Rorschach aggression variables: a study of reliability and validity

This study investigated the extent to which 6 Rorschach variables of aggression (A1, A2, AG, MOR, AgC, AgPast) are related to one another, to the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) Cluster B personality disorder criteria, and to self-report measures of anger, aggression, and antisocial behavior. Seventy-eight patients were found to meet DSM-IV criteria for an Axis II disorder, Cluster A personality disorder (paranoid, schizoid, schizotypal) = 9, Cluster B (antisocial personality disorder [ANPD] = 16, borderline personality disorder [BPD] = 23, histrionic personality disorder = 5, narcissistic personality disorder = 12) = 56, and Cluster C personality disorder (avoidant, dependent, obsessive-compulsive) = 13. The results of this study indicated that (a) these 6 Rorschach aggression variables can be scored reliably; (b) 2 factors, revealed by factor analysis, accounted for 77% of the total variance; (c) selected variables were found to be empirically related to DSM-IV diagnostic criteria for ANPD and BPD; and (d) selected variables were found to be empirically related to a self-report measure of anger and antisocial practices. The conceptual nature and clinical utility of these Rorschach aggression variables as well as implications for future research are discussed.     

Rorschach intercoder reliability for protocol-level comprehensive system variables in an international sample

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.     

The Rorschach test for predicting suicide among depressed adolescent inpatients.

With the decreasing length of psychiatric hospitalizations, identification of test indicators of suicide risk becomes critically important. This Rorschach study was designed to model a clinical decision-making scenario concerning adolescent suicide risk. Using Psychiatric Evaluation Form (PEF) scores, we selected a sample of 25 severely depressed and suicidal adolescents; 26 severely depressed, not suicidal adolescents; and 28 not suicidal, not depressed adolescent inpatients at The Sheppard and Enoch Pratt Hospital. A Rorschach Index using the Exner (1986) Comprehensive System for scoring was developed to predict group membership. Four of six of the features on this index selected 64% of suicidal subjects. This constellation included traditional affective variables (vista responses, color-shading blends, color dominated responses, and morbid content) as well as measures of cognitive distortion (inaccurately perceived human movement responses [M-] and special scores). We discuss the implications of these findings for the diagnosis and treatment of the suicidal adolescent.     

Usefulness of structural Rorschach data in identifying inpatients with depressive symptoms: a preliminary study

To explore the usefulness of various structural Rorschach data in identifying psychiatric inpatients with symptoms of depression, 54 adult inpatients were administered a Rorschach. Results indicated that the Comprehensive System, Rorschach Depression Index did not identify many of these individuals as depressed, but did identify most of the extratensive depressed individuals. Each variable included in the Depression Index and other potential, Rorschach correlations of depression were also investigated. Most of them were found to occur more often among these depressed patients than among nonpatients. Furthermore, adding other variables and using more liberal cutoffs may result in more accurate identification of patients with depressive symptoms.     

The Last-Weiss Rorschach Ego-Strength Scale as a prognostic measure for psychiatric inpatients

This study tested the hypothesis that the Last-Weiss (Last & Weiss, 1976) Rorschach Ego-Strength Scale would predict outcome among a representative sample of first-lifetime psychiatric admissions. One hundred seventeen patients were assessed with structured symptom, psychiatric history, and social data interviews at hospital admission, and 2-year follow-up. Outcome measures included a multidimensional variable involving rehospitalization time, social and work functioning, and recent symptom level and symptom measures. Unexpectedly, the Last-Weiss Sum E variable correlated significantly with negative multidimensional outcome, a result that was strengthened when any possibly confounding effects of social class, IQ, and number of Rorschach responses were partialled out. It was found that Sum E's predictive value for poorer outcome was due to the space response (S+) component of the ego-strength variable. Possible explanations of the findings and implications for the previously validated Klopfer's Rorschach Prognostic Rating Scale are discussed.     

Attributional versus preattributional variables in self-esteem and depression: a comparison and test of learned helplessness theory

Predictions made according to the attributional reformulation of learned helplessness theory concerning the cognitive determinants of low self-esteem and depression were tested in two samples of undergraduates; real and hypothetical life events were used. As predicted, internal attributions for hypothetical success and failure were correlated with self-esteem, but there was an unexpected correlation with global attributions for negative outcomes. Two "preattributional" variables, consensus and consistency judgments, were also related to self-esteem and depression. In contrast to learned helplessness theory, a path analysis indicated that these variables were not attributionally mediated. Consensus judgment was as strong a predictor of depression as the number of recent distressing life events that subjects had experienced. Other evidence that links depression to perceived low consensus is described, and a possible etiological role for this variable is outlined.     

Attributional styles for helplessness and depression: The importance of sex and situational context

Differences between the sexes in attributions for positive and negative outcomes in either affiliative or achievement situations were examined using the Attributional Style Questionnaire (ASQ). Separate regression analyses for each sex related the ASQ to a measure of helplessness and the Beck Depression Inventory. No differences were noted for attributions to internality or stability; however, females attributed more global causality to positive outcome affiliative situations and negative outcome achievement situations. Regression analyses failed to support the helplessness attributional model of depression. No ratings on the ASQ predicted depression for males; furthermore, for females, only the internal/external dimension was relevant, moderated by both outcome and type of situation. Sex differences were discussed in light of the higher incidence of depression among females.     

The interclinician reliability of Rorschach interpretation in four data sets

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.     

Proneness to hypomania/mania symptoms or depression symptoms and asymmetrical frontal cortical responses to an anger-evoking event

The behavioral approach system (BAS) reflects the propensity to respond to signals of reward, including stimuli associated with safety and goal-oriented attack (e.g., anger). Hypomania/mania has been posited to involve increased BAS activity. In contrast, depression has been posited to involve decreased BAS activity. Building on past research, which suggests that increased left frontal cortical activity is a neurophysiological index of BAS activity, the present research tested the hypotheses that proneness toward hypomania/mania symptoms would be related to increased relative left frontal activity and that proneness toward depression symptoms would be related to decreased relative left frontal activity in response to an anger-evoking event. Results from 67 individuals who had completed a measure of proneness toward these affective symptoms and were exposed to an anger-evoking event supported the hypotheses.     

Learned helplessness,depression and the perception of reinforcement

Depressed and nondepressed subjects were given escapable, inescapable, or no noise. Then, their perceptions of reinforcement contingencies in skill and chance tasks were assessed. Depressed-no noise and nondepressed-inescapable noise subjects exhibited smaller decreases in expectancy following failure in skill, but not in chance, than nondepressed-no noise subjects. So, depression and inescapable noise both produced perception of failure in skill as response-independent. Contrary to predictions, neither depression nor inescapable noise had a significant effect on increases in expectancy after success. These results partially support the learned helplessness model of depression which claims that a belief in independence between responding and reinforcement is central to the etiology and symptoms of depression in man.     

Construct validity of the helplessness/hopelessness/haplessness scale: correlations with perfectionism and depression

In a sample of 117 undergraduates, helplessness scores and the discrepancy scores on a measure of perfectionism predicted depression scores, providing evidence for construct validity for the hopelessness, helplessness, and haplessness scales.     

The Coping Competence Questionnaire: A measure of resilience to helplessness and depression

Based on helplessness/hopelessness theories of depression, the 12-item Coping Competence Questionnaire (CCQ) was designed to assess resilience against helplessness and depression. Evidence from a study involving 2,224 participants indicates that the CCQ is highly reliable, stable over a 1-month period, unidimensional, and internally valid. The CCQ converged negatively with measures of depression, neuroticism, and stress reaction and showed discriminant validity with a variety of other personality constructs. Compared to a measure of attributional style, the CCQ proved to be a superior predictor of depressed mood. Path models support the assumption that the CCQ buffers the effects of stress and negative life events on depressed mood and that dysfunctional coping mediates the effects of coping competence deficits on depression.     

MMPI and Rorschach indices of schizophrenic and depressive diagnoses among adolescent inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

The cognitive specificity of learned helplessness and depression deficits: The role of self-focused cognitions

Abstract

Four experiments assessed similarities and differences in learned helplessness and depression-related deficits in cognitive performance and self-focused cognitions. Subjects answered the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), were exposed to no-feedback or failure in unsolvable problems, and their response time in a digit comparison task (with or without a memory component, with different number of digits, and different number of mental transformations) and self-focused cognitions were assessed. Learned helplessness and depression deficits were found in a memory task, and the deficits increased with the number of digits. Depression deficits also increased with the number of transformations, and were also found in the no-memory/two transformation condition. Finally, task-related worries were related to learned helplessness deficits, and task-irrelevant thoughts were related to depression deficits. Findings were discussed in terms of the cognitive specificity of learned helplessness and depression deficits.     

A principal components analysis of Rorschach aggression and hostility variables

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 revealed 2 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.     

A meta-analysis of the reliability and validity of the Rorschach

The results of a meta-analysis of Rorschach studies indicate that reliabilities in the order of .83 and higher and validity coefficients of .45 or .50 and higher can be expected for the Rorschach--when hypotheses supported by empirical or theoretical rationales are tested using reasonably powerful statistics. Three important determinants of variance accounted for in a variety of Rorschach scores were identified in 530 statistics from 39 papers published in the Journal of Personality Assessment from 1971 to 1980. The a priori theoretical or empirical evidence determining the likelihood of obtaining significant results, and the power of the statistic used to measure the results, as well as the interaction between the likelihood of results and the power of the statistic used, were all significant determinants of the proportion of variance accounted for in the Rorschach measures reported.     

Tripartite model of depression and anxiety in youth psychiatric inpatients: relations with diagnostic status and future symptoms

Examined the relation of the depression aspect of the tripartite model of depression and anxiety to the diagnostic status and future symptoms of two samples that included 74 child and adolescent psychiatric inpatients, ages 7 to 17 years (M = 13.57, SD = 2.39), some with either internalizing or externalizing diagnoses. The tripartite model suggests that anhedonia (low positive affect, or PA) differentiates depression from other conditions, whereas generalized negative affect (NA) also characterizes depression but is not specific to it. In this study, differences among children in PA and NA were associated with depressive versus externalizing diagnostic status and with future symptoms of depression. Depressive disorder diagnoses were associated with the combination of low levels of PA and high levels of NA. Changes over time in depression, but not in anxiety, also were associated with the combination of low PA and high NA. Results provide support for the applicability, clinical utility, and extension of the tripartite model with children.