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.     

A Review of MMPI and Rorschach interrelationships in adult samples

The MMPI and Rorschach are consistently ranked among the most widely used psychological assessment instruments across adolescent and adult clinical settings. Although there is an extensive research literature available on each instrument individually, relatively little research attention has been focused on the interrelationships between these measures. This article reviews the literature derived from 37 studies that have reported interrelationships between MMPI and Rorschach variables in adult populations. The results of these studies generally indicate limited or minimal relationships between the MMPI and Rorschach. A number of methodological issues, however, prevent drawing firm conclusions from the literature at this time. Directions for future research are discussed, including consideration of issues related to sources of alpha and beta error and the need for studies examining the incremental validity of combinations of Rorschach and MMPI data in prediction to relevant external criteria.     

Weighing evidence for the Rorschach's validity: a response to Wood et al. (1999)

Wood, Nezworski, Stejskal, Garven, and West (1999) challenged Ganellen's (1996) characterization of the revised Rorschach Depression Index (DEPI; Exner, 1991) as a promising psychometric marker of depression that deserves serious attention by researchers and clinicians. To the contrary, however, a careful examination of existing studies indicates that no compelling empirical evidence exists indicating that Ganellen's conclusions should be modified at the present time, although no firm conclusions about the DEPI can be reached until further evidence accumulates. Furthermore, although Wood et al. (1999) suggested that evidence supporting the reliability and validity of the Rorschach in general is weak, ample evidence exists demonstrating that the Rorschach can be scored reliably (Meyer, 1997), that Rorschach variables in general have respectable levels of criterion-related validity (Bornstein, 1996; Hiller, Rosenthal, Bornstein, Berry, & Brunnel-Neuleib, 1999), and that the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and Rorschach have comparable levels of criterion-related validity, with the MMPI outperforming the Rorschach in certain respects and the Rorschach outperforming the MMPI in others (Bornstein, 1999; Hiller et al, 1999).     

罗夏墨迹测验中“装好”与诈病反应的研究与进展

传统观念认为罗夏测验具有投射测验的性质,因此受测者无法在其测验中故意“装好”和诈病。但相关研究发现,受测者的“装好”反应对于罗夏测验结果没有产生实质性的影响,不能改变罗夏测验的基本数据特征和结构汇总性量表;而诈病反应的研究结论不尽相同,受测者有可能造成罗夏测验变量得分的改变,伪装成相应精神病理症状。如果联合使用MMPI和罗夏测验,则可以精确地评估受测者的伪装反应。目前已有的研究存在被试取样单一、研究数量偏少、无法确定临界值等问题。罗夏测验“装好”和诈病反应研究还处于初步阶段,需要继续深入研究并建立专门的“装好”和诈病量表。     

Case Studies of Two Schizophrenic Patients

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.     

MMPI-Rorschach Interrelationships: Proposed Criteria for Evaluating Explanatory Models

An extensive empirical literature, spanning 50 years and 45 published investigations, leads to the conclusion that the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) bear little or no meaningful relationship to each other. An inherent tension exists between these empirical findings and the widespread clinical practice of integrating MMPI and Rorschach results. At least three perspectives have been advanced concerning the relationship between these two instruments. One view holds that variables from the two measures will demonstrate significant patterns of convergence only in carefully designed research studies that involve specific, well-constructed and theoretically derived predictions. A second view postulates that although variables from the Rorschach and MMPI do not bear a high intercorrelation with each other, these variables may be combined to contribute significantly to the prediction of outcome variance. In this view, the combined use of the two instruments yields clinically useful increases in incremental validity not achievable by the use of either instrument in isolation. A third approach is reflected in the proposition that although the MMPI and Rorschach do not produce significant interrelationships under general conditions, meaningful relationships may be yielded under specific psychometric conditions, for example, under conditions in which the response styles are consistently displayed across those two instruments. This article will review research evidence related to each of these perspectives, with particular emphasis on the importance of clearly specifying the criteria to be applied in evaluating these models. The concepts of parsimony and heuristic value are proposed for these evaluation purposes.     

Clinical Considerations in the Conjoint Use of the Rorschach and the MMPI

Contemporary clinical and research findings concerning the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) indicate that (a) objectivity and subjectivity are relative and not categorical dimensions of these two instruments; (b) apparent contradictions between Rorschach and MMPI results are generative and not invalidating; (c) within limits, false negative findings are not cause for concern in the clinical application of Rorschach and MMPI variables; and (d) differences between the Rorschach and the MMPI in how they are structured and what they measure demonstrate considerable advantage in using them in complementary fashion to support clinical inferences.     

MMPI-Rorschach interrelationships: proposed criteria for evaluating explanatory models

An extensive empirical literature, spanning 50 years and 45 published investigations, leads to the conclusion that the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) bear little or no meaningful relationship to each other. An inherent tension exists between these empirical findings and the widespread clinical practice of integrating MMPI and Rorschach results. At least three perspectives have been advanced concerning the relationship between these two instruments. One view holds that variables from the two measures will demonstrate significant patterns of convergence only in carefully designed research studies that involve specific, well-constructed and theoretically derived predictions. A second view postulates that although variables from the Rorschach and MMPI do not bear a high intercorrelation with each other, these variables may be combined to contribute significantly to the prediction of outcome variance. In this view, the combined use of the two instruments yields clinically useful increases in incremental validity not achievable by the use of either instrument in isolation. A third approach is reflected in the proposition that although the MMPI and Rorschach do not produce significant interrelationships under general conditions, meaningful relationships may be yielded under specific psychometric conditions, for example, under conditions in which the response styles are consistently displayed across those two instruments. This article will review research evidence related to each of these perspectives, with particular emphasis on the importance of clearly specifying the criteria to be applied in evaluating these models. The concepts of parsimony and heuristic value are proposed for these evaluation purposes.     

Clinical considerations in the conjoint use of the Rorschach and the MMPI

Contemporary clinical and research findings concerning the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) indicate that (a) objectivity and subjectivity are relative and not categorical dimensions of these two instruments; (b) apparent contradictions between Rorschach and MMPI results are generative and not invalidating; (c) within limits, false negative findings are not cause for concern in the clinical application of Rorschach and MMPI variables; and (d) differences between the Rorschach and the MMPI in how they are structured and what they measure demonstrate considerable advantage in using them in complementary fashion to support clinical inferences.     

Predicting DSM-IV Cluster B Personality Disorder Criteria From MMPI-2 and Rorschach Data: A Test of Incremental Validity

Despite their frequent conjoint clinical use, the incremental validity of Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has not been adequately established, nor has any study to date explored the incremental validity of these tests for predicting Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs). In a reanalysis of existing data, we used select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial, borderline, histrionic, and narcissistic PD criteria in a sample of treatment-seeking outpatients. The correlational findings revealed a limited relation between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) variables, with only 5 of 30 correlations reaching significance (p < .05). Hierarchical regression analyses showed that both the MMPI and Rorschach data add incrementally in the prediction of DSM-IV borderline and narcissistic PD total criteria scores. The findings were less clear for the incremental value of Rorschach and MMPI-2 data in predicting the total number of DSM-IV histrionic PD criteria, which were best predicted by Rorschach data, and antisocial PD criteria, which were best predicted by MMPI-2 data. In addition to providing evidence of the incremental validity of Rorschach data, these findings also shed light on the psychological characteristics of the DSM-IV Cluster B PDs.     

Predicting DMS-IV cluster B personality disorder criteria from MMPI-2 and Rorschach data: a test of incremental validity

Despite their frequent conjoint clinical use, the incremental validity of Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has not been adequately established, nor has any study to date explored the incremental validity of these tests for predicting Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs). In a reanalysis of existing data, we used select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial, borderline, histrionic, and narcissistic PD criteria in a sample of treatment-seeking outpatients. The correlational findings revealed alimited relation between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) variables, with only 5 of 30 correlations reaching significance (p <.05). Hierarchical regression analyses showed that both the MMPI and Rorschach data add incrementally in the prediction of DSM-IV borderline and narcissistic PD total criteria scores. The findings were less clear for the incremental value of Rorschach and MMPI-2 data in predicting the total number of DSM-IV histrionic PD criteria, which were best predicted by Rorschach data, and antisocial PD criteria, which were best predicted by MMPI-2 data. In addition to providing evidence of the incremental validity of Rorschach data, these findings also shed light on the psychological characteristics of the DSM-IV Cluster B PDs.     

On the integration of personality assessment methods: the Rorschach and MMPI

Despite being the most studied and used personality assessment tools, data from the Rorschach and MMPI generally disagree (Archer & Krishnamurthy, 1993a, 1993b). Independence is proposed to result from at least 3 factors: (a) the methods tap unique levels of personality, (b) personality has a complex organization, and (c) response styles generate considerable method variance that must be considered in nomothetic research. These ideas led to 5 hypotheses, each of which received support. Rorschach and MMPI response styles are uncorrelated, although response styles are quite consistent within a method family. MMPI-2 and Rorschach constructs of dysphoria, psychosis, or wariness are uncorrelated when response styles are ignored. However, robust convergent validity is evident when patients have similar response styles on each method (e.g., for dysphoria, M r = .59) and dysphoria is expressed in opposing ways on each method when response styles are discordant (i.e., M r = -.54). Data from the latter analyses were correlated with genuine clinical phenomena and implications were discussed for clinical practice and research.     

MMPI and Rorschach Indices of Schizophrenic and Depressive Diagnoses Among Adolescent Inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

Can sex offenders who minimize on the MMPI conceal psychopathology on the Rorschach?

Rorschach sensitivity to minimization is important in forensic evaluations of sex offenders because these individuals frequently deny psychological problems. To study Rorschach minimization, we divided alleged sex offenders according to whether they minimized on the MMPI (Hathaway & McKinley, 1943) or MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and compared their Rorschachs on indexes of distress, faulty judgment, interpersonal dysfunction, and cognitive distortions. We predicted there would be no differences between MMPI minimizers and nonminimizers on these indexes and that sex offenders of both groups would show greater psychopathology than normative adult samples. Results indicate that mini- mizers produce normal MMPI clinical profiles but still show evidence of psychopathology on the Rorschach. As predicted, sex offenders showed more Rorschach psychopathology than normative samples. Sex offenders' protocols that contained sexual content also showed perceptual distortions. These findings indicate that the Rorschach is resilient to attempts at faking good and may therefore provide valuable information in forensic settings where intentional distortion is common.     

MMPI and Rorschach indices of schizophrenic and depressive diagnoses among adolescent inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

Comparative Diagnostic Judgments from the Rorschach and the MMPI

Three experienced psychologists made diagnostic judgments from the Rorschach, the MMPI, and gave an overall diagnostic impression for 50 male and 48 female patients. Judgment on the first test viewed was given before looking at the second test. Order of viewing the tests and sex of patient were counterbalanced. The results indicated (a) the judges consistently rated the tests on a given individual as agreeing on diagnostic impression significantly more often than disagreeing; (b) interjudge agreement was low but significant for the MMPI and overall impressions, not significant for the Rorschach impressions; (c) in cases of disagreement, there was a highly significant tendency for the Rorschach to be seen as indicating more pathology than the MMPI.     

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We examined empirical findings related to the integration of the Rorschach and the MMPI in assessing adolescents. Intercorrelations between 50 Rorschach variables and the 13 MMPI basic scales are reported for a clinical sample of I97 adolescents. Significant correlations only slightly exceeded the number expected by chance. A review of six additional studies of adolescent samples also generally revealed either very modest or nonsignificant relationships between the Rorschach and the MMPI. These findings leave open the possibility that combining data from the two instruments may increase incremental validity, an issue that should be assessed by using multivariate analyses. Guidelines for integrating Rorschach and MMPI data in clinical practices with adolescents are provided.     

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.     

Correlates of the Egocentricity Index in Child and Adolescent Outpatients

This study examined the Rorschach and MMPI covariates of Exner's Egocentricity Index, 3γ + (2): R, in a sample of child and adolescent outpatients (n = 46). Consistent with previous findings on adult psychiatric inpatients (Barley, Doff, & Reid, 1985), significant positive correlations were obtained between the Index and M, FM, χ + %, and D when controlled for the number of protocol responses. The Egocentricity Index was negatively associated with lambda and, in a subsample of adolescents (n = 19), depression scores. The index bore no significant relationship to either Minnesota Multiphasic Personality Inventory (MMPI) validity or clinical scales, also congruent with earlier investigations. Implications for the interpretation of childrens' Egocentricity Indices are discussed.     

Correlates of the Egocentricity Index in child and adolescent outpatients

This study examined the Rorschach and MMPI covariates of Exner's Egocentricity Index, 3r + (2): R, in a sample of child and adolescent outpatients (n = 46). Consistent with previous findings on adult psychiatric inpatients (Barley, Dorr, & Reid, 1985), significant positive correlations were obtained between the Index and M, FM, X + %, and D when controlled for the number of protocol responses. The Egocentricity Index was negatively associated with lambda and, in a subsample of adolescents (n = 19), depression scores. The index bore no significant relationship to either Minnesota Multiphasic Personality Inventory (MMPI) validity or clinical scales, also congruent with earlier investigations. Implications for the interpretation of childrens' Egocentricity Indices are discussed.