Abstract : Interrater agreement and reliability for the Rorschach have recently come under increasing scrutiny. This is the second report examining methods of Comprehensive System reliability using principles derived from observational methodology and applied behavioral analysis. This study examined a previous nonpatient sample of 20 protocols (N = 412 responses) and also examined a new clinical sample of 20 protocols (N = 374 responses) diagnosed with Research Diagnostic Criteria. Reliability was analyzed at multiple levels of Comprehensive System data, including response level individual codes and coding decisions and ratios, percentages, and derivations from the Structural Summary. With a number of exceptions, most Comprehensive System codes, coding decisions, and summary scores yield acceptable, and in many instances excellent, levels of reliability. Limitations arising from the nature of Rorschach data and Comprehensive System coding criteria are discussed.

Abstract : This article examines the milieu of Hermann Rorschach's Psychodiagnostics (1921/2021) under development between 1911 and his death in 1922 and explores new evidence about the direction Rorschach's test might have taken after publication of Psychodiagnostics. This includes direct and indirect influences from turn of the century continental philosophy and science and innovative colleagues in the Swiss psychiatric and psychoanalytic societies. The availability of newly translated scholarship, including the correspondence between Ludwig Binswanger and Hermann Rorschach following the 1921 publication of Psychodiagnostics, Binswanger's posthumous 1923 commentary in the International Journal of Psychoanalysis, and recent new translation of Psychodiagnostics, permits a fresh appraisal of the milieu and foundations of Rorschach's development. Understanding these sources and influences opens new vistas in reappraising the nature of Rorschach's “test theory” which Rorschach considered undeveloped at the time of his death. This paper presents new evidence that, under the influence of Rorschach's close colleague, Ludwig Binswanger, the Geisteswissenschaften and phenomenology might have figured prominently in future developments. The paper concludes that Rorschach, preoccupied with considerations of kinesthetic subjectivity in his innovative conceptualization of human movement responses, was a nascent phenomenologist whose untimely death cut short further developments in his theory of the test.

Abstract : This study investigated eye movements associated with the production of different Rorschach responses involving the use of the inkless (or “white space”) areas of the inkblots. More specifically, we examined whether Space Integration (SI) and Space Reversal (SR) responses associated with different test-taker’s approaches to visually inspecting the Rorschach inkblots while completing the test. We retrieved archival data from 71 non-clinical volunteers who took the Rorschach test while their eye movements were being registered. The results of our analyses indicated that: (a) SI, but not SR, positively associated with the overall number of eye fixations recorded while scanning the Rorschach inkblots; (b) SR, but not SI, associated with a proportionally greater visual focus (i.e., greater number of fixations and longer duration of fixations) on white than non-white areas of inkblots. Taken together, these findings support Rorschach Performance Assessment System (R-PAS) determination to interpret SI and SR responses differently.

Abstract : This study investigated whether complexity and the other related Rorschach Performance Assessment System (R-PAS) variables in the engagement and cognitive processing domain would associate with eye-tracking measures reflecting increased cognitive engagement and effort while visually scanning the Rorschach inkblots. A nonclinical sample of 71 adult volunteers were administered the Rorschach task while their eye movements were recorded using an eye tracker. Then, the average duration of fixations, the average number of fixations, the average amplitude of saccades, and the average maximum pupil size recorded during the response phase (RP) of the Rorschach administration were correlated with protocol-level, R-PAS variables located in the engagement and cognitive processing. As expected, complexity correlated, with a large effect size (r . .526, p < .01), with the number of fixations occurring during the RP of Rorschach administration. Some other variables related to complexity (e.g., Synthesis, Sy) also produced similar associations. The other eye-tracking variables under examination, however, produced weak or nonsignificant correlations.

Abstract : The ongoing COVID-19 pandemic has required psychologists to adopt measures like physical distancing and mask wearing, though other safety procedures such as travel restrictions or prohibitions on in-person practice and research have fostered the use of tele-health tools. In this article, we review options for using the Rorschach task via videoconference and provide preliminary data from using a new electronic app for remote R-PAS administration to determine whether the remote administration in an electronic form yields different information than in-person administration with the cards in hand. As a pilot study, our focus is on the “first factor” of all Rorschach scores, i.e., complexity. Data were collected from 60 adult Italian community volunteers, and statistical analyses evaluated the extent to which the average complexity score significantly departed from R-PAS normative expectations (SS=100), accompanied by Bayesian likelihoods for supporting the null hypothesis. Results suggest that the general level of complexity shown by the test-takers when administered the Rorschach remotely with the new R-PAS app closely resembles that previously observed using “standard” in-person procedures. Tentative analyses of other R-PAS scores suggested normative departures that could be due to the effects of the app, testing at home, or responses to the pandemic. We offer recommendations for future research and discuss practical implications.

Abstract : Health risk behaviors, such as cigarette smoking, may be triggered by failures in thought suppression, a cognitive avoidance strategy associated with rumination. To date, no study has examined the role of personality features in the performance of thought suppression in smokers and nonsmokers. To address this gap in the literature, we aimed to (1) examine whether some stable personality features might be related to thought suppression failure independent of smoking status and (2) investigate whether smokers have different personality traits compared with nonsmokers that might be related to cognitive avoidance strategies and difficulties in cognitive emotion regulation suggesting the presence of rumination/failures in suppressing mental content. We included 39 nonsmokers and 40 regular smokers in the study and implemented a multimethod psychological research design. Specifically, we administered a typical performance-based measure (i.e., Rorschach [R-PAS]) and a behavioral task (i.e., the thought suppression task). Our results indicate that failures in thought suppression are associated with stable aspects of personality related to the presence of thinking problems (e.g., Sum of Severe Cognitive Codes) and passive attitudes (e.g., Passive proportion). Moreover, failures in suppressing a mental content seem to be associated with difficulties in problem-solving strategies with a constant focus on one’s inner world.

Abstract : Hermann Rorschach researched the utility of his inkblot experiment to understand psychopathology and cultural differences. Contemporary research with the Rorschach has evaluated its utility as a test, although it may more properly represent a clinical method with somewhat different evaluation criteria. Recent controversy regarding the adequacy of the Rorschach as a test and the adequacy of its normative data has at times distorted and oversimplified important methodological issues inherent in the study of cultural difference. Cultural processes remain a central and inadequately examined variable in Rorschach research; an important emergent area of inquiry is the Rorschach's clinical utility as a cross-cultural assessment instrument. We review multicultural and cross-cultural methodological issues intrinsic to contemporary Rorschach research here. Consideration of cultural issues enlarges and enriches the Rorschach clinical utility debate and suggests underexplored research strategies that can contribute to its resolution.

Abstract : The Rorschach cards may elicit components of personality functioning that escape consciousness but which may influence observable performance during the test. Similarly, the manifest content of dreams may contain unconscious experiential elements that contribute to the formation of the content that the subject then remembers and tells to other people. The aim of this study was to investigate a possible correspondence between the content of a person’s dreams and the attributions made by the same person when viewing the Rorschach inkblot designs. Participants aged 18–64 years were selected based on criteria related to the frequency of dream recall (i.e., at least once per week). The final sample of our study consisted of 41 individuals (24 women) aged 20–57 years (M = 27.10; SD = 8.09). The dream narratives were collected via email and coded according to the Rorschach Performance Assessment System. There was an association between the content of the dreams and the Rorschach responses in relation to the presence of immature visual imagery, the tendency to see things in perspective, possible occurrence of dissociative experiences, physical worries, and ideas of harm, feelings of fear, a sense of danger and pain, and sadism, that is, disturbing contents possibly related to the loosening of censorship mechanisms during the dream state. This is the first study to examine the possible relationship between dream content and Rorschach responses using an empirical approach capable of understanding the unconscious and subconscious components underlying psychological functioning.

Abstract : The Rorschach cards may elicit components of personality functioning that escape consciousness but which may influence observable performance during the test. Similarly, the manifest content of dreams may contain unconscious experiential elements that contribute to the formation of the content that the subject then remembers and tells to other people. The aim of this study was to investigate a possible correspondence between the content of a person’s dreams and the attributions made by the same person when viewing the Rorschach inkblot designs. Participants aged 18–64 years were selected based on criteria related to the frequency of dream recall (i.e., at least once per week). The final sample of our study consisted of 41 individuals (24 women) aged 20–57 years (M = 27.10; SD = 8.09). The dream narratives were collected via email and coded according to the Rorschach Performance Assessment System. There was an association between the content of the dreams and the Rorschach responses in relation to the presence of immature visual imagery, the tendency to see things in perspective, possible occurrence of dissociative experiences, physical worries, and ideas of harm, feelings of fear, a sense of danger and pain, and sadism, that is, disturbing contents possibly related to the loosening of censorship mechanisms during the dream state. This is the first study to examine the possible relationship between dream content and Rorschach responses using an empirical approach capable of understanding the unconscious and subconscious components underlying psychological functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Abstract : Background: The role that psychological factors and personality traits play in the pathogenesis of Fibromyalgia Syndrome (FMS) is currently controversial. Most of the studies on FMS used self-report measures, and to date only a doctoral dissertation was conducted to compare the Rorschach responses of patients with FMS to the normative sample. Aim and Method: By using the Rorschach Performance Assessment System (R-PAS), we compared the scores of 35 women with FMS with those of 35 women with rheumatoid arthritis (RA). R-PAS is a performance-based task able to provide information on psychological processes occurring in the context outside and beyond the test. Furthermore, we chose RA patients as a contrast group because they both share the same medical picture in terms of pain experiences. Results: Compared to the RA group, the FMS group seemed to experience considerable implicit distress (YTVC’) associated with a sense of helplessness and despair (Y) that interferes with coping and adaptive mechanisms. Moreover, we found that these patients showed a cognitive processing focused mostly on the straightforward components of the environment (SI and Sy), but the interpretation of the environment was more unconventional (FQo%). Finally, we observed that almost half of the FMS group exhibited an excessive worry on the body (An). Conclusions: Our study has two implications for practicing psychologists. First, by using a performancebased test such as the R-PAS, we were able to provide a different clinical picture than self-reports (e.g., we did not find alexithymia features in the FMS protocols) and to identify the problematic features even at different levels of Complexity. Second, the increased levels of implicit stress found in the FMS group require psychological interventions focused on empowering these patients with selfmanagement, active coping strategies when dealing with stressors and pain, so to defy their sense of helplessness.

Abstract : Objectives: Assessment of ADHD typically includes rating scales completed by parents, teachers, and/or patients themselves. However, rating scales may be subject to rater bias effects, and raters may not recognize the patient’s implicit qualities and underlying personality processes. In contrast, the Rorschach test permits standardized, in vivo observation and coding of behaviors as outcomes of implicit personality processes, and, thus, it may assist clinicians in the formulation of contextualized treatment decisions. By using the Rorschach Performance Assessment System (R-PAS), a performance-based personality test characterized by empirical foundation and psychometric efficiency, we conducted an observational study to investigate in depth personality and its implicit qualities in children with ADHD who were not on medication. Methods: After reviewing thoroughly the previous studies on ADHD and the Rorschach and discussing their contradictory findings, we compared the data of our sample (N = 31) with the R-PAS normative children’s group. Results: Several Rorschach variables differed from R-PAS norms and indicated the presence of unconventional perceptions characterized by non-cognitively mediated interactions and difficulties mentalizing human behavior. Conclusions: Overall, it appears that hyperactivity and impulsivity are associated with unconventional and sometimes mistaken processing of information especially relevant to people and relationships. Although we compared the Rorschach profiles to norms rather than a matched control group, our findings could provide useful information for understanding the personality functioning beyond manifest symptoms or symptom reports of children with ADHD.

Abstract : Recent research suggests that attributing human movement to ambiguous and static Rorschach stimuli (M responses) is associated with EEG mu suppression, and that disrupting the left inferior gyrus (LIFG; a putative area implicated in mirroring activity) decreases the tendency to see human movement when exposed to the Rorschach ambiguous stimuli. The current study aimed to test whether disrupting the LIFG via repetitive transcranial stimulation (rTMS) would decrease both the number of human movement attributions and EEG mu suppression. Each participant was exposed to the Rorschach stimuli twice, i.e., during a baseline condition (without rTMS but with EEG recording) and soon after rTMS (TMS condition with EEG recording). Experimental group (N?=?15) was stimulated over the LIFG, while the control group (N?=?13) was stimulated over the Vertex. As expected, disrupting the LIFG but not Vertex, decreased the number of M attributions provided by the participants exposed to the Rorschach stimuli, with a significant interaction effect. Unexpectedly, however, rTMS did not significantly influence EEG mu suppression.

Abstract : According to the “embodied simulation theory,” exposure to certain visual stimuli would automatically trigger action simulation in the mind of the observer, thereby originating a “feeling of movement” modulated by the mirror neuron system(MNS). Grounded on this conceptualization, some of us recently suggested that when exposed to the Rorschach inkblots, in order to see a human movement(e.g., “a person running”) in those ambiguous stimuli, the observer would need to experience a “feeling of movement” via embodied simulation. The current study used repetitive transcranial magnetic stimulation (rTMS) to further test this hypothesis. Specifically, we investigated whether temporarily interfering with the activity of the left inferior frontal gyrus (LIFG;aputativeMNSarea) usingrTMS would decrease the propensity to see human movement (M) in the Rorschach inkblots. Thirty-six participants were exposed to the Rorschach stimuli twice, i.e., during a baseline (without rTMS) and soon after inhibitory rTMS. As for the rTMS condition, half of the sample was stimulated over the LIFG (experimental group) and the other half over the Vertex (control group). In line with our hypothesis, the application of rTMS over LIFG, but not over Vertex, yielded a statistically significant reduction in the attribution of M to the ambiguous stimuli, with large effect size. These findings may be interpreted as being consistent with the hypothesis that there is a link between the MNS and the “feeling of movement” people may experience, when observing ambiguous stimuli such as the Rorschach cards.

Abstract : Ideational slippage—characterized by incorrect word usage and strained logic during dialogue—is common in aging and, at greater frequency, is an indicator of pre-clinical cognitive decline. Performance-based assessment of ideational slippage may be useful in the study of cognitive aging and Alzheimer’s-disease-related pathology. In this preliminary study, we examine the association between corpus callosum volume and a performance-based assessment of ideational slippage in middle-aged and older adults (age 61–79 years). Ideational slippage was indexed from cognitive special scores using the Rorschach Inkblot Method (RIM), which are validated indices of deviant verbalization and logical inaccuracy (Sum6, WSum6). Among middle-aged and older adults, smaller splenium volume was associated with greater ideational slippage (?p 2 = 0.48), independent of processing speed and fluid intelligence. The observed negative associations are consistent with visuospatial perception and cognitive functions of the splenium. The effect was strongest with the splenium, and volumes of the genu and total white matter had small effects that were not statistically significant. Conclusions: Results are discussed with future application of RIM special scores for the assessment of pre-clinical cognitive decline and, based on observed effect sizes, power analyses are reported to inform future study planning.

Abstract : The Rorschach Inkblot test has been adopted and adapted by many researchers to assess and predict different aspects of human experience and cognitive performance. The present review examines research that incorporates the Rorschach to evaluate neural and cognitive aging as well as decline in age-related disease. Specifically, differences in amygdala and cortical regions, as well as mirror neuron and asymmetrical hemisphere activity that correlate with specific responses to Rorschach stimuli are discussed in the context of typical changes in brain structure and function in the course of aging. In addition, the present review provides a proposed framework for expanding the use of the Rorschach to evaluate other domains of neural and cognitive function. The authors conclude that, despite a need for increased research, the Rorschach is a viable measure to evaluate certain aspects of cognitive function and decline throughout the lifespan.

Abstract : Attention deficit hyperactivity disorder in children and adolescents manifests itself in a heterogeneous manner as regards personality aspects. This study aimed to evaluate, by using the Ego Impairment Index, the personality functioning characteristics of children and adolescents between 9 and 15 years old (to be completed), diagnosed with the disorder (clinical group) and compare them with a non-clinical group. The groups included 42 participants each. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version was used for diagnosis, and the Rorschach Performance Assessment System (R-PAS) was utilized for personality traits. When compared to their peers, the participants in the clinical group showed ability to discern adaptive behaviors through proper judgment, difficulty in keeping thinking and reasoning processes stable, a negative view of themselves and others, in addition to difficulty in establishing cooperative relationships.

Abstract : Unique mode of perception, or the ability to see things differently from others, is one of the psychological resources required for creative mental activities. Behavioral studies using ambiguous visual stimuli have successfully induced diverse responses from subjects, and the unique responses defined in this paradigm were observed in higher frequency in the artistic population as compared to the nonartistic population. However, the neural substrates that underlie such unique perception have yet to be investigated. In the present study, ten ambiguous figures were used as stimuli. The subjects were instructed to say what the figures looked like during functional MRI scanning. The responses were classified as "frequent", "infrequent" or "unique" responses based on the appearance frequency of the same response in an independent age- and gender-matched control group. An event-related analysis contrasting unique vs. frequent responses revealed the greatest activation in the right temporal pole, which survived a whole brain multiple comparison. An alternative parametric modulation analysis was also performed to show that potentially confounding perceptual effects deriving from differences in visual stimuli make no significant contribution to this temporopolar activation. Previous neuroimaging and neuropsychological studies have shown the involvement of the temporal pole in perception-emotion linkage. Thus, our results suggest that unique perception is produced by the integration of perceptual and emotional processes, and this integration might underlie essential parts of creative mental activities

Abstract : Interference by amygdalar activity in perceptual processes has been reported in many previous studies. Consistent with these reports, previous clinical studies have shown amygdalar volume change in multiple types of psychotic disease presenting with unusual perception. However, the relationship between variation in amygdalar volume in the normal population and the tendency toward unusual or unique perception has never been investigated. To address this issue, we defined an index to represent the tendency toward unique perception using ambiguous stimuli: subjects were instructed to state what the figures looked like to them, and ‘‘unique responses’’ were defined depending on the appearance frequency of the same responses in an age- and gender-matched control group. The index was defined as the ratio of unique responses to total responses per subject. We obtained structural brain images and values of the index from sixty-eight normal subjects. Voxel-based morphometry analyses revealed a positive correlation between amygdalar volume and the index. Since previous reports have indicated that unique responses were observed at higher frequency in the artistic population than in the nonartistic normal population, this positive correlation suggests that amygdalar enlargement in the normal population might be related to creative mental activity.

Abstract : Unique and unusual responses to inkblot stimuli evoked by emotionally vulnerable psychiatric patients have been considered as examples of interference of emotion with perceptual processes. However, few studies have investigated the interaction between emotion-related and perception-related neural circuits during performance of the inkblot test. In our recent studies using the inkblot stimuli, enlargement of the amygdala was revealed in association with frequent production of unique responses to the inkblot stimuli. Additionally, our studies demonstrated right temporopolar activation associated with the production of unique responses, as well as left anterior prefrontal and bilateral occipitotemporal activation associated with the production of typical responses. On the basis of these results, we hypothesized that the amygdala is involved in modulation of the connectivity among the frontotemporal regions identified in the activation analysis. To address this issue, we performed a functional connectivity analysis of functional magnetic resonance imaging data, using physiophysiological interaction implemented in Statistical Parametric Mapping 2 (SPM2). This analysis revealed that the amygdala imposed a positive modulation on the connection from the anterior prefrontal region to the temporopolar region, and a negative modulation on the connection from the temporopolar region to the occipitotemporal regions. These results suggest that interference of emotion affects perception during the inkblot test.

Abstract : Oral–Dependent Language (ODL) is currently included in the Rorschach Performance Assessment System (R-PAS) as an empirically supported variable that measures both implicit and explicit psychological processes related to dependence and oral motives. To date, almost all studies on ODL have been conducted in the U.S. so that little is known about how it works in other cultural contexts. Additionally, no study has investigated the Oral and Dependent subcomponents of this variable. This paper addresses ODL validity in Italy and its clinical utility by reporting on three studies, each addressing a specific research question. Study 1 examined the association of gender, age, and cultural background to ODL scores. Study 2 addressed predictive validity by examining the relationship of ODL and its subcomponents’ scores to dependent behaviors expressed by nonclinical participants in a laboratory task. Study 3 tested construct validity of ODL and its subcomponents scores via a clinical/nonclinical comparison paradigm. A total of 212 Italian participants (68 obese patients and nonobese volunteers) were enrolled in these studies. Data were analyzed through Bayesian and parametric techniques. Study 1 confirmed that Italian nonclinical individuals produced equivalent ODL scores to U.S. normative data; Study 2 found no association between ODL and occurrence of a dependency-related behavior in a laboratory setting; Study 3 showed that obese patients produced higher ODL scores than controls.

Abstract : Standardized personality tests compare the test taker’s scores to those of a large sample of individuals representing normative expectations. However, what is psychologically normal in one historical context may not be similarly normal in another, so the recent spread of a new coronavirus, SARS-Cov-2 (COVID-19), may have implications for what should normally be expected of a nonclinical person taking a personality test shortly after this dramatic event. To address this research question, we administered the Personality Assessment Inventory (PAI) and the Rorschach Performance Assessment System (R-PAS) to 60 nonclinical volunteers from Italy and compared their scores with the official normative reference values of the two tests, which had been established before COVID-19. The results of a series of two-sample t-tests indicated that our newly collected sample appeared somewhat less psychologically healthy compared with normative expectations, and these discrepancies were more pronounced on the PAI than on the R-PAS. Implications and future perspectives are discussed.

Abstract : Background: Giant Congenital Melanocytic Naevus (GCMN) is a morphological skin alteration present from birth, involving up to 80% of the body surface. GCMN could have a detrimental effect on body perception due to several factors including its aspect, extension and the potential exposure to significant number of surgical interventions. Objective: This pilot study assessed quality of Body Image (BI) and psychological adjustment in subjects with GCMN and their parents. Methods: Subjects and parents underwent a multi-method assessment including a semi-structured interview, a self-administered rating scale to assess BI (Body Uneasiness Test, BUT) and two personality tests: A self-report (MMPI-2RF/A) and a performance test (Rorschach, R-PAS method). Results: Ten families were enrolled in the study. GCMN subjects were all females with high average surgical interventions (median=13). In GCMNs a substantial impairment of BI was detected by the BUT (global severity index=2.34 ± 0.81; Body Image Concern=3.25 ± 0.95), MMPI-2RF/A presented normal ranges and R-PAS showed elevations for the quality of human representations (PHR/GPHR: 119.1 ± 8.1). Mothers showed a trend for health concerns at MMPI-2RF (Malaise: 64.2 ± 9.5), fathers showed under-reporting in almost all tests. Conclusion: This set of GCMN females with relevant surgical history shows significant BI impairment with several aspects of non-integrated body identity at unconscious level, that may result in inability to envision the self and relations with others in adaptive way. Parents show different profiles, including conscious health concerns in mothers and denial in fathers. Families with a GCMN subject could benefit from integrated approaches including medical advice, psychological support and social integration projects.

Abstract : Mental health professionals working in adolescent residential treatment facilities face various challenges in delivering effective treatment to their patients. Establishing therapeutic alliance is often regarded as particularly daunting. Adolescents’ acting-out behaviors, emotional dysregulation, and difficulty in trusting adults can trigger strong reactions in mental health professionals. These reactions may increase the risk that mental health professionals respond to adolescents’ behaviors in similarly unmodulated ways and become involved in a reciprocal pathological process. The Rorschach test can provide vivid imagery and response content that depicts the subjective dilemmas adolescents are struggling with during their recovery in the treatment center. In this paper we show how to use Rorschach imagery to allow the mental health professionals working in adolescent inpatient treatment centers to understand their patients and increase empathy in response to adolescents’ troubling behaviors. We illustrate this procedure through the case of an adolescent patient who engaged in severely disruptive acting-out behaviors with the treating staff. Even though the staff were considering terminating his treatment in the facility as the only viable option, they instead found new empathy and a way to work with him after discussion of his Rorschach led by the inpatient center psychologist.

Abstract : A meta-analysis comparing "undirected" and "conceptual" MMPI studies, and conceptual Rorschach and MMPI studies, indicated the following conclusions, (a) Conceptual work more successfully validates an assessment instrument than does undirected investigation, (b) The validatory success of the "average" conceptual Rorschach study is comparable to that of similar MMPI work. This finding suggests that the former's questionable status may be based on sociocultural factors, rather than scientific ones, (c) The "average" conceptual Rorschach or MMPI study has only modest explanatory power, (d) Investigators' misuse of x2 has resulted in exaggerated effect size in many instances where the statistic was employed. It is suggested that future research be judged on the coherence of its inference processes, the specificity of its predictions, and the amount of variance it explains.

Abstract : Data obtained from Rorschach tests given to 81 high school students support the following conclusions: (1)… the utilization of the experience type as a differential factor in the interpretation of S (white space) response should be discontinued until evidence for its justification becomes available." (2) The hypothesis that the S response reflects oppositional tendencies was partially corroborated. (3) There was no evidence for inferring inadequacy or self-distrust feelings from the S response.

Abstract : The number and temporal sequence of the occurrence of space responses on the Rorschach and the rate of perceptual reversal on the Necker Cube were obtained. Found a significant positive relationship of moderate degree between the rate of reversal on the Necker Cube and the number of primary space responses on the Rorschach and that the frequency of occurrence of primary space responses varied according to the exposure time, with the relative number of primary space responses increasing with increasing time of exposure of the Rorschach cards.

Abstract : Experiencing sexual abuse increases the risk that children will report or otherwise demonstrate problems with emotion, behavior, and health. This longitudinal study of 44 children who experienced sexual abuse examined whether information processing as assessed via the Rorschach Inkblot Test was associated with child-reported depression symptoms assessed via the Children’s Depression Inventory (Kovacs, 1992) concurrently and an average of 15 months later. Children whose Rorschach protocols were relatively free of scores suggesting intense distress, complex processing, and sexual content were more likely to experience remission of depression symptoms at follow-up. Findings provide incremental validity for certain Rorschach indexes to inform prognosis regarding depression symptoms and perhaps their treatment.

Abstract : Processing of ambiguous visual stimuli has been associated with an increased activation of the left lateral prefrontal cortex (PFC) in neuroimaging studies. Nevertheless, the functional role of prefrontal activity in this process is not fully understood. In this experiment we asked participants to evaluate ambiguous inkblots from the Rorschach test, while stimulating the left lateral PFC using excitatory anodal transcranial direct current stimulation (tDCS). In addition, visual insight ability was assessed as a control measure requiring visual and conceptual restructuring and convergent thinking rather than divergent idea generation employed to interpret the equivocal Rorschach inkblots. Using a randomized double-blind design, we demonstrated that anodal tDCS increased the number of meaningful patterns recognized in the inkblots but had no significant effect on visual insight. These findings support the role of left lateral PFC in the processing of ambiguous visual information and object recognition. More generally, we discuss that the PFC may be involved in the mechanisms supporting the activation of stored visual and semantic representations in order to compensate for less informative bottom-up inputs and thus facilitate flexible cognition and idea generation.

Abstract : This Rorschach study explored the suppression of aggression content when violent offenders and non offenders are asked to present themselves as not posing a threat of dangerousness in a court role-playing context. Aggressive content and complexity in this suppressive role-play context was compared to a neutral control condition. A total of 41 participants, approximately half violent offenders and half non offenders took the Rorschach under both conditions. Results indicate that both groups suppressed aggression content on the Rorschach without altering response complexity. This large effect size for testing condition may partly explain the inconsistencies across previous studies. It is possible that violent offenders have typically been tested in highly suppressive conditions whereas non offender or normative groups may have been tested in relatively low suppression conditions. If so, aggression score differences may be a reflection of the testing condition, not group differences. Both instructional sets produced similar levels of complexity, so that individuals do not simplify responses when they screen out aggressive attributions. Violent offenders did not differ from nonviolent offenders in terms of aggression content, but did produce more simplistic records. In addition, this study also undertook a semantic, textual analysis and found that individuals in the suppressive condition tended to eliminate many response elaborations, particularly those with negative of threatening connotations.

Abstract : Using a diverse sample of 4,786 protocols obtained with the Rorschach Performance Assessment System (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011), we provide a contemporary overview of how people organize Rorschach’s inkblots into identifiable regions while formulating responses. After examining how frequently each location was used across all cards in this sample, we examined the consistency of their use by computing parallel information in 17 samples (N D 4,701) obtained using the Comprehensive System (CS; Exner, 2003), including clinical, nonclinical, and adult, child, and adolescent data. Even though the CS data could only record a single location for each response, the average correlation of location use across samples was .96. The results also document continuous dimensionality in use rather than any discontinuities that would demarcate a boundary between common and uncommon locations. Implications of this notable reproducibility and dimensionality are discussed for future conceptualization of location typicality, including location coding considerations and possibilities for improved measures of perceptual fit.

Abstract : The locations people use when constructing responses to the Rorschach task demonstrate their style of perceiving the environment. Current systems code location use into three mutually exclusive categories: use of the whole inkblot (W), common detail areas (D), and rare detail areas (Dd). The location of objects within multiobject W responses typically are never classified and those within D areas might or might not be, which could lead to a biased understanding of the visual structure embedded in the task. To better understand this structure, we systematically coded the location of all individual response objects in 145 normative protocols, finding some notable differences relative to conventional coding guidelines. Across cards, from 8% to 71% (M = 40.2%) of W responses had multiple subcomponent objects that typically are never tallied, and multiple unnumbered location areas are used more often than many specific numbered areas. To assess generalizability, we documented correspondence with location frequencies in 4,786 protocols gathered using Rorschach Performance Assessment System guidelines. The results contribute to an improved understanding of the visual structure built into the inkblot stimuli and a method for quantifying exhaustiveness, commonness, and atypicalness as independent dimensions. We discuss implications for coding and interpreting inkblot location use.

Abstract : Typical visual perception includes an attention bias toward the right hemisphere mediated global, holistic cortical processing. An atypically local, detail-oriented focus of attention is characteristic of left hemisphere processing and is often observed in patients whose field of attention is restricted by certain types of neurocognitive impairment. We designed the present pair of studies to induce a local attentional focus to observe its consequences on neurocognitive measures of visuospatial processing. In Experiment I, participants wore glasses mimicking simultanagnosia, a disorder of visual attention, to induce a narrowed, atypical attentional style while they completed visual neuropsychological tasks. This simulation impaired participants ‘capacities to visually synthesize and efficiently reproduce Complex Figure stimuli as measured with the Boston Qualitative Scoring System (BQSS), and it induced atypical attentional style on Rorschach Performance Assessment System (R-PAS) re-sponges. In Experiment II, participants wore glasses designed to provoke differential hemispheric activation, also hypothesized to influence style of visual attention; but this manipulation did not influence neurocognitive task performance. We discuss implications for the interpretation of BQSS and R-PAS scores and offer directions for future research.

Abstract : The aims of this study are to investigate suicidal behaviors among adolescents and young adults and to test an index composed using Rorschach test responses related to an increased risk of suicide. Using a cross-sectional design, 4 groups were studied (according to criteria of the Columbia Classification Algorithm of Suicide Assessment [Posner, Oquendo, Gould, Stanley, & Davies, 2007]): A group with suicidal ideation (n = 30), a group with parasuicidal behavior (n = 30), a group with near-lethal suicide attempts (n = 26), and a control group (n = 30). Responses to the Rorschach test yielded 6 potential indicators of suicidal behavior (scored according to Exner’s Comprehensive System and the Suicidal Index for Adolescents; Silberg & Armstrong, 1992). Rorschach scores including at least 4 of these 6 indicators selected 69% of the people who had committed serious suicide attempts. The Rorschach Suicidal Index reached an acceptable reliability and was related to other criteria of suicide risk, such as the Beck Depression Inventory (BDI; Beck, Ward, Mendelsohn, Mock, & Erbaugh, 1961) and Linehan Reasons for Living Inventory (RFL–I; Linehan, Goodstein, Nielsen, & Chiles, 1983). Moreover, the Rorschach Suicidal Index showed incremental validity over the BDI and the RFL–I to predict suicidal behavior. A path analysis additionally showed that low social support was an important mediator between the Rorschach Suicidal Index and the number of suicide attempts committed by participants.

Abstract : Using 100 clinical cases, we examined the construct validity of the Mutuality of Autonomy (MOA) Scale (Urist, 1977) using Westen and Rosenthal’s (2003) rcontrast - construct validity (CV) procedure for quantifying a pattern of convergent-discriminant relationships between a target measure and a set of criterion variables. Our 15 criterion variables included the Comprehensive System (CS; Exner, 2003) variables, a CS-based measure of ego strength (Resnick, 1994), and 3 subscales from the Social Cognition and Object Relations Scale (Westen, Lohr, Silk, Kerber, & Goodrich, 1990). We generated the rcontrast - CV coefficients to test 2 competing hypotheses: that the MOA Scale primarily measures object relations (OR) quality or that it primarily measures psychopathology. Results suggest that the MOA Scale is an equally potent measure of OR and psychopathology regardless of the MOA Scale index used.

Abstract : A review of research examining the construct validity of J. M. Masling, L. Rabie, and S. H. Blondheim's ( 1967 ) Rorschach Oral Dependency (ROD) scale as a measure of interpersonal dependency revealed that this scale has demonstrated good interrater reliability, and that evidence regarding the convergent and discriminant validity of the ROD scale is generally strong. Mixed results have been obtained in studies assessing the internal reliability of ROD scale scores. There have been very few studies examining the predictive validity and retest reliability of the ROD scale, and few studies assessing the relationship of ROD scores to scores on other objective and projective measures of dependency. Implications of these findings for laboratory and clinical research involving the ROD scale are discussed, and suggestions for future studies in this area are offered.

Abstract : A meta-analysis of published studies in which scores on objective (i.e., self-report) or projective measures of interpersonal dependency were used to predict some aspect of dependency-related behavior revealed that validity coefficients for projective tests (number of comparisons = 32) were generally larger than validity coefficients for objective tests (number of comparisons = 54). The relationships of setting in which data were collected, source of behavioral ratings, and participant classification method on observed test score-behavior correlations were also assessed. Implications of these findings for use of objective and projective dependency measures in clinical, laboratory, and field settings are discussed.

Abstract : Recent conceptual and methodological innovations have led to new strategies for documenting the construct validity of test scores, including performance-based test scores. These strategies have the potential to generate more definitive evidence regarding the validity of scores derived from the Rorschach Inkblot Method (RIM) and help resolve some long-standing controversies regarding the clinical utility of the Rorschach. After discussing the unique challenges in studying the Rorschach and why research in this area is important given current trends in scientific and applied psychology, I offer 3 overarching principles to maximize the construct validity of RIM scores, arguing that (a) the method that provides RIM validation measures plays a key role in generating outcome predictions; (b) RIM variables should be linked with findings from neighboring subfields; and (c) rigorous RIM score validation includes both process-focused and outcome-focused assessments. I describe a 4-step strategy for optimal RIM score derivation (formulating hypotheses, delineating process links, generating outcome predictions, and establishing limiting conditions); and a 4-component template for RIM score validation (establishing basic psychometrics, documenting outcome-focused validity, assessing process-focused validity, and integrating outcome- and process-focused validity data). The proposed framework not only has the potential to enhance the validity and utility of the RIM, but might ultimately enable the RIM to become a model of test score validation for 21st-century personality assessment.

Abstract : “Why on earth would one use the Rorschach to assess disordered thinking?” was the almost Pavlovian reaction of the second author to the request to write this commentary. This uninformed response was markedly changed after reading the excellent contribution by Kleiger and Mihura (2021), as well as the research they cite. The authors convincingly argue for the reliability and validity of a set of Rorschach scales that assess thought disorder. Hence, we see no reason why one shouldn’t use these scales for this purpose. Apart from reliability and validity, the question “why use the Rorschach?” encompasses utility. This deserves attention if one wishes to convince new researchers and clinicians to start using the instrument. We will review current instruments for disordered thinking and communication and discuss the hypothet- ical (incremental) utility of the Rorschach in research and in clinical practice.

Abstract : No abstract available

Abstract : The rubber hand illusion paradigm allows investigating human body ownership by inducing an illusion of owning a life-sized fake hand. Despite the wide consensus on the fact that integration of multisensory signals is the main interpretative framework of the rubber hand illusion, increasing amount of data show that additional factors might contribute to the emergence of the illusion and, in turn, explain the strong inter-individual differences of the illusory patterns. Here, we explored whether and how personality features contribute to the emergence of the illusion by administering to healthy participants the rubber hand illusion paradigm along with two well known personality tests, i.e., the Personality Assessment Inventory (PAI) and the Rorschach test. Results showed that two Rorschach domains (i.e., “Perception and Thinking Problems” and “Self and Other Representation”) were positively correlated with the illusory mislocalization of the own left hand toward the fake hand. Further analyses suggested that while the tendency to perceive unconventionally is related to mislocalizing the own hand toward the fake hand, the association of the RHI index and other personality features measured by the Rorschach remain uncertain. However, our findings in general suggest that personality features might have a role in the emergence of the rubber hand illusion. This, in turn, could explain the high inter-individual variability of the illusory effects.

Abstract : In a 6-month longitudinal design, the authors examined the links between neediness and increases in depressive symptoms in women. Neediness was assessed with the self-report Depressive Experiences Questionnaire (DEQ), supplemented by a projective measure that assessed an important component of dependency, oral dependency, on the Rorschach. Results indicate that neediness correlated significantly with increases in depressive symptoms over the 6 months. Orality interacted with neediness to substantially increase the prediction of increases in depressive symptoms. (Bulletin of the Menninger Clinic,78[1], 16–33)

Abstract : We investigated the impact of ego depletion on selected Rorschach cognitive processing variables and self-reported affect states. Research indicates acts of effortful self-regulation transiently deplete a finite pool of cognitive resources, impairing performance on subsequent tasks requiring self-regulation. We predicted that relative to controls, ego-depleted participants’ Rorschach protocols would have more spontaneous reactivity to color, less cognitive sophistication, and more frequent logical lapses in visualization, whereas self-reports would reflect greater fatigue and less attentiveness. The hypotheses were partially supported; despite a surprising absence of self-reported differences, ego-depleted participants had Rorschach protocols with lower scores on two variables indicative of sophisticated combinatory thinking, as well as higher levels of color receptivity; they also had lower scores on a composite variable computed across all hypothesized markers of complexity. In addition, self-reported achievement striving moderated the effect of the experimental manipulation on color receptivity, and in the Depletion condition it was associated with greater attentiveness to the tasks, more color reactivity, and less global synthetic processing. Results are discussed with an emphasis on the response process, methodological limitations and strengths, implications for calculating refined Rorschach scores, and the value of using multiple methods in research and experimental paradigms to validate assessment measures.

Abstract : We examined associations among cognitive processing measures that varied on a continuum from maximum to typical performance tasks in the context of an ego depletion study. Our intent was to replicate and extend the findings of Charek, Meyer, and Mihura, which showed that ego depletion had an expected effect on selected scores from the Rorschach inkblot task. We hypothesized that Rorschach variables indicative of cognitive sophistication would correlate with neuropsychological measures of cognitive ability and that Rorschach variables theoretically unassociated with cognitive processing would not correlate with those criterion measures. These hypotheses were supported, providing evidence of convergent and discriminant validity. We also hypothesized ego depletion effects on all measures; however, none were evident. Methodological considerations and implications of the findings are discussed.

Abstract : The increasing obesity rates in the last decades pose a challenge to health care providers, and bariatric surgery is an important tool for treating severe obesity. Because various psychological factors are known to influence the long-term outcome of bariatric surgery and failure of bariatric surgery can lead to psychological harm, candidates for bariatric surgery usually undergo thorough psychological evaluations before being approved for surgery. However, the information obtained through these evaluations comes primarily from self-report measures, which are largely influenced by the ability and willingness of individuals to focus on and describe their own psychological characteristics. To examine the extent to which different assessment methods yield different psychological profiles of bariatric surgery-seeking patients, 50 patients with obesity(BMI=44.9±6.4 kg/m2) seeking bariatric surgery and 29 eutrophic controls (n=29; BMI=23.1±2.8 kg/m2) were administered: (a) some self-report measures assessing psychopathology and emotion regulation; (b) a maximal performance (neuropsychological) test; and (c) a typical performance (personality) test. Statistical analyses showed that when compared to the control group, patients with obesity self-reported lower levels of mental illness, although they showed poorer performance on the maximal performance test and increased defensiveness on the typical performance test. We conclude that the use of a multimethod approach and the assessment of positive response bias are crucial in pre-surgery evaluations.

Abstract : This article presents a Therapeutic Assessment case study of a 48-year-old Catholic nun who was evaluated for concerns related to recurrent depression, difficulty relating to others, trouble following through on tasks, and lack of self-care. Maria was given the Rorschach, MMPI-2-RF, Wartegg Drawing Completion Test, and Thurston Cradock Test of Shame (TCTS). Testing results suggested depression, problems regulating emotion, incongruence between external presentation and internal state, and impaired functional intelligence when negative emotions are triggered. Maria’s TCTS protocol indicated a tendency to deflate in the presence of shame or criticism. She used tentative language around emotion, did not access support, and struggled to resolve emotionally charged situations. The TCTS results appeared to access and explain Maria’s core difficulties. TCTS Cards 6 and 8 were selected for an assessment intervention session (AIS) designed to help Maria understand what she does with negative feelings. Maria was asked to tell a story focusing on the main character. Through half-steps and affective scaffolding, Maria identified how she “swallows” her negative feelings and “isolates” when emotions are strong. The authors discuss how the AIS helped Maria access her split-off affect, and understand its relation to her symptoms, poor self-care, impaired follow-through, and relational difficulties.

Abstract : Despite advances in neuroscience, the field of personality assessment has not yet taken full advantage of the progress in neuroimaging techniques. Functional Magnetic Resonance Imaging (fMRI) is one of the most widely used neuroimaging techniques and allows the detection of brain processes and their anatomically detailed correspondences. In the last fifteen years, few studies have developed research designs using the Rorschach test in fMRI settings, analyzing the relationship between Rorschach variables and brain neural circuits. Although their findings were promising, some methodological issues related to fMRI research design have been outlined. Recently, personality neuroscience is emerging as a new field of research that attempts to deepen and refine neurobiological and psychological theories of personality using fMRI in resting state conditions. Recent studies report that resting state networks show a direct relationship with psychological traits. The aim of the present article is to propose a new research design that employs resting-state functional connectivity analyses to explore the brain’s functional architecture in relation to psychological constructs of Rorschach variables related to perceptual styles and personality traits.

Abstract :

Abstract : The goal of this study was to examine the incremental validity and the clinical utility of the Minnesota Multiphasic Personality Inventory–2 (MMPI–2; (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and Rorschach (Rorschach, 1942) with regard to differential diagnosis in a sample of adult inpatients with a primary psychotic disorder or a primary mood disorder without psychotic features. Diagnostic efficiency statistics have suggested that the Rorschach Perceptual Thinking Index (PTI; Exner, 2000a, 2000b) was better than MMPI–2 scales in discriminating psychotic patients from nonpsychotic patients. We compared the 84% overall correct classification rate (OCC) for the PTI to an OCC of 70% for the MMPI–2 scales. Adding the MMPI–2 scales to the PTI resulted in a decrease in OCC of 1%, whereas adding the PTI to the MMPI–2 resulted in an increase in OCC of 14%. Sensitivity, specificity, positive predictive power, negative predictive power, and kappa were equal or higher with only the PTI in the model.

Abstract : The present study was undertaken to determine if the findings of Ales et al. (2020) could be replicated and extended, especially in light of the replication crisis in psychology and the social sciences. Ales et al. (2020) found that measures from the engagement and cognitive processing domain of the Rorschach performance assessment system (R-PAS) were associated with Eye Tracking variables that reflect cognitive engagement and effort. Notably, Complexity was associated with the number of fixations participants made while scanning the blots and Vg% was inversely associated with a participant’s average fixation durations. The present study utilized a non-clinical sample of60 adult participants. The basic findings of Ales et al. (2020) were replicated. In addition, we found that Complexity and Vg% are associated with additional Eye Tracking variables not utilized in the original study. The current findings bolster and extend the interpretation of Ales et al. (2020),indicating that higher levels of Complexity are also associated with scanning more regions of the blot overall, albeit at a slower rate. Similar effect size values were observed in the two different cultural contexts. Higher levels of Vg% are associated with measures indicating shallower and more superficial search strategies, consistent with the interpretation of Vg% as indicative of a vague, impressionistic, and unsophisticated cognitive style.

Abstract : The MMPI can be scored by a clerk. Also, both the number and form level of Rorschach responses can be easily assessed. Other Rorschach variables should be examined for their incremental validity beyond number of responses and form level, or from these variables plus simple MMPI variables. This study applied multiple regression analyses to 2 data sets with reasonable criteria of pathology that were predicted by W. Perry and D. J. Viglione's (1991) Ego Impairment Index considered alone. The index had only slight incremental validity over and above the number of responses and form quality, and even less when the average MMPI elevation and L. R. Goldberg's (1965) formula for predicting psychosis versus neurosis were entered before these Rorschach variables. Another way of assessing incremental validity is through the use of unit weights, that is, adding standardized variables weighted equally rather than optimally. The unit-weighted incremental validity analysis resulted in the same conclusions.

Abstract : It was hypothesized that field-independent Ss would produce more white space figure-ground reversal responses (S) on the Rorschach test than field-dependent Ss. From 27 females and 25 males given the rod-and-frame test the 7 most field-independent and the 7 most field-dependent took the Rorschach test. The 7 field-independent Ss produced more white space reversals. A control on the number of reversal responses as a function of time of exposure and a control on sex differences showed no contaminating effect. Thus, both measures may refer to the same dimension.

Abstract : Areh et al. (Psychiatry, Psychology and Law 29:183–205, 2022) recently commented on what standards should be applied to determine whether a test is appropriate for psycholegal use and concluded that the Rorschach does not meet their proposed standards. Accordingly, they concluded that psychologists should not use it in legal contexts. However, Areh et al.’s (2022) claims are based on a significant misunderstanding of how the Rorschach task works, relative neglect of the last 20 years of Rorschach research, unrealistic psychometric standards for assessing the reliability and validity of a psychological assessment measure, and a single European legal case in which a forensic expert used the Rorschach inappropriately. Our article seeks to clarify and correct some of their errors and misleading assertions. First, we clarify how the Rorschach task works according to more recent and widely accepted conceptualizations. Then, we show that Areh et al.’s (2022) position that Rorschach task data do not meet acceptable validity standards, especially when compared to medical tests, is empirically untenable. Next, we provide a detailed and nuanced account of what the Rorschach has to offer as a performance-based assessment method for forensic evaluators and the legal system, with attention paid to the anecdotal legal case Areh et al. (2022) highlighted. Finally, we provide four reasons why the Rorschach can be a useful tool for forensic mental health assessments when using the Rorschach Performance Assessment System (R-PAS).

Abstract : Brief and lengthy Rorschach records have been identified as common problems in protocol administration. Clinicians have debated how to prevent overly short and long records, but they have been reluctant to alter standardized administration for fear of introducing bias. The present study examines a nonintrusive method for constraining responses by prompting for an extra response when only one is offered per card and by removing the card after four responses are given. Among patients who typically produce brief records, consisting of a residential sample of civil and forensic patients with a range of disordered thinking, the alternative administration method demonstrated improved Comprehensive System validity in assessing thought disorder and eliminated the need to re-administer the test due to fewer than 14 responses. The findings have clinical implications for protocol administration with thought-disordered populations that typically produce brief records.

Abstract : There was an error reporting descriptive statistics and group comparisons for the Complexity variable in Table 2. All analyses in the study were conducted with the Complexity raw score as intended. However, the values reported in Table 2 were for a per response complexity score (i.e., the Complexity/R ratio). The correct values are given for the Complexity raw scores that should have been reported in Table 2.

Abstract : No abstract available

Abstract : The present study examined the relationship between the Rorschach Ego Impairment Index (EII) and psychiatric severity. Search procedures yielded 13 independent samples (total N = 1402, average n = 108, standard deviation = 90) for inclusion in the meta-analysis. Inter-rater reliability analyses demonstrated that coding of effect sizes and moderator variables was completed with good to excellent reliability. Results indicated that higher EII scores were associated with greater psychiatric severity, with an overall weighted effect size of r = 0.29, p = 0.000002 (95% confidence interval = 0.17–0.40), supporting the EII’s validity as a measure of psychological impairment. Publication bias analyses did not indicate any significant cause for concern regarding the results. The data were demonstrably heterogeneous (Q = 56.82, p = 0.0000001), and results of post-hoc tests indicated that effect sizes with dependent variables obtained via researcher ratings were significantly larger than any of the following: effect sizes with dependent variables obtained via clinician ratings, informant ratings, information about level of treatment or placement status or self-report ratings (p’s = 0.0005, 0.003, <0.001, <0.001, respectively). In addition, there was a trend for effect sizes based on performance-based measures to be larger than those based on information about level of treatment or placement status (p = 0.098) as well as those based on self-report measures (p = 0.076). Other moderator analyses were non-significant (p’s > 0.10).

Abstract : 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 non schizophrenic patients in a Serbian sample. The sample consisted of 211 (109 men and 102women, 18–50 years old) inpatients in Serbia who were divided into 2 groups: schizophrenic (100) and non schizophrenic (111). Test administration, coding, and form quality classification followed CS guidelines. Logistic regression analysis indicated that the new indexes TP–Comp and EII–3have 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.

Abstract : Extensive research demonstrates that the dimensional assessment of psychotic manifestations is a primary strength of the Rorschach inkblot task, which provides an in vivo sample of problem-solving behavior and normative standards concerning the logic and coherence of thought processes and the typicality of perceptual representations. This article presents foundational research for the Thought and Perception Assessment System (TPAS), a Rorschach-based system designed to assess solely for disordered thinking and perceptual aberrations using either the standard 10-card set of inkblots or alternative 3-, 4-, and 5-card short forms. Using data from three patient samples (ns = 61, 93, and 133) and one nonpatient sample (n = 118), we document the equivalence of mean scores across the full and short-form card sets. We also document satisfactory interrater reliability and validity for the full and short forms, as well as strong part-whole reliability coefficients between the short forms and the full form. Consistent with psychometric theory and the principle of aggregation, each type of coefficient decreased as a function of decreasing the number of cards. We discuss implications and future applications in research and clinical assessment.

Abstract :

Abstract : The Rorschach Performance Assessment System(R-PAS; Meyer et al. 2011) is a new system for administering, scoring, and interpreting the Rorschach Inkblot Test that is designed to make the best possible use of currently available scientific and clinical evidence. Many features of R-PAS are well-suited to forensic evaluation generally and to psychological evaluations in psychological injury cases in particular. Among them, R-PAS: (a) offers an alternative to self-report methods that adds incremental validity, (b) provides a useful check against exaggerated or minimized symptom presentation, (d) generates evidence concerning implicit traits and behavioral tendencies, (e) offers techniques for adjusting for abnormal response sets, (f) uses internationally applicable reference data that do not exaggerate or minimize pathology, (g) organizes results according to the strength of the evidence, and (h) presents results on which are interpretations are based in a manner easy for the intelligent layperson to grasp. Despite its recent for malintroduction to the professional assessment community, RPAS takes advantage of decades of research in peer reviewed publications (including the insights of Rorschach critics) and builds on established validity and general acceptance for most of its procedures and features. The article describes the standards and criteria applying to expert psychological testimony in U.S. federal and state courts and applies them to Rorschach-based testimony in general and R-PAS-based testimony specifically. It is argued that when the system is properly used and applied and when such testimony is appropriately formulated, it should be found admissible in both state and federal courtrooms.

Abstract : No abstract available

Abstract : Although the Rorschach is widely used in child custody evaluations, its contributions are often underestimated. As an evidence supported, performance-based method, it adds incremental validity to self-report findings. It yields insights about perceptual and coping styles, reality testing and logical thinking, emotional regulation and sensitivity, and relational schemas. Some evaluators hesitate to use the Rorschach due to concerns about reliability and validity, admissibility, and courtroom presentation. R-PAS, a relatively new Rorschach system, shows particular promise in addressing such concerns. It selects and organizes variables according to their degree of empirical support and clinical meaningfulness, uses internationally relevant, non pathologizing reference data, uses contemporary psychometric statistical methods, and presents results in a format that is easy for a court to understand.

Abstract : Gurley et al. (Psychological Injury and Law 7:9–17,2014) express reservations about the admissibility of testimony based on the Rorschach Performance Assessment System (RPAS)in court. They question whether there is sufficient evidentiary foundation in the underlying psychometrics and adequate general acceptance among psychologists for R-PAS-based testimony to meet either the Daubert or Frye criteria for admissibility and also raise doubts about how well it meets the criteria for the use of forensic tests proposed by Heilbrun (Law and Human Behavior 16:257–272, 1992). This invited comment addresses their concerns about the admissibility of R-PAS-based testimony and corrects some erroneous statements about the psychometrics of R-PAS and the pertinent empirical literature. Gurley et al. characterize R-PAS as being in competition with the established Comprehensive System (CS; Exner 2003), though we clarify that it is actually an evolutionary development from the CS and designed to be a replacement for it. We also point out how their conclusion that R-PAS-based forensic testimony may be hazardous or premature is based on an insufficient familiarity with the R-PAS scientific and professional literature, a misinterpretation of the Frye and Daubert evidentiary standards, and a mischaracterization of several of Heilbrun’s (Law and Human Behavior16:257–272, 1992) criteria for the use of tests in forensic testimony.

Abstract : This article reviews some of the basic elements of visual science, especially the concept of critical stimulus bits, as they apply to the Rorschach response process. Illustrations and data are presented to depict how stimulus features such as contour, position, color, and internal sets can be critical in encouraging or thwarting the selection of certain kinds of Rorschach answers. The findings are discussed in the context of detecting projected material in Rorschach answers.

Abstract : In this article, I highlight 3 major findings from current research in attachment, neurobiology, psychopathology, and psychotherapy: (a) attachment failures and early trauma are related to many forms of psychopathology, (b) one of the major sequelae of developmental trauma is disorganization of the right hemisphere, and (c) psychological interventions that promote emotional experience, awareness, and expression are more effective than those that rely solely on cognitive restructuring. I then suggest implications of these findings for the practice of psychological assessment: (a) the relationship between client and assessor is more important than has been acknowledged generally, (b) performance-based personality tests are very useful in part because they tap right-hemisphere and subcortical brain functioning and provide information that clients cannot directly report, and (c) when psychological assessments provide clients with powerful emotional experiences, therapeutic change is often the result. I illustrate these points with excerpts from the Therapeutic Assessment of a 27-year-old man with compulsive sexual behavior.

Abstract : Collaborative/Therapeutic Assessment (CTA; Finn, 2007) offers a person-centered approach to understanding clients’ problems through mutual engagement with the client’s experience of the data-gathering process. Key tenets of CTA include empowering the client to shape their own assessment questions and goals and connecting with the client in an empathic and meaningful manner. These tenets map onto the core domains of interpersonal theory – that is, agency and communion (Wiggins, 1996). Interpersonal theory can be utilized to conceptualize several different concerns that may arise through the client’s questions during CTA, such as their interpersonal traits, problems, sensitivities, and so on. The present article provides a case conceptualization that utilizes contemporary integrative interpersonal theory (CIIT; Pincus, 2005) to conceptualize an assessment client who presented with symptoms of depression, anxiety, and gastrointestinal problems. Through a multimethod assessment approach grounded in the CTA and CIIT frameworks, the assessor gained a deeper understanding of how the client’s presenting problems are tied to her interpersonal patterns. Finally, the present article explores how interpersonal processes that unfolded during the assessment sessions informed case conceptualization and treatment planning. The synthesis of CTA and CIIT offers promising avenues for new methods of understanding clients’ questions through the lens of interpersonal relationships.

Abstract : The Extended Aggression Scores were developed to quantify the aggressive Rorschach imagery produced by violent Antisocial Personality Disordered (ASPD; American Psychiatric Association, 1980) offenders. In this article we present information concerning the reliability, psychometric properties, and construct validity of the scores and discuss their clinical meanings. We conclude that while AgPotential, AgVulnerability and Sadomasochism need additional research, the current research supports inclusion of the more frequently appearing AgContent and AgPast scores in the Comprehensive System.

Abstract : This study examined whether a defensive response set during a psychological evaluation would skew responses on the Rorschach such that subjects could conceal psychological difficulties. Subjects in this study were commercial airline pilots who were required to undergo an independent psychological evaluation after completing a treatment program for alcohol or substance abuse. Subjects knew the results of the psychological evaluation would be taken into account by the Federal Aviation Administration and their employer when deciding whether to reinstate their pilots license and allowing them to return to work. Thus, subjects potentially had considerable incentive to attempt to create a favorable impression. As expected, subjects responded in a defensive manner, as assessed by standard Minnesota Multiphasic Personality Inventory (MMPI) validity scales. It was expected that a guarded, defensive response set would be manifested on the Rorschach by fewer than average responses, a constricted response style, and an attempt to appear conventional. It was also expected that no or few signs of difficulty would be produced on the Rorschach if subjects were successful in their efforts to create a favorable impression. In spite of defensive efforts to create a favorable impression, these subjects produced valid Rorschach protocols that suggested they experienced emotional distress, self-critical ideation, and difficulties in their interpersonal relationships, problems not reported on the MMPI, Implications of these findings for clinical practice.

Abstract : A call is issued for a moratorium on the use of the Rorschach Inkblot Test in clinical and forensic (but not research) settings. The moratorium should last until we have determined which Rorschach scores are valid and which ones are invalid. Unfortunately, for most Rorschach scores, results from meta-analyses have been uninformative. Also, incremental validity has not been studied for most Rorschach scores. Furthermore, positive findings for Rorschach scores have rarely been independently replicated. Finally, selective reporting of results has been a problem: Some investigators report significant results but not nonsignificant results. The magnitude of this problem has not been determined. Unless a moratorium is adopted, clinicians will continue to interpret invalid scores along with valid scores.

Abstract : Comments are made about the articles comprising the first round of the Special Series on the Rorschach. G. Strieker and J. R. Gold (1999) and D. J. Viglione (1999) praised the Rorschach, but they consistently failed to cite negative findings. R. M. Dawes (1999) obtained results that provide modest support for the Rorschach, but one of his data sets is flawed. J. B. Miller, R. Rosenthal, R. F. Bornstein, D. T. R. Berry, and S. Brunell-Neuleib (1999) reported the results of a meta-analysis, but, among other problems, their coders were not blind to the results of all the studies. J. Hunsley and J. M. Bailey (1999) made a strong case for concluding that there is no scientific basis for using the Rorschach. Recommendations are made for resolving the Rorschach controversy.

Abstract : Rorschach Form Quality (FQ) describes how well a response fits a given inkblot location and is derived from how frequently it is identified and whether raters judge it to be a good fit. A large body of research has established that FQ has excellent validity as a measure of reality testing and severity of psychological disturbance. However, some studies have reported sub-optimal interrater reliability (IRR). In this article we inspected 1588 responses from 60 archival Rorschach protocols. We examined the frequency with which FQ was Tabled (T), Extrapolated (E) or Judged (J), and tested the strength of the association of FQ determination path to FQ scores and IRR. Results showed that when compared to T responses, E and J responses were characterized by increasingly poorer FQ and less optimal IRR. Taken together, these results confirm that the determination path used to code FQ has a notable impact on the scoring accuracy and IRR of FQ. In order to reduce the FQ coding inconsistencies, the authors suggest that future R-PAS developments might try to incorporate computer algorithms to help with the attribution of FQ codes.

Abstract : N/A

Abstract : This study investigated the predictive validity of the ten Rorschach Performance Assessment System (R-PAS) variables from the Stress and Distress domain, by testing whether they predicted increased sympathetic reactivity to a mild, laboratory-induced stress, occurred one week after Rorschach administration. A relatively small student sample (N = 52) contributed to this research: During a first meeting (T1) participants were administered the Rorschach task according to R-PAS guidelines; about one week later (T2) their electrodermal activity (EDA) was recorded during exposure to a mild laboratory stress-inducing task. Based on literature indicating that exposure to stress tends to increase physiological vulnerability/reactivity to stressful situations, we anticipated that Stress and Distress R-PAS variables measured at T1 would positively correlate with increased sympathetic reactivity to stress at T2, as indicated by greater EDA changes from baseline to stress and recovery. Results partially confirmed our hypotheses: The (a) the mean of and (b) the majority of the Stress and Distress R-PAS variables were significantly correlated, in the expected direction, with medium and medium to large effect sizes.

Abstract : The mirror neuron system (MNS) is considered the best explanation for the neural basis of embodied simulation. To date no study has investigated if it may be activated not only by actual but by the “feeling of movement”. The Rorschach test cards were used to investigate evidence of EEGmu wave suppression at central areas, an index of MNSactivity, since human movement responses (M) to the Rorschach elicit such feelings of movement. Nineteen healthy volunteers observed different sets of Rorschach stimuli during attribution, identification, and observation of human movements and different scenarios while their EEG were recorded. Significant mu suppression occurred when subjects perceived movement, regardless of the experimental condition. These results show that mirroring can be activated by static, ambiguous stimuli such as Rorschach cards, suggesting that internal representation of the “feeling of movement” may be sufficient to trigger MNS activity even when minimal external cues are present.

Abstract : 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 D 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.

Abstract : This article introduces a new scientific paradigm that might allow the investigation of the neurological correlates of the Rorschach test without using expensive and time consuming tools such as the fMRI or the EEG. Based on the literature on the Mozart effect, we anticipated that preactivation of a given brain network before exposure to the Rorschach cards would associate with the increased production of responses (or determinants) presumed to be associated with that same network. To pilot test this hypothesis, we focused on the postulated link between human movement (M) responses and mirror neuron system (MNS) activity, and investigated whether preactivation of the MNS would associate with the increased production of M responses. Specifically, 30 students were administered a subset of Rorschach cards immediately after watching three short videos aimed at activating the MNS at three different levels (no/low/high activation). Although no statistically significant differences among the three conditions were found, a linear trend in the expected direction (p = .107), with medium effect size (?² = .087) was observed. In addition to providing information on the M response, this article introduces a new scientific paradigm to investigate the neurological correlates of the Rorschach.

Abstract : This article offers a new methodological approach to investigate the degree of fit between an independent sample and 2 existing sets of norms. Specifically, with a new adaptation of a Bayesian method, we developed a user-friendly procedure to compare the mean values of a given sample to those of 2 different sets of Rorschach norms. To illustrate our technique, we used a small, U.S. community sample of 80 adults and tested whether it resembled more closely the standard Comprehensive System norms (CS 600; Exner, 2003), or a recently introduced, internationally based set of Rorschach norms (Meyer, Erdberg, & Shaffer, 2007). Strengths and limitations of this new statistical technique are discussed.

Abstract : It has been suggested that the Rorschach human movement (M) response could be associated with an embodied simulation mechanism mediated by the mirror neuron system (MNS). To date, evidence for this hypothesis comes from two electroencephalogram studies and one repetitive transcranial magnetic stimulation study. To provide additional data on this topic, the Rorschach was administered during fMRI to a sample of 26 healthy adult volunteers. Activity in MNSrelated brain areas temporally associated with M responses was compared with such activity for other, non-M Rorschach responses. Data analyses focused on MNS regions of interest identified by Neurosynth, a web-based platform for large scale, automated meta-analysis of fMRI data. Consistent with the hypothesis that M responses involve embodied simulation and MNS activity, univariate region of interest analyses showed that production of M responses associated with significantly greater activity in MNS-related brain areas when compared with non-M Rorschach responses. This finding is consistent with the traditional interpretation of the M code.

Abstract : We introduce the concept of “neurobiological foundation” of Rorschach interpretations as an extension of the concept of behavioral representation as a foundation for interpretation of R-PAS variables. Here, we propose that if there is a parallelism between the mental, verbal and perceptual behaviors occurring within the microcosm of the Rorschach task and those occurring in the external environment [behavioral foundation], then the same brain regions engaged by the test-taker when producing of a given code, should be engaged also when reproducing, in the external environment, the same psychological processes underlying that specific Rorschach code [neurobiological foundation]. To investigate this concept, we used archival, fMRI data and tested whether producing Oral Dependency Language (ODL) responses would associate with increased activation in brain regions associated with dependency related, psychological processes. Results from a sample of 21 non-clinical volunteers partially confirmed our hypothesis, providing some support to the neurobiological foundation of the ODL code.

Abstract : Recently, a lot of effort has been made to ground Rorschach interpretations to their evidence base. To date, however, no studies have yet described, via fMRI, what brain areas get involved when one takes the Rorschach. To fill this gap in the literature, we administered the ten-inkblot stimuli to 26 healthy volunteers during fMRI. Analysis of BOLD signals revealed that, compared to fixating a cross, looking at the Rorschach inkblots while thinking of what they might be associated with higher temporo-occipital and fronto-parietal activations, and with greater activity in some small, sub-cortical regions included in the limbic system. These findings are in line with the traditional conceptualization of the test, as they suggest that taking the Rorschach involves (a) high-level visual processing, (b) top-down as well as bottom-up attentional processes, and (c) perception and processing of emotions and emotional memories.

Abstract : It has been suggested that the Rorschach human movement (M) response could be associated with an embodied simulation mechanism mediated by the mirror neuron system (MNS). To date, evidence for this hypothesis comes from two electroencephalogram studies and one repetitive transcranial magnetic stimulation study. To provide additional data on this topic, the Rorschach was administered during fMRI to a sample of 26 healthy adult volunteers. Activity in MNS-related brain areas temporally associated with M responses was compared with such activity for other, non-M Rorschach responses. Data analyses focused on MNS regions of interest identified by Neurosynth, a web-based platform for large scale, automated meta-analysis of fMRI data. Consistent with the hypothesis that M responses involve embodied simulation and MNS activity, univariate region of interest analyses showed that production of M responses associated with significantly greater activity in MNS-related brain areas when compared with non-M Rorschach responses. This finding is consistent with the traditional interpretation of the M code.

Abstract : The Mutuality of Autonomy scale (MA) is a Rorschach variable designed to capture the degree to which individuals mentally represent self and other as mutually autonomous versus pathologically destructive (Urist, 1977). Discussions of the MA’s validity found in articles and chapters usually claim good support, which we evaluated by a systematic review and meta-analysis of its construct validity. Overall, in a random effects analysis across 24 samples (N = 1,801) and 91 effect sizes, the MA scale was found to maintain a relationship of r = .20, 95% CI [.16, .25], with relevant validity criteria. We hypothesized that MA summary scores that aggregate more MA response-level data would maintain the strongest relationship with relevant validity criteria. Results supported this hypothesis (aggregated scoring method: r = .24, k = 57, S = 24; non aggregated scoring methods: r =.15, k =34, S=10; p=.039, 2-tailed). Across 7 exploratory moderator analyses, only 1 (criterion method) produced significant results. Criteria derived from the Thematic Apperception Test produced smaller effects than clinician ratings, diagnostic differentiation, and self-attributed characteristics; criteria derived from observer reports produced smaller effects than clinician ratings and self-attributed characteristics. Implications of the study’s findings are discussed in terms of both research and clinical work.

Abstract : We evaluate 11 Rorschach variables with potential for assessing grandiosity and narcissism. Seven of these variables were drawn from previous literature: Omnipotence, Idealization, Reflection, Personal Knowledge Justification, Exhibitionism, Magic, and Elevated Mood States; four were developed for this research: Expanded Personal Reference, Narcissistic Devaluation, Narcissistic Deflation, and Narcissistic Denial. Using Rorschach protocols from American normative adults and Italian adult outpatients, the dimensional structure of these variables was evaluated by principal components analysis, and validity was tested by correlations with clinician ratings of narcissism on two scales from the Shedler–Westen Assessment Procedure–200 that were made after at least five sessions with the primary clinician. A cohesive dimension was found in both data sets defined by Expanded Personal Reference, Personal Knowledge Justification, Omnipotence, and Idealization, and it was meaningfully correlated with the clinician ratings of narcissism (M r = .41). Implications of the findings include the applicability of these variables in clinical practice and research for assessing narcissistic personality dynamics.

Abstract : We used self-reported narcissistic grandiosity and vulnerability and a component derived from 11 potential grandiosity and narcissism variables (GNVs) coded from Rorschach behavior to predict fluctuations in self-esteem and their links to anger and defensive reactions. We assessed state mood, state self-esteem, and performance attributions in 105 college students who underwent a self-esteem manipulation involving success followed by failure on cognitive testing. Self-reported grandiosity predicted the disavowal of effortful ability as a factor in failure, but we did not replicate other previously reported findings for this variable. Self-reported vulnerability predicted oscillations in self-reported mood and self-esteem. The GNV scale predicted spontaneously expressed hostility and externalization following self-esteem insult, and attributions mediated its relationship with anger expressed after failure. We discuss implications of these results and recommend additional replication research.

Abstract : The temporal stabilities of the Rorschach method scoring systems were investigated. A comprehensive literature search was conducted to find all test-retest studies, both regular and from control samples in therapy evaluation studies. Meta-analyses were conducted for samples, individual entries, and variables in 36 samples. Separate analyses were made for 10 samples using the Comprehensive System (CS; Exner, 1993). The temporal stability was high, especially those obtained from regression model predictions. The CS consistently shows higher stability than other systems, whereas increasing retest intervals leads to decreasing stability. Shortcomings of the available studies are highlighted and discussed, and recommendations are given for design and methodology.

Abstract : I examined Rorschach assessment of personality changes following psychotherapy. I conducted a comprehensive literature search to find all studies using the Rorschach method at least twice for the same participant in connection with psychotherapy. I conducted meta-analyses for 38 samples, and I performed regression analyses to identify moderating factors. Across all Rorschach scores, the total weighted sample effect size was r = .26, and nearly half the variables obtained effect sizes higher than .30. Several moderating factors were found. Most important, effect sizes increased with longer and more intensive therapy. More concern for interscorer reliability was associated with larger effect sizes, whereas a higher degree of scorer blinding was associated with smaller effect size magnitudes. Predicted levels of change based on the regression models indicated substantial increases in effect size with longer therapies. The data indicate that many elements in the Rorschach are valid indicators of change despite the poor reputation the method has acquired within psychotherapy research.

Abstract : Five predicted relationships between age and intellectual level and 16 Rorschach variables were examined through a cross-sectional analysis of 47 healthy, community-dwelling elderly men and women. Subjects were compared by age and intellectual level using gender, level of medication, and scores on the Geriatric Depression Scale (GDS) and the Geriatric Social Readjustment Questionnaire (GSRQ) as covariates. Screening tests for psychiatric and physical illness, recent life events, and hearing and vision loss were administered. In contrast to prior research suggesting changes in Rorschach scores with differences in age and intellectual level, only one significant difference was found for these variables. The data suggest that age and intellectual level may contribute less to Rorschach responses than was previously thought.

Abstract : Este trabalho teve como objetivo comparar o desempenho no Teste de Rorschach (R-PAS), de pessoas instruídas sobre os sintomas da esquizofrenia e solicitadas a responder ao Rorschach, tentando se passar por um paciente com esse diagnóstico (n=40), com o de pacientes diagnosticados com esquizofrenia (n=35). Os participantes responderam ao Teste de Rorschach (R-PAS), a Magical Ideation Scale (MIS) e ao Inventory of Problems-29 (IOP-29) tentando simular esquizofrenia. Os resultados das comparações entre os grupos evidenciaram diferenças estatisticamente significativas para as variáveis (Hd), An, FQo, FQu, FQ-, P, M, PEC, WSumCog, MAH, GHR e Complexity. Encontrou-se também associação positiva e de forte magnitude entre os escores obtidos no IOP-29 e os escores brutos da MIS (r=0,73, p=0,0001). Os achados evidenciaram que, mesmo diante das tentativas de distorção das respostas ao teste, simuladores não conseguem distanciar da própria precisão perceptiva.

Abstract : Abstract The admissibility of the Rorschach has been a concern of forensic psychologists for many years. The focus of this debate has been the Comprehensive System, which is the most researched of the current Rorschach Systems available in the USA. However, recently, a new, competing system has been published: the Rorschach Performance Assessment System (R-PAS; Meyer et al., Rorschach Performance Assessment System: Administration, Coding, Interpretation, and Technical Manual, 2011). Using Heilbrun’s (Law and Human Behavior 16:257–272, 1992) guidelines as a framework, we examine the admissibility of this new system according to the standards outlined in Daubert (1993) and Frye (1923). We conclude that we have reservations about the admissibility of the R-PAS in court at the present time, notwithstanding ongoing work on this system.

Abstract : This case study used test data from a patient with Dissociative Identity Disorder (DID; American Psychiatric Association, 2013) to illustrate how two main personality states of the patient (“Ann” and “Ben”) seemed to function. The Rorschach Performance Assessment System (R–PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011) and the Inventory of Interpersonal Problems–Circumplex (IIP–64; Horowitz, Alden, Wiggins, & Pincus, 2000), administered to Ann and Ben in separate settings, exposed two diverse R–PAS and IIP–64 profiles. Ann’s R–PAS profile suggested an intellectualized style of information processing with few indications of psychological problems. Ben’s profile indicated severe perceptual, cognitive, and interpersonal difficulties combined with suspicion and anxiety. Ann’s IIP–64 profile suggested minor interpersonal problems, whereas Ben’s indicated serious relational difficulties. The findings were discussed in relation to the theory of trauma-related structural dissociation of the personality (van der Hart, Nijenhuis, & Steele, 2006), which implies an enduring split in the organization of the personality with more or less separate entities with their own sense of self, perception of the world, and ways of organizing emotional, cognitive, and social functions. The DID personality structure is seen as a defense strategy and as a pathway in the personality development producing serious psychological pain and symptoms.

Abstract : We tested 140 male candidates at the Naval Special Forces (NFS) of Norway on the Rorschach (Exner, 2003; Rorschach, 1921/1942) and the Norwegian version of the Big Five personality dimensions (Engvik & Føllesdal, 2005). Rorschach variables significantly correlated with training completion (effect sizes of re = .14–.25), whereas none of the Big Five factors or facets did. The combination of Rorschach and Big Five variables framed in the illusory mental health concept provided strong predictive ability. Testing under stress produced slightly higher predictive validity coefficients between the Rorschach variables and pass–fail than under calm testing. The findings support the results of Hartmann, Sunde, Kristensen, and Martinussen (2003), indicating that Rorschach variables and indications of good mental health may be valid predictors of NFS training.

Abstract : To examine the impact of Internet-based information about how to simulate being mentally healthy on the Rorschach (Exner, 2003) and the MMPI–2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), 87 psychiatric outpatients completed the tests under 4 conditions: uncoached and Internet-coached outpatients under faking healthy instructions (faking patients and Internet-faking patients) and patients and nonpatients under standard instructions (standard patients and standard nonpatients). On the Rorschach, faking patients and Internet-faking patients did not manage to portray healthy test performance and, like standard patients, revealed a significantly greater number of perceptual and cognitive disturbances than standard nonpatients. Faking patients scored in the psychopathological direction on most variables. Internet-faking patients produced constricted protocols with significantly higher F% (57%) and lower use of provoking and aggressive contents than the other groups. On the MMPI–2, faking patients and Internet-faking patients were able to conceal symptoms and, like standard nonpatients, scored in the normal range on the clinical scales. The validity scale L successfully detected the faking patients and the Internet-faking patients, whereas the F scale only distinguished the Internet-faking patients and K only the faking patients. We conclude that Internet-based information could threaten test validity.

Abstract : We examined discriminant and convergent validity of theoretically relevant Rorschach Comprehensive System (CS) variables (Exner, 2003) and Meloy and Gacono’s (1992) aggression variables in distinguishing between imprisoned violent offenders (VO) who were psychopathic (P–VO) and non psychopathic (NP–VO) under psychiatric treatment, schizophrenic inpatients (ISs), and university students (USs). A total of 7 of 12 variables discriminated significantly between P–VO and NP–VO, which suggests more aggressive, cognitive, and interpersonal disturbances among P–VO. We also found significant differences between VOs, ISs, and USs. Logistic regression analyses revealed that AgPast accumulated incrementally in the classification of P–VO versus NP–VO, and AgC accumulated incrementally in the classification of VO versus IS when entered after CS variables. The findings support the view that psychopathy is a distinctive form of antisocial personality disorder (Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association, 1994) organized at a more severe pathological level.

Abstract : This study investigates the reliability, validity, and diagnostic efficiency of the Rorschach Perceptual-Thinking Index (PTI) in relation to the accurate identification of psychotic disorder (PTD) patients. The PTI is a revision of the Rorschach Schizophrenia Index (SCZI), designed to achieve several criteria, including an increase in the diagnostic utility of the Rorschach for assessing thought disorder and to increase clinical focus on the dimensional aspects of impaired perceptions and thoughts (Exner, 2000a; 2000b). Seventy-eight patients who met DSM-IV criteria for a PTD or Axis II disorder [PTD = 33; borderline personality disorder (BPD) = 23; cluster A personality disorders (CA) = 9; cluster C personality disorders (CC) = 13] and 40 non-patients were compared on the PTI. The results of this study indicate that the PTI can be reliably scored and is internally consistent. In addition, the PTI can be used to effectively differentiate PTD patients from a non-patient sample as well as from personality disorder patients characterized by moderate to, at times, severe perceptual thought disorder. Finally, the PTI can also be employed for classification purposes in ways that are clinically meaningful in the diagnosis of a psychotic disorder. Conceptual and methodological issues are discussed in relation to the assessment of psychosis.

Abstract : Growing evidence supporting the effectiveness of Collaborative/Therapeutic Assessment (C/TA) has led clinicians and researchers to apply C/TA to a variety of clinical populations and treatment settings. This case example presents a C/TA inpatient adaptation illustrated with narcissistic personality disorder. After a brief overview of salient concepts, I provide a detailed account of the clinical interview, test interpretation paired with diagnostic considerations specific to narcissism, planned intervention, and discussion of assessment results. Throughout the case study, I attempt to demonstrate defining features of C/TA, inpatient adaptations, and clinical techniques that encourage meaningful engagement with a “hard to reach” personality.

Abstract : In this article, we describe the impact of Rorschach (Exner, 2003) card rotation and orientation preference on reflection responses. We anticipated exposure to sideways-orientated cards would facilitate landscape-type reflections, particularly for cards people find appealing to view sideways. When we examined 4 experimental conditions using an undergraduate sample, results in Experiments 1 (n = 123) and 2 (n = 38) showed that viewing the cards sideways produced a large increase in reflections. In Experiment 3 (n = 69), we examined preferences to view each card in a particular orientation. Cards producing higher rates of landscape reflections in the experimental conditions that encouraged turning were strongly correlated with preferences to view those cards sideways. The results imply reflections are in part a function of stimulus properties from viewing the card in a rotated orientation and not just the personal characteristics of the test taker.

Abstract : Controlling the number of Rorschach responses (R) as a method to reduce variability in the length of records has stimulated controversy among researchers for many years. Recently, the Rorschach Performance Assessment System (R–PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011) introduced an R-Optimized method to reduce variability in R. Using 4 published and 2 previously unpublished studies (N = 713), we examine the extent to which 51 Comprehensive System–based scores on the R–PAS profile pages are affected as a result of receiving Comprehensive System (CS; Exner, 2003) administration versus a version of R-Optimized administration. As hypothesized, R—the intended target of R-Optimized administration—showed reliable weighted average differences across each method of administration. As expected, its mean modestly increased and its standard deviation notably decreased. Also as hypothesized, the next largest effects were decreases in the variability (SD) of 2 variables directly related to R, R8910% and Complexity. No other reliable differences were observed. Therefore, because R-Optimized administration does not notably modify the existing CS-based normative values for other profiled R–PAS variables, the data do not support concerns that R-Optimized administration notably modifies the Rorschach task or that existing CS research data would not generalize to R–PAS. However, because R-Optimized administration reduces variability in R, it allows a single set of norms to apply readily to more people.

Abstract : In the previous Special Section, the authors presented empirical evidence and logical analysis that were sufficient to demonstrate that the widespread use of the Rorschach in clinical, legal, forensic, and occupational settings is unwarranted on both scientific and ethical grounds (J. Hunsley and J. M. Bailey, see record [rid]1999-11130-004[/rid]). To expand on their analysis and to respond to issues raised in the previous and current Special Sections, they begin their article by examining a number of conceptual issues that are at the heart of the disagreements about the Rorschach. The focus is then shifted to the central issue of clinical utility, with an emphasis on why current research is insufficient to demonstrate the utility of the Rorschach. Next, the psychometric issues raised by I. B. Weiner (see record [rid]2001-05665-002[/rid]) are addressed and an alternative perspective on the psychometric viability of the Rorschach is provided. Finally, the authors conclude with some suggestions for future directions that must be taken in research to address the substantive concerns raised by Rorschach critics.

Abstract : First responders are generally a high-risk group, repeatedly exposed to traumatic and distressing scenes and events on their daily duties. Identification of detailed features and recurring patterns of intrusive visual imagery for first responders with posttraumatic stress disorder (PTSD) can uncover the psychological difficulties, defenses, and further adjustment issues of occupational groups exposed to repetitive trauma. To this end, 20 Rorschach protocols for Korean first responders with PTSD symptoms were collected and analyzed. The analysis of the Rorschach records was twofold. First, the structural features of the Rorschach responses, including R and the Trauma Content Index, were examined quantitatively. Second, the detailed features of the morbid content, such as thematic classification, trauma memory responses, and emotional reactions, were qualitatively reviewed. Both analyses identified a biphasic pattern between constricted and flooded responses, showing the participants’ unsuccessful endeavors to defend against intrusive trauma-related imagery, which resulted in significant disorganization in thought and affect.

Abstract : In order to investigate the effects of color stimuli of the Rorschach inkblot method (RIM), the cerebral activity of 40 participants with no history of neurological or psychiatric illness was scanned while they engaged in the Rorschach task. A scanned image of the ten RIM inkblots was projected onto a screen in the MRI scanner. Cerebral activation in response to five achromatic color cards and five chromatic cards were compared. As a result, a significant increase in brain activity was observed in bilateral visual areas V2 and V3, parietooccipital junctions, pulvinars, right superior temporal gyrus, and left premotor cortex for achromatic color cards (p < .001). For the cards with chromatic color, significant increase in brain activity was observed in left visual area V4 and left orbitofrontal cortex (p < .001). Furthermore, a conjoint analysis revealed various regions were activated in responding to the RIM. The neuropsychological underpinnings of the response process, as described by Acklin and Wu-Holt (1996), were largely confirmed.

Abstract : This study clarifies the psychological basis for the linkage between adult attachment and the texture response on the Rorschach by examining the mediational role of the accessibility of tactile knowledge. Japanese undergraduate students (n D 35) completed the Rorschach Inkblot Method, the Experiences in Close Relationship Scale for General Objects (Nakao & Kato, 2004) and a lexical decision task designed to measure the accessibility of tactile knowledge. A mediation analysis revealed that the accessibility of tactile knowledge partially mediates the association between attachment anxiety and the texture response. These results suggest that our hypothetical model focusing on the response process provides a possible explanation of the relationship between the texture response and adult attachment.

Abstract : Recent progress in neuroscience has made it possible to use neurophysiological techniques to validate and deepen the interpretation of Rorschach variables. The aim of this article is to review the results from Rorschach studies using the neurophysiological approach to discuss the consistencies and inconsistencies between the different results, and then to consider the future direction of Rorschach research in this area. We also provide unpublished data to complement the picture from peer-reviewed studies. Two main approaches to neuropsychological studies on the Rorschach exist. One approach is to measure brain activities directly during the Rorschach administration; a series of studies using multiple neurophysiological methods revealed activation of the mirror neuron system with relation to human movement responses. Another possible approach is to investigate whether individual differences in Rorschach scores can be explained by neurophysiological measurements during the administration of another psychological task. This article reviews how these two approaches provide novel insights into the Rorschach Test.

Abstract : It has been suggested that the posterior medial prefrontal cortex (pMPFC) implements cognitive functions involved during negative feedback processing. It has also been suggested that the presentation of the feedback elicits emotional processes. This functional MRI study examined whether pMPFC was associated with the emotional component in feedback processing. Participants were exposed to feedback while performing a version of a motion prediction task. The pMPFC was activated during negative feedback presentation and emotion-related activity was extracted from the pMPFC activation through parametric imaging analysis. It was found that the emotional pMPFC activity was greater in participants who scored higher on depressive mood scales. The results suggest that pMPFC also implements feedback-related emotional functions, which individually vary depending on depressive moods.

Abstract : Objective: Theoretical conceptualizations of interpersonal dependency and dependent personality disorder suggest that (a) high levels of dependency in parents may increase risk for perpetration of child abuse and neglect and (b) children who are victimized may show elevated levels of dependency later in life. This study used meta-analytic techniques to examine these hypothesized links. Method: A systematic search of psychological and medical online databases revealed 14 published studies (21 effect sizes) examining the link between parental dependency and perpetration of abuse or neglect (overall N of perpetrators = 1,321), and 14 published studies (25 effect sizes) assessing dependency in victims of child abuse and neglect (overall N of victims = 38,265). Results: The dependency-abuse effect size (d) for perpetrators collapsed across all moderating variables was 0.36, which is considered to be in the medium range. The dependency-victimization effect size (d) collapsed across all moderating variables was 0.29, also a medium effect size. Conclusion: These results support and extend analyses of the relationship between dependency and child maltreatment, and suggest that dependency may be both a precipitant of child maltreatment and consequence of victimization. Theoretical and clinical implications are discussed, with suggestions for further research outlined.

Abstract : We examined the structure of 9 Rorschach variables related to hostility and aggression (Aggressive Movement, Morbid, Primary Process Aggression, Secondary Process Aggression, Aggressive Content, Aggressive Past, Strong Hostility, Lesser Hostility) in a sample of medical students (N = 225) from the Johns Hopkins Precursors Study (The Johns Hopkins University, 1999). Principal components analysis revealed2 dimensions accounting for 58% of the total variance. These dimensions extended previous findings for a 2-component model of Rorschach aggressive imagery that had been identified using just 5 or 6 marker variables (Baity & Hilsenroth, 1999; Liebman, Porcerelli, & Abell, 2005).In light of this evidence, we draw an empirical link between the historical research literature and current studies of Rorschach aggression and hostility that helps organize their findings. We also offer suggestions for condensing the array of aggression-related measures to simplify Rorschach aggression scoring.

Abstract : It is a rare opportunity to be able to comment on four articles written by four leading personality assessment researchers and scholars focusing on the cutting edge developments in the science and practice of Rorschach assessment. We will first address Meyer & Eblin’s article that provides a succinct yet comprehensive overview of the Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). We will then address Erard’s article that focuses on the application of R-PAS in forensic psychology and makes a compelling argument about the admissibility of the R-PAS under both the Frye and Daubert Standards. We will then comment on Viglione, Towns, and Dawn’s article that discusses the unique contribution of the Rorschach method in the assessment of psychological trauma. We conclude by commenting on Mihura’s article in which she convincingly argues for the advantage of incorporating a performance-based measure of personality to the self-report method of assessment in clinical and forensic psychological evaluations. We will focus our comments on issues related to forensic psychological evaluation and to personal injury assessment in particular.

Abstract : We investigated how scores from the Rorschach task and self-reports of psychotic-like disturbance distinguish individuals attempting to appear insane (i.e., feigning) from patients with psychotic disturbances or nonpatient controls. We also evaluated whether Rorschach scores provide incremental validity over self-reported symptoms. The study used 50 nonpatients asked to feign (F; age M?=?19.5, SD?=?1.5), 88 incarcerated forensic inpatients deemed not guilty by reason of insanity or incompetent to stand trial (P; age M?=?40.8, SD?=?13.5), and 47 standard nonpatient controls (S; age M?=?19.8, SD?=?2.2). Participants responded to the Rorschach Performance Assessment System (R-PAS), the Magical Ideation Scale (MIS), and the Perceptual Aberration Scale (PAS). We compared each pair of groups (i.e., F vs. P, P vs. S, and F vs. S) with separate predetermined hypotheses addressing the multimethod assessment of feigning or psychosis and ran logistic regressions including Rorschach and self-reported scores to predict group membership (e.g., F vs. P). Primary analyses found validity for Critical Contents and a revised version of it, the Thought and Perception Composite (TP-Comp), a variable we call Breaking the Card Boundary (BCB), and self-reported symptoms. In supplementary analyses, we document validity for subcomponents of TP-Comp alone and in combination with BCB. We also found it was easier to feign self-reported symptoms than R-PAS assessed characteristics and that R-PAS variables had incremental validity over self-reports on the MIS-PAS. Finally, we note limitations and suggest future paths, such as evaluating the generalizability of the results when considering attempts to feign severe mental illness on the trauma spectrum and creating a feigning composite using cross-validated logistic regression equations.

Abstract : The Rorschach Performance Assessment System (R–PAS) aims to provide an evidence-based approach to administration, coding, and interpretation of the Rorschach Inkblot Method (RIM). R–PAS analyzes individualized communications given by respondents to each card to code a wide pool of possible variables. Due to the large number of possible codes that can be assigned to these responses, it is important to consider the concordance rates among different assessors. This study investigated interrater reliability for R–PAS protocols. Data were analyzed from a nonpatient convenience sample of 50 participants who were recruited through networking, local marketing, and advertising efforts from January 2013 through October 2014. Blind recoding was used and discrepancies between the initial and blind coders’ ratings were analyzed for each variable with SPSS yielding percent agreement and intraclass correlation values. Data for Location, Space, Contents, Synthesis, Vague, Pairs, Form Quality, Populars, Determinants, and Cognitive and Thematic codes are presented. Rates of agreement for 1,168 responses were higher for more simplistic coding (e.g., Location), whereas agreement was lower for more complex codes (e.g., Cognitive and Thematic codes). Overall, concordance rates achieved good to excellent agreement. Results suggest R–PAS is an effective method with high interrater reliability supporting its empirical basis.

Abstract : In our original article, we computed and reported interrater reliability using intraclass correlations (ICCs). We subsequently discovered that instead of the average measure ICCs that we reported, we should have been reporting single measure ICCs. Because average measure ICCs are always higher than single measure ICCs, the interrater reliability values we reported are inflated. In addition, technically, dichotomous decisions like those in our study are typically calculated using the kappa coefficient. Although kappa will return results virtually identical to single measure ICCs, we decided to report a statistic that is more familiar to readers for dichotomous decisions in interrater reliability. We thank Joni L. Mihura for her very valuable assistance in correcting these results.

Abstract : The Rorschach Performance Assessment System (R-PAS) was introduced in 2011 as an alternative to Exner’s Comprehensive System (CS). This article critically evaluates the contemporary use of the R-PAS in forensic contexts. The standing of the R-PAS in relation to relevant legal standards, professional guidelines, and published professional models is considered. Normative reference data, revised administration procedures, and general acceptance are discussed, and questions surrounding the comparability of the R-PAS to the CS are explored. Historical transitions to revised versions of existing assessment procedures are reviewed with particular attention to the recurrent question of comparability and how such concerns were addressed. Although the R-PAS shows signi?cant promise, fully adopting it into current forensic practice may be premature.

Abstract : 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.

Abstract : In its first 100 years, the Rorschach has been heralded as a valuable method for investigating disturbances in thought organization and reasoning. It has survived periods of intense scrutiny and criticism, as contemporary researchers continued to demonstrate the empirical validity of the Rorschach as a measure of disordered thinking (Mihura et al., 2013). It is fitting to mark the centenary of Rorschach’s “experiment” by summarizing contemporary contributions of the Rorschach Performance Assessment System (R-PAS) and reviewing the empirical and conceptual bases for using the inkblots to assess disordered thinking and communication.

Abstract : The aim of this study was to contribute to differential diagnoses of unipolar and bipolar depression using cognitive variables of the Rorschach test (Comprehensive System).

Abstract : The Rorschach Inkblot Method (RIM) is a performance-based personality assessment instrument used in both clinical and research settings worldwide. This investigation examines response-level, interrater reliability of U.S. graduate students enrolled in the same doctoral program and divided into two unique participant groups: 20 of those with previous Comprehensive System (CS) training background who are now trained in Rorschach Performance Assessment System (R-PAS; initial coders N = 11, blind coders N = 9), and 19 of those trained solely with R-PAS (initial coders N = 10, blind coders N = 9). Trainees’ coding was analyzed based on a sample of 50 protocols (half per group) representing a total of 1,189 responses. Blind coding was used among trainees and coding between the two investigated training groups was analyzed for each variable at the response level and expressed as percent agreement, Gwet's AC, and kappa values. Rates of agreement between the trainees were similar across both groups, and most of the concordance rates can be characterized as excellent. Overall, these results suggest that trainees may learn how to code R-PAS variables with similar reliability levels whether or not they had prior CS knowledge.

Abstract : Although projective techniques continue to be widely used in clinical and forensic settings, their scientific status remains highly controversial In this monograph, we review the current state of the literature concerning the psychometric properties (norms, reliability, validity, incremental validity, treatment utility) of three major projective instruments: Rorschach lnkblot Test, Thematic Apperception Test (TAT), and human figure drawings. We conclude that there is empirical support for the validity of a small number of indexes derived from the Rorschach and TAT. However, the substantial majority of Rorschach and TAT indexes are not empirically supported. The validity evidence for human figure drawings is even more limited. With a few exceptions, projective indexes have not consistently demonstrated incremental validity above and beyond other psychometric data. In addition, we summa- rize the results of a new meta-analysis intended to examine the capacity of these three instruments to detect child sexual abuse. Although some projective instruments were better than chance at detecting child sexual abuse, there were virtually no replicated findings across independent investigative teams. This meta-analysis also provides the first clear evidence of substantial file drawer effects in the projectives literature, as the effect sizes from published studies markedly exceeded those from unpublished studies. We conclude with recommendations regarding the (a) construction of projective techniques with adequate validity, (b) forensic and clinical use of projective techniques, and (c) education and training of future psychologists regarding projective techniques.

Abstract : We investigated the impact of administration and inquiry skills on Rorschach Comprehensive System (CS; Exner, 1974, 1991, 1993) protocols collected for the Italian adult nonpatient reference sample. The same research team collected CS protocols on two occasions. The initial reference sample (N = 212; Lis, Rossi, & Priha, 1998) was collected under the supervision of experienced psychologists who carefully studied CS administration and scoring procedures (Exner, 1986, 1990, 1993). The second sample (N = 101; Lis, Zennaro, Calvo, & Salcuni, 2001) was collected after the team obtained additional and sustained CS training from Rorschach workshops certified instructors. Both samples were scored, reliably but they showed large differences on many codes, with protocols from the second sample being richer and more complex than the first. The results indicate that administration skills can have a dramatic impact on CS protocols and may contribute to variations in samples collected by different investigators. Training standards should be devised to insure uniform administration procedures are followed when collecting CS protocols.

Abstract : Psychoanalytic theories suggest that color perception on the Rorschach relates to affective modulation. However, this idea has minimal empirical support. Using a clinical sample, the authors explored the cognitive and clinical correlates of Rorschach color determinants and differences among four affective modulation subtypes: Controlled, Balanced, Under-Controlled, and Flooded. Subtypes were differentiated by measures of affective regulation, reality testing/confusion, and personality traits. Initial support for the relationship of chromatic color response styles and affective modulation was found.

Abstract : Psychologists who carry out personality assessments must be conversant in diverse technical languages to describe their clients’ social contexts and inner personality function. The clinician needs to understand a person’s family, gender role, ethnic identity, religious beliefs, and similar qualities, and also a client’s inner personality functioning, including the workings of motives, emotions, cognition, and self-control: These can be characterized by relevant psychiatric symptoms, personality traits, and individual test scores such as those on the MMPI–2–RF and Rorschach-Performance Assessment System. The Personality Systems Framework for Assessment (PSF–A) can support the assessment process by organizing information about both an individual’s context and personality function, freeing professionals to optimally focus on characterizing their clients.

Abstract : The sexual abuse crisis in the Catholic Church demands that we assess the utility of all assessment methods. Despite 20 years of persistent and often heated debate over the utility of the Rorschach Inkblot Method (RIM), we know that the Rorschach has been and continues to be used by about 60% of seminaries and religious institutes in their assessment of candidates. One must ask, is the Rorschach useful today? This article addresses this question and other concerns based on the best available psychological research. It consists of five major sections: the first details the overall utility of the Rorschach, its history, and its unique functions in any assessment. The second section will look at the recent controversies surrounding the Rorschach and the resolution to these in the new Rorschach Performance Assessment System scoring system. Next, it will summarize and detail the data, which support the utility of the Rorschach in clergy assessments, particularly in indicating both red flags and protective factors to be identified in any seminary or candidate assessment. Fourth, it reviews church documents and the ecclesial context in the assessment of candidates to seminaries and religious institutes. The last section describes various directions for research with realistic and possible solutions for the proper use of the RIM in multimethod, multitrait assessments of candidates to diocesan seminaries and religious institutes.

Abstract : Objective: To investigate the differences of Ego Impairment Index ( ffi) of Rorschach test between patients with schizophrenia and nonnal individuals. Methods: Totally 60 patients with schizophrenia (17 -53 years old) meeting the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and 60 age-and gender-matched nonnal subjects were involved in this study. The Rorschach ink blots test was used in both patients and nonnal subjects. The Ego Impairment Index ( Ell) of all the participants were calculated on the basis of their responses to the Rorschach ink blots test The Ell and the subcomponents of it ( including distorted fonn quality, weighted sum of cognitive processing errors, distorted perceptions of human movement, critical content, good human representation, and poor human representation) of the two samples were compared to explore Ell's discrimination to patients and nonnal individuals. Results: The score of Ell [ ( 0. 7 ± 1. 7) vs. ( -0. 9 ± 0. 9)], distorted fonn quality [ ( 6. 2 ± 2. 3) vs.( 3. 4 ± 2.6 )], weighted sum of cognitive processing errors [(14.0 ± 6.5) vs.(7.2 ± 4.2)],distorted perceptions of human movement[(0.7 ± 1.2) vs.(0.3 ± 0.7)], and poor human representation [ (3. 1 ± 2. 7) vs. ( 1. 8 ± 1. 8) J were higher in patients than in normal participants. No significant differences were found for the score of dude human representation and critical content between the two groups (Ps <0.05). The result of Diagnostic Test showed that when EII equaling to -.5, the sensitivity, specificity, and Youden Index of it to distinguish patients from normal individuals were .91, .75, and .66 respectively. Conclusion: It suggests that the ego functions of patients with schizophrenia have become serious damage compared with normal individuals. The EII of Rorschach test has high sensitivity while relatively low specificity in discriminating patients with schizophrenia, which needs to be further perfected.

Abstract : This article focuses on clinical and research problems associated with response frequency (R) being a variable in the Rorschach. Despite the fact that variations in R directly contribute to 50% of the explainable variance among Rorschach raw scores, there is a dearth of empirical evidence to document what R actually measures. Furthermore, in the practical use of the Rorschach's structural data, R is considered to be a nuisance variable that is controlled and not deemed interpretively significant. Given this information, two research agendas are proposed. The first is to more thoroughly determine whether R measures anything of substantial clinical importance. The second is to evaluate systematically the relative merits of making R a constant rather than a variable through use of an R-controlled method of Rorschach administration. This strategy would resolve many of the psychometric problems related to R. Introducing greater structure and clearer expectations to the task may also sharpen the Rorschach's ability to assess and predict important aspects of personality. However, significant disadvantages would also result from this change in administration. Both sides of the issue are discussed in some detail.

Abstract : The Rorschach Inkblot Test was factor analyzed to assess for a two-dimensional structure that was expected to reflect the traditional interpretation of many scores, as well as two dimensions that have become a basic paradigm for studying self-reported personality and mood. In my sample (N = 268), Comprehensive System scores had a four-dimensional structure. These factors replicated many earlier findings but were independent of self-report measures. Two of the Rorschach dimensions were strongly defined by response frequency (R) and reflect the powerful impact that R has on determining scores and their intercorrelations. A third dimension was comprised of form-dominant shading determinants and partially corresponded to a hypothesized factor of dysphoria. The fourth dimension was comprised of holistic nonform-dominant color and shading determinants and appears to reflect Shapiro's (1965) description of the hysterical mode of cognition. This study suggests it is necessary to expand our conceptualization of the Rorschach to account for its reproducible factors.

Abstract : I first examined the effects of response frequency (R) on the Comprehensive System's constellation indices (Exner, 1991). R is significantly associated with 26 of the 29 constellation criteria that are based on raw numbers and significantly correlated with total scores on each of the constellations. I then examined how R impacts the external validity of the constellations. The ability of the Schizophrenia Index and the Suicide Constellation to discriminate diagnostic groups appears to be impaired when protocols deviate from average length, whereas the Hypervigilance Index (HVI) appears most diagnostic of a paranoid condition when it is relatively elevated in brief records. R also clearly mediates the relationship between the Rorschach and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) criteria. In lengthy protocols, many of the cross-method convergent correlations between appropriate MMPI-2 scales and the Depression Index, Obsessive Style Index, and HVI are quite high and approach the maximum found in personality research. In brief protocols, there are strong negative correlations between these constellations and self-reports of depression and interpersonal distress. Implications from these findings for the integration of assessment methods are discussed.

Abstract : Reasons for Minnesota Multiphasic Personality Inventory (MMPI) and Rorschach disagreement at the nomothetic level are explored. Building on an understanding of measurement distinctions from other sciences, it is proposed that the Rorschach and MMPI procedures are differentially sensitive to unique manifestations of personality. By necessity, each method is then also recognized as having a limited scope of effectiveness, such that neither can provide a complete picture of personality in its full complexity. Drawing on the more extensive self-report literature, the idiosyncracies and limited scope of the self-report method are documented. Finally, an ideographically rooted, cross-method, configural model is proposed for validation research in personality assessment. Several examples consistent with this approach are drawn from the assessment literature and discussed.

Abstract : Despite being the most studied and used personality assessment tools, data from the Rorschach and MMPI generally disagree (Archer & Krishnamurthy, 1993a, 1993b). Independence is proposed to result from at least 3 factors: (a) the methods tap unique levels of personality, (b) personality has a complex organization, and (c) response styles generate considerable method variance that must be considered in nomothetic research. These ideas led to 5 hypotheses, each of which received support. Rorschach and MMPI response styles are uncorrelated, although response styles are quite consistent within a method family. MMPI-2 and Rorschach constructs of dysphoria, psychosis, or wariness are uncorrelated when response styles are ignored. However, robust convergent validity is evident when patients have similar response styles on each method (e.g., for dysphoria, M r = .59) and dysphoria is expressed in opposing ways on each method when response styles are discordant (i.e., M r = -.54). Data from the latter analyses were correlated with genuine clinical phenomena and implications were discussed for clinical practice and research.

Abstract : Psychologists have debated the clinical utility of the Rorschach for many years. In an effort to bring greater clarity to the relevant issues, a Special Series was organized for this journal. With the exception of a neutral, meta-analytic review, articles for the Special Series were solicited from scholars known to have opposing views on the Rorschach. The authors agreed to engage in a structured, sequential, and scientifically grounded dialog that focused on strengths and limitations when using the Rorschach in applied clinical settings. The debate takes place over the course of three iterations, with later articles building on and reacting to those generated earlier. This Introduction provides a rationale and overview for the full Special Series. In addition, it briefly describes the five Special Section articles published in this issue of Psychological Assessment. Five additional articles are expected to be published in an upcoming Special Section. In combination, these two Special Sections should provide clinicians, researchers, educators, and students with the most thorough, empirically rigorous, and up-to-date evaluation of the Rorschach's clinical utility.

Abstract : Past research indicated the convergence of Rorschach and MMPI scales may be a function of (a) simple Rorschach response frequency (R) or (b) complex response-character styles on both methods. In this study, new criteria were developed for defining the second assumption using F and K from the MMPI and R and Lambda from the Rorschach. Although substantially different from the factor criteria used previously (KS = .45 and .30), the new criteria still produced the expected pattern of correlations among MMPI and Rorschach scales. Averaged across 17 constructs, the new criteria produced strong validity coefficients for patients with similar styles (M composite r = .50), though they were less effective for patients with discordant styles (M composite r = -.27). It was also demonstrated that R by itself does not moderate convergent validity. Rather, statistical modeling with two sets of 300 random samples (a) demonstrated the prior findings related to R were the result of sampling error and (b) supported the general hypothesis that Rorschach and MMPI scales correlate to the extent response-character styles correlate. Implications are considered.

Abstract : A recent meta-analysis found that the Rorschach Prognostic Rating Scale (RPRS) had a strong ability to predict subsequent outcome (r = .44, N = 783; Meyer & Handler, 1997, this issue). However, that review did not directly address questions of incremental validity. This article focuses on the ability of the RPRS to predict outcome after taking into account other sources of data. Across studies that examined both the RPRS and the MMPI Ego Strength scale, the RPRS had a strong ability to predict outcome (r = .40, N = 187), whereas the MMPI scale did not (r = .02, N = 280). Nine studies examined the RPRS along with an intelligence test and allowed direct numerical estimates of incremental validity to be calculated. Across studies, the RPRS demonstrated strong incremental validity after controlling for intelligence (incremental r = .36, N = 358). It is clear that the Rorschach can make unique contributions to understanding clinically relevant processes in ways that self-reports or measured intelligence cannot. Contemporary Rorschach scales should continue to be evaluated for their distinctive and incremental contribution to clinical practice.

Abstract : I describe problems in an article by Wood, Nezworski, Stejskal, Garven, and West (1999b). These include (a) claims that researchers found or said things they did not, (b) an assertion that my data did not support the incremental validity of the Rorschach over the MMPI-2 when the opposite was true, (c) complications with their recommended incremental validity procedures, (d) unwarranted criticism of Burns and Viglione's (1996) statistical analyses, (e) oversimplifying issues associated with extreme groups research, (f) misleading criticisms of composite measures, and (g) faulty criticisms of Burns and Viglione's composite scale that overlooked relevant evidence. Wood et al. also asserted that Burns and Viglione's primary Rorschach variable was faulty and created a formula that seemed to show how Burns and Viglione's scores were "incompatible" and "not ... even very close" to those obtained from the proper formula. These criticisms were made even though Wood et al. had been told that their formula was incorrect and shown that it was almost perfectly correlated with the proper formula in 8 large samples (rs > .998). Sound criticism of Rorschach research will advance science and practice, but the Wood et al. article did not provide sufficient guidance.

Abstract : Reports an error in the original article by G. J. Meyer (Journal of Personality Assessment, 2000[Aug], Vol 75[1], 46-81). The error occurred in the syntax used to classify the depressive spectrum disorders employed in this article. The article stated that 212 of 262 patients had a depressive spectrum disorder, but in actuality 186 patients had one of these diagnoses. Using the corrected diagnostic criterion, regression findings reported in Table 2 are no longer correct.

Abstract : Possible factors affecting normative shifts in Rorschach data are considered, including (a) genuine changes in mental health over time, (b) alterations in the type of target sample under consideration, (c) evolving scoring rules, and (d) variations in test administration skills or context. I show that the Comprehensive System (CS) criteria for coding form quality have changed substantially over time. Building on the extensive research of others, I also show that CS data collected around the world from people tested outside of a clinical context look somewhat less healthy than Exner's reference sample of socially/vocationally functioning nonpatients but somewhat more healthy than Exner's reference sample of people starting outpatient psychotherapy. Furthermore, preliminary results from Exner's new non-patient sample recruited using the same procedures as before reveals scores that are generally quite similar to the existing reference values. The assertion that CS norms overpathologize people is not supported.

Abstract : A Special Series was organized to clarify the merits of the Rorschach for clinical assessment. Except for a neutral meta-analytic review, articles were solicited from scholars known to have opposing views on the Rorschach. The authors participated in a structured, sequential, evidence-based dialogue that focused on strengths and limitations when using the Rorschach for applied purposes. The debate has taken place over 4 iterations, with later articles building on and reacting to those generated earlier. The first 5 articles in the Special Series were published earlier (G. J. Meyer, 1999), and the final 6 articles are published in this issue of Psychological Assessment. This article provides a brief overview of the full Special Series and an introduction to the 6 articles contained in this Special Section. The Special Series provides clinicians, researchers, educators, and students with a thorough review of the evidence and logic that are critical for understanding the Rorschach's strengths and limitations in clinical assessment.

Abstract : This study uses an archival data set to correlate Rorschach scores with measures of cognitive functioning in youth, and extends the literature in three ways. First, although Wechsler-based scales of intellectual ability are criteria in the primary sample, correlates with specialized measures of neuropsychological functioning are provided in smaller subsamples, with a focus on tests of perceptual accuracy and perceptual synthesis. Second, absolute levels of cognitive ability are examined, rather than age-adjusted scores, in order to match with the non-age adjusted Rorschach scores. Third, the results expand the relevant research literature on Comprehensive System scores and provide novel data for scores in the Rorschach Performance Assessment System. Findings showed an expected pattern of correlations for Rorschach scores of organizational activity, synthesized responses, perceptual accuracy, conceptual complexity, and complex perceptual representations. The Rorschach scores most correlated with neuropsychological perceptual synthesis skills were those related to perceptual accuracy and those requiring complex perceptual representations, although Rorschach scores tended to be more strongly associated with verbal abilities than with perceptual organizational skills. These data provide further evidence for the validity of selected Rorschach scores and contribute to an understanding of the cognitive characteristics linked to various types of Rorschach responses.

Abstract : I provide a contemporary overview of Hermann Rorschach’s inkblot task, including how it was developed, why it seems to work as it does, and how to contextualize inferences drawn from the things that people see, say, and do while completing the task. Following this, I review the meta-analyses that have been conducted concerning Rorschach validity, several multi-sample studies concerning focused topics, and a selection of recent individual studies. The aim of this part of the article is to illustrate the validity of the Rorschach as a behavioral performance task that can provide a useful complement to self-reported characteristics – both in clinical practice and in research on per-sonality processes. Administering and coding Rorschach’s task is much more time consuming than many other sources of personality data, particularly the ubiquitous introspective self-report method. However, it is argued that Rorschach performance provides a unique source of information about people that can validly add to the assessment and understanding of personality and psychological processes. As such, despite its history of controversy, it is an instrument that is worth consideration or reconsideration by personality assessors and researchers.

Abstract : I provide a contemporary overview of Hermann Rorschach’s inkblot task, including how it was developed, why it seems to work as it does, and how to contextualize inferences drawn from the things that people see, say, and do while completing the task. Following this, I review the meta-analyses that have been conducted concerning Rorschach validity, several multi-sample studies concerning focused topics, and a selection of recent individual studies. The aim of this part of the article is to illustrate the validity of the Rorschach as a behavioral performance task that can provide a useful complement to self-reported characteristics – both in clinical practice and in research on personality processes. Administering and coding Rorschach’s task is much more time consuming than many other sources of personality data, particularly the ubiquitous introspective self-report method. However, it is argued that Rorschach performance provides a unique source of information about people that can validly add to the assessment and understanding of personality and psychological processes. As such, despite its history of controversy, it is an instrument that is worth consideration or reconsideration by personality assessors and researchers.

Abstract : This article serves three goals. First, I review complexity in Rorschach responding. As a construct, complexity illuminates ways people differentially register experiences, which produces distinct patterns of expressed behavior when completing the task. Rorschach first described this dimension, creating novel terminology for it, and it was central to Rapaport, Gill, and Schafer’s system and Schachtel’s classic text. As a scored variable, Viglione and Meyer defined it when they were brought together by Exner to work on advancing the Comprehensive System (CS) through his Rorschach Research Council; later it was adopted in the Rorschach Performance Assessment System (R-PAS). Second, I review early factor analytic research identifying complexity and provide new data to document how Complexity as a scored variable is an excellent index of the first unrotated principal component when factoring individually assigned Rorschach scores. Third, I document a number of assertions published about Complexity by Fontan and Andronikof that are incorrect and misleading. I correct those assertions by means of explanation and also statistical results from two data sets. I close by offering 10 basic conclusions about complexity.

Abstract : As the final article in the Special Series on "The Utility of the Rorschach for Clinical Assessment," the authors provide an overview of this instrument's current status. They begin with a thorough review of global and focused meta-analyses, including an expanded analysis of K. C. H. Parker, R. K. Hanson, and J. Hunsley's (1988) data set, and conclude that Rorschach, Minnesota Multiphasic Personality Inventory, and IQ scales each produce roughly similar effect size magnitudes, although all tests have greater validity for some purposes than for others. Because this evidentiary foundation justifies addressing other issues, the authors build on contributions to the Special Series to identify 11 salient theoretical and empirical gaps in the Rorschach knowledge base and make recommendations for addressing these challenges to further the evolution of the Rorschach and document its strengths and inherent limitations.

Abstract : This study first explored the adequacy of items on the Rorschach Rating Scale (RRS), which measures Rorschach constructs from a variety of scoring systems. Analyses determined that all items had an adequate capacity to differentiate people and none were clearly redundant. At the same time, the current version of the RRS requires good reading comprehension skills for accurate completion (13th grade level). Next, we developed two sets of RRS scales. Factor analysis of observer ratings (N = 234) indicated the RRS contained six broad, empirically derived factors. In addition, 19 conceptually derived scales were developed from the RRS item pool. Both sets of scales were evaluated for reliability and then compared to the Big Five model (B5M) of personality through a series of factor and regression analyses. Results indicated that RRS scales do not provide adequate definition of all B5M dimensions and B5M scales do not provide adequate definition of all RRS dimensions. We discuss the place of psychotic processes within a comprehensive model of personality and other implications from these findings.

Abstract : We provide an overview of the Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). After providing a general introduction to Rorschach-based assessment, the rationale and features of R-PAS are outlined. As part of this discussion, some of the ways in which R-PAS differs from the Comprehensive System (CS) (Exner, 2003) are delineated.

Abstract : We build on the work of all the authors contributing to this Special Supplement by summarizing findings across their samples of data, and we also draw on samples published elsewhere. Using 21 samples of adult data from 17 countries we create a composite set of internationally-based reference means and standard deviations from which we compute T-scores for each sample. Figures illustrate how the scores in each sample are distributed and how the samples compare across variables in eight Rorschach Comprehensive System (CS; Exner, 2003) clusters. The adult samples from around the world are generally quite similar, and thus we encourage clinicians to integrate the composite international reference values into their clinical interpretation of protocols. However, the 31 child and adolescent samples from 5 countries produce unstable and often quite extreme values on many scores. Until the factors contributing to the variability among these samples are more fully understood, we discourage clinicians from using many CS scores to make nomothetic, score-based inferences about psychopathology in children and adolescents.

Abstract : This article summarizes evidence and issues associated with psychological assessment. Data from more than 125 meta-analyses on test validity and 800 samples examining multimethod assessment suggest 4 general conclusions: (a) Psychological test validity is strong and compelling, (b) psychological test validity is comparable to medical test validity, (c) distinct assessment methods provide unique sources of information, and (d) clinicians who rely exclusively on interviews are prone to incomplete understandings. Following principles for optimal nomothetic research, the authors suggest that a multimethod assessment battery provides a structured means for skilled clinicians to maximize the validity of individualized assessments. Future investigations should move beyond an examination of test scales to focus more on the role of psychologists who use tests as helpful tools to furnish patients and referral sources with professional consultation.

Abstract : The Rorschach offers a unique and interesting paradigm from the perspective of the (Bayesian) brain. This contribution to the cross-disciplinary special issue considers the Rorschach from the perspective of perceptual inference in the brain and how it might inform subject-specific differences in perceptual synthesis. Before doing so, we provide a broad overview of active inference in its various manifestations. In brief, active inference supposes that our perceptions are the best hypothesis to explain sensory impressions. On a Bayesian account, the requisite belief updating rests sensitively upon the precision or confidence ascribed to sensory input, relative to prior beliefs about the causes of sensations. This focus– on the balance between sensory and prior precision – has been a useful construct in both cognitive science (e.g., as a formal explanation for attention) and neuropsychology (e.g., as a formal explanation for aberrant or false inference in hallucinations). In this setting, false inference is generally understood as abnormally high precision afforded to high-level hypotheses or explanations for visual input, which may compensate for a failure to attenuate sensory precision. On this view, the Rorschach offers an interesting paradigm because the amount of precise information about the causes of visual input is deliberately minimized –and rendered ambiguous – thereby placing greater emphasis on prior beliefs entertained by the respondent. We close by exploring this issue and several other areas of intersection between Rorschach responding and active inference.

Abstract : We examined the association of gender, ethnicity, age, and education with 60 Rorschach scores using three clinical and nonclinical samples of adults and youths (ns = 640, 249, and 241). As anticipated for our data sets, there were no reliable associations for gender, ethnicity, or adult age. However, in adults years of education was associated with variables indicative of complexity, the articulation of subtlety and nuance, cognitive synthesis, and coping resources. In the clinical sample of youths, increasing age was primarily associated with more conventional perception and less illogical thought processes. Limitations are discussed in conjunction with further research that could address them, along with implications for applied practice.

Abstract : To evaluate the ability of the Rorschach to predict subsequent outcome, the journal literature on the Rorschach Prognostic Rating Scale (RPRS) was reviewed and a meta-analysis was conducted on 20 statistics derived from a combined sample of 752. Using outcome criteria obtained an average of l year after initial testing, the uncorrected population correlation between RPRS scores and outcome was found to be p = .443 (95% confidence interval = .39 to .50). After making corrections to determine the validity of the RPRS when all subjects, all RPRS scores, and all outcome scores were included in the final statistical analysis, the estimated parameter increased to p = .560 (90% credibility value = .53). We are not aware of any other personality scale that uniformly demonstrates such high predictive validity. To flesh out the meaning of these results, they were placed in the context of other predictor-criterion relations drawn from various fields of study. The disparity between this strong evidence for validity and the chronic criticisms leveled against the Rorschach is discussed and suggestions are made for future research.

Abstract : Details corrections on the meta-analysis of the authors on the Rorschach Prognostic Rating Scale (RPRS). Omission of the footnotes to Table three in the printed article; Completion of the RPRS scale by 42 patients instead of the indicated 40 of the 93 patients; Corrections on the RPRS data in two psychotherapy samples.

Abstract : In this article, we describe interrater reliability for the Comprehensive System (CS; Exner. 1993) in 8 relatively large samples, including (a) students, (b) experienced re- searchers, (c) clinicians, (d) clinicians and then researchers, (e) a composite clinical sample (i.e., a to d), and 3 samples in which randomly generated erroneous scores were substituted for (f) 10%, (g) 20%, or (h) 30% of the original responses. Across samples, 133 to 143 statistically stable CS scores had excellent reliability, with median intraclass correlations of.85, .96, .97, .95, .93, .95, .89, and .82, respectively. We also demonstrate reliability findings from this study closely match the results derived from a synthesis of prior research, CS summary scores are more reliable than scores assigned to individual responses, small samples are more likely to generate unstable and lower reliability estimates, and Meyer's (1997a) procedures for estimating response segment reliability were accurate. The CS can be scored reliably, but because scoring is the result of coder skills clinicians must conscientiously monitor their accuracy.

Abstract : The Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011) introduced R-optimized administration to reduce variability in the number of Responses (R). We provide new data from six studies of participants randomly assigned to receive a version of this method or Comprehensive System (CS; Exner, 2003) administration. We examine how administration methods affect 3 types of codes most likely to contain potential projective material and the frequency of these codes for the 1st, 2nd, 3rd, 4th, or last response to a card (R in Card). In a meta-analytic summary, we found 37% of responses have 1 type of code, 19% have 2 types, and 3% have all 3 types, with stable proportions across responses within cards. Importantly, administration method had no impact on potential projective variable means. Differential skew across samples made variability harder to interpret. Initial results suggesting differences in 3 of the 18 specific Type by R in Card pairs did not follow a coherent pattern and disappeared when using raw counts from all participants. Overall, data do not support concerns that R-optimized administration might alter potential projective processes, or make potentially “signature” last responses to the card any different in R-PAS than the CS.

Abstract : We surveyed practicing clinicians who regularly used the Rorschach about the perceived clinical validity of specific Rorschach scores from many coding systems. The survey included quantitative feedback on the validity of specific variables as well as qualitative input in several areas, including the validity of specific variables, the potentially unique information that can be obtained from them, coding challenges associated with Comprehensive System (CS) codes, and recommendations for CS developments. Participants were recruited by applying a snowball sampling strategy. Based on responses from 246 experienced clinicians from 26 countries, composite judgments on rated variables were quite reliable (e.g., Ma = .95 across 88 CS variables), despite limited agreement among any 2 judges. The aggregated judgments clearly differentiated among scores that were considered more and less clinically valid and the overall results aligned with recently obtained meta-analytic conclusions from the traditional validity literature (Mihura, Meyer, Dumitrascu, & Bombel, 2012). The judges also provided guidance concerning revisions and enhancements that would facilitate Rorschach-based assessment in the future. We discuss the implication of the quantitative and qualitative findings and provide suggestions for future directions based on the results.

Abstract : We evaluated the utility of an integrative, multimethod approach for assessing hostility-related constructs to predict premature cardiovascular disease (CVD) and premature coronary heart disease (CHD) using participants from the Johns Hopkins Precursors Study, which was designed to identify risk factors for heart disease. Participants were assessed at baseline while in medical school from 1946 to 1962 (M age = 24.6) and have been followed annually since then. Baseline assessment included individually administered Rorschach protocols (N = 416) scored for aggressive imagery (i.e., Aggressive Content, Aggressive Past) and self-reports of 3 possible anger responses to stress. Cox regression analyses predicting morbidity or mortality by age 55 revealed a significant interaction effect; high levels of Aggressive Content with high self-reported hostility predicted an increased rate of premature CVD and CHD, and incrementally predicted the rate of these events after controlling for the significant covariates of smoking (CVD and CHD) and cholesterol (CHD) that were also assessed at baseline. The hostility and anger measures, as well as other baseline covariates, were not predictors of CVD risk factors assessed at midlife during follow-up. Overall, this integrative model of hostility illustrates the potential value of multimethod assessment to areas of health psychology and preventive medicine.

Abstract : The article discusses the use of the words "objective" and "projective" in psychological testing literature and shows that these words cause confusion. Objective tests allow the test administrator to be objective, but the test taker must subjectively interpret the question being asked and then subjectively consider their feelings about it. Projective tests are meant to allow the examiner to see the thought process and personality of the person being tested. Both kinds of tests are ambiguous.

Abstract : This chapter focuses on Madeline from a psychodynamically informed perspective. After briefly describing five guiding principles, models for conceptualization, and an approach to understanding assessment methods and the data they generate, we review contemporary research on four standardized but open-ended measures of psychological functioning that are used to better understand her—the Rorschach inkblot task, Thematic Apperception Test, Object Relations Inventory, and Washington University Sentence Completion Test. We highlight key aspects of Madeline’s history and observations of her during the current assessment as context for interpreting the four measures, including their formal scores, the idiographic significance of their raw responses, and her reactions to those data and our inferences. The chapter closes with a summary of Madeline based on all sources of information, illustrating the five psychodynamic principles that opened the chapter and the complex richness that is intrinsic to her as a person.

Abstract : To examine agreement on Rorschach Comprehensive System (CS; Exner, 2004) interpretations, 55 patient protocols were interpreted by 3 to 8 clinicians across 4 data sets on a representative set of 29 characteristics. Substantial reliability was observed across data sets, although a problematic design produced lower results in one. Unexpectedly, a Q-sort task had slightly lower reliability than a simple rating task. As expected, scales that summarized judgments had higher agreement than judgments to individual interpretive statements, and some clinicians produced more generalizable inferences than others. Interpretations for all clinicians were more strongly associated with patients' psychometric true scores (aggregated judgment M range = .82 to .92) than with the judgments of other clinicians (range = .76 to .89). Compared to meta-analyses of interrater reliability in psychology and medicine, the findings indicate these clinicians could reliably interpret Rorschach CS data.

Abstract : We replicated prior research on Rorschach and MMPI-2 convergent validity by testing 8 hypotheses in a new sample of patients. We also extended prior research by developing criteria to include more patients and by applying the same procedures to 2 self-report tests: the MMPI-2 and the MCMI-II. Results supported our hypotheses and paralleled the prior findings. Furthermore, 3 different tests for methodological artifacts could not account for the results. Thus, the convergence of Rorschach and MMPI-2 constructs seems to be partially a function of how patients interact with the tests. When patients approach each test with a similar style, conceptually aligned constructs tend to correlate. Although this result is less robust, when patients approach each test in an opposing manner, conceptually aligned constructs tend to be negatively correlated. When test interaction styles are ignored, MMPI-2 and Rorschach constructs tend to be uncorrelated, unless a sample just happens to possess a correlation between Rorschach and MMPI-2 stylistic variables. Remaining ambiguities and suggestions for further advances are discussed.

Abstract : This article describes 3 studies evaluating normative reference data for the Rorschach Comprehensive System (CS; Exner, 2003, 2007), with a particular focus on the viability of the Composite International Reference Values (CIRVs) that were compiled from 21 adult studies by Meyer, Erdberg, and Shaffer (2007). Study 1 documented how the CIRV norms are virtually identical when organized into 3 groups differentiated by the quality of their data collection effort, including an optimal group of 4 samples that relied on multiple experienced examiners and provided ongoing quality control over administration and coding. Analyses also showed that relative to the group of more optimal samples, the group of less optimal samples did not produce more variability in summary scores within or across samples or lower interrater reliability for coding. Study2 used the existing CS reference norms to generate T scores for the CIRV means and documented how the CS norms make other samples of healthy nonpatients look psychologically impaired in multiple domains. Study 3 documented with examples from 4 different countries how 2 sets of within-country local norms produced notably different results on some variables, which compromises the ability of local norms to be used instead of the CIRVs. Taken together, the 3 studies provide support for the use of CIRVs in clinical practice as norms that are generalizable across samples, settings, languages, and cultures and that account for the natural variability that is present when clinicians and researchers contend with the ambiguity contained in the standard CS reference materials concerning the proper ways to administer and code. We conclude by urging CS users to rely on the CIRVs when making clinical inferences and to adopt alternative methods of ensuring they are following cohesively standardized administration and coding guidelines.

Abstract : Lambda is an important variable in the Rorschach Comprehensive System. However, because of the way it is calculated it has properties that can produce problems for parametric statistical analyses. We illustrate these difficulties and encourage the use of Form% (i.e., pure form responses/total responses) instead of Lambda in research. Form% is easy to calculate, and it is conceptually and mathematically comparable to Lambda. Because it is much more normally distributed, Form% is suitable to use in parametric analyses (e.g., t tests, analyses of variance, correlations, factor analyses, multiple regressions).

Abstract : Although emotional intelligence is frequently measured with performance tasks, they are often correlated with self-report measures of personality. The present research compared the scores of two performance tests: the Rorschach Inkblot Method for personality (scored using R-PAS), and the Computerized Test of Primary Emotions Perception for emotional perception and understanding, branches of emotional intelligence. Participants were 93 Brazilian people, including undergraduates and psychiatric outpatients. Significant correlations were found, ranging from .20 to .37. The results indicate that the ability to perceive emotional expressions in people’s faces is related to empathy and interest in human interaction, attention to details, integrative thinking, and complex cognitive processing. Distortion in emotional perception, that is perceiving emotions that were not present, correlated with thought and perception disturbances.

Abstract : Several approaches in psychology converge with the concept that individual characteristics may interfere with the perception and interpretation of the world. We hypothesized that such phenomenon could be identified in instruments that were not only projective techniques. The research’s goal was to study perceptive distortions in a cognitive test and their relations with personality instruments. Responses from 222 participants in the Computerized Test of Primary Emotions Perception (PEP) were rated in distortion scores, which related to perceiving emotions that were not present. We used Spearman correlations between these scores and the Rorschach Inkblot test, Dimensional Clinical Personality Inventory, and tasks of Verbal and Abstract Reasoning. Results showed that the distortions were not related to intellectual abilities. Distortions of joy were associated with greater interest in interpersonal contact; love with positive view of the interactions and need for attention; fear with concerns about aggressiveness and autonomy; sadness with lower perception of damaged objects; disgust with feelings of loneliness; and anger with criticism avoidance, distrust, feelings of loneliness, and aggressive behaviour. The results support the proposal that altered perception of reality is related to affective or personality characteristics.

Abstract : This article presents a logical and empirical argument for the necessity of a multi-method approach to psychological assessment. Both in clinical and forensic psychology, self-report methods such as questionnaires and interviews are popular. The Rorschach is presented in this article as an additional test method. The article describes recent meta analyses that evaluate the construct validity of individual Rorschach scales and that serve as major guideposts in the development of a new Rorschach system (Rorschach Performance Assessment System). The combination of self report and Rorschach methods is used to discuss the importance of multi-method assessment in the context of incremental validity and dissimulation. Practically speaking, the assessor should consider the test method as an indispensable part of the formula when choosing tests, writing reports, and generally understanding the client.

Abstract : This article documents and discusses the importance of using a formal systematic approach to validating psychological tests. To illustrate, results are presented from a systematic review of the validity findings cited in the Rorschach Comprehensive System (CS; Exner, 2003) test manual, originally conducted during the manuscript review process for Mihura, Meyer, Dumitrascu, and Bombel’s (2013) CS meta-analyses. Our review documents (a) the degree to which the CS test manual reports validity findings for each test variable, (b) whether these findings are publicly accessible or unpublished studies coordinated by the test developer, and (c) the presence and nature of data discrepancies between the CS test manual and the cited source. Implications are discussed for the CS in particular, the Rorschach more generally, and psychological tests more broadly. Notably, a history of intensive scrutiny of the Rorschach has resulted in more stringent standards applied to it, even though its scales have more published and supportive construct validity meta-analyses than any other psychological test. Calls are made for (a) a mechanism to correct data errors in the scientific literature, (b) guidelines for test developers’ key unpublished studies, and (c) systematic reviews and meta-analyses to become standard practice for all psychological tests.

Abstract : Recently, psychologists have emphasized the response process—that is, the psychological operations and behaviors that lead to test scores—when designing psychological tests, interpreting their results, and refining their validity. To illustrate the centrality of the response process in construct validity and test interpretation, we provide a historical, conceptual, and empirical review of the main uses of the background white space of the Rorschach cards, called space reversal (SR) and space integration (SI) in the Rorschach Performance Assessment System. We show how SR and SI's unique response processes result in different interpretations, and that reviewing their literatures with these distinct interpretations in mind produces the expected patterns of convergent and discriminant validity. That is, SR was uniquely related to measures of oppositionality; SI was uniquely related to measures of cognitive complexity; and both SR and SI were related to measures of creativity. Our review further suggests that the Comprehensive System use of a single space code for all uses of white space likely led to its lack of meta-analytic support as a measure of oppositionality (Mihura, Meyer, Dumitrascu, & Bombel, 2013). We close by discussing the use of the response process to improve test interpretation, develop better measures, and advance the design of research.

Abstract : The goal of this chapter is to illuminate the relevance of incorporating different methods of assessment into treatment planning. To date, this is a relatively novel endeavor, which may be somewhat surprising given the intuitive look between assessment and treatment. Thus, the present chapters unique in its attempt to "make the implicit, explicit" regarding the relationship that multi method assessment has with treatment planning. The basic tenet of this chapters that different assessment methods tap different aspects of personality and have implications for a person's experiences and functioning, which, in turn, uniform case conceptualization and treatment planning. Our transtheoretical approach should make the chapter relevant to a wide range of practitioners and researchers in the field.

Abstract : Our study addresses the question, “In what settings, with what age groups, and for what purposes is the Rorschach used internationally?” We present preliminary results from 342 Rorschach users representing 36 different countries from a survey created as part of the US contribution to a larger international project on teaching and using the Rorschach in different countries. The survey was distributed to R-PAS account holders with a request to forward to non-R-PAS users. Of the respondents, 80% used R-PAS, 35% used the CS, and 17% used both. Overall, 91% used the Rorschach with adults, and 43% and 69% with children and adolescents, respectively. The most common setting was private practice (63%). The most common reason for using the Rorschach was differential diagnosis (65%), with psychosis (58%) and personality disorders (56%) as the main diagnoses. US respondents were more likely to use the Rorschach to assess for psychosis (65% vs. 48%), especially emerging psychosis in adolescents (46% vs. 25%). We discuss the strong meta-analytic support for using the Rorschach to assess psychosis, a use supported by even the test’s staunchest critics. We close by discussing study limitations and future directions, such as translating the survey to different languages and implementing a wider distribution.

Abstract : No abstract available

Abstract : Wood, Garb, Nezworski, Lilienfeld, and Duke (2015) found our systematic review and meta-analyses of65 Rorschach variables to be accurate and unbiased, and hence removed their previous recommendation for a moratorium on the applied use of the Rorschach. However, Wood et al. (2015) hypothesized that publication bias would exist for 4 Rorschach variables. To test this hypothesis, they replicated our meta-analyses for these 4 variables and added unpublished dissertations to the pool of articles. In the process, they used procedures that contradicted their standards and recommendations for sound Rorschach research, which consistently led to significantly lower effect sizes. In reviewing their meta analyses, we found numerous methodological errors, data errors, and omitted studies. In contrast to their strict requirements for interrater reliability in the Rorschach meta-analyses of other researchers, they did not report interrater reliability for any of their coding and classification decisions. In addition, many of their conclusions were based on a narrative review of individual studies and post hoc analyses rather than their meta-analytic findings. Finally, we challenge their sole use of dissertations to test publication bias because (a) they failed to reconcile their conclusion that publication bias was present with the analyses we conducted showing its absence, and (b) we found numerous problems with dissertation study quality. In short, one cannot rely on the findings or the conclusions reported in Wood et al.

Abstract : We respond to Tibon Czopp and Zeligman’s (2016) critique of our systematic reviews and meta-analyses of65 Rorschach Comprehensive System (CS) variables published in Psychological Bulletin (2013). The authors endorsed our supportive findings but critiqued the same methodology when used for the 13 unsupported variables. Unfortunately, their commentary was based on significant misunderstandings of our meta analytic method and results, such as thinking we used introspectively assessed criteria in classifying levels of support and reporting only a subset of our externally assessed criteria. We systematically address their arguments that our construct label and criterion variable choices were inaccurate and, therefore, meta analytic validity for these 13 CS variables was artificially low. For example, the authors created new construct labels for these variables that they called “the customary CS interpretation,” but did not describe their methodology nor provide evidence that their labels would result in better validity than ours. They cite studies they believe we should have included; we explain how these studies did not fit our inclusion criteria and that including them would have actually reduced the relevant CS variables’ meta-analytic validity. Ultimately, criticisms alone cannot change meta-analytic support from negative to positive; Tibon Czopp and Zeligman would need to conduct their own construct validity meta-analyses.

Abstract : We systematically evaluated the peer-reviewed Rorschach validity literature for the 65 main variables in the popular Comprehensive System (CS). Across 53 meta-analyses examining variables against externally assessed criteria (e.g., observer ratings, psychiatric diagnosis), the mean validity was r _ .27 (k _770) as compared to r _ .08 (k _ 386) across 42 meta-analyses examining variables against introspectively assessed criteria (e.g., self-report). Using Hemphill’s (2003) data-driven guidelines for interpreting the magnitude of assessment effect sizes with only externally assessed criteria, we found 13 variables had excellent support (r _ .33, p _ .001; _ FSN _ 50), 17 had good support (r _ .21, p _ .05, FSN _ 10),10 had modest support (p _ .05 and either r _ .21, FSN _ 10, or r _ .15–.20, FSN _ 10), 13 had little(p _ .05 and either r _ _ .15 or FSN _ 10) or no support (p _ .05), and 12 had no construct-relevant validity studies. The variables with the strongest support were largely those that assess cognitive and perceptual processes (e.g., Perceptual-Thinking Index, Synthesized Response); those with the least support tended to be very rare (e.g., Color Projection) or some of the more recently developed scales(e.g., Egocentricity Index, Isolation Index). Our findings are less positive, more nuanced, and more inclusive than those reported in the CS test manual. We discuss study limitations and the implications for research and clinical practice, including the importance of using different methods in order to improve our understanding of people.

Abstract : We surveyed American Psychological Association–accredited clinical psychology doctoral programs’ (n =83) training in psychological assessment—specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method—self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships’ assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association’s requirements for preinternship assessment competencies.

Abstract : Objective: The aim of this study was to examine reality testing in schizophrenic children and compare it with normal children using minus responses subcomponent in ego impairment index of the Rorschach test. Methods: In a descriptive design, 20 accidentally sampled children, including 10 schizophrenic and 10 normal children, were recruited in to two groups and were compared in terms of reality testing sub component of Ego Impairment Index (EII). After initial interview, the Rorschach inkblot test was administered on the two groups, and Distorted Quality responses(FQ-) were calculated. The results were then analyzed by independent test and Cohen’s d for effect size .Results: The result of independent t-test revealed that the mean of minus responses in schizophrenic children was significantly higher than that of normal children. In addition, the usefulness of the Rorschach ego impairment index (EII) in evaluating reality testing in schizophrenic children was confirmed. In addition, it was found that defect in reality testing is one of the prominent characteristics of schizophrenic children .Conclusion: The higher minus responses in schizophrenic children indicate that schizophrenic children have weaker functioning in reality testing compared with normal children.

Abstract : The present study consisted of a meta-analytic review of the criterion validity of the Rorschach Mutuality of Autonomy (Urist, 1977) scale. Search procedures yielded 27 independent samples (total N _ 1,803, average n _ 67, SD _ 31) for inclusion in the meta-analysis. Results support the criterion validity of the Mutuality of Autonomy with an average overall weighted effect size of r _ .24,p _ .001 (95% confidence interval _ .18, .29). Publication bias analyses indicate the possibility for bias and demonstrate that the likely impact of any such bias would bring the average overall weighted effect size down to r _ .18,p _ .001 (95% confidence interval for adjusted effect size _ .11, .24). The data were not demonstrably heterogeneous (Q _ 37.67, df _ 26, p _ .07), and all between-study moderator analyses were nonsignificant (ps _ .19) with the exception of the specific type of criterion variable. Implications for future research and clinical practice are discussed.

Abstract : 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 72middle-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 (_ _ .23, p _ .02) and social skills capacity(_ _ .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.

Abstract : This case study demonstrates the procedures and the complementary function and contribution of the Rorschach within a multi-method forensic mental health evaluation. This particular case addressed the state of mind of a perpetrator and related traumatic reactions and the possibility of Posttraumatic Stress Disorder (PTSD) associated with violent attacks involving rape. The verbatim Rorschach record contained repeated and troubled images of splitting and ripping, and of transitions from cooperative and pleasing to darkness and evil representations, that likely reflected the individual’s distressed perception of his own dissociation. A previous review of the research of the Rorschach and post-traumatic reactions (Viglione et al., 2012) provided the main structure for applying the Rorschach in this case. The resultant Rorschach interpretations were consistent with the outcome of self-report assessments including measures of mental status and trauma reactions, as well as with additional familial declarations and forensic and clinical interviews. The full battery of tests provided the image of a criminal suffering from chronic, complex PTSD with dissociative symptoms reflecting opposing affiliative and aggressive traits; his fluctuating aggressive behavior was consistent with features of antisocial personality disorder.

Abstract : This study presents an examination of the influence of response format on convergence between performance based and self-report assessments of similar mental health constructs, to determine if such method variance might account for prior findings of lack of relationship.

Abstract : Objective. To assess the possible influence of blockade of cholinesterase on negative disorders in schizophrenia patients. Materials and methods. The study included 26 patients (including 13 women) with paranoid schizophrenia, episodic-progressive form (ICD-10), in remission and receiving stable antipsychotic therapy. Mean age was 40.4 (SD 11.7) years. The following psychometric scales were used: the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning Scale (GAF), a neurocognitive method (the Brief Assessment of Cognition in Schizophrenia, BACS), and projective psychological methods (Rorschach test). Results and conclusions. These studies showed that augmentation of maintenance antipsychotic therapy with a cholinesterase blocker was found to be an effective means of influencing negative disorders, particularly decreasing the extent of symptoms of emotional defi cit. Improvements in cognitive functioning on the BACS occurred independently of changes in the severity of negative disorders on the PANSS. The Rorschach test demonstrated improvements in conventional orientation of thinking in the patients. There were no cases with exacerbation of psychotic symptoms.

Abstract :

Abstract : Objective: This investigation presents a comparison among students from public and private schools in specific variables of the Rorschach test, Comprehensive System. Method: One hundred eighteen adolescents from the city of São Paulo participated in the study, aged 13-17 years, from public (N= 49) and private schools (N= 69). Mixed linear effects models were used to test the effect of school, controlled by sex, years of education (fixed effects), and evaluator (random effect).Results: Private schools students presented higher values of(p= 0.015, d= 0.47) and Complexity scores(p= 0.007, d= 0.53). After inserting Complexity as a fixed factor in the model, the only variable that remained significant was Xu% (p= 0.008, d= -0.52), lower in private schools students. Conclusion: The small number of differences found in this study indicates, at least for this age range, a trend to equivalent performance when comparing private and public schools. Even though the Rorschach is a method of personality assessment, it is clear that it can also signalize information related to each group’s personal experiences.

Abstract : All tests that are used in psychology assessment need to be locally validated when they are imported from a foreign country, and the Rorschach test is not an exception to this rule. This task was started in the City of São Paulo in 1999, and the results presented at the 10th Latin American Congress of Rorschach in Rosario (Nascimento, 2001, 2002). The sample included 200 adult subjects of both sexes, residents of the city of São Paulo, ages ranging from 17 to 65, of various marital statuses and levels of education, of different socioeconomic levels as classified by the criteria of the ABIPEME (Brazilian Association for Market Research), all of whom had presented no complaint and/or had no psychological or psychiatric treatment. This articles talks about the impact of education and/or socioeconomic conditions on Rorschach data in a Brazilian nonpatient sample.

Abstract : Although it has been proposed that attachment is a key factor in psychopathy and violence, conceptualization of its potential role remains limited. This article uses the dynamic-maturational model of attachment and adaptation (DMM; Crittenden, 2008) and a case study to illustrate an etiological model of psychopathy and violence. The Adult Attachment Interview (AAI; George, Kaplan, & Main, 1984–1996), coded according to the DMM system (Crittenden & Landini, 2011), was used to identify the participant’s self-protective attachment strategies, and to explore indexes indicating opportunities for change. To allow a more elaborated understanding of this participant’s personality, AAI findings were compared and contrasted with the Rorschach method (Rorschach, 1921/1942). The AAI indicated unresolved loss and trauma, alternation between delusionally idealizing dismissive (Type A) and menacing-paranoid entangled (Type C) strategies, possible depression, and the potential for reorganization. The Rorschach showed many similarities with the AAI findings. Implications for the understanding of psychopathy, violence, and treatment are presented.

Abstract : Recently, Hartmann and Hartmann (2014) found that psychiatric outpatients, both with and without access to Internet-based information about the Rorschach Inkblot Method (RIM; Weiner, 2003) and the MMPI–2(Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), were unable to imitate healthy test performance on these tests. We replicated the study by administering the RIM and the MMPI–2 to 63incarcerated violent offenders using similar testing conditions. As in the previous study, comparisons were made not only among the 3 subgroups of incarcerated offenders, but also between these offender groups and the group of nonpatients examined in the previous study. On the RIM, Internet-coached and un coached “faking good” offenders produced records with significantly higher F% and X–% and significantly lower M, m, SumC, XC%, P, AG, and COP than non offenders under standard instructions(effect sizes between d D 0.24 and d D 2.39). For AgC, AgPot, AgPast, and TCI% there were no significant differences between the faking offenders and the non offenders under standard instructions. On the MMPI–2 clinical scales, there were no significant differences between the faking good groups and the non offenders under standard instructions, except on Hs, Pd, and Sc. Both faking groups were identifiably their high L scale scores. Although both faking groups managed to avoid giving responses with aggressive and generally psychopathological content on the RIM, they were unable to produce test profiles demonstrating healthy test performance on any of the tests; nevertheless, Internet-based test information might weaken test validity.

Abstract : This study examined personality functioning in a group of 27 incarcerated criminal debt collectors as assessed by the Rorschach Inkblot Method (RIM; Rorschach, 1921/1942) and the Psychopathy Checklist–Revised (PCL–R; Hare, 2003). To explore whether these individuals represent a distinct subgroup within the violent offender population, we compared them to a group of incarcerated homicide offenders (n D 23)without a previous history of significant violence and a group who had committed less serious violent crimes (n D 21). Results revealed significantly more Rorschach indicators of past trauma (Trauma Content Index), aggressive urges (Aggressive Potential) and identification(Aggressive Content) among the debt collectors than the 2 other groups. In addition, debt collectors displayed significantly more interpersonal interest (Sum Human content), and significantly higher scores on the PCL–R. Our findings suggest that the debt collector might be viewed as a hostile variant of psychopathy.

Abstract : This study used the Adult Attachment Interview (AAI), and the Rorschach Inkblot Method (RIM; Rorschach, 1921/1942) to investigate the personality structure and internal dynamics of a rage murderer. Contrasting AAI and Rorschach findings, interpreted within an attachment-oriented framework, suggested the presence of a borderline spectrum, dual personality organization, characterized by a split between a more benign, overcontrolled upfront, and a self, fused by sexualized urges and sadistic rage. I present inferences regarding the murder and discuss issues related to future violence risk and treatment.

Abstract : Test norms enable determining the position of an individual test taker in the group. The most frequently used approach to obtain test norms is traditional norming. Regression-based norming may be more efficient than traditional norming and is rapidly growing in popularity, but little is known about its technical properties. A simulation study was conducted to compare the sample size requirements for traditional and regression-based norming by examining the 95% interpercentile ranges for percentile estimates as a function of sample size, norming method, size of covariate effects on the test score, test length, and number of answer categories in an item. Provided the assumptions of the linear regression model hold in the data, for a subdivision of the total group into eight equal-size subgroups, we found that regression-based norming requires samples 2.5 to 5.5 times smaller than traditional norming. Sample size requirements are presented for each norming method, test length, and number of answer categories. We emphasize that additional research is needed to establish sample size requirements when the assumptions of the linear regression model are violated. Keywords minimum sample size requirements for norms, norm distribution of test scores, precise test norms, regression-based norming, traditional norming.

Abstract : Fifty-one multitraumatized mental health patients with refugee backgrounds completed the Rorschach (Meyer & Viglione, 2008), Harvard Trauma Questionnaire, and Hopkins Symptom Checklist–25 (Mollica, McDonald, Massagli, & Silove, 2004), and the World Health Organization Quality of Life-BREF questionnaire (WHOQOL Group, 1998) before the start of treatment. The purpose was to gain more in-depth knowledge of an understudied patient group and to provide a prospective basis for later analyses of treatment outcome. Factor analysis of trauma-related Rorschach variables gave 2 components explaining 60% of the variance; the first was interpreted as trauma-related flooding versus constriction and the second as adequate versus impaired reality testing. Component 1 correlated positively with self-reported reexperiencing symptoms of posttraumatic stress(r = .32, p < .05). Component 2 correlated positively with self-reported quality of life in the physical, psychological, and social relationships domains (r = .34, .32, and .35, p < .05), and negatively with anxiety (r = –.33, p < .05). Each component also correlated significantly with resources like work experience, education, and language skills.

Abstract : Response to mental health treatment varies highly among refugee patients. Research has not established which factors relate to differences in outcome. This study is a follow-up of Opaas and Hartmann’s (2013)Rorschach Inkblot Method (RIM; Exner, 2003) pretreatment study of traumatized refugees, where 2 RIM principal components, Trauma Response and Reality Testing, were found descriptive of participants’ trauma-related personality functioning. This study’s aims were to examine relationships of the RIM components with measures of anxiety, depression, posttraumatic stress, quality of life (QOL), employment, and exile language skills throughout 3 years. We found that impaired Reality Testing was related to more mental health symptoms and poorer QOL; furthermore, individuals with adequate Reality Testing improved in posttraumatic stress symptoms the first year and retained their improvement. Individuals with impaired Reality Testing deteriorated the first year and improved only slightly the next 2 years. The results of this study imply that traumatized refugee patients with impaired Reality Testing might need specific treatment approaches. Research follow-up periods should be long enough to detect changes. The reality testing impairment revealed by the RIM, mainly perceptual in quality, might not be easily detected by diagnostic interviews and self-report.

Abstract : This study is composed of 52 older adults, ages 60 to 80, all from the United States. In addition to being administered the Rorschach (Rorschach, 1942), all participants also were administered the Wechsler Adult Intelligence Scale—Revised (WAIS–R; Weschler, 1981), the Minnesota Multiphasic Personality Inventory—2 (MMPI–2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), the Neuro Cognitive Status Examination (NCSE; Kiernan, Mueller, Langston, & Van Dyke, 1987), and the Trail Making Test Part B (Reitan, 1958; Reitan & Wolfson, 1993). Examiners included the principal author as well as three other trained examiners. Inclusion criteria are described. Interrater reliability statistics at the response level are presented along with scores for the Rorschach Comprehensive System (CS; Exner, 1995).

Abstract : Exner (1989) and Weiner (2003) identified 3 types of Rorschach codes that are most likely to contain personally relevant projective material: Distortions, Movement, and Embellishments. We examine how often these types of codes occur in normative data and whether their frequency changes for the 1st, 2nd,3rd, 4th, or last response to a card. We also examine the impact on these variables of the Rorschach Performance Assessment System’s (R–PAS) statistical modeling procedures that convert the distribution of responses (R) from Comprehensive System (CS) administered protocols to match the distribution of R found in protocols obtained using R-optimized administration guidelines. In 2 normative reference databases, the results indicated that about 40% of responses (M D 39.25) have 1 type of code, 15% have 2types, and 1.5% have all 3 types, with frequencies not changing by response number. In addition, there were no mean differences in the original CS and R-optimized modeled records (M Cohen’s d D –0.04 in both databases). When considered alongside findings showing minimal differences between the protocols of people randomly assigned to CS or R-optimized administration, the data suggest R-optimized administration should not alter the extent to which potential projective material is present in a Rorschach protocol.

Abstract : To generate normative reference data for the Rorschach Performance Assessment System (R–PAS),modeling procedures were developed to convert the distribution of responses (R) in protocols obtained using Comprehensive System (CS; Exner 2003) administration guidelines to match the distribution of R in protocols obtained using R-Optimized Administration (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011).This study replicates the R–PAS study, examining the impact of modeling R-Optimized Administration on Brazilian normative reference values by comparing a sample of 746 CS administered protocols to its counterpart sample of 343 records modeled to match R-Optimized Administration. The results were strongly consistent with the R–PAS findings, showing the modeled records had a slightly higher mean Rand, secondarily, slightly higher means for Complexity and V-Comp, as well as smaller standard deviations for R, Complexity, and R8910%. We also observed 5 other small differences not observed in the R-PAS study. However, when comparing effect sizes for the differences in means and standard deviations observed in this study to the differences found in the R–PAS study, the results were virtually identical. These findings suggest that using R-Optimized Administration in Brazil might produce normative results that are similar to traditional CS norms for Brazil and similar to the international norms used in R–PAS.

Abstract : Building on the comparative nonpatient study of Pianowski et al., we examine data from the Rorschach Performance Assessment System (R-PAS) and Comprehensive System (CS) in 100 nonpatients and 100 patients, 50 of each per system. Replicating their results but now in a patient sample, R-PAS produced more patient protocols having an optimal number of responses (R) for interpretation and eliminated the need for readministration due to low R. The R-PAS protocols were also much less variable in R, despite having about 2.5 more responses. Extending their results, we document that the primary markers of psychopathology in each system validly differentiate patients from nonpatients. However, R-PAS produced stronger effects. Finally, Complexity added to the valid discrimination of patients from nonpatients just for R-PAS, with patients producing less complex and rich records. The more erratic variability in R for the CS produced larger Complexity standard deviations (SDs) that obscured these genuine differences in people. We discuss implications for research and applied practice, along with directions for future research.

Abstract : We examined the impact of the changes in administration and coding introduced by the Rorschach Performance Assessment System (R-PAS) relative to the Comprehensive System (CS) on the Rorschach response process, as manifested in variables relevant to interpretation. We also examined the efficiency of each system to obtain protocols in an optimal range of responses (R) for interpretation. As hypothesized, when comparing 50 CS and 50 R-PAS nonpatient protocols, RPAS produced many more protocols in the optimal R range (18-27) than the CS (78% vs. 24%) and it eliminated the need for re-administration, which was required for five CS protocols. As expected, R was less variable with R-PAS, as were two variables derived from it, R8910% and Complexity. In addition, as expected because of different Form Quality tables, R-PAS showed notably fewer and less variable perceptual distortions than the CS, and an increase in more conventional perceptions. The other 58 variables showed no reliable differences in means or standard deviations, though modest power precluded definitive inferences about equivalence. Overall, our results support previous findings about the benefit of R-PAS to obtain protocols in an optimal range for interpretation, while keeping the core manifestations of the response process unchanged.

Abstract : Recently, the Rorschach Performance Assessment System (R–PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011) was introduced to overcome some possible limitations of the Comprehensive System (CS; Exner, 2003) while continuing its efforts to link Rorschach inferences to their evidence base. An important, technical modification to the scoring system is that R–PAS interpretations are based on both standard scores and complexity-adjusted scores. Two previous U.S. studies reported good to excellent interrater reliability (IRR) for the great majority of R–PAS variables; however, IRR of complexity-adjusted scores has never been investigated. Furthermore, no studies have yet investigated R–PAS IRR in Europe. To extend this literature, we examined R–PAS IRR of Page 1 and Page 2 raw and complexity-adjusted scores with 112 Italian Rorschach protocols. We collected a large sample of both clinical and nonclinical Rorschach protocols, each of which was coded separately by 2 independent raters. Results demonstrated a mean intraclass correlation of .78 (SD = .14) for raw scores and.74 (SD = .14) for complexity-adjusted scores. Overall, for both raw and complexity-adjusted values, most of the variables were characterized by good to excellent IRR.

Abstract : Form Quality (FQ) scores are well-validated measures of the accuracy of perceptive processes, of reality testing, and of the severity of psychological disturbance. Research studies reveal that inter-rater reliability of FQ scoring is good when visualized objects are available in the FQ tables. However, many visualized objects are not found in the FQ tables so that scoring must rely on one’s individual judgment. Thus, a major question remains unsolved: How reliably can examiners make FQ judgments in the absence of the FQ tables? To address this question, we used the Rorschach Performance Assessment System (R-PAS) method. We asked 21 graduate students from our research labs to rate Form Accuracy (FA) and FQ for 86 objects from a subset of four Rorschach card (I, III, VI, and VIII). The results clearly reveal that FQ judgments made by individual examiners without using the FQ tables are not reliable. When scoring FQ, one should carefully scrutinize the empirically supported FQ tables and base the FQ score on these rather than personal judgments.

Abstract : Electroencephalographic l wave suppression was investigated using all 10 static, ambiguous Rorschach stimuli. In an earlier study using four Rorschach stimuli, the two stimuli that elicited feelings of movement were associated with l suppression. In this study, we replicated this relationship using all 10 Rorschach stimuli while overcoming a number of other earlier limitations. The results strongly support the hypothesis that internal representation of the feeling of movement is sufficient to suppress the l rhythm even when minimal external cues are present. This outcome increases the generalizability and ecological validity of this approach and gives support to the traditional interpretation of the Rorschach human movement responses as being associated with cognitive functioning, empathy, and social cognition.

Abstract : Three hundred and nine nonpatient adults, evenly distributed according to sex, age, educational level, and residence, took part in the Rorschach test study carried out in Portugal. The sample was drawn from selected regions of the country and was balanced for population density in urban and rural areas. Test administration was controlled through the services of psychologists familiar with the Rorschach Comprehensive System (CS; Exner, 1993). Results indicate that, in Portugal (Pires, 2000), level of education is the variable that seems to have the largest effect on Rorschach responding.

Abstract : Human movement (M) responses to the Rorschach are related to cognitive sophistication, creativity, and empathy. Recent studies also link Ms to EEG-mu suppression, an index of mirroring activity in the brain. In this article, we further investigate the link between Ms and mu suppression by testing some clinical interpretative distinctions. Previously collected EEG data recorded during the administration of the Rorschach were reanalyzed. We hypothesized that (a) among several responses investigated, only M would be associated with mu suppression, and (b) Ms with active movement, ordinary form quality, or whole human figures would be most strongly associated with mu suppression. Hypothesis 1 was fully confirmed, thus supporting that the traditional interpretation of M has a neurobiological foundation. Hypothesis 2 was partially confirmed; that is, active Ms were associated with mu suppression more strongly than passive Ms (p < .05), but no other significant differences emerged. Clinical implications are discussed.

Abstract : The emotional responses of psychotherapists to their patients, known as countertransference, can yield valuable insights into the patient’s psychological functioning. Albeit from a different perspective, the Rorschach test also provides information about the patient’s psychological processes. In particular, the Rorschach human movement response (M) has been shown to be a useful measure of higher-level psychological functioning. In an attempt to bridge these two largely different perspectives, the aim of this study was to explore the association between M responses in the Rorschach protocols of psychotherapy patients and emotional responses exhibited by their therapists. To this end, a convenience sample of 149 outpatients were administered the Rorschach according to the Comprehensive System, and their therapists completed the Therapist Response Questionnaire. Through a series of regression models, controlling for response style, response complexity, and degree of psychopathology, M demonstrated a significant association with the therapists’ emotional responses. A lower number of M responses was associated with the therapists’ feelings of disengagement, and a higher number of M responses was associated with the therapists’ feelings of being more involved with the patient. Taken together, these results suggest a potential relationship between the number of M responses the respondent gives in the Rorschach and the subsequent development of the therapeutic alliance between the respondent and their therapist.

Abstract : Human movement responses (M) on the Rorschach have been traditionally viewed as lying neither completely in the inkblot (external reality) nor within the subject’s mind (inner world). The authors contend that M is not reducible to the “body that I have” but to the “body that I am,” which is a higher level organization of bottom-up and top-down brain networks, integrating body implicit awareness, psychological functioning, and social cognition. Two sources of evidence suggest the close relationship among M, psychological functions, and brain mechanisms. One comes from meta-analytical evidence supporting the close association between M and higher level cognitive functioning or empathy. The second comes from some preliminary studies showing that M activates brain circuits included in the mirror neuron system (MNS). Two conclusions can be drawn: (a) M is related to the effective use of the mentalization function; and (b) future neuroscientific investigations could lead to an understanding of the neuropsychological mechanisms underlying Rorschach responses and variables.

Abstract : The construct validity of Rorschach Comprehensive System (CS) variables theoretically linked to alexithymia was evaluated in 92 outpatients with inflammatory bowel disease, 32 of whom were categorized as alexithymic, 15 as indeterminate-alexithymic, and 45 as nonalexithymic, on the basis of Toronto Alexithymia Scale scores. Six sets of Rorschach CS marker variables were selected for analysis: fantasy, affect, adaptive resources, cognition, social adaptation, and projection. Most variables significantly differentiated the three groups. Compared with the other groups, alexithymic subjects were more likely to show an impoverished fantasy life, poorly adapted emotional expression, poor coping resources, concrete and stereotypical thinking, and social conformity with compromised relationships.

Abstract : In this study we sought to identify Rorschach differences between African Americans and White Americans and to understand these differences within a social and cultural framework. Data from the Exner (1993) Comprehensive System normative sample (N = 700) was used to form a group of 44 African Americans and 44 White Americans matched for age, sex, education, and socioeconomic status. Twenty-three Rorschach variables were chosen a priori and group differences were analyzed. The only clinically significant difference found was that African Americans offered significantly less cooperative movement. This lower frequency of cooperative movement may suggest African Americans do not anticipate cooperative interactions with others as a routine event. This may reflect a shared feeling among African Americans that most members of our society are less likely to be sensitive to or responsive to their needs relative to others. However, the study demonstrates a striking similarity between the groups, supporting the clinical use of the Rorschach with African Americans.

Abstract : This manuscript presents a single case study of a psychotically disturbed adult male (whom we call “Peter”), focusing on similarities and differences in Rorschach interpretation based on three different Rorschach approaches. Specific questions were raised as to whether the client suffered from a paranoid psychosis (paranoia) or paranoid schizophrenia. Three distinct models of psychopathology and Rorschach interpretation are initially presented. We then address Peter’s psychotic symptoms, according to the Parisian approach (specifically the Nancy French subgroup), the Lausanne Rorschach approach, and the American Rorschach approach (Comprehensive System and R-PAS). Analysis shows many convergences between the three approaches on the client’s nature of conflicts and links to reality, object relations, self-representation and anxiety, defense mechanisms, and disordered thinking, but interpretation of these variables differed somewhat despite agreement on a diagnosis within the psychotic spectrum. Concluding remarks discuss the divergences and point out the limitations of a case study method. Future research is suggested.

Abstract : For many years, the effects of variability in the length of Rorschach records has been debated, and a new administration procedure aimed at reducing the proportion of short and long records has recently been introduced. Using an outpatient sample of children and adolescents, this study explored the impact of an early version of the Rorschach Performance Assessment System (R–PAS) administration, on the central tendencies of Rorschach variables. Specifically, the mean values of 51 variables in 142 Comprehensive System versus 99 R–PAS collected records were compared with each other. Results found comparable mean values across CS and R–PAS administration methods for the variables that guide interpretation with children and adolescents. Both methods produced a comparable number of long (> 27 responses) records. The only relevant difference that emerged is that the early R–PAS administration version yielded significantly fewer short (14–16 responses) records and lower variability in the number of responses.

Abstract : The Rorschach Developmental Index (DI) is a composite measure of psychological development. The aim of this study was to examine the criterion validity of the DI by investigating its relationship with age, nonverbal intelligence, and the impact of institutionalization in a sample of Brazilian children. The sample included 231 children, ages 7 to 11, who were either living with their families or in an institutionalized setting. The results indicated that the DI is strongly associated with nonverbal intelligence. Multiple regression analysis revealed that 71% of the variability in the DI was associated with nonverbal intelligence, whereas age explained only 2%. Moreover, the DI scores and nonverbal intelligence scores were significantly lower for children living in institutionalized settings. The DI appears to be effective in assessing various levels of psychological development, especially when expressed in cognitive ability. The DI was developed in the United States, and this study suggests that the DI can be adapted to diversecultures, regions, or languages.

Abstract : In reply to Grove et al. (2002), the authors attempt to limit their focus on the question of admissibility of the Rorschach Comprehensive System for expert testimony under the guidelines of the U.S. Supreme Court Daubert/Kumho/Joiner decisions. The article refutes the argument that a “raging controversy” exists as evidence that the Rorschach is not accepted in the field of psychology. The authors again argue that Grove et al. have misconstrued the intent of Daubert/Kumho and misidentify nonclinician academics as the appropriate evaluators of the admissibility of the Rorschach. The authors add to their previous argument (2002) that the Rorschach has sufficient reliability, validity, and error rates to be admissible under Daubert and conclude by countering the Grove et al. argument that the Journal of Personality Assessment is not an adequate forum for peer review of the Rorschach.

Abstract : The Rorschach Comprehensive System has been considered by W. M. Grove and R. C. Barden (1999) as inadmissible for expert psychological testimony according to the guidelines from the Daubert (1993), Joiner (1997), and Kumho (1999) decisions. This article refutes W. M. Grove and R. C. Barden’s conclusions, arguing that the Rorschach Comprehensive System is (a) testable, (b) valid and reliable, (c) extensively peer reviewed, (d) associated with a reasonable error rate, (e) standardized, (f) accepted by a relevant and substantial scientific community, and (g) appropriate for a wide range of forensic issues. In drawing their negative conclusions, W. M. Grove and R. C. Barden overlooked or minimized a substantial body of empirical data supporting the reliability and validity of the Rorschach Comprehensive System and misinterpreted the language and intent of the Supreme Court decisions.

Abstract : Although the Rorschach is the most widely studied and used non self-report measure to assess personality, no empirical studies have been carried out to investigate what level of expertise is needed to properly collect valid Rorschach protocols. The aim of the current study was to explore, using a within-subject design, the effect of training on proficiency in administering the Rorschach, specifically a) what kind of errors are associated with different levels of training, and b) what level of expertise guarantees a sufficiently effective Rorschach administration. The second (T1), the fifth (T2) and the tenth (T3) Rorschach protocols collected by 50 licensed psychologists attending a Rorschach training course were examined to explore what kind of mistakes were made at the different stages of training. In the Response phase, examiners collected more simplistic protocols and made more errors at T1, while they showed satisfactory proficiency at T2. Regarding the Inquiry Phase, the most relevant finding was that at T1 examiners made both errors of omission and commission, while at T2 they no longer made errors of omission but they did make more errors of commission, likely as a temporary effect of the training. At T3 a sufficiently effective Rorschach administration was carried out. Findings suggest that a 100-h Rorschach training course and 10 administrations as practicum, each followed by individual feedback and group discussion, might be sufficient to guarantee sufficiently effective Rorschach administration skills.

Abstract : Charles Manson gained notoriety and infamy for orchestrating the “Tate–LaBianca” murders of seven individuals in August 1969. In 1971, he received the death penalty for his involvement in these killings. The death penalty was invalidated in 1972 by the U.S. Supreme Court. He served out his life sentence until his death in November 2017 in the California Department of Corrections at the age of 83. During the course of his confinement, Manson was evaluated many times by psychiatrists and psychologists. His diagnoses ranged from various personality disorders to schizophrenia, undifferenti- ated type. In August 1997, Manson was transferred to Pelican Bay State Prison to serve a Secure Housing Unit (SHU) term for a serious rule infraction. A comprehensive psychological evaluation was conducted there using the following instruments: the Rorschach Psychodiagnostic Test, the Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2), Wechsler Adult Intelligence Scale–Revised (WAIS-R) Similarities and Vocabulary subtests, the Test of Non-Verbal Intelligence, Version 2 (TONI-2), the Wide Range Achievement Test–Revised (WRAT-R) Reading subtest, and the Psychopathy Checklist–Revised (PCL-R). This 1997 evaluation and related test results only became publicly available after Manson’s death in 2017. Therefore, this study contains the first publication of psychological test data from Charles Manson. Noted assessment professionals recently rescored and interpreted the MMPI-2 and Rorschach (i.e., R-PAS). The results are presented and discussed in the context of his personality, noted psychopathology, the question of psychosis, and the threat of current extremist ideology referred to as “accelerationism.”

Abstract : No abstract available

Abstract : This study examines the intercoder reliability of Rorschach Comprehensive System (CS; Exner, 2001) protocol-level variables. A large international sample was combined to obtain intercoder agreement for 489 Rorschach protocols coded using the CS. Intercoder agreement was calculated using an Iota coefficient, a statistical coefficient similar to kappa that is corrected for chance. Iota values for the variables analyzed ranged from .31 to 1.00, with 2 in the poor range of agreement, 4 in the fair range, 25 in the good range, and 116 in the excellent range of agreement. Discrepancies between variables are discussed.

Abstract : This is the first study to demonstrate the existence of a relationship between patient pretreatment object relations functioning as measured by the Mutuality of Autonomy (MOA) Scale and patient-rated therapeutic alliance. Specifically, MOA scores were related to a patient-rated alliance Bond score (lower, more adaptive object-relations representations were associated with a stronger alliance). In addition, higher MOA scores indicating more malevolent object relations were related to a greater use of psychodynamic techniques. Specific psychodynamic techniques focused on the patient’s relationships with the therapist as well as cyclical patterns in actions, feelings, and experiences. Implications for clinical practice and future research are discussed.

Abstract : We examine interrater reliability for scoring the Rorschach Performance Assessment System (R-PAS) in a sample of 89 adolescents (MAge = 13.2, SD = 1.01) from Brazil using exact agreement intraclass correlations coefficient (ICCs) for the 60 protocol-level scores that are the focus of interpretation. The first author completed or reviewed all of the primary coding, and seven R-PAS proficient psychologists trained at different sites independently produced secondary coding. Overall, excellent agreement was found (M ICC = 0.89; SD = 0.09). When averaged across this study and three other comparison studies, stronger reliability was present, in general, for commonly coded variables (M = 0.87) as opposed to rare or infrequent variables (M = 0.78). In addition, 78.3% of the variables showed excellent interrater reliability and an additional 20.0% had good reliability. The results also showed that the ICCs for most variables had low variability across studies, suggesting clear coding guidelines. However, variables with higher ICC variability across studies indicated domains where it would be desirable to expand guidelines with more detailed parameters. Overall, the findings indicate excellent interrater reliability for the great majority of codes and present solid grounds for future research on interrater reliability with R-PAS.

Abstract : The present paper utilized the case study of an incarcerated serial killer (“Keith”) to demonstrate how combining three assessment techniques (the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, the Rorschach task, and a comprehensive battery of neuropsychological meas- ures) within a multilevel personality assessment framework might elucidate possible personality- based underpinnings of extreme and repetitive violence—representing a “next wave” of serial killer research while also highlighting the empirical and clinical value of an empirically-neglected multi- level assessment approach. Gacono and Meloy’s multimethod “levels” model was selected as a multilevel framework, and Leary’s recommended examination of inter-level consistency was utilized as an integrative strategy. Results indicated marked divergencies among Keith’s data levels in areas of executive abilities, psychotic symptoms, affective/emotional disconnectivity, and sexual disturb- ance that suggested areas for potential change (perhaps in therapy), while consistencies among lev- els in social cognition and object relations suggested more stable characteristics that may be resistant to modification. The application of multilevel personality assessment methods to extremely and repetitively violent persons represents an important clinical approach worthy of future study— potentially having implications for research, clinical and forensic assessment, and treatment, and advancing empirical and clinical understandings of the continuum of interpersonal violence.

Abstract : To determine the effects of reading the Wikipedia article on the Rorschach on Comprehensive System variables, participants in this study (recruited from parent–teacher associations, online message boards, and graduate schools; N = 50) were provided with either a copy of the Wikipedia article on the Rorschach (from April 2010) or an irrelevant article, then administered the Rorschach and instructed to “fake good.” Monetary incentives were used to increase motivation to dissimulate. Initial results indicated that participants given the Wikipedia article produced a lower number of responses (R) and had higher scores on Populars, X+%, XA%, and WDA% as compared to controls. However, post-hoc analyses revealed that when the influence of Populars was controlled, significant differences for X+%, XA%, and WDA% disappeared. No significant differences were found for Form%, Zf, Blends, or PER, although post-hoc analyses controlling for differences in R revealed a significant difference between groups on Zf%. Limitations of the study and implications for clinical and forensic practice are discussed.

Abstract : No abstract available

Abstract : A literature review yields a surprisingly small number of nonpatient studies focusing on three widely used assessment tools: the WAIS-R, Rorschach, and MMPI-2. In this study, 123 nonpatient adults residing in central California were administered these three instruments. We performed intercoder reliability statistics on 52 of the 123 Rorschach records. WAIS-R and MMPI-2 results are similar to current standardization data for these instruments, whereas many of the Rorschach variables are quite different from those published in the manual for the Comprehensive System (Exner, 1995). We discuss these findings and offer recommendations for further normative research.

Abstract : This article presents an update on adult nonpatients living in central California previously described by Shaffer, Erdberg, and Haroian (1999). In this study an additional 160 nonpatients were administered the Rorschach for a total sample size of 283. Graduate students enrolled in a 2-year Rorschach research seminar administered the Rorschach (Exner, 1995), WAIS–R (Weschler, 1981), and MMPI–2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), and were provided with extensive supervision and ongoing quality control. All protocols were recoded by the first two authors and a psychologist with extensive Rorschach experience. Exclusion criteria are described. Interrater reliability statistics at the response level are presented along with scores for Rorschach Comprehensive System (CS), WAIS–R, and MMPI–2 variables.

Abstract : We build on the work of all the authors contributing to this Special Supplement by summarizing findings across their samples of data, and we also draw on samples published elsewhere. Using 21 samples of adult data from 17 countries we create a composite set of internationally-based reference means and standard deviations from which we compute T-scores for each sample. Figures illustrate how the scores in each sample are distributed and how the samples compare across variables in eight Rorschach Comprehensive System (CS; Exner, 2003) clusters. The adult samples from around the world are generally quite similar, and thus we encourage clinicians to integrate the composite international reference values into their clinical interpretation of protocols. However, the 31 child and adolescent samples from 5 countries produce unstable and often quite extreme values on many scores. Until the factors contributing to the variability among these samples are more fully understood, we discourage clinicians from using many CS scores to make nomothetic, score-based inferences about psychopathology in children and adolescents.

Abstract : No abstract available

Abstract : N/A

Abstract : This study examines the construct validity of the Social Cognition and Object Relations Scale—Global Rating Method (SCORS-G) by exploring the degree of convergence across different narrative sources (i.e., early memories [EM] and psychotherapy narratives [PT]) using a university-based outpatient sample (n = 101). First, we examined intercorrelations between SCORS-G ratings of EM and PT. Intercorrelations between SCORS-G EM and PT revealed that three of the dimensions significantly correlated with themselves across narrative type (Emotional Investment in Relationships [EIR], Experience and Management of Aggressive Impulses [AGG], and Self-Esteem [SE]), but that only AGG had its strongest correlation with itself (i.e., EM AGG to PT AGG). In addition, EM AGG was significantly related to all but one of the PT SCORS-G dimensions. Likewise, EM SE correlated with all but two of the PT SCORS-G dimensions. Second, we examined how narrative source related to clinical findings. With the use of a multimethod approach, we assessed how SCORS-G ratings from both narrative types correlated with selected variables from the Personality Assessment Inventory (PAI) and Rorschach Inkblot Test. Findings indicated that there were only three instances in which both narrative types had significant relationships to the same variable/scale, and all three instances were with the Rorschach. Together, these findings suggest that even when using the same scale (SCORS-G), different narrative sources differentially activate aspects of object relations. In addition, the results highlight that difficulties with self-esteem and poor management of aggression in childhood interactions relates to patients' object relational functioning later in life. Clinical implications and future research are discussed.

Abstract : The histories of incarcerated women exhibit a multitude of personality issues including psychopathy, trauma, and interpersonal dependency. Two studies were undertaken to better understand these issues with psychopathic (PCL-R = 30; N = 115) and non-psychopathic (PCL-R = 24; N = 53) women incarcerated for drug, theft, fraud, violence, and sex offenses. In the first study, trauma symptoms were compared on Rorschach variables, TSI-2, and PAI scales. The female psychopathic group experienced more problems related to intrusive experiences and dissociation (TSI-2, Rorschach). In the second study, interpersonal dependency was also examined with the PAI, TSI-2, and Rorschach. The psychopathic females had higher rates of interpersonal dependency (PAI, Rorschach). Based on our findings we discuss the relationship between trauma and interpersonal dependency and the meaning of these testing variables and concepts within the personality functioning of these antisocial women.

Abstract : Psychopathy is an essential construct in forensic mental health. While male psychopathy and aggression has been thoroughly studied, less is known about this relationship with female psychopathy. In this article, the relationship between female psychopathy (Psychopathy Checklist-Revised [PCL-R] total, factor, and facet scores) and the Rorschach Aggression indices (Aggressive Movement [AG], Aggressive Content [AgC], Aggressive Past [AgPast], Aggressive Potential [AgPot], Sadomasochistic Aggression [SM]) were examined. Rorschach Aggression indices between female psychopathic (PCL-R total score = 30; N = 84) and non-psychopathic female offenders (PCL-R total score = 24; N = 39) were also compared. PCL-R total score was significantly correlated (p <.05) with AgC, AgPast, AgPot, and SM and there were also significant correlations between the Aggression scores and PCL-R Factor/facet scores. The female psychopaths produced more AgC, AgPast, and AgPot responses than the non-psychopathic females. Rorschach aggression indices supported theory and suggested that the violence in psychopathic women stems from their identification with aggression and pervasive feelings of entitlement. Psychopathic women evidenced higher levels of these variables than the non-psychopathic offenders. The results add to the link between aggression and psychopathy as well as a better understanding of aggression in female offenders.

Abstract : Based on findings from prior research studies, trauma histories have been found to be ubiquitous in psychopathic women. In this study, the Rorschach Trauma Content Index (TCI) was used to better understand the trauma histories of incarcerated women (N = 180). The TCI was significantly correlated with total reported trauma events, reported sexual abuse, other Rorschach scores (AgPast, ROD), and scales on both the Personality Assessment Inventory and the Trauma Symptom Inventory-2. The TCI may be related more to sexual abuse than physical abuse and the traumatic intrusions appear to be related to borderline features and dependency in this sample. These results suggest that the TCI facilitates our understanding of trauma in the lives of incarcerated women.

Abstract : The new Rorschach Perceptual–Thinking Index (PTI; Exner, 2000a, 2000b) was designed to assess thought disorders more accurately than the Schizophrenia Index (SCZI; Exner, 1993). Using a sample of child and adolescent inpatients, we examined the relation of Rorschach variables (PTI, SCZI, M–, and X–%) to thought disorder indexes on a behavior rating scale (Behavior Assessment System for Children; Reynolds & Kamphaus, 1992) and a self-report measure (Personality Inventory for Youth; Lachar & Gruber, 1995). Results indicate that, when used in a categorical manner, the PTI differentiated between those patients with and without elevated thought disorder scores on the other measures. Of all Rorschach variables, M– was most related to the other measures, indicating that this variable may be a particularly robust indicator of thought disorder among children and adolescents.

Abstract : The aim of this study was to develop and to provide an initial validation of a Rorschach index measuring developmental progress and growth. The Developmental Index (DI) was created in a 3-step, sequential strategy with adult and child data in which we (a) selected potential DI variables from quantitative research literature and from data available to us, (b) identified an optimal group of DI variables and created the DI equation using an independent non patient sample, and (c) provided an initial cross-validation of the DI using an independent clinical sample. Age and age rank categorization groups from normative data associated with the Wechsler intelligence scales (Wechsler, 2003, 2008) and contrasts between adults and children served as criteria for development. These samples include a large amount of data from a diverse international subject pool using the Comprehensive System of the Rorschach. Interim validity checks were undertaken to ensure the analytic strategy was sound. The DI includes12 variables with individual weights determined by regression analysis. The initial independent cross-validation of the DI with a clinical sample revealed that it discriminated well between children and adults. Thus, initial support for this scale as a measure of psychological development across cultures and geography was established, but future research is needed. Clinical implications and specific research needs are presented.

Abstract : The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) measures the quality of object relations in narrative material. The reliability and validity of this measure have been well established. However, a psychometric oddity of this scale is that default ratings are given to select dimensions when the relevant construct is not present. This can result in narrative ‘blandness’ and may impact clinical findings. The aim of these two studies is to understand these phenomena both psychometrically and clinically. In the first study, we identified 276 outpatients who had SCORS-G ratings for TAT Cards 1, 2, 3BM, and 14, set criteria for narrative ‘blandness’ across all eight dimensions, and examined group differences. In Study 2, we used a subset (N = 99) of Study 1 and examined how percentage of formal default ratings for Emotional Investment in Values and Moral Standards (EIM), Experience and Management of Aggressive Impulses (AGG), Self-Esteem(SE), and Identify and Coherence of Self (ICS) impacted robustness of correlations across tests of intelligence, psychopathology, and normal personality functioning. Taken together, we identified clinical characteristics of patients who are more likely to produce ‘bland’ narratives and increased percentages of formal default ratings. Also, an excess of default ratings per protocol impacts robustness of correlations and weakens significant correlations. As cut-off scores increase (> 25% and > 28.12%), the likelihood of being able to interpret EIM, AGG, SE, and ICS decreases. Psychometric and clinical implications are discussed.

Abstract : Although the Rorschach white space response (S) has been traditionally interpreted in terms of oppositional tendencies attempts to validate this relationship have been hampered by the lack of a criterion specific measure of oppositionality. As part of a broader investigation of the relationship between handedness and personality styles, a rating scale measure of oppositionality was designed. Oppositionality ratings were obtained for 40 male Navy enlisted men and correlated with white space scores earned by each S on the Rorschach test. Significant positive correlations between degree of rated oppositionality and amount of white space perception were obtained. High levels of white space response were found to be most effective in prediction of the degree of rated oppositionality.

Abstract : Identifying performance-based assessments of emotion regulation is needed for the study of myriad mood and neurological disorders. Color and form responses on the Rorschach Inkblot Method are valid measures of emotion response control, but have not been studied in relation to known neural correlations of emotion regulation. A discrepancy of color (CF + C) greater than form (FC) responses suggests low cognitive control over emotional responses. This preliminary report explores the discrepancy between form-color responses as a correlate of regional cortical thickness. A sample of community-dwelling adults were administered the Rorschach Inkblot Method and participated in a structural MRI scan. Greater middle frontal cortex thickness was associated with a positive discrepancy score [(CF + C) – FC], indicating less emotion response control (rs = 0.48, p < 0.05); a moderate, non-significant correlation was also observed with insula cortex (rs = 0.42, p = 0.07).The results provide evidence in support of the Rorschach Inkblot Method as a valid behavioral measure of emotion response control. More specifically, these results support the use of color-related variables included in contemporary evidence-based Rorschach methods. The results are discussed with implications for the study of emotion regulation in mood disorders and sensitivity analyses based on the observed effect sizes are reported to inform future study planning.

Abstract : Better therapeutic alliances are known to predict better treatment outcomes, but little knowledge still exists on the patient characteristics that lead to better alliances. In a sample of 128 outpatients assigned to long-term psychodynamic psychotherapy and suffering from mood and/or anxiety disorder, this study evaluated how the alliance, measured using the Working Alliance Inventory (WAI), is predicted by three different measures for assessing psychological resources and vulnerabilities: the Wechsler Adult Intelligence Scale—Revised (WAIS–R), the Defense Style Questionnaire (DSQ), and the Rorschach-based Ego Impairment Index (EII-2). All the three measures showed some ability to predict the development of the alliance during long-term therapy. The WAIS–R was found to be the strongest independent predictor, with higher intelligence scores predicting favorable development of both the patient- and therapist-rated alliance. Lower DSQ values, indicating less use of immature defenses, predicted greater improvement in the patient- but not the therapist-rated alliance. Higher EII-2 values, indicating more problematic ego functioning, predicted likewise greater patient-rated alliance improvement over the course of treatment. These findings support the value of pretreatment multimethod psychological assessment when tailoring treatment to the individual needs of patients.

Abstract : This study investigated the cultural and linguistic adaptability of the Rorschach Performance Assessment System (R-PAS), a new Rorschach administration, scoring, and interpretation system that minimizes psychometric weaknesses of the Comprehensive System (CS). This investigation addressed the validity of R-PAS measures of psychotic characteristics and psychopathology severity in Taiwan, including the incremental validity of the R-PAS relative to the CS variables measuring the same constructs. Ninety Taiwanese individuals (75 psychiatric patients and 15 nonpatients) were tested with standard R-PAS administration and scoring. Two non-Rorschach severity of disturbance measures and 2 psychosis measures served as independent criterion measures. The R-PAS measures were found to be valid in Taiwan in assessing psychotic symptoms and psychopathology severity, thus demonstrating cultural and linguistic adaptability. Moreover, hierarchical regression analyses demonstrated incremental validity for the R-PAS variables over their CS counterparts, providing support that the R-PAS revisions enhance the test psychometrically. These research findings also demonstrate the viability of the R-PAS as a Rorschach system that can be effectively employed outside the U.S. in a different language and culture.

Abstract : Research suggests that productivity could impact the stability of Rorschach scores. To explore for this effect, we conducted secondary analyses of test–retest data gathered using the Rorschach Comprehensive System (Exner, 2003) and available for 75 French, nonpatient adults (Sultan, Andronikof, Reveillere, & Lemmel, 2006). We examined how response frequency (R) impacted stability using hierarchical regression models. Results on 83 variables from the lower part of the structural summary showed that stability was impacted by the mean level of productivity in 12 variables with medium to large effects (including Zf, HVI, and W location). Stability was also impacted by variations of productivity in 9 variables with medium to large effects (including Passive Movement, D Location, or Human Contents). Higher mean R and variability of R impacted stability levels negatively. Transforming scores into proportions (i.e., dividing scores by R) was beneficial for some important variables (including FM+m, Zf, DQ+). Procedures should be developed to limit productivity and control for R variations across time if one wishes to derive more reliable descriptions of individuals from the Rorschach.

Abstract : There is lack of empirical findings on a direct link between suicidality and dependency in youth. This is particularly relevant for children and adolescents with a trauma history, since traumatization is a well-established risk factor for suicidality in this population. Research on dependency predominantly uses self-report assessments, which may be susceptible to biases. In this study, performance-based interpersonal dependency scores in inpatient children and adolescents with trauma history were compared with patients' suicidal behavior (suicidal ideation and suicidal attempts) as derived from chart records. The results showed a gender effect. High dependency scores were associated with higher suicidal ideation for girls and with lower suicidal attempts for boys. These findings demonstrate that a relationship between dependency and suicidality for hospitalized traumatized youth is impacted by gender.

Abstract : Since the publication of the Rorschach Inkblot Method (Rorschach, 1921/1942), theorists, researchers, and practitioners have been debating the nature of the task, its conceptual foundation, and most important its psychometric properties. The validity of the Rorschach Comprehensive System (CS; Exner, 1974, 2003;Exner & Weiner, 1995) has been supported by several meta-analyses that used different types of non testexternal criterion for validating individual variables. In a recent meta-analysis, Mihura, Meyer, Dumitrascu, and Bombel (2013) found coefficients ranging from modest to excellent for most of the selected CS variables, with 13 of them reported as showing “little to no support.” This article focuses on these variables. Although endorsing Mihura et al.’s mainly validating findings, we also suggest that the evidence presented for the little or no validity of these 13 variables is not quite compelling enough to warrant changing their definition or coding, or removing them from the system. We point to some issues concerning the description and interpretation of these variables and the appropriateness of the external criteria used for exploring their validity, and suggest considering these issues in further CS research. Implications of Mihura et al.’s meta-analysis for clinical and forensic practice are discussed.

Abstract : The study attempts to demonstrate a structurally-based consistency to subjects' object relations as measured across various independent ratings. Particular interest was aimed at the capacity of the Rorschach to tap developmentally crucial aspects of the structure of patients' object relations. A scale was developed to measure the degree to which relationships between figures on the Rorschach were perceived in terms of a mutuality of autonomy. These Rorschach ratings were then correlated with independent measures of this mutuality of autonomy dimension which were obtained from a written autobiography, and ratings by ward staff. Based on a sample of 40 inpatient subjects, the resulting intercorrelation among measures proved to be highly significant.

Abstract : The level of personality functioning, relevant for treatment planning, can be evaluated by the Rorschach Comprehensive System (CS) Ego Impairment Index-2 (EII2) and by interview assessment of the severity of personality pathology. However, few studies on the association between these assessment methods have been reported. This study examines the strength of association between the EII-2 and its subcomponents with the interview-based Level of Personality Organization (LPO) assessment scale, and investigates their mutual associations with psychiatric symptoms, diagnoses, and history. Altogether, 315 mood or anxiety disorder out patients without severe personality pathology we reassessed with the LPO and tested with the CS, on which the EII-2 and its subcomponents (FQ-, WSum6, Criticalcontents, M-, PHR, GHR, and R) were calculated. Significant, but weak association between the EII-2 and the LPO was found. The WSum6, a measure of thought disorder, was the only EII-2 subcomponent significantly associated with the LPO. Both measures were consistently associated with psychiatric symptoms, diagnoses and history.The findings partially support the EII-2 and the LPO as consistently associated, relatively independent measures of the severity of personality pathology. More research on the incremental benefits of the measures is needed in clinical populations, covering non-severe and complex psychopathology.

Abstract : Over the years, projective tests lost their power and became the target of criticism. The methods were old, not supported by any powerful evidence, and were ridiculed in cartoons, movies, and popular media. It is difficult for clinicians to deal with these criticisms. A difficulty often heard among clinicians who are proficient in personality assessment is how to cope with skepticism and preconceptions in the use of projective methods. Working in a forensic setting and a residential setting for people with severe personality disorders challenged us on how to implement the Rorschach in our daily work as assessors, teachers, and supervisors. In this article we describe our journey in trying to work collaboratively with our clients, management staff, colleagues, and students in the use of projective methods. Although research overall shows that multimethod assessment is the gold standard, daily practice shows differently. The use of semi-structured self-report methods seems to be more popular, and these are perceived as more evidence-based. We compare the implementation of the Rorschach in an evidence-based setting with the implementation of a new therapeutic model from a heuristic point of view (Hutsebaut et al., 2012).

Abstract : To address the utility of the Rorschach, the author synthesized a large sample (N = 138) of empirical, quantitative research published in the past 20 years. Longitudinal and behavioral criteria and ecological incremental validity beyond self-report and interview were emphasized because of their relationship with test applications. Methodological issues (temporal consistency, diversity, clinician judgment), applications (treatment outcome, schizophrenia, thought disorder, depression and suicide risk), and selected Rorschach variables are addressed. The evidence reveals that many Rorschach variables are efficient tools for clinical, forensic, and educational applications. The test is particularly useful in (a) individualizing case conceptualizations and interventions and (b) predicting and evaluating outcomes. These conclusions are consistent with using the Rorschach as a behavioral problem-solving test that illuminates the interaction among psychological, biological, and environmental factors.

Abstract : Based on available research findings, the Rorschach Performance Assessment System (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011) was recently developed in an attempt to ground the administration, coding, and interpretation of the Rorschach in its evidence base, improve its normative foundation, integrate international findings, reduce examiner variability, and increase utility. This study sought to establish inter-rater reliability for the coding decisions in this new system. We randomly selected 50 Rorschach records from ongoing research projects using R-Optimized administration. The records were administered by 16 examiners and came from a diverse sample in terms of age, sex, ethnicity, educational background, and patient status. Results demonstrated a mean intraclass correlation of .88 and median of .92. Overall, the findings indicate good to excellent inter-rater reliability for the great majority of codes and are consistent with previous findings of strong inter-rater reliability for alternative Rorschach systems and scores.

Abstract : The special issue editors selected us to form an “adversarial collaboration” because our publications and teaching encompass both supportive and critical attitudes toward the Rorschach and its recently developed system for use, the Rorschach Performance Assessment System (R-PAS). We reviewed the research literature and case law to determine if the Rorschach and specifically R-PAS meet legal standards for admissibility in court. We included evidence on norms, reliability, validity, utility, general acceptance, forensic evaluator use, and response style assessment, as well as United States and selected European case law addressing challenges to mental examination motions, admissibility, and weight. Compared to other psychological tests, the Rorschach is not challenged at unusually high rates. Although the recently introduced R-PAS is not widely referenced in case law, evidence suggests that information from it is likely to be ruled admissible when used by a competent evaluator and selected variables yield scores that are sufficiently reliable and valid to evaluate psychological processes that inform functional psycholegal capacities. We identify effective and ethical but also inappropriate uses (e.g., psychological profiling) of R-PAS in criminal, civil, juvenile, and family court. We recommend specific research to clarify important aspects of R-PAS and advance its utility in forensic mental health assessment

Abstract : Currently, there is some debate about whether to use Comprehensive System norms (CS; Exner, 2003) or the Composite International Reference Values (CIRV; Meyer, Erdberg, & Shaffer, 2007) when interpreting Rorschach Inkblot Method (RIM; Rorschach, 1921) protocols administered with the CS method. The goal of this study is to assist clinicians in making this decision by providing information about the effects of choosing one option or the other. Accordingly, this research evaluates the effects of using the CS versus CIRV norms with children, adolescents, and adults. First, we identified 43 variables for which the CS and the CIRV for children and adolescents differ from each other by at least a Cohen’s d value of .50. Next, we evaluated whether these divergent variables are the same as those previously identified as divergent for the adult population. Results showed that for both children and adolescents, as well as for adults, relying on CS norms versus CIRV would result in interpretations that are more pathological in terms of (a) perception and thinking, (b) psychological resources and cognitive and emotional abilities, and (c) representations of human relationships. A discussion on the clinical effects of using one versus the other set of norms follows.

Abstract : 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.

Abstract : A large body of empirical evidence supports the reliability, validity, and utility of the Rorschach. This same evidence reveals that the recent criticisms of the Rorschach are largely without merit. This article systematically addresses several significant Rorschach components: interrater and temporal consistency reliability, normative data and diversity, methodological issues, specific applications in the evaluation of thought disorder and suicide, meta-analyses, incremental validity, clinician judgment, patterns of use, and clinical utility. Strengths and weaknesses of the test are addressed, and research recommendations are made. This information should give the reader both an appreciation for the substantial, but often overlooked, research basis for the Rorschach and an appreciation of the challenges that lie ahead.

Abstract : Variability in the number of Rorschach responses (R) has stimulated controversy among clinicians and researchers for many years, and recent research reveals that R is much more variable than previously thought. Because R is correlated with other scores, its excessive variability may reduce the reliability, validity and clinical utility of these other scores. We present two experimental studies and additional results from other clinical datasets with the aim of developing a new administration procedure to diminish variability in R by reducing the number of very short and long records. In the first experiment, protocols were obtained using standard Comprehensive System administration or an alternative where we encouraged a second response if only one was given to a card and allowed only four responses on each card. This alternative method reduced the proportion of short records but produced an undesirable number of long records. To minimize the proportion of long records, in a second experiment, we added an instruction to give two or maybe three responses per card when introducing the test. Comparisons to CS administrations revealed that this procedure reduced variability in R by limiting the proportion of both short and long records. This reduced range was largely retained in an outpatient sample of older respondents with schizophrenia and a mixed clinical sample. Thus, we recommend this method of optimizing the range of R, which has since been included with very minor changes in the Rorschach Performance Assessment System. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message:• Alternative administration method successfully eliminated overly short and excessively long records.? Utility is potentially increased by greatly reducing both short records that often lack reliability and validity, as well as long records that consume an excessive amount of examiner administration and scoring time.• Psychometric properties and the ability to apply parametric statistics are likely increased across variables given that the distribution of R is more normal.• Re-administration due to inadequate R is almost never needed.• Results are consistent with the conclusion that this alternative procedure reduces examiner variability by offering simple, but explicit instructions for encouraging sufficient productivity.• Overall variability of R produced using the refined alternative procedure was significantly less than that produced using the traditional CS method, although more in line with Exner’s (2003) normative expectations.? Suggests that when using the alternative method, R becomes less of a confound for all other scores that are moderately to highly correlated with R.• Also demonstrated that the reduced variability of R and the reduced number of less useful short and long records are generalized to clinical samples.? Additional research (Reese, Viglione, & Giromini, 2014) provides support for these conclusions with child clinical samples.

Abstract : Learning to code the imagery, communication, and behavior associated with Rorschach responding is challenging. Although there is some survey research on graduate students’ impressions of their Rorschach training, research has not identified which coding decisions students find to be the most problematic and time-consuming. We surveyed students to identify what they struggled with most when learning coding and to quantify how difficult it is to learn how to code. Participants (n = 191) from the United States, Brazil, Denmark, Israel, and Italy rated 57 aspects of coding using a 4-point scale that encompassed both the time required to code and the subjective difficulty of doing so. Mean ratings for coding in general indicated that students considered the overall task challenging. Ratings also revealed that students struggled most with Cognitive Special Scores, Determinants, and extrapolating from the tables to code Form Quality for objects that were not specifically listed. The findings offer suggestions about how to improve the guidelines for some of the more difficult variables and where it is most necessary to focus teaching time. Taking these steps might help new students in learning the Rorschach.

Abstract : We used multiple regression to calculate a new Ego Impairment Index (EII-3).The aim was to incorporate changes in the component variables and distribution of the number of responses as found in the new Rorschach Performance Assessment System, while sustaining the validity and reliability of previous EIIs. The EII-3formula was derived from a large, diverse, developmental sample (N = 411) and was tested on an independent validation sample (N = 206) procured from psychiatric, forensic, research, and nonclinical control contexts. Additional analyses revealed high correlations with previous EIIs with similar reliability and validity but superior distributional qualities.

Abstract : The Human Experience Variable (HEV; Perry & Viglione, 1991) provided information about interpersonal perceptions not previously available within the Comprehensive System (CS; Exner, 1993). Research data suggests that it was related to interpersonal functioning and as a result, psychological impairment and health. In this article, we present the rationale and empirical basis for recent psychometric refinements to the HEV, consequently renamed the Human Representational Variable (HRV). Research addressing the reliability and validity for the HRV is summarized. Based on data and experience with the HEV, this study summarized some small modifications to the original algorithm. The refined variable, the HRV, has been added to the CS (Exner, 2000). Data presented here suggest that the HRV has improved psychometric properties compared to the HEV and that it is simpler to understand. Research recommendations and interpretive suggestions are also presented.

Abstract : The Ego Impairment Index (EII; Perry & Viglione, 1991) is a composite measure of psychological impairment and thought disturbance developed from the empirical and theoretical literature on the Rorschach. In this article, we summarize reliability and validity data regarding the EII. Our major goal was to present the rationale and empirical basis for recent refinements in the EII. Among the subcomponents of the original EII was the Human Experience variable (HEV), which has recently been revised and replaced with the Human Representational variable (HRV; Viglione, Perry, Jansak, Meyer, & Exner, 2003). In this study, we replaced the HEV with the HRV to create the EII–2. This was accomplished by recalculating the factor coefficients with a sample of 363 Rorschach protocols. We present additional validity data for the new EII–2. Research recommendations and interpretive guidelines are also presented.

Abstract : This chapter provides a meaningful, comprehensive, and historically informative conceptual framework for understanding performance tests of personality. Their distinctive characteristics are discussed, along with what they add to assessment, and how one should understand and interpret them. An explanation of why the term projective has been replaced with the term performance is provided. Additionally, common misperceptions about performance tests and a more informed approach to using them are addressed. A response process framework that includes both self-expressive and organizational components—that is, what the respondent says and how he or she structures the response—is provided as a framework for understanding these tests. A problem-solving model in which input-processing-output is the response sequence is used to explain how to understand the performance test response. The implications of the response process framework for performance tests of personality and contributions of this type of testing to assessment at large are addressed. In general, discussion of specific tests is limited to the Rorschach, Thematic Apperception Test, figure drawings, sentence completion tests, and the early memory tests.

Abstract : Although a great deal of data has been published in the past 20 years supporting the interrater reliability of the Rorschach, recently commentators have raised anew concerns over the interrater reliability of this well-known and frequently used measure. An analysis of the literature reveals that these concerns are based on a selective review of the literature. The current study reports interrater reliability statistics for 70 interpretive Rorschach variables (n = 84), breaking down intraclass correlations statistics by base rate. Results confirm the strong empirical evidence of the interrater reliability of this measure when scored by a well-trained and diverse group of researchers and clinicians. Reliability is especially strong and consistent for the high base-rate variables from which clinicians often base their interpretations. These data further suggest that large samples are needed for stable reliability estimates of low base-rate variables and that estimates of the reliability of low base-rate variables are subject to error.

Abstract : Partially, in response to recent and current military conflicts, many forensic and clinical researchers and practitioners have devoted increasing interest to post traumatic stress disorder (PTSD) and the individual variations in response to trauma. Such efforts have produced a considerable amount of research and opinion supporting the assessment of post-traumatic conditions with the Rorschach Inkblot Test. Based on PTSD and Rorschach research and an appreciation as the Rorschach as a performance test, five interpretive considerations are presented (1) cognitive constriction,(2) trauma-related imagery, (3) trauma-related cognitive disturbances, (4) stress response, and (5) dissociation. These five provide a conceptual starting point for the understanding and application of the test to post-traumatic conditions. Implications for the clinical and forensic evaluation of post-traumatic conditions and for research are presented.

Abstract : There were several typographical errors in Appendix B, which describes simplified procedures for manually calculating the EII–2 score. The corrected values are given below. For actual calculations, the example values underlined would be replaced by client-specific values.

Abstract : In this brief article, we update the training of newer versions of the Minnesota Multiphasic Personality Inventory (MMPI) and Rorschach and compare to a 2015 assessment training survey of American Psychological Association accredited clinical psychology doctoral programs. The survey sample sizes for 2015, 2021, and 2022 were 83, 81, and 88, respectively. By 2015, of the programs teaching any adult MMPI version, almost all (94%) were still teaching the MMPI-2, and 68% had started teaching the MMPI-2-RF. In 2021 and 2022, respectively, almost all programs (96% and 94%) had started teaching the MMPI-2-RF or MMPI-3, although most were still teaching the MMPI-2 (77% and 66%). By 2015, of the programs teaching the Rorschach, 85% were still teaching the Comprehensive System (CS) and 60% had started teaching the Rorschach Performance Assessment System (R-PAS). In 2021 and 2022, respectively, most programs had started teaching R-PAS (77% and 77%) although many (65% and 50%) were still teaching the CS. Therefore, doctoral programs are indeed switching to newer versions of the MMPI and Rorschach, although more slowly than one might expect. We recommend that APA provide more guidance in selecting test versions for training programs, practitioners, and researchers.

Abstract : In this article, the authors discuss how the Rorschach can be useful in certain Therapeutic Assessments (TAs) by creating an opening for clients to report and discuss past traumatic events that have not previously been resolved. Two case examples are presented. In the first, a 31-year-old woman sought psychological help to understand why she was so afraid all the time, why she did not know what was best for her, and why she was so influenced by others’ opinions. The client saw many disturbing percepts in the Rorschach and was very unsettled afterward. During an extended inquiry she revealed an extensive history of physical and sexual abuse that she had put out of her mind and never told anyone about previously. Talking about her trauma with the assessor helped her understand why she was struggling. In the second case, a 35-year-old woman experienced a flashback when presented with Card X to finding her father after his suicide when she was 8 years old. The client had not previously recalled the details of this event, which were verified by family members. Retrieving this memory helped the client understand her family better and resolve problems she had in her adult romantic relationships. We believe there are essential elements that permit such therapeutic events to occur: (1) the power of the Rorschach to access split-off affects and memories, (2) the secure relationship created in TA that allows for traumatic material to emerge safely, (3) the technique of scaffolding in TA that helps locate clients' growing edge, and (4) how client–assessor collaboration creates an intersubjective field in which nonlinear healing events may occur.

Abstract : Recently, an eye-tracking study found that Complexity and other R-PAS variables located in the Engagement and Cognitive Processing domain correlated with a proxy marker for cognitive effort and engagement. The goal of the current study was to test the robustness and validity of those eye-tracking findings by inspecting fMRI data. We hypothesized that the greater the level of engagement and cognitive effort put in place by a Rorschach test-taker, the greater the engagement of his/her cortical areas reflecting ongoing top-down attentional processes should be. We re-analyzed archival fMRI data from 26 healthy participants exposed to the Rorschach inkblots with the instruction to think of what they might be. The association of various Engagement and Cognitive Processing R-PAS scores to increased BOLD signals in the Dorsal Attention Network of the brain was examined. As expected, Complexity showed the strongest effect size across all R-PAS variables under investigation (d = 0.43), followed by Synthesis (d = 0.32) and Human Movement (d = 0.21). Noteworthy, the correlation between the effect sizes found in the current fMRI study and those found in the previously published eye-tracking study consists of an impressive r = .80.

Abstract : A survey of 7,934 recent federal and state court cases in which psychologists presented Rorschach testimony revealed only 6 in which the appropriateness of the Rorschach was challenged and just one in which the testimony was not admitted into evidence. There is accordingly good reason to believe that, despite occasionally voiced concerns to the contrary, the Rorschach is welcome in the courtroom.

Abstract : We comment on the meta-analysis by Mihura, Meyer, Dumitrascu, and Bombel (2013), which examined the validity of scores in Exner’s Comprehensive System (CS) for the Rorschach. First, we agree there is compelling evidence that 4 categories of cognitive scores—the “Rorschach cognitive quartet”—are related to cognitive ability/impairment and thought disorder. We now feel comfortable endorsing the use of these scores in some applied and research settings. Second, we conducted new meta-analyses (k _ 44) for the 4noncognitive Rorschach scores with highest validity in the Mihura et al. findings. Unlike Mihura et al., we included unpublished dissertations (although we did not attempt to exhaustively unearth all unpublished studies), calculated correlations instead of semi partial correlations, and used the Rorschach International Norms for a larger proportion of comparisons. Our validity estimates for the Suicide Constellation and Weighted Sum of Color were similar to or even higher than those of Mihura et al., although we concluded that support for the Suicide Constellation is limited and that Weighted Sum of Color probably does not measure its intended target. Our validity estimates for Sum Shading and the Anatomy and X-ray score were much lower than those of Mihura et al. We conclude that their meta-analysis accurately reflects the published literature, but their exclusion of unpublished studies led to substantial overestimates of validity for some and perhaps many Rorschach scores. Therefore, the evidence is presently insufficient to justify using the CS to measure noncognitive characteristics such as emotionality, negative affect, and bodily preoccupations.

Abstract : The present article comments on a classic study by Garfield (1947) then reviews research on the Rorschach and psychiatric diagnoses. Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool. Deviant verbalizations and bad form on the Rorschach, and indices based on these variables, are related to Schizophrenia and perhaps to Bipolar Disorder and Schizotypal Personality Disorder. Patients with Borderline Personality Disorder also seem to give an above-average number of deviant verbalizations. Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or psychopathy.

Abstract : The norms of the Comprehensive System (CS) for the Rorschach have been praised for their scientific and clinical value. However, recent findings by Shaffer, Erdberg, and Haroian suggest that the CS norms are inaccurate. We examined 14 CS variables in 32 studies of non-patient adults. The participants in these studies exhibited statistically and clinically significant differences from CS nonpatient norms for all 14 variables. Overall, nonpatient adults tended to appear pathological when compared with the CS norms. The implications of these findings for misdiagnosis and the misperception of psychopathology are discussed. Use of the CS norms in clinical or forensic settings is inadvisable. Commonly held beliefs about the validity of CS variables are likely to be false and in need of revision.

Abstract : The Comprehensive System (Exner, 1993) is widely accepted as a reliable and valid approach to Rorschach interpretation. However, the present article calls attention to significant problems with the system. First, contrary to common opinion, the interrater reliability of most scores in the system has never been demonstrated adequately. Second, important scores and indices in the system are of questionable validity. Third, the research base of the system consists mainly of unpublished studies that are often unavailable for examination. Recommendations are made regarding research and clinical use of the Comprehensive System.

Abstract : Psychological assessment has been a defining area of practice, training, and research for professional psychologists since the field’s inception. We conducted the present survey of professional psychologists as a follow-up to surveys conducted by the American Psychological Association in the 1990s to describe (a) current psychological assessment practices and trends; (b) demographic factors and beliefs associated with assessment use; (c) barriers discouraging assessment use; and (d) factors that may encourage psychologists to make assessments a larger part of their practices. Our survey supports the common perception that, in general, assessment represents a smaller part of the practices of professional psychologists than before managed care; however, for psychologists in some specialty areas and settings (e.g., forensic psychology, inpatient settings), assessment represents a significant portion of their work. Moreover, the large majority of psychologists believe psychological assessment is a valuable aid in making diagnostic decisions and treatment recommendations. Many psychologists identify that greater coverage by third-party payers, as well as having access to less costly assessment instruments, would enable greater use of assessment.

Abstract : Limit testing in psychological assessment is understood typically as a unidirectional technique in which the assessor intentionally introduces a parameter(s) in the service of data gathering by modifying standard procedures. Other parameters are introduced as conflict-based enactments tied to projective identification processes, and represent modifications in the assessment framework. Such modifications, abstracted from the psychotherapy literature, include atypical shifts in the assessor’s usual practices concerning fees, scheduling, confidentiality, privacy, anonymity, administrative and technical procedure, and intervention style. In this article, I suggest that most framework modifications, if analyzed, hold the promise of an incremental data yield. These points are illustrated through discussion of (a) the assessment frame, enactments, and projective identification; (b) transference–countertransference interplay in response to frame issues; (c) 2 Rorschach responses that symbolically reflect enactments and projective identification; (d) interaction with coding consultants; (e) configurational analyses of the Rorschach responses; (f) patient–assessor and assessor–consultant parallel processes; and (g) test feedback.

Abstract : Differences in perceptional processes between shading responses and achromatic-color responses were examined by comparing eye movements. The following hypotheses were tested. Hypothesis 1: Shading responses, compared to non-shading responses, would show an increased fixation time directed at the inside of the area of shading stimuli and a decreased fixation time directed at the outline. Hypothesis 2: The differences in fixation times proposed in Hypothesis 1 would not be observed between achromatic-color responses and non-achromatic-color responses. Eye movement data of 60 responses produced for the W in Card IV and D1 in Card VI were analyzed. The results indicated that shading responses had significantly longer fixation times directed at the inner area and significantly shorter fixation times directed at the outline, compared to non-shading responses. On the other hand, achromatic-color responses did not show a significant main effect or interaction. The above results supported Hypotheses 1 and 2.

Abstract : The creation of the Rorschach Performance Assessment System (R-PAS) requires research that allows its use in the Brazilian population. The Formal Quality (FQ) category is essential both for clinic and research. The aim of this study was to compare form quality variables in Rorschach protocols from psychiatric patients and ratings coded in the Comprehensive System (CS) and R-PAS. The sample comprised 206 Rorschach protocols from adult patients in psychiatric treatment, who were also assessed by SCID-I and SCID-II. Most protocols were administered in the CS and recoded according to the R-PAS. The kappa coefficient was calculated, and we compared the means of these variables in both systems. The kappa results varied from almost perfect to substantial consistency for all variables, however, the descriptive statistics confirmed that the R-PAS elicits more FQ ordinary coding while the CS elicits more FQ minus coding.

Abstract : We examined the utility of inferential norming using small samples drawn from the larger Wechsler Intelligence Scales for Children–Fourth Edition (WISC-IV) standardization data set. The quality of the norms was estimated with multiple indexes such as polynomial curve fit, percentage of cases receiving the same score, average absolute score differences, score distributions, score correlations, and sensitivity in identifying children who are gifted or intellectually disabled. Norms developed using inferential norming method and sample sizes of 50 and 75 per age group had qualities comparable to the norms derived using larger sample size. So, when large sample sizes are infeasible due to practical constraints, N = 50 per group can be considered a lower bound to derive decent norms using inferential norming method. Cautions for implementing inferential norming with smaller sample sizes and suggestions for future research are discussed.

Abstract : PTSD elicits hypervigilance to trauma-related stimuli. Our novel research examined event-related potentials from Blood, Anatomy, and Morbid content derived from the Rorschach's traumatic content index (TCI). Participants included: 16 with PTSD, 24 trauma-exposed without PTSD (non-PTSD), and 16 non-traumatized Controls. P3 oddball paradigms were used with TCI-derived Distractors and neutral Targets/Standards. We predicted larger P3 amplitudes in the context of TCI-related Distractors among trauma-exposed participants. Significant interaction of Group and Distractor type was found for P3 amplitude. PTSD and non-PTSD groups exhibited larger P3 amplitudes from Blood and Anatomy Distractors, and attenuated amplitudes from Morbid; the reverse pattern was found among Controls. A late negative component was observed, denoting a significantly larger area under the curve (AUC) among the PTSD group for Anatomy and Blood Distractors. Larger AUC's were observed for Distractors among the PTSD group, and Targets among Controls. The findings concur with the neurocircuitry model of PTSD and suggest impairment in cerebral suppression of attention to stimuli that may have been perceptually primed with trauma.