The application of J. E. Exner’s isolation index in the diagnosis of schizophrenia

Abstract

Difficulties schizophrenic people have in social interaction are exhaustively documented in professional literature. The difficulties stem from the nature of the disease itself but they may also be the result of stigmatization and lack of support from social environment. In his comprehensive study and interpretation of Hermann Rorschach’s test, J. E. Exner introduced the concept of the “isolation index”. The index provides information concerning the outlooks on and reactions of the examined people to their social environment. J. E. Exner did not link the level of the isolation index to schizophrenia. The difficulties schizophrenic people have with social interaction make it justifiable to examine whether the values of the “isolation index” are higher among the ill people than among healthy ones – this constitutes the main of aim of this research. Ninety-five subjects (40 women and 55 men) suffering from schizophrenia and 68 healthy controls (33 women and 35 men) were examined. The criterion for inclusion into the patient group was the medical diagnosis of schizophrenia based on ICD-10. The health group criteria were: the lack of psychiatric treatment, good functioning in work or school and lack of serious psychological problems. Three working hypotheses were formulated: 1. the levels of the “isolation index” in the schizophrenic group will be higher as compared to the healthy group. 2. higher values of the “isolation index” in the group of ill people will be to a greater extent linked to “personality variables” manifested by such characteristics as reduced interest in other people, and lower emotional reactivity (withdrawal). 3. higher values of the “isolation index” will be associated with lower general emotionality, and this correlation will be stronger in the schizophrenic group. It was revealed that the “isolation index” was not linked to the disease. The group of schizophrenic patients did not differ in this respect from the group of healthy subjects. Significant interrelations have been observed, however, concerning the sex of the examined subjects, their state of health and some particular thematic categories constituting the index. Two thematic subcategories were isolated on account of their symbolical character (stone and water). The subcategories significantly differentiated the ill and healthy men. Hypothesis 2 was not confirmed unambiguously, also the direction of the relationship was found as previously expected. Hypothesis 3 was not confirmed, quite the opposite, there was no difference between the ill and healthy groups in their general emotionality and the relationship between the index value and emotionality was opposite to the expected one. The aforementioned results were interpreted as an effect of the style of perception and the style of interpreting the blots.