Rorschach interrater agreement estimates: An empirical evaluation

A standardized estimation of Rorschach interrater agreement is needed. Percentage agreement, although widely used, is found to be unsuitable. Forty-one protocols from adults in both a normal and a psychiatric sample were scored by two or three scorers, making 85 scoring pairs. Percentage agreement, correlations (phi and Pearson's r ), and kappa were computed on single response, total score, and category level. Percentage agreement shows minimal variation. Even when exceeding 0.80, it can obscure major disagreements. Kappa and correlations both vary in a similar way with level of disagreement. Total score level does not give additional information compared to single score and category levels. Kappa proved to be conservative and reliable and is therefore suggested as a standard estimate.     

Rorschach assessment of changes following psychotherapy: a meta-analytic review

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.     

Rorschach evaluation of adolescent bulimics

It has become apparent that the excessive dieting engaged in by many girls when they reach puberty frequently serves as an impetus for the later development of eating disorders. While the existence of bulimia nervosa has been well documented in late-adolescent girls, only minimal research has been devoted to delineating the personality characteristics that distinguish bulimics from normal adolescents. The present study utilized the Rorschach to contrast 12 DSM-III-R diagnosed adolescent bulimics with 12 female adolescent controls. Exner's (1986) Comprehensive System was used for scoring the protocols. Statistically significant group differences were detected on both the overall Depression and the Schizophrenia Indices, as well as on several subcomponents of each. Additionally, bulimics averaged a greater number of aggression responses. The data suggested that the adolescent bulimics were more depressed, self-punitive, and negativistic than their peers, and that they had more disordered thoughts, inaccurate perceptions, and impaired judgment. The cognitive disturbances were not limited to the areas of food and weight. The results are alarming for this young population, particularly since the severity of symptoms certainly will increase over time if left untreated. Recommendations are made for early symptom identification and intervention.     

Affect at the different phases of cognitive behavioral therapy: An evaluation of psychotherapy provided by candidates

The purpose of this study was to investigate the affect, as measured by “Positive and Negative Affect Schedule” (PANAS), its influence on psychopathology, and to examine the effect of changing affect during cognitive behavioral therapy (CBT). The study was carried out at the psychotherapy training center, Karlstad University. The hypothesis was whether clients with mental disorders have a self‐destructive affective personality (low PA and high NA) and healthy individuals have a self‐actualizing personality (high PA and low NA). Thirty‐two healthy participants and 44 clients participated in the study. The clients were asked to fill in the PANAS once throughout CBT, either during evaluation, treatment or finishing phase, accordingly there were three different groups at different therapy phases. The healthy subjects were also asked to fill in the self‐report scale once. The comparison of the three phases of therapy and the four affective personality types showed a significant difference between the phases of therapy and the four affective personality types: totally 16 (of 22) and eight (of nine) clients measured at the evaluation and treatment phases, respectively, had a self‐destructive personality. However, at the end of therapy five (of 13) clients had a self‐actualizing personality characteristics, while only three of them were self‐destructive. Furthermore, the results indicate that affective personality does not seem to be a basic and stable personality trait, which could be altered by therapy. The affections measured by PANAS may be influenced by psychopathology and CBT, when conducted by candidate therapists it can be effective in terms of affect changes.     

An evaluation of the effects of Rorschach EB style on the diagnostic utility of the Depression Index

Several empirical studies have found the Rorschach Depression Index (DEPI) to have questionable diagnostic utility. Studies using adolescent samples suggest that the DEPI has limited sensitivity and fails to differentiate effectively between adolescents with and without depression diagnoses. The present study was conducted to evaluate Viglione, Brager, and Haller's suggestion that the DEPI may have better discriminative ability for individuals with extratensive problem-solving styles, measured by the Rorschach EB (Erlebnistypus) variable, compared to those with introversive and ambitent styles. Comparisons were conducted between adolescents with depression-related diagnoses and adolescents with other diagnoses for each of the three EB groups. The results failed to support the hypothesized greater discriminative power of DEPI for depressed extratensives, and suggest caution in using the DEPI to evaluate adolescent depression.