Chiara CRESPI, Mariateresa MOLO

PERSONALITY AND PSYCHOPATHOLOGY

IN GENDER IDENTITY DISORDER: A RORSCHACH STUDY

Congresso WAS Goteborg 2009

Centro Interdipartimentale Disturbi dell’Identità di GenereOspedale San Giovanni Battista , Turin –Italy

University of Turin

SUMMARY

Introduction and Aim

Materials and Method

Participants characteristics

Results

Conclusions

AIM

To assessG.I.D. people personality

To compare MMPI and Rorschach

test clinical data

To compare G.I.D. population with normative sample

Material and Method

The study is based on

• CLINICAL DATA

• RORSCHACH TEST (Exner Comprhensive System Method)

• M.M.P.I.-2 (MINNESOTA MULTIPHASIC PERSONALITY INVENTORY )

Materials and Method: RORSCHACH

VARIABLES:

-     Response Style

- Stress Control

- AFFECT Area

-     SELF Perception

- INTERPERSONAL Perception

-     Information Processing

-     Mediation

-     Ideation

    

COGNITIVEAREA

PERSONALITYORGANIZATION

Materials and Method: M.M.P.I.-2

CLINICAL SCALES

Hypochondria Depression

 Hysteria

Psychopatic DeviationMasculinity/Femininity

Paranoia

Psychasthenia 

Schizophrenia Hypomania

Social Introversion

FtMMtF

26,7%(n=8)

N=30

73,3% (N=22)

Partecipants characteristics

G.I.D. (N=30)

Sex, N : MtF: 22 FtM: 8

Age, years ( DS) 32,10 (8,64)

Marital Status, N (%):

Single Married

Cohabitation

20 (66,7%)0 (0%)

10 (33,3%)

Educational level (years)11,73 (3,03)

Social and demographic caracteristics

AIM

1

To assess G.I.D. peoplepersonality

To compare G.I.D. population with normative sample

RORSCHACH

  RESPONSE STYLE

Cautious and defensive approach to testing (expected result because of the setting and

motivation dell'assessment ) cosa vuol dire?

LAMBDA

SCORE:

High score: avoidant style

45

87

20 30 40 50 60 70 80 90 100

R

Lambda

Response Style

*

Stress Control

D and Adj.D < 0

(Control value of stress)

stress control is only fairly low due to a low activation of cognitive-affective responses to stress (LOW PERCEPTION OF STRESS)

EA(value of internal

resources)

Internal resources are very limited but these subjects are less severe(?) because of the low value of Adj.es.: GID patients have very limitated resources but also have a low perception of stresso (?) stress.

Stress Control

48

44

30

38

20 30 40 50 60 70 80 90 100

D

Adj.D

EA

Adj.es

Affect Area

The activation of the emotions remained low, consistent with the style avoided (avoidant style ?)(high L). Emerging defensive

operations of avoidance of emotional involvement (?)

The values are in the normal range, therefore there is no affective

psychopathology

Affective Area

43

3651

42

38

52

32

51

46

20 30 40 50 60 70 80 90 100

SumShd

WSumC

Afr

FC

CF

C

Blends

ColShdBld

S

Self Perception

4136

49

90

53

4147

2030405060708090

100F

r-rF

Eg

oIn

dx

Su

mV

An

Xy M

Su

mH

Pu

re H Hx

* * **

113

** *

Self Perception 1

Specific dysfunctions in the self-perception: low index (?) of

mature identification

Average high score of EGO INDEX

Average low score of SumH and Pure H

The self-perception is based on their beliefs, judgments and values.

These subjects keep low (mantengono basso) the value

awarded to the judgments of others (?)

Self Perception 2

Average high score of Hx and

anatomical contents

Average low score of M

based on very abstract

aspects

HIGH INTELLECTUALIZATION OF SELF-PERCEPTION

Not based on experiental aspects

Self Perception 3

Given the particular problem about gender identity, the mechanisms emerged from the tests

carry a high adaptive function (as well as defensive): Subjects can feel better in their own gender identity and in their body if they avoid the weight of social opinion and if they build

their own identity in an intellectual way

Interpersonal Perception

37 40 39 4050

40 3848

3742

49

2030405060708090

100

Act

ive

Pa

ssiv

e

Ma

Mp

Fo

od

Su

mT

GH

R

PH

R

CO

P

AG

Iso

late

Interpersonal Perception

The values are normal but it is possible that, according to the style of response given(low number of

responses, high value of Lambda), interpersonal problems have been (were) underestimated in this test

(and therefore we get false negative result)

NON DA PROIETTARE MA DA DIRE A VOCE

RORSCHACH

VARIABLES:

-     Response Style

- Stress Control

- AFFECT Area

-     SELF Perception

- INTERPERSONAL Perception

-     Information Processing

-     Mediation

-     Ideation

    

COGNITIVEAREA

Information Processing

4149

44 4652

3945

72

20

30

40

50

60

70

80

90

100

Zf

Zd W D

Dd

DQ

+

DQ

o

DQ

v

* **

Cognitive Area: Information Processing

    The information processing is normal. It shows a tendency to (have) a low ability to integrate environmental stimuli

DQ v elevato: vedere significato

Mediation

47 4737

52

36

2030405060708090

100

Xa

%

WD

A%

X-%

Xu

%

Po

p

Cognitive Area

    Mediation: l’esame di realtà è nella norm

DA NON PROIETTARE. SOLO DA COMUNICARE

Ideation

41 42

73

42 46 4755

2030405060708090

100

FM m

Inte

llec

t

WS

um

6

Lv2 M

-

EII

-2

*

Cognitive Area

    Ideation: non emergono alterazioni patologiche del corso del pensiero

Si conferma anche la tendenza all’intellettualizzazione

DA NON PROIETTARE. SOLO DA COMUNICARE

AIM

2

To compare MMPI and Rorschach

test clinical data

MMPI-2 Clinical Scales

59

48

58

50

545557585769

65

5955

525255

50

68

4950

20

30

40

50

60

70

80

90

100

Hs D Hy Pd Mf Pa Pt Sc Ma Si

*

MMPI-2

fare diapo

Unica Scala Patologica

Scala PD

Scala MF

Elevata negli MtF ma la differenza con gli FtM non è statisticamente

significativa. Potrebbe indicare una > carica di ribellione verso

l’autorità, maggiori problemi familiari e maggior aggressività

manifesta

Scala Pa

Significativamente inferiore negli FtM ma in entrambi i gruppi i

valori sono al di sotto di 65 punti T, quindi non clinicamente

rilevanti

Conclusion (1)

In agreement with the literature, the profiles of both tests indicate

the absence of a specific psychopathology. In contrast, in the two tests, our sample showed some functional mechanisms for

adaptation.

Conclusion (1) Atteggiamento al test ( E’ ripetizione)

Al Rorschach i soggetti hanno manifestato un atteggiamento guardingo e difensivo simile a quello che si ritrova in un setting di tipo forense

E’ possibile che tali soggetti manifestino uno stile evitativo che consenta loro un miglior adattamento . Evitare gli eccessivi coinvolgimenti sia emotivi che interpersonali può essere una difesa contro la paura del rifiuto e dell’abbandono come anche un fattore protettivo per il mantenimento della propria autostima (PIERO)

Conclusion (2): Affective Area, Interpersonal Area and Stress control

“Less is better”: DA CONTROLLARE L’INGLESE mantenendo un basso coinvolgimento affettivo, ci si garantisce un miglior adattamento interpersonale ed una gestione più adeguata dei livelli di stress (maintaining a low affective involvement, you will secure a better interpersonal adjustment and a more suitable management of stress levels)

Conclusion (3):Cognitive Area

Not significant clinical disorders concerning the connection with reality and the course of thought.

Conclusion (4):Self Perception

Self perception is the only problematic area. Self-esteem is maintained while minimizing the weight of others' opinions and building a very intellectualized identity. Under the assumption that what counts is what I think about myself it is easier to retain an adequate self-esteem for the social adaptation.

Thanks for your Thanks for your attention…attention…

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