Rorschach Measures Research Articles

Cross-Cultural Validation of the Rorschach Developmental Index

The Developmental Index (DI) has recently been introduced as a composite Rorschach measure of psychological development and maturation, which can be used both with the Comprehensive System (Exner, 2003), and with the recently developed Rorschach Performance Assessment System (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). As the DI is new, and its validity has not yet been investigated with independent non-U.S. samples, we tested the correlation between DI and age using 3 relatively large samples, 2 of which were from outside the United States (total N = 902). Other Rorschach variables presumably associated with maturation, such as complexity and productivity, were also investigated. As expected, the DI significantly correlated with age, with small variations across the 3 samples. Importantly, the correlation between DI and age remained statistically significant also after controlling for productivity (i.e., the number of responses) and complexity.

Creativity and Emotional Distress on the Rorschach Test

While the relationship between creativity and emotional distress has been extensively reviewed, little research has been done on creativity as demonstrated in the Rorschach test. Forty participants were administered the Rorschach as well as the Remote Associates Test (RAT) of verbal creativity. A significant correlation was found between the RAT and the following Rorschach variables: FQminus, (H)+(Hd), M none, MOR, and DEPI. The present findings call for caution when attributing emotional distress on the basis of Rorschach measures, since these measures are also indicative of the individual’s creative strengths. These results concur with recent literature that found a connection between emotional distress and creativity.

A Comparison of New and Revised Rorschach Measures of Schizophrenic Functioning in a Serbian Clinical Sample

We empirically evaluated indexes derived from the Rorschach Comprehensive System (CS) and the Rorschach Performance Assessment System (R–PAS) that are used for the assessment of psychotic functioning in schizophrenia. We compared the Perceptual Thinking Index (PTI) and the Ego Impairment Index (EII–2) with their revised versions: Thought and Perception Composite (TP–Comp) and EII–3. We evaluated their predictive validity for differentiating schizophrenic from nonschizophrenic patients in a Serbian sample. The sample consisted of 211 (109 men and 102 women, 18–50 years old) inpatients in Serbia who were divided into 2 groups: schizophrenic (100) and nonschizophrenic (111). Test administration, coding, and form quality classification followed CS guidelines. Logistic regression analysis indicated that the new indexes TP–Comp and EII–3 have slightly better predictive power than their counterparts, PTI and EII–2, in identification of schizophrenia, and that TP–Comp performed better than other indexes, although all 4 indexes were successful in differentiating these groups. The results supported the use of TP–Comp in diagnosis of schizophrenia and generally provided evidence for the utility of the Rorschach in evaluating psychosis and for its use in a cross-national context.

Rorschach measures of cognition relate to everyday and social functioning in schizophrenia.

Neurocognitive impairment and negative symptoms contribute to functional disability in people with schizophrenia. Yet, a high level of unexplained variability remains after accounting for the role of these factors. This study examined the role of thought disorder, psychological complexity, and interpersonal representations, as measured by the Rorschach, in explaining functional and social skills capacity in 72 middle-aged and older outpatients with schizophrenia (mean age = 51.2 years). Participants responded to the Rorschach administered with the R-Optimized administration instructions and scored with the Rorschach Performance Assessment System. Relationships with neuropsychological performance and psychopathology were also explored. Psychological complexity, which refers to a person's cognitive capacity for problem solving and organizing his or her surroundings, was correlated with functional capacity (r = .30) and social skills capacity (r = .34). Healthy interpersonal representations were correlated with positive social skills (rs = .24-.28). In multiple regression models, psychological complexity accounted for significant variation in functional (β = .23, p = .02) and social skills capacity (β = .35, p < .01) after controlling for neurocognitive functioning and psychopathology. These data suggest that psychological complexity plays a significant role in the functional limitations seen in schizophrenia, above and beyond the contributions of neurocognitive impairment and negative symptoms. Support was also found for the impact of healthy object relations functioning with social functioning. Clinical implications include novel information for future development of cognitive remediation treatment strategies based on a patient's developmental level of psychological capacity and healthy interpersonal schemas.

Rorschach Measures of Aggression: A Laboratory-Based Validity Study

This study sought to complement the archival research designs that have established the empirical foundations of Rorschach aggression scores, including Exner's (2003) Aggressive Movement (AG) score and Meloy and Gacono's (1992) Aggressive Content (AgC), Aggressive Past (AgPast), and Aggressive Potential (AgPot) variables. Utilizing a highly controlled laboratory-based aggression paradigm and self-report measures of violence history in a sample of 35 undergraduate males with an average age of 19.38 (SD = 2.11), this study found that only AgC was positively associated with in vivo aggression (r = .40, p = .02). None of the Rorschach measures of aggression were significantly associated with self-reported violence history, although there were several trends approaching significance. Theoretical and methodological implications are discussed.

Developing Continuous Variable Composites for Rorschach Measures of Thought Problems, Vigilance, and Suicide Risk

Using a multiple regression approach with a large developmental sample (N = 460) of Rorschach protocols from psychiatric, forensic, and nonclinical control groups, the authors created continuous multivariable Composite scores corresponding to the Comprehensive System (CS) Perceptual-Thinking Index, Hypervigilance Index, and Suicide Constellation. Within a validation sample (N = 230), these three new scores, called the Thought and Perception Composite, Vigilance Composite, and Suicide Concern Composite were strongly associated with the three original CS Indices. Additional analyses suggest that the new Composite scores were more reliable than and at least as valid as the original Indices. Interpretive guidelines are offered.

A Comparison of Rape and Molest Offenders in Prison Psychiatric Treatment

Differences in offense history, brain functioning, and psychological functioning of rape (n = 45) and molest offenders (n = 15) who were receiving psychiatric treatment while in prison were evaluated. Significant differences were found in each of these domains. Rape offenders were more likely to have histories of high violence offenses other than sexual offense, including murder, serious juvenile offenses, and both juvenile and adult sexual offenses. Rape offenders were more likely to show lower intellectual functioning and diffuse brain dysfunction associated predominantly with temporal and prefrontal brain cortices. Rape offenders were also more likely to display psychological functioning associated with illogical thinking and disordered attachment but less immature self-focus and fewer feelings of alienation than demonstrated by molest offenders. Implications for treatment and social policy for sexual offenders are suggested. Logistic regression demonstrated that these neuropsychological measures resulted in 71.7% accurate prediction and Rorschach measures resulted in 79.2% accurate prediction in differentiating rape from molest offenders. Implications for theoretical understanding of sexual offending are discussed.

Applying Clinical Methods for Assessing Patterns of Functioning in Negotiation Processes: The Rorschach Reality-Fantasy Scale (RFS)

This clinical paper suggests applying a new Rorschach measure, the Reality-Fantasy Scale (RFS; Tibon et al. 2005, Int J Appl Psychoanal Stud 2:40–57) for evaluating patterns of functioning in negotiation processes. The RFS is a psychoanalytically oriented diagnostic tool, designed to operationalize Winnicott’s (Playing and reality. Basic Books, New York, 1971) construct of potential or transitional space by using a paradigm that conceptualizes the Rorschach task as inviting the respondent to enter the intermediate transitional space between inner and outer reality. The RFS ranges from − 5, representing extreme reliance on fantasy (reality collapse) to + 5 representing extreme reliance on reality (fantasy collapse). A score approximating zero indicates adaptive and functional use of potential space, pointing out high level of negotiator effectiveness. A case example is presented, demonstrating the utility of the RFS in evaluating negotiator effectiveness in an encounter aimed at achieving peace agreement. Although not itself a report of a lab or field experiment the paper illustrates the potential usefulness of psychoanalytically oriented conceptualization and clinical assessment methods in negotiation research and practice.

Convergence of Self-Report Scales and Rorschach Indexes of Psychological Distress: The Moderating Role of Self-Disclosure

In this study, we addressed the weak associations found in research between self-report measures and the Rorschach test (Exner, 1978, 1991), from the perspective of Bornstein's (2002) “process dissociation framework.” Specifically, in the study, we focused on the associations between self-report measures of psychological distress and their corresponding Rorschach indexes while inspecting the moderating role of self-disclosure. A total of 59, nonpatient Israeli adults participated in a 2-session study. In the first session, they completed self-report scales measuring self-disclosure and psychological distress (suicidality, depression, and loneliness). In the second session, the Rorschach test was administered and coded. The participants were divided into high and low self-disclosure groups. A convergence between self-report and Rorschach measures of psychological distress was found only among high self-disclosers. In the discussion, we address the theoretical and clinical implications of these findings.

Perceptual-Organizational Characteristics of the Rorschach Task

The present study was designed to begin to explore the perceptual and visuospatial organization required to respond to the Rorschach task. Previous research has shown a relative independence of Rorschach scores from other measures of neurocognitive functioning (e.g., Zillmer & Perry, 1996). However, many of the neuropsychological measures used in previous studies did not require the patient to organize a complex visuospatial stimulus in the same way that the Rorschach does. In this study, data from 27 children and adolescents administered the Rorschach and the Rey-Osterreith Complex Figure Test (ROCF) were examined. Results of analyses indicated that, accounting for age and Full Scale IQ, there were a number of significant relationships between accuracy of ROCF renditions and Rorschach measures of developmental quality and perceptual accuracy. Implications for the understanding the nature of the Rorschach response process and its utility in clinical neuropsychology are discussed.

Social cognition and object relations scale: Convergent validity and changes following intensive inpatient treatment

To assess the convergent validity and clinical utility of the Social Cognition and Object Relations Scale (SCORS), we utilized data on treatment-resistant young adults in intensive, psychoanalytically oriented, inpatient treatment. Convergent validity was assessed through correlations between the SCORS and Rorschach measures of mental representations, clinical assessments of interpersonal behavior, and a measure of defense mechanisms. Results of the convergent validity were mixed. Correlations between the SCORS and Rorschach measures of object relations were weak. Correlations between all four SCORS dimensions and two measures of interpersonal behavior as well as with defense mechanisms, however, were statistically significant. The clinical utility of the SCORS was also supported by significant changes in the SCORS scores over 15 months of intensive inpatient treatment. These findings indicate the utility of the SCORS to assess therapeutic change in severely disturbed, treatment-resistant young adults.

A Rorschach Investigation of Incarcerated Female Offenders With Antisocial Personality Disorder

Although male psychopathy has been linked to histrionic, narcissistic, and antisocial personality disorders (ASPD), less is known about female psychopathy. The Psychopathy Checklist-Revised (PCL-R) and the Rorschach were used to explore the personality functioning of 45 incarcerated female offenders with ASPD delineated by their psychopathy level. Psychopaths (PCL-R > or = 30) and nonpsychopaths (PCL-R < 24) were compared on Rorschach measures of self-perception, interpersonal relatedness, and reality testing. Compared to female offenders with ASPD who were nonpsychopathic, female offenders with ASPD who were psychopathic exhibited marked disturbances in self-perception, interpersonal relatedness, and reality testing. Our findings highlight the heterogeneity of the ASPD diagnosis in women, support the utility of the psychopathy construct with female offenders, and implicate important differences between men and women with ASPD. These gender differences have relevance to the evaluation (PCL-R scoring) and treatment of female offenders. Our findings are discussed within the context of the female psychopath's hypothesized hysterical character style.

A Five-Factor Theory Perspective on the Rorschach

Many of the constructs the Rorschach is used to assess are related to personality traits included in the Five-Factor Model, but studies to date have not shown convergence between Rorschach and self-report measures of these traits. This poses a problem for the Rorschach, because recent research on the universality, stability, heritability, and consensual validity of traits demonstrate that self-report measures cannot be dismissed. In an effort to understand these issues, we examine the Rorschach from the perspective of Five-Factor Theory (FFT), a systems model of the person. FFT is compatible with the projective hypothesis, but would generally lead to the expectation that Rorschach signs and self-reports should be correlated. Where they are not, the validity of Rorschach measures of personality traits would need to be confirmed by demonstrations of their heritability, stability, and convergence with observer ratings. The Rorschach may be more useful when interpreted in the context of a global psychodynamic assessment. Clinicians who use the Rorschach should gather the data necessary to test its validity as a measure of personality traits and related constructs, and clinicians and researchers should consider the possible use of Rorschach responses in assessing dynamic processes.

Personality and Symptom Change in Treatment-Refractory Inpatients: Evaluation of the Phase Model of Change Using Rorschach,TAT, and DSM-IV Axis V

In this study, we examined global treatment outcomes during 16 months of intensive, psychodynamic treatment for 77 inpatients suffering from treatment-refractory disorders. Hypotheses based on the phase model of treatment change (Howard, Lueger, Maling, & Martinovich, 1993; Howard, Moras, Brill, Martinovich, & Lutz, 1996) were supported in the study results. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis V scales assessing behavioral functioning demonstrated large and medium effect size change, whereas stable, enduring personality functioning assessed by psychoanalytic Rorschach scales and the Social Cognition and Object Relations Scale (Westen, 1995) for the Thematic Apperception Test (Murray, 1943) demonstrated small and medium effect size change. We also report assessment of reliable change index and clinical significance. The ecological validity of Rorschach measures is supported by significant validity coefficients (in the hypothesized directions) between implicit measures of personality functioning and behavioral ratings.

Assault in Prison and Assault in Prison Psychiatric Treatment

Studies have described measures associated with assault in the community, but few have identified measures associated with assault in prison or prison psychiatric treatment. In this study, prison assault histories and assaults while in prison psychiatric treatment for 222 randomly selected male inmates were evaluated. Using record reviews, interviews, neuropsychological, Rorschach, and psychopathy measures, risk factors for assault in prison and in prison psychiatric treatment were identified. Youth Authority placement, inhalant use, antisocial lifestyle, neurological injury, neuropsychological impairment, and higher PCL-R Factor II ratings were associated with assault in prison. Absence of major mental disorder, neurological impairment, or psychotic thinking, but presence of psychopathy was associated with assault in prison psychiatric treatment. In identifying risk for violence, the importance of (1) the context in which violence occurs; (2) the need for clear admission criteria for prison psychiatric treatment; and (3) the need to develop risk assessments that are specific to prison environments are emphasized.

Prediction of Adolescent and Adult Delinquency From Childhood Rorschach Ratings

Relatively few studies have predicted adolescent or adult delinquency from childhood Rorschach data. Incremental validity of Rorschach measures over other known consistent and more easily obtained predictors has typically not been investigated. We addressed Rorschach data's incremental validity over mother's reports of externalizing behavior and mother-child relations for predicting officially registered adolescent and adult delinquency in a longitudinal study of 122 Swedish men. The Rorschach measures we used were aggregates of blind, prospectively performed, global expert ratings based on a holistic evaluation of protocols. An aggregate of Rorschach-based ratings of ego strength significantly improved the prediction of delinquency in adolescence and adulthood over and above earlier identified best predictors (mother's ratings of mother-child relations and externalizing problem behavior).

Rorschach Measures of Aggressive Drive Derivatives: A College Student Sample

This study investigated measures of aggressive drive derivatives on the Rorschach and Personality Assessment Inventory with 70 college students. As predicted, (a) self-reported physical aggression potential was related to Rorschach measures of identification with the aggressor and aggressive impulses, (b) suicidal ideation with impulsivity was related to a Rorschach measure of aggressive impulses turned toward the self, and (c) the borderline features scale was related to a Rorschach pathological object relations measure. Hierarchical regression analyses showed that a Rorschach measure of emotional impulsivity added unique variance to these Rorschach aggression variables in predicting self-reported physical aggression potential, suicidal ideation with impulsivity, and borderline features. Finally, caution is advised in applying our findings when there is motivation to suppress aggressive responses.

A Rorschach Study of Interpersonal Disturbance In Priest Child Molesters

This study compared the Rorschach protocols of 76 Catholic priests in treatment for same-sex ephebophilia with those of a comparison group of 74 Catholic priests in treatment for some other form of psychological disorder. The two groups were compared using two Rorschach measures of interpersonal functioning (the Human Representational Response and the Mutuality of Autonomy Scale) and a measure of sexual disturbance, the Rorschach Sexual Score. The ephebophile group gave more pathological responses on all three measures. Contrary to expectation an equivalent number of good or neutral responses was given by both groups on the two interpersonal measures.

Rorschach measures during depth hypnosis and suggestion of a previous life.

Using a procedure with suggestions to prompt false memories from an alleged previous life, we hypnotized 16 normal subjects and collected Rorschach data before and during the hypnotic induction. During hypnosis 9 subjects produced memories that they claimed to remember from a former life. The Rorschach findings bore no resemblance to the available data for other dissociative disorders. Rorschach variables during hypnotic trance remained almost unchanged from baseline. These results indicate that the Rorschach poorly reflects hypnotic trance.

ALEXITHYMIA AND SOCIOCULTURAL FACTORS IN A JAPANESE SAMPLE: A STUDY WITH THE RORSCHACH

We reexamined the Japanese version of the 20-item Toronto Alexithymia Scale, a self-report scale for measuring alexithymic characteristics, by comparing the scores on three factors and the total scores with variables of the Rorschach in a sample of 40 (originally 48) Japanese college students. Based on prior studies, our aims were to further validate the 20-item Toronto Alexithymia Scale by comparing its scores with those on a projective technique. We also investigated whether sociocultural factors, such as repression of hostility, are associated with scores on the 20-item Toronto Alexithymia Scale (especially Factor 3). None of the seven Rorschach Alexithymia Variables were significantly related to the factors and total scores of the 20-item Toronto Alexithymia Scale. However, scores for Factor 1 (difficulty identifying feelings) of the 20-item Toronto Alexithymia Scale correlated positively with scores on Sum C' (reserved responses to emotional stimuli) and Adj es (stimulus demand), suggesting that individuals who score high for Factor 1 experience gloomy, depressive feelings but in constricted ways. Scores for Factor 3 (externally oriented thinking) correlated positively with the D scores (stress tolerance) and negatively with m (situational stress) responses, suggesting that Factor 3 may reflect a psychological defense that enhances stress tolerance. There was a nonsignificant negative correlation between Factor 1 and Factor 3 scores, but, unlike our hypothesis, Factor 3 was neither related to AG (aggression) nor S (space responses reflecting oppositional tendency), indices of aggression or hostility in the Rorschach Comprehensive System. It may be that the 20-item Toronto Alexithymia Scale and the Rorschach measure quite different aspects of personality, but further research is necessary.