Incremental validity of the Rorschach Prognostic Rating Scale over the MMPI Ego Strength Scale and IQ

A recent meta-analysis found that the Rorschach Prognostic Rating Scale (RPRS) had a strong ability to predict subsequent outcome (r = .44, N = 783; Meyer & Handler, 1997, this issue). However, that review did not directly address questions of incremental validity. This article focuses on the ability of the RPRS to predict outcome after taking into account other sources of data. Across studies that examined both the RPRS and the MMPI Ego Strength scale, the RPRS had a strong ability to predict outcome (r = .40, N = 187), whereas the MMPI scale did not (r = .02, N = 280). Nine studies examined the RPRS along with an intelligence test and allowed direct numerical estimates of incremental validity to be calculated. Across studies, the RPRS demonstrated strong incremental validity after controlling for intelligence (incremental r = .36, N = 358). It is clear that the Rorschach can make unique contributions to understanding clinically relevant processes in ways that self-reports or measured intelligence cannot. Contemporary Rorschach scales should continue to be evaluated for their distinctive and incremental contribution to clinical practice.     

The concurrent validity of child Rorschach interpretations

Rorschach records were obtained by 10 examiners from 59 preschool children. These records were reliably scored and interpreted. Interpretation consisted of preparing a list of Rorschach concepts for each child. An additional number of Rorschach concepts of equal frequency in this sample were added to each child's list of concepts. Half of the concepts on each child's list were checked for agreement by school personnel. The children were described with consistency across judges and over time by the same judges. The school personnel were able to differentiate concepts that described each child from nonrelevant concepts. The Rorschach concepts provided data that was validated by teacher perception of these children. This methodology for Rorschach validation makes use of interpretive concepts derived directly from data rather than from reports.     

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.     

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, there was no evidence of increased accuracy of perception.     

A replication of Rorschach and MMPI-2 convergent validity

We replicated prior research on Rorschach and MMPI-2 convergent validity by testing 8 hypotheses in a new sample of patients. We also extended prior research by developing criteria to include more patients and by applying the same procedures to 2 self-report tests: the MMPI-2 and the MCMI-II. Results supported our hypotheses and paralleled the prior findings. Furthermore, 3 different tests for methodological artifacts could not account for the results. Thus, the convergence of Rorschach and MMPI-2 constructs seems to be partially a function of how patients interact with the tests. When patients approach each test with a similar style, conceptually aligned constructs tend to correlate. Although this result is less robust, when patients approach each test in an opposing manner, conceptually aligned constructs tend to be negatively correlated. When test interaction styles are ignored, MMPI-2 and Rorschach constructs tend to be uncorrelated, unless a sample just happens to possess a correlation between Rorschach and MMPI-2 stylistic variables. Remaining ambiguities and suggestions for further advances are discussed.     

An external construct validity study of Rorschach personality variables

This study examined (a) hypothesized relationships between Rorschach variables and self-report test measures relating to nominally similar aspects of personality functioning and (b) interrelationships among Rorschach variables. Sixty-two undergraduates were administered the Rorschach, Barron Ego Strength Scale, Kaplan Self-Derogation Scale, Eagly Self-Esteem Scale, Multiple Affective Adjective Checklist (MAACL), Marlowe-Crowne Social Desirability Scale, and the Rotter Locus of Control Scale. Only a few of the predictions received confirmation: inanimate movement (m) correlated, as expected, with MAACL anxiety and hostility, the egocentricity index (3r + 2)/R (R = total responses) correlated significantly with self-esteem, and human movement with minus form level (M-) correlated (inversely) with ego strength. Among the unpredicted findings were some that appear inconsistent with standard Rorschach interpretation. Rorschach variables human movement (M), and experience actual (EA), generally interpreted as reflecting coping resources, related significantly with self-report measures of poor coping and of dysphoric affect. In general, the Rorschach appears better at identifying weaknesses in the ego rather than strengths.     

A one-year concurrent validity study of the Rorschach prognostic Rating Scale

A study was conducted of one year's referrals to a Juvenile Court Clinic, comparing the ratings of psychiatrists and social workers regarding a child's prognosis for psychotherapy with ratings from the Rorschach Prognostic Rating Scale (RPRS). The RPRS proved to be highly reliable and to correlate significantly with psychiatric ratings. Intelligence did not appear to be a confounding factor, and no difference was suggested in RPRS prognosis for Caucasian or Negro subjects.     

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.     

Six-month prognostic norms derived from studies of the Rorschach Prognostic Rating Scale

The Rorschach Prognostic Rating Scale (RPRS) was introduced in 1951 by Klopfer. Kirkner, Wisham, and Baker. The predictions of Klopfer et al. are compared to the outcomes in four studies of the RPRS. The originalinterpretation is shown to predict higher percentages of success than revealed by the empirical studies. A second interpretation of the scale is proposed on the basis of the experimental data. This interpretation relates RPRS scores to the chance for substantial improvement within 30 weeks of once weekly therapy by client-centered, rational-emotive, desensitization, aversion, or traditional methods. For any given RPRS score, the chance for substantial improvement is approximately the same for every type of therapy, and increases as the RPRS score increases. The second interpretation is proposed in both tubular and algebraic forms as a stimulus to further research and clinical applications.     

Convergent validity of Rorschach and TAT scales of object relations.

The Rorschach Mutuality of Autonomy Scale (MOA) and the Social Cognition and Object Relations Scale (SCORS) have been shown to be reliable and valid measures of interpersonal functioning. Utilizing a sample of 57 outpatients with a Diagnostic and Statistical Manual of Mental Disorders Axis II diagnosis, this study extends the findings of previous research demonstrating the reliability and convergent validity of each measure. Analyses focused on the convergent validity between the Rorschach MOA Scale and 8 SCORS variables (complexity, affect, emotional investment in relationships, emotional investment in values and morals, understanding of social causality, management of impulses/aggression, self-esteem, identity/coherence of self) ratings of Thematic Apperception Test narratives. The conceptual nature and clinical utility of these findings are discussed in relation to psychological assessment.     

A method to optimize the response range while maintaining Rorschach Comprehensive System validity

Brief and lengthy Rorschach records have been identified as common problems in protocol administration. Clinicians have debated how to prevent overly short and long records, but they have been reluctant to alter standardized administration for fear of introducing bias. The present study examines a nonintrusive method for constraining responses by prompting for an extra response when only one is offered per card and by removing the card after four responses are given. Among patients who typically produce brief records, consisting of a residential sample of civil and forensic patients with a range of disordered thinking, the alternative administration method demonstrated improved Comprehensive System validity in assessing thought disorder and eliminated the need to readminister the test due to fewer than 14 responses. The findings have clinical implications for protocol administration with thought-disordered populations that typically produce brief records.     

Rorschach Depression indices with children and adolescents: concurrent validity findings.

Exner (1983, 1986) developed and recently revised (1990b) a Rorschach Depression Index based on scores from variables in the Comprehensive System. This study evaluated both the original and the revised DEPIs for child and adolescent outpatient (n = 67) and inpatient (n = 99) samples in order to assess the diagnostic utility of these indices. There were no significant relationships between the original form and the revised form of the DEPI and clinical elevations on the Depression scale of the Personality Inventory for Children in the outpatient sample or treatment team diagnostic judgments in the inpatient sample. These findings sound a strong cautionary note for using only Rorschach Depression indices to diagnose depression in children and adolescents.