Rorschach Protocols From Children and Adolescents Diagnosed With Posttraumatic Stress Disorder

Rorschach protocols from 35 children and adolescents with posttraumatic stress disorder (PTSD) and 35 with oppositional defiant disorder (ODD) were compared. Both groups revealed significant differences from the normative tables on the same 12 variables: SCZI, DEPI, CDI, X+%, EgoC, Afr, T, EA, P, WSumC, RawSumSS, and WgtSumSS. However, as predicted, 4 of those variables, the Schizophrenic Index (SCZI) and 3 of the criterion tests that comprise it (X+%, RawSumSS, and WgtSumSS) were significantly different between the PTSD and ODD groups, with the PTSD group responding with more extreme scores. These findings contradict Exner's (1993) statement that only people with schizophrenia can be "defined or conceptualized as having both the problems of disordered thinking and inaccurate perception" (p. 356). Children and adolescents with PTSD also display these problems when trauma interrupts the child's naive belief that the world has predictable rules, the people in it are trustworthy and fair, and punishment and pain are consequences of bad behavior. When young victims cannot comprehend or make sense of what has happened to them, life becomes irrational, illogical, and confusing. Exner's SCZI does what it was designed to do: identify individuals with disordered thinking and inaccurate perception. Therefore, SCZI should be renamed the Perception and Thinking Index (PATI) to reflect its function rather than a diagnostic category.     

Rorschach Egocentricity Index and Self-Concept in Children and Adolescents

In a sample of 65 child and adolescent psychiatric inpatients, the hypothesized relation between the Egocentricity Index from the Rorschach and standard self-report measures of self-concept was not supported. Although the sample as a group had a markedly tow mean Egocentricity Index, self-reported self-concept was at a normative level. The validity of the Egocentricity Index and self-report measures of self-concept is discussed, and guidelines for their interpretation are presented.     

Irritability in Children and Adolescents With OCD

Irritability is a common, impairing transdiagnostic symptom in childhood psychopathology, though it has not been comprehensively studied in pediatric obsessive-compulsive disorder (OCD). Further, the central cognitive behavioral treatment component for OCD, exposure and response prevention therapy (ERP), has been recently proposed as a treatment for irritability. This study aimed to evaluate whether certain clinical characteristics are associated with irritability in pediatric OCD and whether irritability reduces following ERP. Participants were 161 youth (ages 7–17) with OCD and a caregiver participating in a randomized controlled trial of D-cycloserine or pill placebo augmented ERP. Participants completed validated assessments during treatment. Irritability was significantly and positively associated with depressive symptoms, defiance, functional impairment, and family accommodation, but was not associated with pretreatment OCD severity, symptom dimensions, obsessive beliefs. Irritability significantly declined following treatment, with over half of youth with any pretreatment irritability experiencing clinically significant change, though this change was not related to OCD improvement. Results suggest that irritability may be a marker of psychiatric comorbidity, parental accommodation, and impairment in youth with OCD. Implications for the exposure-based treatment of irritability are discussed.     

A Comparison Between Comprehensive System and an Early Version of the Rorschach Performance Assessment System Administration With Outpatient Children and Adolescents

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.     

Sex-Typed Responses in the Rorschach Protocols of Children With Gender Identity Disorder

A coding system was developed to measure sex-typed responses in the Rorschach protocols of children with gender identity disorder (n = 79). Their responses were compared to that of sibling (n = 25), psychiatric (n = 26), and normal (n = 28) controls. Results show that children with gender identity disorder gave significantly more cross-sex responses than same-sex responses, whereas the psychiatric and normal controls gave significantly more same-sex responses than cross-sex responses. The siblings did not differ in the number of same-sex and cross-sex responses. Results are discussed with regard to various assessment issues in the study of children with gender identity disorder.     

The Effects of Using the International Versus Comprehensive System Rorschach Norms For Children,Adolescents, and Adults

Currently, there is some debate about whether to use Comprehensive System norms (CS; Exner, 2003 Exner, J. E. (2003). The Rorschach: A Comprehensive System: Vol. 1. Basic foundations (4th ed.). New York, NY: Wiley. [Google Scholar]) or the Composite International Reference Values (CIRV; Meyer, Erdberg, &; Shaffer, 2007 Meyer, G. J., Erdberg, P., &; Shaffer, T. W. (2007). Toward international normative reference data for the Comprehensive System. Journal of Personality Assessment, 89(Suppl. 1), S201–S216.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) when interpreting Rorschach Inkblot Method (RIM; Rorschach, 1921 Rorschach, H. (1921). Psychodiagnostik [Psychodiagnostics]. Bern, Switzerland: Bircher. [Google Scholar]) 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.     

Sixteen-Session Group Treatment for Children and Adolescents With Parental Alienation and Their Parents

This study reports the findings of a 16-session parallel group therapy program for 22 children with parental alienation and their parents. The children's level of anxiety and depression decreased significantly following the therapeutic intervention. Families who had participated in the treatment protocol were found to have improved practical parameters of parental collaboration 12 months following the completion of treatment than a control group of families with parental alienation treated with standard community treatment. Parental object relation scores were negatively correlated with children's level of anxiety and depression at pretreatment and with the decrease in anxiety and depression level along the treatment.     

Brief Rorschach records with children and adolescents

In order to determine the frequency with which children and adolescents give brief Rorschach (R less than 14) records and to test the hypothesis that brief records represent a resistance to testing, the psychological evaluations of 439 admissions to an inpatient unit were reviewed. Of the records reviewed, 16.6% were found to contain less than 14 responses. When the complete test protocol of those subjects who provided brief records were compared with those of a matched group, it was found that the group with brief records failed to complete the other parts of the evaluation significantly more often than did those subjects who did not give brief records. There was no significant difference between the two groups on IQ scores or on self-report scores of depression, anxiety, and social desirability. Result are interpreted as supporting Exner's (1988) hypothesis that brief records represent a form of resistance to being tested.     

Rorschach Object Relations of Adolescents Who Committed Homicide

We investigated the object relations of adolescents who committed homicide. A clinical sample of 55 adolescents who committed homicide did not differ from a comparison group of nonviolent delinquents on Rorschach measures of object differentiation, mutuality of autonomy, and aggressive content. However, the subgroup of adolescents who committed homicides in the context of another crime (e.g., robbery or burglary) did manifest significantly lower object relations (poorer object differentiation and more victim responses) than the subgroup of adolescents whose homicides were committed in the context of an interpersonal conflict or dispute with the victim. These findings support the need for differentiated classification of violent individuals as urged by Megargee (1970) over 20 years ago.     

Rorschach Erlebnistypus and Problem-Solving Styles in Children

This study was designed to determine whether introversive versus extratensive children differed, on the basis of their Rorschach Erlebnistypus score, with respect to their approaches to three subtests (Block Design, Object Assembly, and Mazes) of the Wechsler intelligence Scale for Children-Revised. it was thought that the extratensives would manipulate the test materials more and make more mistakes than the introversives, owing to the notion that introversives would internalize more of their manipulations and attempted solutions. Analysis of the data revealed mixed results.     

Biases in Visual Attention in Children and Adolescents With Clinical Anxiety and Mixed Anxiety-Depression

Recent research has indicated that anxious adult and child patients and high trait-anxious adults selectively shift attention toward threatening stimuli. The present study extends this research and investigates the content-specificity of the effects in clinically anxious and mixed anxious–depressed children and adolescents. Twenty four generally anxious patients, aged 9 to 18, 19 mixed anxious–depressed patients, and 24 normal controls were comparable with respect to age, sex, verbal IQ, and vocabulary level. The participants carried out an attentional deployment task in which probe detection latency data were used to determine the distribution of visual attention for threat-related and depression-related material. The results showed that clinically anxious children, relative to controls, selectively allocated processing resources toward threat stimuli. However, mixed anxious–depressed children, relative to controls, did not show any attentional bias towards either threat- or depression-related stimuli. Preliminary data on age and gender differences are also presented. The results of this study are discussed in the light of previous research.     

A Comparison of Rorschach Records of Three Multiple Personalities

Inter- and intra-protocol comparisons among the Rorschachs of three authenticated cases of multiple personality were presented. The original or primary personalities seemed reasonably complex but, as successive personalities emerged, a definite tendency toward simplification was noted. A theoretical explanation for this phenomenon was advanced.     

Measuring Psychological Development With the Rorschach

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 nonpatient 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 includes 12 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.     

Defense Mechanisms Development in Children,Adolescents, and Late Adolescents

To replicate and extend Cramer's (1987) original cross-sectional study concerning the development of defense mechanisms, the Thematic Apperception Test responses of 148 students in Grades 2, 5, 8, 11, and college freshmen were collected and scored for denial, projection, and identification using Cramer's Defense Mechanisms Manual (1991). Our results supported the notion that the relative use of denial and projection decreases and identification increases as a function of grade level. The findings provide additional support for the psychoanalytic view (Freud, 1966) of an ontogenetic developmental line of defense.