La relazione tra Wais-IV e test di Rorschach: studio delle correlazioni, dei profili clinici e dello sviluppo di nuove applicazioni in campo medico-legale

Background: La Wechsler Adult Intelligence Scale-IV (WAIS-IV) il Rorschach Inkblot Test sono due strumenti ampiamente utilizzati in campo clinico e scientifico. All’interno della letteratura internazionale, l’associazione tra i due test è stata approfondita nei cento anni di sviluppo di entrambi gli strumenti. Inoltre, questi strumenti ampiamente utilizzati richiedono un tempo di somministrazione estremamente elevato, provando altamente sia il clinico che il valutato. Obiettivi: Gli obiettivi del presente studio sono molteplici: a) Analizzare le statistiche descrittive ottenute dai soggetti inclusi nello studio; b) Investigare ed approfondire la relazione statistica tra gli indici della WAIS-IV e quelli del test di Rorschach; c) Osservazione delle differenze significative nei profili Rorschach tra il gruppo di soggetti con diagnosi di disabilità intellettive e il gruppo non clinico; d) Mediante l’analisi della regressione, creare un’equazione predittiva che permetta il calcolo di un valore QI WAIS predetto dalla sola somministrazione del test delle macchie di Rorschach. Metodi: Attraverso la selezione di cartelle cliniche dall’archivio di un grande ospedale di Roma sono state N = 36 soggetti sottoposti a valutazione psicologica per finalità medico-legali. Al fine di permettere l’analisi delle differenze significative il campione di ricerca è stato diviso in due gruppi, il primo composto dai soli soggetti con diagnosi accertata di Disabilità Intellettiva (DSI; N= 25), e il gruppo composto da individui senza nessuna diagnosi (NCL; N= 11) Analisi statistiche: Al fine verificare gli obbiettivi prefissati sono state eseguite le seguenti analisi statistiche: a) Per verificare la correlazione tra WAIS-IV e Rorschach sono state eseguite sul campione delle analisi della correlazione Spearman Rho; b) Le differenze trai gruppi sono state verificate mediante l’utilizzo del test Mann–Whitney U per l’analisi dei dati non parametrici; c) Per la creazione della formula predittiva è stata eseguita un’analisi della regressione gerarchica; inoltre è stata eseguita una seconda analisi della regressione utilizzando il metodo Stepwise per creare una seconda equazione regressiva con le variabili provenienti da tutti e due gli strumenti utilizzati. Risultati: L’analisi della correlazione ha evidenziato la correlazione di diverse variabili del Rorschach con gli indici della WAIS-IV (IQ, IRP, ICV, IML, IVE) e i suoi dieci subtest; inoltre, la verifica del secondo obiettivo ha individuato differenze significative tra i gruppi DSI e NCL. Infine, considerando l’obbiettivo di sviluppare un’equazione predittiva del QI a partire dalla regressione delle variabili del Rorschach ha prodotto dei risultati non adeguati. Infatti, sono state rilevate delle alte discrepanze tra il QI predetto e il QI reale. Al contrario la seconda equazione creata ha raggiunto dei risultati maggiormente soddisfacenti con una percentuale discrepanza al di sotto dei due punti di errore pari al 69%. Discussione: I risultati ottenuti, permettono di esplorare maggiormente la relazione statistica tra WAIS-IV e Rorschach. Tuttavia, i risultati maggiormente significativi sono identificabili nelle differenze riscontrate tra i gruppi patologici che pongono le basi per il tracciamento di un profilo dell’individuo affetto da disabilità intellettiva. Inoltre, l’equazione “mista” creata dall’unione dei test fornisce lo spunto per lo sviluppo di una misura ibrida che misuri simultaneamente sia le caratteristiche cognitive sia quelle di personalità con un tempo di somministrazione ridotto

Divergences between Rorschach and MMPI-II in Psychopathy: A forensic case report

This study aims to investigate the divergences observed in the results obtained from the MMPI-II and Rorschach Test in psychopathic individuals. Through the analysis of a case report, we will discuss the different assessment approaches provided by these two diagnostic tools in the context of capacity to understand and volition. The case will be examined to analyse the discrepancies between the two instruments, with a particular focus on the pathological elements highlighted by the Rorschach Test, including frank thought disturbances, which were not captured by the MMPI-II. Findings suggest that the MMPI-II does not prominently detect pathological elements in the psychopathic subject under assessment. However, the Rorschach Test provides a more comprehensive picture of the functioning, revealing thought disturbances and other relevant indicators. This discrepancy raises important questions regarding the use of diagnostic tools and underscores the importance of considering a multifactorial approach for a comprehensive assessment of psychopathology. In conclusion, the results emphasize the need to integrate different assessment methodologies to achieve a more accurate understanding of psychopathic disorders. The integration of MMPI-II with the Rorschach Test can provide a more comprehensive and in-depth evaluation, enabling more precise identification of thought disturbances and other clinically significant aspects in psychopathic individuals

CORRELATION BETWEEN EGO-SYNTONIC INFORMATION SELECTION AND PERSONALITY PATTERNS

Background. In the health care field, disinformation is a widespread practice, especially regarding the topic of vaccination coverage. In recent years, studies that has focused on the observation of users behaviour, especially during fruition pro and antivaccine pages inside social networks, has shown how the effect of “selective exposure” to non-truthful content within social networks produces a large influx of users who draw information from the "no-vax" pages without any control about the sources. Polarization of users on social networks provides a useful clue to understand the phenomenon called "misinformation" whereby a subject becomes an "involuntary" agent of the spreading of mistaken information outside the virtual context. Objectives. The purpose of the present study is to investigate whether exist a relationship between personality patterns and the ways used by the subjects to select informations recognized as “ego-syntonic.” The following areas will be explored: - beliefs related to pharmaceutic, vaccines and complementary and alternative medicine (C.A.M.) treatments; - personality patterns assessed through the administration of personality questionnaires (Minnesota Multiphasic personality inventory-2, Personality assessment Inventory, Big Five questionnaire and 16-PF); - administration of self-report questionnaires that assess the presence of sceptical attitudes or non-objective thought that concern health-care topic (conspiracy beliefs scale, vaccine conspiracy beliefs scale, Vaccination Attitudes Examination Scale); Expected Results. Our expectations are to see that subjects who totalize higher scores on the scales focused on the assessment of specific personality patterns (for example the Pa scale of MMPI-2) are more inclined to mark the items focused on conspiracy beliefs and mistaken beliefs towards pharmacological and medical treatments. Future Perspectives. Our study could suggest how the detection of a set of specific personality models can be correlated with the mode of selection of information that is recognized by the subject as ego-syntonic, as suggested by the “confirmation bias” theory. Our expected findings could be useful to improve the “health communication techniques.

THE QUANTITATIVE RELATIONSHIP BETWEEN RORSCHACH AND WAIS-IV: PATTERN DIFFERENCES BETWEEN SUBJECTS WITH INTELLECTUAL DISABILITY AND NON-CLINICAL GROUP

Objectives: The aim of the present work is to determine, by studying the differences between groups of individuals with intellectual disability and individuals without an obvious pathology in order to determine the typical profile of individuals with intellectual disability. Methods: subject profiles were selected from more than two hundred medical records of patients evaluated for forensic purposes. The full study sample (N=36) was sorted into two groups based on the IQ score obtained by the WAIS test. Groups were divided as follows: a Group composed of individuals diagnosed as intellectual disabled (N=25) and a group of non-clinical people. Statistical analysis: To analyse groups differences a Mann-Whitney U test was performed. Results: The Mann-Whitney U test shows that moderate differences exist between groups for the variables Zd, Zf, FQu, M, W, Blends, A and Ad (p=0.05). On the other hand, strongly significant differences were discovered for the variables WSC, R-PAS, Complexity, H, FQo, Age and whole number of R (p=0.01). Discussion: The results show how the analyses carried out provide statistically significant characteristics to detect a prototypical profile of a subject with a diagnosis of intellectual disability. Considering also legal and social medicine aspects, the identification of these patterns represents a substantial help for clinicians to recognize the «state of handicap» useful to access to the benefits provided by Italian welfare state and especially by law 104/92 in the Italian legislation

THE QUANTITATIVE RELATIONSHIP BETWEEN RORSCHACH AND WAIS-IV: PATTERN DIFFERENCES IN IQ PROFILES

Background: Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Rorschach Inkblot Test are often included in diagnostic routines by most of the clinicians to measure the “Performance” from two different points of view; while WAIS-IV is used to analyse intelligence and cognitive abilities, Rorschach measures how a subject respond, both emotively and cognitively, to unstructured stimuli. Methods: The full study sample (N=34) was sorted into three groups based on the IQ score obtained by the WAIS test. Groups were composed in the following way: IQ lower than 69 (N=19); IQ ranging from 70 to 99 (N=6); IQ higher than 100(N=9). Statistical analysis: To analyse differences between groups we used a univariate analysis of variance (ANOVA). In addiction differences between groups were deeply analysed using Bonferroni Post-hoc Test. Results: The ANOVA analysis shows that moderate differences exist between the groups for the parameters Zd, Zsum, S, M, Zf, R (p=0.05). On the other hand, strongly significant differences were found on the following parameters WSC, Complexity, Human responses, Animal detail, unusual form quality, W (p=0.01). Discussion: The results show how the analyses carried out provide statistically significant characteristics to detect a prototypical profile of a subject with a diagnosis of intellectual disability. Considering also legal and social medicine aspects, the identification of these patterns represents a substantial help for clinicians to recognize the "state of handicap" useful to access to the benefits provided by Italian welfare state and especially by law 104/92

CORRELATIONS BETWEEN ROSCHACH AND WAIS-IV IN SUBJECTS WITH INTELLECTUAL DISABILITY

Background. Wechsler Adult Intelligence Scale – IV (WAIS-IV) and Rorschach Inkblot Test are often included in diagnostic routines by many clinicians in order to measure the “Performance” from two different points of view; while the WAIS-IV is used to analyse intelligence and cognitive abilities, the Rorschach test evaluates how people respond to various standardized tasks. The administration of projective methods in subjects with a diagnosis of intellectual disability presents some issues related to the validity of the test and therefore the reliability of the results. Methods. The sample of this study consisted in 25 records of outpatients with intellectual disability selected from the archives of Policlinico Umberto I Hospital’s clinical psychological assessment service. All the selected records had to contain the full administration of psychological assessment battery which including both the Rorschach test and the WAIS-IV; in addition, all the Rorschach worksheets have been coded using the Comprehensive system of J.E Exner. Multiple Spearman’s rank correlations were performed to determine whether there were significant association between WAIS-IV and Rorschach indexes. Furthermore, the total sample was splitted in two subgroups: the first was composed of subjects whose IQ scores falls in the WAIS-IV range of <69 points (N=19), while the second one was composed by those whose IQ scores falls into 70-79 range (N=5). N=1 case has been excluded because the subject wasn’t part of neither of the previous ranges of IQ. In order to analyse differences between groups a one-way ANOVA was performed. Results. Rorschach’s Zd index (Z difference) reaches a strong negative correlation with both WAIS-IV Full IQ scale (p=<0.01) and Perceptual Reasoning Index (PRI; p=<0.01), while a moderate negative correlation was found with Working Memory Index (WMI; p=<0.05) and Processing Speed Index (PSI, p=0.05). Another moderate correlation was found between S (White space responses) and PRI (p=<0.05). One-way ANOVA shows that the two subgroups only differ in S responses. Conclusions. These findings suggest that Zd may not just be a factor which describes processing Efficiency, but it could describe a complex factor which also involves cognitive domains associated with Perceptual reasoning assessed within WAIS-IV. Regarding the findings on S responses, results are in line with the international literature

INFLUENZA DELLA DISINFORMAZIONE NELL’ATTEGGIAMENTO VERSO LA SOMMINISTRAZIONI DEI VACCINI

Introduzione. L’avvento di Internet ha favorito un nuovo paradigma dei sistemi di informazione denominato “post-verità”. All’interno di questi sistemi di informazione una notizia viene concepita dando maggior risalto al contenuto emotivo (ad esempio richiamando un sentimento di ingiustizia sociale preesistente) a scapito dell’analisi concreta ed accurata dei fatti oggettivi evidenziati dalla notizia stessa. In campo sanitario la pratica della post-verità è particolarmente diffusa soprattutto per quanto riguarda l’obbligo vaccinale. Ad esempio, una delle campagne “Anti-vaccini” più nota riguarda il nesso di causalità tra vaccino parotite-morbillo-rosolia e autismo descritto in un articolo pubblicato sulla rivista medica “The Lancet” nel 1998 che, nonostante la smentita, viene tuttora utilizzato per instaurare un clima di dubbio nei confronti dell’efficacia dei vaccini. All’interno di una galassia sterminata come quella di “Internet” il rischio di imbattersi in blog o siti tematici permei informazioni false o scorrette rimane tuttora molto molto alto. Metodi. Lo studio è stato effettuato selezionando nei database di Scopus e Pubmed le pubblicazioni nazionali ed internazionali che rispondono alle key-words, fake-new e vaccine. Inoltre, sono state incluse anche delle pubblicazioni accademiche acquisite al di fuori della ricerca per key-words o non indicizzate nei precitati database. Conclusioni. Gli alti tassi di copertura vaccinale nell'infanzia sono importanti per prevenire le malattie infettive che contribuiscono alla mortalità e alla morbilità. In questo contesto, le vaccinazioni rappresentano uno degli strumenti più importanti della prevenzione primaria. La mancanza di informazioni e le fake-news sono riconosciuti come i principali fattori che contribuiscono alla bassa copertura vaccinale. Considerando la diffusione del fenomeno delle fake-news anti-vaccini, una recente indagine promossa dall’Istituto Superiore di Sanità ha stabilito che solo lo 0,7% del campione analizzato, composto da genitori di bambini tra i 16 e i 36 mesi, ha espresso la propria contrarietà nei confronti dei vaccini mentre il 15,6% si è dichiarato come “esitante”. Inoltre, dalla letteratura internazionale emerge che la contestata misura dell’obbligo vaccinale non è adottata unicamente in Italia ma, contestualmente, è parte di una strategia adottata da più paesi europei per sopperire ai bassi tassi di copertura vaccinale. Infine, emerge che organismi come “Federazione nazionale degli ordini dei medici chirurghi e odontoiatri” sta adottando delle strategie di debunking mirate alla gestione della diffusione delle fake-news in campo medico-sanitario. Tali strategie agiscono compensando la mancanza di informazioni attraverso lo sviluppo e la sponsorizzazione di siti specializzati dedicati alla spiegazione di tutte le credenze erronee diffuse dalle fake-news

Atypical Sexual Abuse in Childhood

This study focuses on the analysis of some cases of atypical collective sexual abuse (called RA or ritual abuse). These cases of abuse are characterized by the presence of tales of bloody satanic rites, bizarre disguises animal related game with a sexual background, psychological and sexual violence, protracted intimidation conducted by abusers of children to prevent these events not to tell by their parents. The fundamental objective was to compare the prototypical cases of ritual abuse as the case of McMartin Preschool (“the case 0”) in California and the case of an Italian preschool. For the comparison we have used scientific articles about the McMartin case and the proceedings of the trial of the Italian case. These official documents were consulted with a particular attention to the psychological construct statements grid, taking into account the role played by the legal and para-legal in the event, the different legal systems in the two nations and the contribution of the media in giving processes a distorted public dimension. It will be discussed more thoroughly the content of the stories of children comparing it with literature Satanist looking coincidences between rituals described by young victims of ritual abuse with the ritual traditions of Satanism. The many ideas taken from scientific sources taken into analyses have not proved sufficient to clarify the dynamics of the various processes related to the ritual abuse given the countless variables involved throughout the evolution of the legal proceedings in which there have been mistakes by the courts that compromised the integrity of the evidence collected in the investigation. To avoid these errors is therefore necessary to extend the study of the psychological factors related to cases of ritual abuse taking into account the legal framework in which these events branded as mass hysteria evolve

XII Seminar - PhD Day Happiness is a simple system

The last meeting of PhD students in Infectious Diseases, Microbiology and Health has been strongly influenced by, and focused on the COVID-19 pandemic. The XII meeting tries to get out from the emergency, with invited talks dedicated to two aspects: happiness and simplicity/complexity. Happiness is intended as the including the comprehensive concept of well-being, while the contrasting simple/complex dichotomy is a paradigm of biological systems that requires both complex interactions and simple adaptive solutions

Behavioural indices in sexual abuse in childhood. Evidence based medicine or fantasy?

This study proposes a focus on behavioural indices that characterize the alleged collective sexual abuse that took place in an Italian kindergarten. The evidence given by the parents of the victims showed the character improper changes to the children's age (the age of the children involved in the case was between 2-3 years). Such attitudes were linked to abnormal sexuality, in fact the children had of enactments as recurring attitudes of restlessness and crying unmotivated, conducted masturbatory done outside of the school environment and often mediated by household objects (often toys and rag dolls), compulsive in strip and coated plastic dolls and frequent sexual questions and requests regarding the parents' genitals. These sexualized attitudes it also adds a number of reminiscences mostly nocturnal like unnecessary fears towards the cracks of the door and nightmares with sexual and scary contents. The data presented here were extrapolated by consulting the documents included in the legal papers belonging to the process of the Italian pre-school at the prosecutor. These behavioural elements were found in many children estimated during the investigation of the Italian case bringing back these symptoms to a PTSD linked to a life of sexual abuse. Given the homogeneity of the behavioural indicators of abuse found in children the response of the experts to the questions from the judge did not rule out a disease related to abuse. Having regard to the lack reliable data that can explain the origin of such behaviours considering that the judicial process established the innocence of the defendants involved in the case, there are no elements to cataloguing the behavioural indicators of abuse previously seen to a profile corresponding to a collective abuse victim