The Rorschach Ink-Blot Test as an Instrument for Evaluating Quality of Life in Breast-Cancer Victims

Abstract

Background. The psychological discomfort associated to breast-cancer diagnosis and related treatments is universally recognized. However homogeneous modalities of intervention are lacking. The questionnaires are the most employed tools to analyze pre-morbidity personality traits and the quality of life of cancer patients, but they lack valid indicators of the patients' overall quality of life. On the other hand, counseling along with administered psychological tests allows listening and mutual relationship between patient and examiner. The aim of this study was to evaluate the impact of the Rorschach test, a multidimensional method of collecting data on personality functioning, as an instrument to assess mood disorders, object relation, self-image and quality of life in breast cancer patients. Methods. 135 consecutive women affected by operable breast cancer underwent psychological counseling and the Rorschach test within 2–4 weeks after surgery. Results of the test were interpreted according to the structural and experiential approaches. The discrimination between “compact” and “noncompact” tables makes it possible to study the changes of patients identity during the illness, while the Experienced Stimulation and Experience Actual indices, providing information about the patient's coping to therapeutic approach, were calculated according to the Exner system. The records from a sample of 60 healthy women, equally distributed in three age groups (< 50, 50–59, > 60) coming from the same Italian region (regional sample) and the results from 736 nonpatient Italian subjects (national sample) were used as controls. Results. Quantitative results were comparable within groups, except for parameters of cognitive characteristics regulating the approach to reality (G, G+, F+, Anat, Ban). No patient fulfilled the parameter configuration corresponding to depressive disorder, but alexithymia with a state reaction interpreted as an adjustment disorder with depressive mood was recorded. This trait was correlated with lower educational levels and increasing age.