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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…
C.I.D.I.Ge.M. Centro Interdipartimentale Disturbi Identità di Genere A.S.O. San Giovanni Battista di Torino - Sede Molinette
Il C.I.D.I.Ge.M. è un centro di intervento clinico nel percorso di adeguamento per le persone che intendono chiedere la riassegnazione chirurgica del sesso, secondo la legge 164 del 1982.
Si rivolge ai pazienti provenienti da tutte le regioni d’Italia
Offre i seguenti servizi: Valutazione psicodiagnostica Inquadramento medico-internistico e trattamenti ormonali Psicoterapia individuale e di gruppo Gruppi di supporto Interventi chirurgici specifici Seminari informativi per operatori e familiari.Con il patrocinio di
Università degli Studi di TorinoFacoltà di Medicina e Chirurgia
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since1992
since1998
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