One more datum on Rorschach form quality

The central purpose of this work is to examine to what extent Form Quality (FQ) scoring of Rorschach responses, using Exner's (2003) Table A, is the reason for lower FQ to often be found in normative data outside the United States. The Rorschach protocols of 180 Portuguese boys and girls between 6 and 10 years of age were codified with respect to Form Quality in accordance with Exner's table of objects classified as ordinary, unusual, and minus, based on frequencies seen among U.S. adults and on an analogous Portuguese table (Table P) constructed from the protocols of 400 nonpatient children. Mean differences between the various FQ variables of the 2 tables were found to be insignificant. However, use of Janson's (2003) iota coefficient to evaluate agreement between the 2 approaches to scoring on the same protocols revealed that the more striking differences occurred in the FQu variable when agreement was assessed on the basis of each individual response. In view of these results, the authors recognize the possibility of Rorschach normative data to be universally applied, but still consider the possible advantage of each country or culture to build its own FQ table that will permit preservation of its particularities.     

Bruno Klopfer: A Rorschach Pioneer

Bruno Klopfer is perhaps best known for his pioneering work on the Rorschach Inkblot Test. His efforts in developing and popularizing projective techniques were to have a profound impact on the development of psychological personality testing. In fact, prior to the introduction of Exner's comprehensive Rorschach scoring system, the Klopfer scoring system was the most popular among practicing clinicians (Exner & Exner, 1972, p. 13). Professionals in clinical psychology and psychiatry are certainly very indebted to Bruno Klopfer.     

A Rorschach Study of Narcissism Defense,and Aggression in Borderline,Narcissistic, and Cluster C Personality Disorders

We examined the differences between narcissism, mode of defense, and level of aggression on the Rorschach. We also investigated differences in borderline, narcissistic, and Cluster C personality disorders by examining responses to Rorschach content variables. The Lerner Defense Scale (P. Lerner & H. Lerner, 1980), the aggressive content section of the Holt (1977) method for assessing primary process manifestations, a modified version of Exner's (1986a) Egocentricity Index, Wagner's (1965) exhibitionistic M score, and grandiosity were scored on the Rorschach protocols of 17 borderline, I7 narcissistic, and 17 Cluster C personality disorders. Borderlines were found to employ primitive defensive structures to a greater degree and severity, show more intense and overall aggression as welt as more responses on the three forms of aggression in the Holt method, and have higher levels of grandiosity. Narcissists evinced significantly higher levels of egocentricity than borderlines and higher levels of idealization than the Cluster C group. Convergent validity was found on the measures of defense and aggression, which showed a strong relationship between primitive aggression and primitive defense.     

Bruno Klopfer,A Measure of the Man and His Work: A Review of Developments in the Rorschach Technique: volumes I,II, and III

This article reviews Bruno Klopfer's life and his contributions to the Rorschach, especially as they are represented in his three volume series: Developments in the Rorschach Technique, volumes I, II, and III. It emphasizes Klopfer's many contributions to Rorschach administration and interpretation, as well as his superior teaching and organizational abilities. Klopfer organized what eventually became The Society for Personality Assessment and began the journal that eventually became the Journal of Personality Assessment. His legacy is reflected in much of Exner's system of administration and scoring.     

Directory of Members of the Society for Projective Techniques as of March 1, 1964

The appearance of depressive features, as reflected by responses to the Rorschach test, were explored in two groups of children from divorced and nondivorced families (referred to here as divorce and nondivorce children). The relationships between the depression scores and the children's hostility, aggression, and anxiety levels were also studied. The Rorschach Inkblot Test was individually administered to a nonclinical sample of 108 Swedish school children between 10 and 12 years old. The subjects constituted two groups,, a divorce group (27 girls, 27 boys) and a nondivorce group (27 girls, 27 boys). Divorce children scored significantly higher on Exner's (1986) Depression Index than their nondivorce peers. Furthermore, divorce children with depressive features in their Rorschach responses were found to have a high level of hostility and aggression (as manifested in their Rorschach protocols), whereas no such associations were found among nondivorce children.     

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.     

John Exner and the Book That Started It All: A Review of The Rorschach Systems

This article is a review and a reassessment of Exner's (1969) The Rorschach Systems. The book reviews the history of the development of the Rorschach, primarily in the United States, including a detailed analysis of the progressive development of systems devised by Klopfer, Beck, Piotrowski, Hertz, Rapaport, and Schafer. The final versions of each system are compared with each other, and with Rorschach's own system. The development of the book is linked to Exner' s personal relationship with Klopfer, Beck, and Hertz. The book is described as the basic forerunner of Exner's Comprehensive System.     

Predicting Institutional Adjustment With the Lifestyle Criminality Screening Form and the Antisocial Features and Aggression Scales of the PAI

This article sheds light on the theoretical foundations of projective testing. Drawing on the psychoanalytic perspective, especially Winnicott's works, it elucidates the nature of projection and transitional relatedness, with particular reference to the Rorschach. This conceptualization of the Rorschach task is compared with Exner's more cognitive-behavioral orientation, which holds that the Rorschach is not a projective test. I suggest that Exner's Comprehensive System could become more truly comprehensive if it were integrated with a more complex understanding of the response process, allowing more importance to the role of stimuli from the inner world to counterbalance its focus on the processing of external stimulation. Clinical and research implications are discussed.     

Effects of Alternate Modes of Administration on Rorschach Performance of Deaf Adults

This study examined two modes of administering the Rorschach Inkblot Technique to determine which was more appropriate for a college-educated, deaf population. Twenty-four prelingually deaf adults took the Rorschach in sign language and in written English, using a counterbalanced test-retest design, and their sign and written scores were compared to each other and to 1986 norms for Exner's Comprehensive System. Seventeen variables measuring such areas as perceptual accuracy, perceptual complexity, and self-focus were found to vary more than one standard deviation from Exner's norms. Differences between sign and written conditions on several affective variables were found. Written administration can be used by examiners who are informed about deafness and aware of variables that may be underreported by written inquiry.     

A Rorschach Investigation of Narcissism and Hysteria in Antisocial Personality

We investigated Rorschach responses associated with narcissism and hysteria in a group of antisocial personality disordered offenders. The Rorschach protocols of 42 subjects who met the criteria from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) for antisocial personality disorder were analyzed using Exner's (1986) criteria for pairs, reflections, and personal responses, and Gacono's (1988) criteria for the impressionistic response. Severe, or primary psychopaths (n = 21), scoring ≥30 on the Hare (1980) Psychopathy Checklist (PCL), were compared to moderate, or secondary pscyhopaths (n = 21), scoring <30 on the PCL. The mean number of pair and impressionistic responses did not significantly differ for the two antisocial groups. The highly psychopathic group, however, did exhibit a significantly greater mean number of reflection and personal responses. We discuss pair and reflection responses and their relationship to narcissism in psychopathic disturbance. We recommend interpreting the personal response within the context of the psychopathic character and view personal responses as expressions of narcissism and omnipotence in highly psychopathic subjects. We also hypothesize that the impressionistic responses are indicative of primitive dissociative processes and hysteria in psychopathic subjects, and that their presence provides construct validity for the work of Guze (1976) and others who suggested an underlying histrionic dimension to psychopathy.     

An Empirical Study of Object Relations and Defensive Operations in Antisocial Personality Disorder

This study assessed the object relations, defensive operations, and level of psychopathy and narcissism in a group of antisocial personality disordered offenders. The Rorschach protocols of 33 subjects who met the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-111-R], American Psychiatric Association, 1987) criteria for antisocial personality disorder were analyzed utilizing Kwawer's (1980) criteria for borderline object relations categories (borderline phenomena), the Lerner and Lerner (1980) Defense Scale, and a number of experimental criteria including Cooper and Arnow's (1986) defense criteria. Level of narcissism was assessed utilizing Exner's (1973) Self-Focus Sentence Completion Test. Hare's Psychopathy Checklist was used as an independent variable to determine a subject's level of psychopathy. Those subjects scoring 30 or more on the psychopathy checklist were compared to subjects scoring less than 30. The level of narcissism or proportion of defenses did not differ significantly between the severe psychopaths (230) and the moderate psychopaths (< 30). The severe psychopaths produced a significantly greater number of borderline object relations. I conclude that antisocial individuals tend to be highly egocentric, and that narcissism is one component of psychopathy. Severe psychopaths, as a group, tend to be more borderline in their functioning than those exhibiting moderate levels of psychopathic disturbance. I also conclude that individuals who are incarcerated for felony offenses and also meet the DSM-111-R criteria for antisocial personality disorder exhibit degrees of borderline personality organization.     

Scoring accuracy using the comprehensive system for the Rorschach.

The Comprehensive System (CS; Exner, 1974, 1978) for scoring Rorschach responses is the most widely taught and most widely accepted system in use today. The complexity and labor- intensive nature of the CS makes the issue of scoring accuracy a central concern. Twenty-one graduate psychology students and 12 professionals scored 20 Rorschach responses drawn from normal and clinical protocols. In general. accuracy scores for both students and professionals were below acceptable levels. Accuracy scores were clearly better for the code categories of Location, DQ, Pairs, Popular, and Z than for Determinants, FQ, Content, and Special Scores. Responses from clinical protocols were subject to more error. The results suggest that high levels of scoring errors may exist in the field use of the CS. Training standards may need to be devised to insure scoring competence.     

Rorschach Developmental Quality and Intelligence Factors

Research has demonstrated a relationship between cognitive development and the location and complexity of Rorschach responses. This study examined the association between the Wechler Adult intelligence Scale-Revised (WAIS-R) and Exner's Developmental Quality (DQ). This study had two objectives: to examine the relationship between DQ and WAIS-R intelligence factors and IQs and to determine whether the DQv/ + score taps a synthesizing visual-perceptual operation. An overall goal was determining the extent to which DQ represents Friedman's operationalization of Werner's orthogenetic principle. Subjects were 125 nonclinical volunteers. Findings suggest that DQ taps a visual-perceptual problem-solving skill in which complex whole responses make the most significant contribution. There was no evidence that DQv/+ responses represent visual-perceptual synthesis. It was concluded that DQ not an operationalization of Werner's orthogenetic principle and that developmental quality, at least in the sense that Werner or Friedman might have intended it, may be a misnomer.     

An Investigation of Interrater Reliability for the Rorschach Performance Assessment System (R–PAS) in a Nonpatient U.S. Sample

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.     

Some Developmental Aspects of Primary Process Manifestations in the Rorschach

A group of 27 male subjects were administered the Rorschach at ages 14 and 24. The protocols were scored for the main categories of the Holt Primary Process scoring system. A comparison of the two age groups indicates that at age 24 there is a decrease in the percentage of primary process responses and an increase in “adaptive regression.” Individual differences for all the primary process scoring categories remained highly consistent for the 10-year period spanned by the data. Adaptive regression was found to be significantly correlated with IQ, field independence (RFT), and Rorschach ratings of intellectualization at both ages. The results were viewed as suggesting that primary process manifestations on the Rorschach seem to be mediated by stable aspects of an individual's cognitive abilities and cognitive style.     

The Validity of the Rorschach for Assessing Cognitive and Affective Changes

Exner's (1985) Rorschach norms of children 5 to 16 years old were used to test predictions based on developmental theory, previous cognitive studies, and Achenbach and Edelbrock's (1981) norms on behavior problems in children. In the cognitive realm, the Rorschach scores reflected the predicted increase in complexity, integration, and precision of thinking; richness of ideas; conformity to socially acceptable ways of thinking; and the concomitant decrease in unrealistic, egocentric ideas. In the affective realm, the Rorschach scores reflected the predicted decrease in uncontrolled expression of affect, increase in controlled expression of affect, and increase in inwardness. However, the Rorschach scores failed to reflect the predicted decrease in anxiety and increase in depression. Finally, tin, ere was no evidence of increased accuracy of perception.     

Rorschach indices for discriminating between two schizophrenic syndromes

Thinking disturbance and disorder of affects may be different in two subtypes of schizophrenia, the "florid" and the "withdrawal" syndromes. In Exner's approach to the Rorschach system, the diagnostic indicators of disordered thinking may point out large differences not only between schizophrenic and control subjects but also between different types of schizophrenics. The Rorschach protocols of 45 subjects (15 "florid" schizophrenics, 15 "withdrawn" schizophrenics, and 15 controls of the same age and education, matched by sex) were examined on several Exner indices. Compared with the control group, both schizophrenic types confirmed an impairment of perceptual accuracy and of reality testing as well as a reduced emotional control. Compared with the "withdrawn" group, the "florid" schizophrenic subjects showed significantly higher indices of poor perceptual functioning, of an inadequate organizational activity (more Whole and Z responses characterized by negative Form Quality) and greater disordered ideational production.     

Testing the Effectiveness of Family Therapeutic Assessment: A Case Study Using a Time-Series Design

This study reports normative data for the Peebles Rorschach content scoring system. Group Rorschach protocols from undergraduates were scored and reliably classified by quadrant. Frequencies were obtained by sex and by quadrant. Social desirability was demonstrated to vary across quadrants. The validity of quadrant classification was suggested by self-reports and MMPI scales. MMPI profile code predictions were made by experts for each quadrant and compared with obtained mean profile codes. The scoring system was evaluated and theoretical origins were discussed.