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Minerva Psichiatrica 1999 June;40(2):117-28

language: Italian

Evolutive breakdown. A clinical contribution

Marocco Muttini C., Manna A.


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Background and aim. The study examines the personality structure emerging from Rorschach's test in a group of adolescents diagnosed as suffering from breakdown in order to evaluate the presence of specific elements.
Methods. a) The cases were referred to the attention of an Infantile Neuropsychiatry unit to be taken into care; in clinical terms, they presented pathologies that could be referred to breakdown. b) The study included all subjects aged between 12 and 18 who had attended the unit and presented the aforesaid clinical characteristics. c) The series consisted of 13 cases which differed in age, sex, social conditions, schooling, carefully chosen as suffering from evolutive breakdown. d) In addition to the clinical examination, all subjects carried out Rorschach's test. e) The interpretation of the test concerned both formal elements and content, in order to achieve a description of the personality traits.
Results. The tests showed varying levels of immaturity connected not only to chronological age at the time of the test, but to the age at which the development disorder became manifest. Despite the variety of individual personality structures, the following common features emerged in the protocols: weakness of rational defences, undervalued self-image, which may correspond to a lack of boundary cohesion, insufficient object investment, thus compromising relations with others, and at the same time weak recourse to compensatory narcissistic investment.
Conclusions. The lability of defensive systems produces regression risks, like acute psychotic episodes and attempted suicide, but also makes it possible to achieve movement in an evolutive sense through diagnosis and prompt treatment. The greatest prognostic reserves concern cases with early onset owing to the damage to the cognitive sphere.

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