Use of the Rorschach Inkblot Test to aid in diagnosis of bipolar disorder in children and adolescents

Although Bipolar Disorder was once considered rare in children and adolescents, in recent years it has become a frequent diagnosis for youth. However, diagnosis of Bipolar Disorder (BPD) in children is complicated by ambiguous symptoms and co existence with other psychiatric disorders. Existing research into differential diagnosis of BPD in children focuses on interviews and parent report instruments. This study sought to give counseling psychologists more tools with which to make differential diagnosis, by ascertaining what variables and indices of the Rorschach Inkblot Test might signal the presence of BPD. v The present study examined differences in Rorschach profiles of psychiatric inpatient youth diagnosed with bipolar disorder as compared to those given another DSM-IV-TR Axis I diagnosis. A hierarchical discriminant function analysis was used to examine the ability of selected Rorschach variables to improve accuracy of diagnosis beyond the use of historical and behavioral variables alone. A discriminant function analysis with historical and behavioral information was able to classify children into BPD and Depression groups beyond what would be expected by chance. Although the discriminant function was still significant when Rorschach variables were added, Rorschach variables did not significantly improve the ability of the function to classify children as BPD or Depressed. A discriminant function including behavioral and historical variables was unable to predict diagnostic group membership in Bipolar Disorder Type I or a broader Bipolar diagnosis, regardless of whether Rorschach variables were included in the equation. T-tests were performed to examine differences in selected Rorschach variables between diagnostic groups; again, no significant results were found. Results, implications, and limitations of the study as well as future research directions are discussed.