Considerations in collecting Rorschach reference data

Recent Rorschach research with nonpatients has yielded reference data that differ in several respects from nonpatient normative data published for the Comprehensive System (Exner, 1995). Conclusions concerning the implications of these new findings are premature, however, pending careful consideration of appropriate guidelines for collecting Rorschach reference data. In proposing guidelines for future research of this kind, I note (a) that the relatively unstructured nature of Rorschach assessment may complicate obtaining useful data from nonpatient volunteers, (b) that normative studies should include various types of patient as well as nonpatient samples, and (c) that identification of psychological disturbance from Rorschach protocols may be guided more accurately by how closely a record resembles the records of patients with certain disturbances than by how much the record differs from the records of nonpatients.     

SCL-90-R symptom patterns for adolescent psychiatric inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress Index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward further analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

SCL--90--R Symptom Patterns for Adolescent Psychiatric Inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward farther analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

Selective processing of food,weight, and body-shape words in nonpatient women with bulimia nervosa: Interference on the Stroop task

The study investigated whether the Stroop interference effect could be found in nonpatients with a self-report consistent with a diagnosis of bulimia nervosa. The nonpatient bulimic group showed significantly more interference to disorder-specific words (food, weight, and body shape) than to control words. The two nonpatient comparison groups, a depressed-nonbulimic group and a nonbulimic-nondepressed group, showed no interference. These results indicate that nonpatients with bulimia nervosa can be used to test various models of the cognitive and emotional processes involved in bulimia nervosa with the modified Stroop task. Methodological issues in the use of the computerized Stroop task with clinical populations are also noted.     

Rorschach Comprehensive System (CS) reference data for Israeli adolescents

This study presents Rorschach Comprehensive System (CS; Exner, 1974, 2003) data for a sample of 100 Israeli nonpatient adolescents divided into 2 age-based groups: 11-14 (n = 42) and 15-18 (n = 58). The data are compared to those derived from the international project of Meyer, Erdberg, and Shaffer (2007). The results suggest that contemporary Israeli adolescents demonstrate age-appropriate inclination to show excessive self-inspection (FD), to be overly individualistic, perceiving reality in a unique and unconventional manner (elevated Xu%; lowered X+% and P), and to be involved in scientific issues (elevated Sc). The age-based group of 11 to 14, however, also tends to show difficulties in affect modulation (C > 0). Nonetheless, Israeli nonpatient adolescents are quite unlikely and not more than nonpatient adults, to show elevation on the major CS constellations of psychopathological manifestations. Although these observations are mostly in agreement with data collected from their peers around the world, the Israeli youngsters seem to be more similar to adults than to youngsters from other countries as to various CS measures, including those pointing to openness and attentiveness to stimuli (i.e., Lambda, F%). The main conclusion is that with the exception of some age-appropriate deviations, the international reference data for adults can be used for evaluating psychopathology in adolescents.     

A new U.S. adult nonpatient sample

A project to collect an American adult nonpatient sample for the Rorschach Comprehensive System (CS; Exner, 2001) took place between 1999 and 2005, and this article presents data for 450 participants in the project. Inclusion criteria, demographic information, and interrater agreement statistics are described. Findings for most of the CS variables are similar to earlier Rorschach Workshops samples, but some differences emerged and their implications for modifying interpretive guidelines are discussed.     

Rorschach Comprehensive System data for a sample of 141 adult nonpatients from Denmark

A sample (n = 141) of Danish nonpatients 25-50 years of age, never hospitalized with a psychiatric diagnosis and currently employed, was demographically representative of two geographical areas of Copenhagen with different social strain. The sample, as well as 45 persons not currently employed, was tested with the Rorschach (Exner, 1995), MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), Word Association Test (Ivanouw, 1999b), WAIS Comprehension subtest (Hess, 1974), and SCL-90-R (Olsen, Mortenson, & Bech, 2006). Half of the persons contacted volunteered for the study. There was no difference in rate of volunteering between a standard no-feedback condition and a feedback condition; the latter, however, tended to attract more psychologically resourceful persons. The employed persons tended to appear healthier than the not employed. Response style of the subjects, quality of the Rorschach protocols, reliability of scoring, and the effect of the data being grouped on geographical area and examiner were examined. Form level, color, texture, cooperative movement, and EA were lower than in the Comprehensive System (CS; n = 450) sample, but higher than in nine international nonpatient Rorschach studies. Unique for the Danish sample was a low number of animal movement answers. The Rorschach data showed women to be healthier than men. Differences in Rorschach variables based on educational level were small.     

Rorschach Comprehensive System data for a sample of 116 preadolescent and 117 adolescent nonpatients from Italy

This project provides information on how preadolescent and adolescent nonpatients perform on the Rorschach test, administered and scored following Exner's guidelines (2003). Lis, Salcuni, Parolin, and Superchi (2001) reported previously initial data for 51 adolescent nonpatients living in Italy who were administered this instrument by graduate and postgraduate students in a 2-year research course at the Psychotherapy School of the University of Padua, between July 1998 and February 2001. The current study is an extension of that work and includes information on additional adolescent nonpatients and preadolescent nonpatients, gathered between April 2001 and December 2006. The study thus includes information on 233 participants, 116 preadolescents (aged 12-14) and 117 adolescents (aged 15-18). Individuals were excluded if they had a major medical illness in the past 6 months, any psychiatric hospitalization, psychological treatment within the past 2 years, any felony conviction, or psychological testing within the past year. Interrater reliability statistics at the response level for scoring segments are reported both with percentage of agreement and iota. Rorschach Comprehensive System (CS) findings are presented.     

Realism of confidence in obsessive-compulsive checkers

The study examined whether obsessive-compulsive (OC) checkers have reduced confidence in their knowledge. OC checkers were compared with panic disorder (PD) patients and nonpatient controls using a calibration-of-knowledge procedure. Participants completed a general knowledge questionnaire, rated their confidence in each answer, and estimated the total number of correct answers. These responses were converted to 2 measures of confidence relative to performance--over/underconfidence and over/underestimation. OC checkers had lower scores than nonpatients did on both measures, whereas the PD patients did not differ from either group. For the OC checkers, relative confidence was inversely related to the severity of obsessions. The authors speculate that confidence may depend on a confirmation bias in testing hypotheses and that the reduced confidence in OC checkers may reflect a disconfirmation bias in this population.     

Introduction to the JPA special supplement on International Reference Samples for the Rorschach Comprehensive System

This Introduction provides an overview to the JPA Special Supplement on International Reference Samples for the Rorschach Comprehensive System (CS; Exner, 2001). It contains a history of this project and a table including all of the lead authors, their country and the type and size of their sample. Suggestions for conducting this type of research are offered, including information on normative vs. nonpatient samples, inclusion/exclusion criteria, the use of collateral instruments, and concerns relative to representativeness. Reliability and coding concerns are addressed, and information on the Popular response in Japan are reviewed. Finally, trends within and across the data are highlighted.     

Interobserver agreement, intraobserver reliability, and the Rorschach Comprehensive System

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.     

Rorschach Comprehensive System data for a sample of 249 adult nonpatients from Italy

This project provides information on how Italian adult nonpatients perform on the Rorschach test administered and scored following Rorschach Comprehensive System (CS) guidelines (Exner, 1995). Lis, Zennaro, Calvo, and Salcuni (2001) reported previously initial data for 101 of the nonpatients who were administered this instrument between July 1998 and February 2001 by graduate and postgraduate students in a 2-year research course at the Psychotherapy School of the University of Padua. The current study extends that previous work and includes information on an additional 148 participants gathered between April 2001 and March 2004, for a total of 249 individuals. Exclusion criteria are described and interrater reliability statistics at the response level for scoring segments are reported using both percent of agreement and iota. Comprehensive System findings are presented.     

Rorschach Comprehensive System data for a sample of 343 adults from Finland

This article combines Rorschach Comprehensive System (CS; Exner, 1990, 1993) data from four projects conducted in Finland between 1990 and 1995. The projects studied a stratified random sample of Finnish nonpatients, a cohort of twins, a group of elderly men, and a random sample collected to investigate sleep difficulties. The 343 records from these four studies provide a representative survey of Rorschach responding throughout the Finnish population.     

Rorschach Comprehensive System data for two samples of nonpatient children from Italy: 75 aged 5-7 years and 148 aged 8-11 years

This project provides information on how nonpatient children perform on the Rorschach test, administered and scored following Exner's guidelines (1995). Lis, Parolin, Zennaro, and Mazzeschi (2001) previously reported initial data for 70 nonpatient children living in Italy who were administered this instrument by graduate and postgraduate students in a 2-year research course at the Psychotherapy School of the University of Padua between July 1998 and February 2001. The current study is an extension of that work and includes information on an additional 153 participants gathered between November 2002 and December 2006. The total number of participants includes 223 individuals, 75 5-7-year-old children in the first level of elementary school, and 148 8-11-year-old children in the second level of elementary school. Exclusion criteria are described, and interrater reliability statistics at the response level for scoring segments are reported using percent agreement and iota. Rorschach Comprehensive System (CS) findings are presented.     

Rorschach Comprehensive System data for a sample of 90 adult nonpatients from Argentina

This study is composed of 90 nonpatient adults, ages 16 to 65, all from Buenos Aires and its suburban area. All of the data were gathered by the author. Inclusion and exclusion criteria are described and interrater reliability statistics at the response level are presented along with findings for the Rorschach Comprehensive System (CS; Exner, 2003). Results show that several variables yield values that deviated from the nonpatient ranges proposed by Exner, and these findings suggest the need for further exploration.     

Rorschach Comprehensive System data for a sample of 100 adult nonpatients from the Belgian French-speaking community

This article presents normative data for the Rorschach Comprehensive System (CS) on 100 adult nonpatients from the Belgian French-speaking community. We compare our Belgian sample to a French one (Sultan et al., 2004), data of Exner's (Exner & Erdberg, 2005) and a Californian sample (Shaffer, Erdberg, & Haroian, 1999). Each sample's specific characteristics are explored, as well as findings provided by sample-specific comparisons. Exner's data, ultimate normative reference for the CS, differ significantly from the three other samples for many variables. Cultural factors, examiner's level of experience, as well as participants' selection and recruitment, presumably flow into calculated differences between the four samples. Our findings indicate the necessity for constituting normative data for different communities, as well as the indispensability of examiners' familiarity with the CS, in order to provide reliable clinical information.     

Cross-cultural diagnostic applicability of the Pictogram Test

The aim of this study was to determine whether the Pictogram Test (PT; Vygostsky, 1960) a test of logical memory that was developed in Russia, is applicable for diagnosing and understanding thought disturbances in schizophrenia within an English-speaking population. Participants included 62 patients with schizophrenia or schizoaffective disorders and 80 community nonpatients from Russia and the United States. We used correlational analysis to organize PT variables into Concrete (CI), Attribute (AI), and Geometric (GI) indexes. Discriminant function analysis revealed that only AI and GI had significant discriminatory power. These indexes correctly classified 91% of English-speaking and 86% of Russian-speaking participants as either patients or nonpatients. Controlling for age and education, multivariate analysis revealed that patients had significantly lower AI and significantly higher GI scores relative to nonpatients, and those differences were similar across languages. These results indicate that the PT can discriminate between patients with schizophrenia or schizoaffective disorders and nonpatients, which suggests that characteristics of the PT could be used to understand the mechanism of logical thinking in patients and nonpatients.     

Rorschach Comprehensive System data for 100 nonpatient children from the United States in two age groups

Building on our previously published study (Hamel, Shaffer, & Erdberg, 2000), which provided data on 100 nonpatient children aged 6 to 12 from the United States, we here provide reference data for two more homogeneous age subgroups: 6 to 9 (N = 50) and 10 to 12 (N = 50). Inclusion criteria are described, and expanded interrater reliability statistics at the response level are presented along with scores for the Rorschach Comprehensive System (CS; Exner, 2001) at each age grouping. In addition to the children being administered the Rorschach, their parents were given the Conners' Parent Rating Scale-93 (CPRS-93; Conners, 1989), and these results are presented as well.     

Cross-Cultural Diagnostic Applicability of the Pictogram Test

The aim of this study was to determine whether the Pictogram Test (PT; Vygostsky, 1960) a test of logical memory that was developed in Russia, is applicable for diagnosing and understanding thought disturbances in schizophrenia within an English-speaking population. Participants included 62 patients with schizophrenia or schizoaffective disorders and 80 community nonpatients from Russia and the United States. We used correlational analysis to organize PT variables into Concrete (CI), Attribute (AI), and Geometric (GI) indexes. Discriminant function analysis revealed that only AI and GI had significant discriminatory power. These indexes correctly classified 91% of English-speaking and 86% of Russian-speaking participants as either patients or nonpatients. Controlling for age and education, multivariate analysis revealed that patients had significantly lower AI and significantly higher GI scores relative to nonpatients, and those differences were similar across languages. These results indicate that the PT can discriminate between patients with schizophrenia or schizoaffective disorders and nonpatients, which suggests that characteristics of the PT could be used to understand the mechanism of logical thinking in patients and nonpatients.