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Detection of Psychosis by Rorschach Performance Assessment System Variables in Adolescents With Chronic Daily Cannabis Use

John M. Spores

Ethical Human Psychology and Psychiatry April 1, 2025 DOI: 10.1891/ehpp-2024-0005 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Retrospective case-control study Peer reviewed
Sample size 20
Population Adolescents without a history of psychosis; 10 daily cannabis users and 10 with no cannabis or other substance use history, matched on sex and age
Duration Daily cannabis use for 6 or more months
Measures Rorschach Performance Assessment System (R-PAS)
Topics Cannabis
Key findings Seven of eight R-PAS perception and thinking variables distinguished daily cannabis-using adolescents from non-using peers, with the cannabis group scoring approximately two to three standard deviations higher and falling in very high or extremely high interpretive categories, which the authors characterize as signs of psychotic disturbance as operationally defined by these R-PAS variables.

Abstract

A retrospective sample of 20 adolescents without a history of psychosis was divided into two equal groups of 10: one with daily use of cannabis for 6 or more months and one without any history of cannabis or other substance use. The groups were matched on both sex and age. All 20 adolescents were administered the Rorschach Performance Assessment System (R-PAS), which were all determined to be valid protocols. A series of eight independent samplettests with Cohen’sdeffect sizes were done, along with other descriptive and inferential statistics. Results showed that seven of eight perception and thinking R-PAS variables reliably distinguished between the Cannabis and No Cannabis groups. Further, the Cannabis group showed standard scores falling within either the very high or extremely high interpretive categories for this test, hence manifesting unequivocal signs of psychotic disturbance as operationally defined by the perception and thinking R-PAS variables. Further, the Cannabis group scored approximately two to three standard deviation differences on these R-PAS variables versus the No Cannabis group, hence manifesting consistently large effects. Implications of these findings were discussed, including some limitations of the present study and suggestions for future research.