—
chiat., 4:31—42, 1934.
Pacella, B. L., Piotrowski, Z., and Lewis, N. I).
G: Am. J. Psychiat., 104:83-91, 1947.
Piotrowski, Z.: Psychiat. Quart, 14:267-273.
1940; 15:807—822, 1941.
Rabin, A. 1.: Am. Psychol., 2:284, 1947.
Rees, W. L., and Jones, A. M.: J. Ment. Sc., 97:
681-689, 1951.
H.: Psychodiagnostics, Crune &
Stratton, New York, 1942.
16. Varvel, W. A.: Bull. Menninger Clin., 5:5-12,
15. Rorschach,
1941.
�Pragmatic Value of Rorschach Criteria in Clinical
Beeponse
to Convulsive 'Iherapy
Robert L. Kahn Ph.D. and
From
Max
Fink M.D.
the Department of Experimental Psychiatry, Hillside Hospital, Glen Oaks,
L.I., NJ.
Aided, in part,
by grant
Public Health Service.
M
927, National
Institute of
Mental Health, U.S.
Presented at the Electroshock Research Association, San Francisco,
May 11, 1958.
5-5-58
�Prognostic Value of Rorschach Criteria in Glynical
Response
RObert L.
to Convulsive Therapy
W
Phone and Max Fink
In a series of studies of convulsive therapy
MOD.
we have
observed marked
individual differences in behavioral response. It has been shown that the
induction of a behavioral change is related to the presence of altered
brain function (2, 5). Yet, among those with equivalent degrees of
physiologic change, there are
still
differences in the clinical patterns
of behavior. While some patients became hypcmanic, others show paranoid
reactions, withdrawal, increased somatization or expressions of fear (3).
we have
postulated that personality is one of the significant factors
affecting this variability. This hypothesis has been tested in a previous
study using structured interviews with members of the patient's family (6).
It
was
reported that patients
who were
rated as recovered or
much improved
following treatment were generally non-empathic, non-introspective, non-
verbally communicative, highly conventional and stereotyped, with
imagination or creative capacity.
The concepts
derived from these observations lend themselves to study
by other methods.
used
little
in this study.
The Rorschach
test, another
The Rorschach
measure of
personality,
technique had the advantages both of
testing the patient directly and of being a standardized procedure
providing data which could be verified by otherS.
The
specific purpose of the present study
was
to determine:
1) the relationship between Rorschach findings and personality
aspects previously found to be significant in family
interviews, and
was
�.2.2) the application of Rorschach
criteria in the prognosis of
the clinical response to convulsive therapy.
METHOD:
The
population consisted of 86 consecutive, unselected patients
referred for convulsive therapy in a voluntary mental hospital. All patients
received electrocommlsive therapy three times a week, using either
midirectional or alternating current instruments.
A
minimmn
of 12
treatments was given, with the supervising psychiatrist in charge of the
treatment determining the final number
on the
The improvement exraluation was made by
basis of clinical criteria.
the supervising psychiatrist
the patient's behavior in the hospital setting in a period
to four weeks following the termination of treatment. In this
and was based on
of two
patient
manner each
was
rated as either
much improved,
moderately improved
criteria previously described (5).
Each patient was given the Rorschach test in the standard mnner in
the week prior to treatment. This data constituted the main focus of this
or unimproved, using
study.
To
determine
however, the
of treatment.
test
was
stability
of the Rorschach pattern with treatment,
readministered two weeks following the termination
�RESULTS :
A.
Relatim of Rorschach Factors to Clinical
The Rorschach
records were scored according to the criteria
of Klopfer and Kelley (9). (July these
however, which could be analyzed
total
Change:
common components were
studied,
quantitatively. These included
of responses, 2) per cent whole reSponses, 3) Per
cent form responses, )4) number of content categories included in the
1)
number
responseS,
5) number of movement responses,
6) per cent popular
responses, 7) presence or absence of shading responses,
movement reaponses, and
8) type of
9) type of color responses.
In Table I the comparison is
made between
those patients
who were
clinical response and those whose reSponse was
moderate or poor. The much improved patients had significantly fewer
number of responses, and significantly more per cent whole and form
rated as having a
responses .
good
�TABLE
I
Relation of Rorschach Factors to Clinical Response in Convulaive Therapy:
Number, Per Cent Whole, Per Cent Form Responses
Number
Mean
§_:_D_o
(38)
13.0
6.7
(h8)
19.5
12.8
of Resmnses
Much Improved
Moderate or
UnimProved
Diff.
6.5
L
2.7
*‘hL
Per Cent Whole Resmnse
Much Improved
(38)
37.6
21.0
Moderate or
Unimproved
(ha)
2h.h
18.2
(38)
71.8
19.0
(ha)
61.9
21 .h
13 .2
3.00
*4:"
Per Cent Form Resoonse
Much
anrorved
Moderate or
Unmproved
9.9
2.2 *
as
Significant at .05 level
*"‘
Significant at .01 level
�-5significantly fewer content categories in the Rorschach
records in the much improved patients. (TableJI). They also demonstrated
There were
fewer movement and a greater per cent of popular responses, than the
unimproved and moderately improved groups.
TABIEII
of
have
kind
to
less
any
likely
patients
shading responses, as shown in Table III. In this table the comparison is
also shown for the different types of movement and. color responses. Those
patients who had human movement responses (M) had the poorest clinical
were also
The much improved
had the best
results
inanimate movement
movement
improved), while those with no movement of any kind
(28% much
reaponses
(63% much
(m)
improved). Patients with animal
(FM)
or
reaponses were rated better than those with human
but not as well as those without any movement at
all.
With
respect to color, those patients with form color (F0) reaponses had the
poorest results, “those with no color at all the best, although patients
with
CF
or
C
responses did almost as well.
TABLE
III
�.6.
TABLEII
Relation of Rorschach Factors to Ciinical Response in Convulsive ’Iherapy:
Content Categories, Movement and Per Cent Poplgar Responses
Number
$.13.
(38)
3.8
2.2
(he)
h.9
2.3
Diff.
of Content Categories
Much Improved
Mod
Mean
erate or
Unimproved
ifl,
1.1
2.1
2.6
**
2.7
11.1
*
Number of Moveme‘ot Responses
Much Improved
(38)
2.3
2.7
Moderate or
Unimproved
(hi3)
h.9
5.1
(38)
37.7
21.6
(h8)
26.6
1h.3
Per Cent Pomar Responses
Much Improved
Moderate, or
Unimproved
* Significant
**
2.8
V.
at .05 level
Significant at .01 level
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�-8In Table IV the patients were grouped according to combinations
of
H
and
rated as
FC
responses.
01‘
those
who had both
much improved and 25% were
of those with neither
M
nor
M
and
PC
only
1775
were
considered mimproved. In contrast,
EC, 66% were much improved and
only
3%
were
improved. The ratings of the group with one or the other of these
deteminants
fell in
between.
unnuumm
TABLES
IV
W...‘.
B. chnErison of Pre- and Posttreatment Records
Posttreatment records were obtained from hl patients. These
showed
little
difference from the types of responses found prior to
treatment. .fith respect to
human movement (M),
for example,
recorfls shared no change. In four cases patients with
none afterwards;
follow-ring
three other patients with no
treatment.
M
M
3h of the
responses showed
response had such response
�«a.
TABLE IV
Relation of Rorschach Factors to Clinical Response in Convulsive Therapy:
Human Movement SM) and Form
Color
$130)
Rorschach
___N__
M
and
M
or
FC
F0
Neither
M
M
nor
FC
and FC/Neither Mmr
Much Improved
(21:)
h
(25)
10
(ho%)
(38)
25
(6655
FC
(17%)
Moderateg ImEroved
W
6
(25%)
(36%)
6
(20%)
(32%)
1
(3%)
1h
(58%)
9
12
x2
=
x2
- 12.26
17.82
p
<
p.<;
.01
.001
�.10..
DISCUSSION:
this study confirm the findings previously reported
concerning the relationship of personality to clinical response after
convulsive therapy. Patients who had a good clinical result showed
The
results
of
Rorschach records characterized by few responses and
content, no shading or
movement or
little variety
of
color reaponse, and a high percentage
of whole, form and popular reSponses.
This pattern indicates a personality
pattern which i s non-empathic, non-introspective, non-verbally cormunicative,
highly conventional and stereotyped and with little manifestation of
imagination or creative capacity. These aspects are identical with these
described in the previous study based on interviews with family members (6).
The
prognostic value of the Rorschach as a clinical instrument is
demonstrated by
this data. ifhile there are a
number
of studies in the
literature on the prognostic value of the Rorschach in somatic therapy,
the results have not been consistent. T:Jhile Rabin (3), for example, has
stated that "single Rorschach factors cannot serve ... as predictors of
improvement ," Piotrowski has described specific prognostic criteria (12).
It is likely that the difference in point of view, as well as in the
varying criteria offered, reflects differences in the type of population
and the varieties of somatic treatment observed. Despite these problerns,
however, the results of those studies with the largest series of patients
report similar observations to those in the present study. For
example, their data shows that the absence of human movement (M) is more
(12,
114)
often associated with a favorable clinical response, and that patients
�.uwith
F0
responses are more likely to have a poor result (1h).
The
that
significance of these results might
be
questioned on the basis
clinical response and
type of illness rather than flue personality pattern. In this regard
numerous studies have reported that depressed patients, the most likely
candidates for convulsive therapy, show no human movement or color
we
have demonstrated a
reSponses (h, 10, 15, 16).
by other
relationship
Our
studies (1, 7, 8, 11),
after treatment,
between
observations, however, substantiated
show a constancy
of the Rorschach before
indicate that the reSponse pattern reflects
aspects of the basic personality rather than transient features as the
and
prevailing
mood
and
or type of illness.
�SUMMARY.AND CONCLUSION:
1. Eighty-seven unselected cases referred for convulsive therapy
were administered a Rorschach
test prior to,
and two weeks following,
treatment.
2.
A
favorable clinical response was observed in subjects with
pretreatment records characterized by few responses, a small number of
content categories, absence of shading, movement and color responses
(particularly lack of
human movement and form
color), and a high percentage
of whole, form and popular reSponses.
This data confirms previous observations on the
3.
personality factors to clinical
outcome
relation of
in convulsive flierapy.
favorable evaluation is most likely in patients
who
A
are predominantly
non-empathic, non-introSpective, nonaverbally communicative, highly
conventional and stereotyped, with
little
imagination or creative capacity.
significant
change
in Rorschach records obtained
There was no
A.
It is
that pretreatment Rorschach patterns
in this population reflect the basic personality rather than the prevailing
following treatment.
mood
concluded
or type of illness.
5.
can be
patterns, by providing a set of prognostic criteria,
useful adjuncts in the selection of patients for convulsive
therapy.
Rorschach
�.13-
2.‘
Fink,
3.
and Katm, R.L.: Relation of
Electroencephalographic Delta
Activity to Behavioral Response in Ele ctroshoclc, A.M.A. Arch.
Neurol. 8: P_s,zchiat., IQ: 516-525 (1957).
A
M.
Behavioral Patterns with Induced States of
tered Brain Function, Div. Meeting A.P.A. (New York 1957).
:
14.
Guirdham, A.: Diagnosis of Depression by
Med. Psycho . _1_§: 130-115 (1936).
5.
Kahn,
the Rorschach Test, Brit. J.
R.L., Fink, M. and Weinstein, E.A.: Relation of Amobarbital
Test to Clinical Bnprovement in Electroshock, A.M.A.
Arch.
Neurol.
and Psychiat. 1g: 23-29 (1956).
,: Personality
7.
8.
9.
10.
11.
12.
Factors in Behavioral Reaponse to
Electroshock Therapy, Conf. Neural. (in press)
Kelley, D.M., Margolis, H. and Barbara, S.E.:
of
the
Stability
Rorschach Method as Demonstrated in Electric Comrulsive
Therapy
Cases, Rorsch. Res. Exch., 5: 35-143 (19M).
Kisker, G.W.: A Projective Approach to Personality Patterns
During
Insulin-Shock and Metrazol-Convulsive Therapy, J. Abn. &
Soc.
21: 120“12)4 (19112).
mo:
Klopfer, B. and Kelley, D.: The Rorschach Technigue. (World Book
Co. , New York 19h2).
levy,
D.M. and Beck
Psychosis,
Am.
S.J.:
Rorschach Test in Manic-Depressive
J. Orthops‘gchiat” ll: 314:2 (19311).
The
Pacella, B.L., Piotrowski, Z. and Lewis, N.D.C.: The Effects of
Electric Convulsive Therapy on Certain Personality Traits
in
Psychiatric Patients, Am. J. Psvchiat. 1011: 83—91 (19M).
Piotrwski, Z.:
A
Simple Experimental Device
for the Prediction
Quart., lg: 267-273 (1910);
Aid in the Insulin Shock Treatment of
Schizophrenia,
Psychiat.
Quart. 15: 807—822 (19141).
�REFERENCES
13. Rabin, A.I: Effects of Electric Shock Treatment upon Some Aspects
of Personality and Intellect, Am. PsEhol. g: 281; (1911?).
lb.
Rees, W.L. and Jenes, A.M.: An Evaluation of the Rorschach Test as
a Prognostic Aid in the Treatment of Schizophrenia by Insulin
Coma Therapy, Electronarcosis, Electroconvulsive Therapy and
Leucotomy, J. Ment. Sci. 97: 681-689 (1951).
15. Rorschach, H.: Psydhodiagnostics (Grune
Stratton,
The Rorschach Test in Psychotic and
Manninger 01111., S: 5'12 (19,41)-
16. Varvel, MtA.:
Bull.
&
New
York, 19h2).
Neurotic Depressions,
�
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Prognostic value of Rorschach criteria in clinical response to convulsive therapy. J Neuropsychiatr. 1960 May-Jun; 1:242-5.
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1960
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Kahn, Robert; <a title="Fink, Max, 1923-" href="http://id.loc.gov/authorities/names/n79039548" target="_blank">Fink, Max, 1923-</a>
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Reprint and [preprint]. Reprint from Journal of Neuropsychiatry, Vol. I, No. 5, May—June, 1960
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