PERSONALITY AND PSYCHOPATHOLOGY
IN GENDER IDENTITY DISORDER:
A RORSCHACH STUDY
Congresso WAS Goteborg 2009
Chiara CRESPI, Mariateresa MOLO
Centro Interdipartimentale Disturbi dell’Identità di Genere
Ospedale San Giovanni Battista , Turin –Italy
University of Turin
SUMMARY
Introduction and Aim
Materials and Method
Participants characteristics
Results
Conclusions
To assess
G.I.D. people
personality
AIM
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
COGNITIVE
AREA
PERSONALITY
ORGANIZATION
Materials and Method: M.M.P.I.-2
CLINICAL
SCALES
Hypochondria
Depression
Schizophrenia
Hypomania
Paranoia
Social
Introversion
Psychasthenia
Masculinity/Femininity
Hysteria
Psychopatic Deviation
Partecipants characteristics
N=30
73,3%
(N=22)
26,7%
(n=8)
FtM
MtF
Social and demographic caracteristics
G.I.D.
(N=30)
Sex, N :
MtF: 22
FtM: 8
Age, years ( DS)
32,10 (8,64)
Marital Status, N (%):
Single
Married
Cohabitation
Educational level (years)
20 (66,7%)
0 (0%)
10 (33,3%)
11,73 (3,03)
To assess
G.I.D. people
personality
AIM
1
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
Response Style
87 *
Lambda
45
R
20
30
40
50
60
70
80
90
100
Stress Control
D and Adj.D < 0
(Control value of
stress)
EA
(value of
internal
resources)
stress control is only fairly
low
due to a low activation of
cognitive-affective responses
to stress (LOW PERCEPTION OF
STRESS)
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
38
Adj.es
EA
Adj.D
D
30
44
48
20 30 40 50 60 70 80 90 100
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
46
S
51
ColShdBld
Blends
32
52
C
38
CF
42
FC
Afr
WSumC
SumShd
20
51
36
43
30
40
50
60
70
80
90
100
Self Perception
113
100
90
80
70
60
50
40
30
20
90
53
49
M
*
Pure H
Xy
*
SumH
An
SumV
Fr-rF
EgoIndx
*
*
41
41
36
*
*
Hx
47
*
Self Perception 1
Average low score of
SumH and Pure H
Average high
score of
EGO INDEX
Specific dysfunctions in the selfperception: low index (?) of
mature identification
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
HIGH INTELLECTUALIZATION OF SELF-PERCEPTION
Not based on
experiental
aspects
based on
very abstract
aspects
Average low
score of M
Average high score
of Hx and
anatomical contents
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
38
42
AG
37
PHR
GHR
Mp
40
SumT
40
39
Food
40
Ma
Passive
Active
37
48
49
Isolate
50
COP
100
90
80
70
60
50
40
30
20
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
RORSCHACH
VARIABLES:
-
Response Style
-
Stress Control
- AFFECT Area
-
SELF
Perception
-
INTERPERSONAL Perception
-
Information Processing
-
Mediation
-
Ideation
COGNITIVE
AREA
Information Processing
100
90
80
72
70
60
50
40
49
46
44
41
52
45
39
30
DQv
DQo
Dd
D
W
*
DQ+
*
Zd
Zf
20
*
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
100
90
80
70
60
50
40
30
20
47
52
47
Pop
36
Xu%
X-%
WDA%
Xa%
37
Cognitive Area
Mediation: l’esame di realtà è nella norm
DA NON PROIETTARE.
SOLO DA COMUNICARE
Ideation
100
90
80
70
60
50
40
30
20
73
55
*
EII-2
M-
Lv2
WSum6
m
FM
41
47
46
42
Intellect
42
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
100
90
80
70
60
50
68
65
57
59
50
49
Hs
D
55
69
58
48
58
50
57
50
59
55
55
54
52
52
Ma
Si
40
30
20
Hy
Pd
Mf
*
Pa
Pt
Sc
MMPI-2
fare diapo
Scala MF
Scala PD
Scala Pa
Unica Scala Patologica
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
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. Selfesteem 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
attention…
Who are we?
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
since
1992
since
1998
percorso di adeguamento per le persone che intendono
chiedere la riassegnazione chirurgica del sesso, secondo la
legge 164 del 1982.
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Offre i seguenti servizi:
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Seminari informativi per operatori e familiari.
Con il patrocinio di
Università degli Studi di Torino
Facoltà di Medicina e Chirurgia