Date of Award

8-1985

Degree Name

Doctor of Education

Department

Counselor Education and Counseling Psychology

First Advisor

Dr. Kenneth Bullmer

Second Advisor

Dr. Bradley Huitema

Third Advisor

Dr. Gilbert Mazer

Abstract

Misdiagnosis of the bipolar affective disorder (manic type) has profound consequences Including prescription of counterproductive medication, non-aggressive treatment approaches, extended hospitalizations, and poor prognosis (Fleve, 1975). Misdiagnosis Is extensive and has resulted from the tendency to over diagnose schizophrenia (Fleve, 1975), the tendency to equate psychotic symptomatology with schizophrenia (Garvey & Tuason, 1980), the similarity of psychotic symptomatology of the bipolar affective and schizophrenic disorders (American Psychiatric Association, 1980), past confusion regarding diagnostic criteria of the bipolar affective disorder (Spltzer, Williams, & Wynne, 1983), and the absence of psychometric tools to differentiate the bipolar affective and schizophrenic disorders.

The purposes of this study were to determine If the bipolar affective and schizophrenic disorders were distinguishable using the Rorschach, to replicate prior research, and to survey subscores to explore possible discriminative qualities. The "Comprehensive System" (Exner, 1969) was employed for administration, scoring, and Interpretation of the Rorschach.

The Independent variable was the diagnostic classification (bipolar affective disorder, manic, or schizophrenic disorder, undifferentiated or paranoid type). Dependent variables were Rorschach subscores. Forty-nine Rorschach subscores were investigated. The sample consisted of 70 subjects, 31 with bipolar affective disorders, and 39 with schizophrenic disorders. Subjects were administered the Rorschach while evidencing psychotic symptomatology.

Statistical analyses of data revealed no significant differences of mean score or variance of the six subscores which were previously identified in the literature as having discriminative qualities. Results of this study indicate the bipolar affective disorder and the schizophrenic disorder are not distinguishable using the six investigated subscores as scored by the "Comprehensive System" (Exner, 1969). Analysis of the 43 additional subscores identified 17 subscores with unverified clinical utility which may warrant further investigation.

The consonance of symptomatology of these disorders when individuals were in psychotic states was psychometrically demonstrated. Due to the mutual psychotic symptomatology, diagnosis should not be based solely on a clinical interview or the subscores investigated. It is recommended clinicians employ a comprehensive approach in diagnosis utilizing all available clinical data.

Access Setting

Dissertation-Open Access

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