Toward a Synthetic Approach to the Rorschach: The Case of a Psychotic Child

Much Rorschach research on case material focuses on the utility of a single scoring system, set of variables, or scale in isolation from other systems, scales, or perspectives. This approach fails to acknowledge the complexity of the Rorschach and to reflect the manner in which sophisticated clinicians select and synthesize various perspectives during the clinical inference and decision-making process. A case of a psychotic child is presented to illustrate the utility of a synthetic approach to the Rorschach. The strengths and weaknesses of various Rorschach perspectives in addressing specific diagnostic issues is explored through the case material.     

Conceptual and Empirical Perspectives on the Rorschach Assessment of Psychopathology

Conceptual and empirical perspectives on the Rorschach assessment of psychopathology are described and placed in a complementary perspective that stresses the value of conceptual formulations and the necessity of empirical data. Empiricism without concepts fails to explain adequately why Rorschach assessment yields useful information; conceptualization without empirical support fails to document adequately the psychometric soundness of Rorschach inferences. Used in tandem, explanatory concepts and supportive data enhance the scientific Stature and professional utility of Rorschach assessment.     

Conceptual and empirical perspectives on the Rorschach assessment of psychopathology

Conceptual and empirical perspectives on the Rorschach assessment of psychopathology are described and placed in a complementary perspective that stresses the value of conceptual formulations and the necessity of empirical data. Empiricism without concepts fails to explain adequately why Rorschach assessment yields useful information; conceptualization without empirical support fails to document adequately the psychometric soundness of Rorschach inferences. Used in tandem, explanatory concepts and supportive data enhance the scientific stature and professional utility of Rorschach assessment.     

Constructivism and the projective assessment of meaning in Rorschach administration

Constructivist perspectives on the Rorschach are outlined. I discuss ways in which constructivism complements and adds to existing Rorschach methodologies. It is suggested hat the constructivist emphasis on personally and socially constructed meanings is very consistent with many of the ways the Rorschach has been used and resonates with recent emphases on the Rorschach as a representational task. Furthermore, constructivist perspectives on Rorschach also provide an opportunity to supplement Exner's (1993, 1995) efforts to standardize and norm the Rorschach in a way that maintains the instrument's historic and admirable attention to relational elements of assessment and psychotherapy. I present a variety of meaning-based techniques for conducting Rorschach assessment, incorporating both the constructivist and social constructionist perspective.     

The Rorschach and psychopathy: toward a more accurate understanding of the research findings

In this article we present the reader with an understandable essay on the relation between the Rorschach and psychopathy. Some degree of sophistication and applied knowledge of the Hare Psychopathy Checklist-Revised (Hare, 1991) and the Rorschach (Rorschach, 1921/1942) are necessary to wade through the literature, weigh the relative merits of arguments made by proponents and detractors of Rorschach assessment, and meaningfully interpret the findings of relevant studies. Often studies reviewing the Rorschach's utility in assessing Antisocial Personality Disorder (American Psychiatric Association, 1994) and psychopathy exhibit a flawed or superficial understanding of essential theoretical and methodological issues. Argument derived from a suspect or specious premise, such as the notion that the Rorschach was designed or aspires to correspond with formal diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1952, 1994), vitiates conclusions based on such a premise. In this article, we discuss theoretical and methodological issues that can aid the reader or reviewer in achieving a more accurate understanding of this body of research.     

Construct validation of scales derived from the Rorschach method: a review of issues and introduction to the Rorschach rating scale

I suggest the main goal of Rorschach validation should be a refined understanding of what each score means. Toward this end, I review general issues in construct validity, hurdles unique to the Rorschach, and general limitations with validation criteria. I then recommend two approaches for improving criteria so they can begin approximating the gold standards that are necessary for a refined understanding of what scores actually measure. The first is a method for improving expert clinical judgment, and the second is a method for aggregating data across diverse judges. Finally, the Rorschach Rating Scale (RRS) is presented as a criterion tool to be used with either of these approaches to validation. The RRS is a fairly comprehensive summary of the constructs thought to be measured by various Rorschach scoring systems. The utility of the RRS for research and training are discussed, as are other practical, theoretical, and psychometric issues in its application.     

Barren Rorschachs: a conceptual approach.

A discussion is presented of five Rorschach protocols that appear to meet the criteria proposed by Exner and Weiner (1982, p. 31) for "brief and barren" Rorschach protocols. The protocols were obtained from a social service agency treating abused, neglected, disturbed, and delinquent youths. An attempt is made to bring to bear a conceptual approach to these Rorschachs, so that they may be seen as clinically valuable and revealing, hence not "invalid" diagnostic protocols. Emphasis is placed on the subjects' approach to the task, the subject-examiner interaction, and the meaning of the subjects' ostensibly peripheral comments. Recommendations are offered regarding ways to maximize the clinical utility of such protocols.     

Validation of the SASB Introject Surface in a Norwegian Clinical and Nonclinical Sample

Aronow, Reznikoff, and Moreland (this issue) have written a thoughtful contribution to the debate on the status of nomothetic and idiographic approaches to the Rorschach test. One of the interesting and attractive features of the current Rorschach er a is—as the Rorschach has experienced a resurgence of interest—the continuing interest in the foundations of the test and the historic antecedents to contemporary thought about the Rorschach (cf. Handler, 1994). One cannot consider Rorschach's seminal insights or those of the first and second generation and not deepen one's contemporary understanding and practice. In other words, the more you know about the test, the better "Rorschacher" you will be. This is witness to the test's utility and profundity. For this we may be grateful for the thought-provoking contribution of Aronow and his colleagues.     

Contributions of cognitive science to the Rorschach Technique: cognitive and neuropsychological correlates of the response process

This article presents an understanding of the Rorschach Technique in terms of emergent models from cognitive science. We propose a linkage between cognitive psychology and neuropsychology in understanding the operations that underlie the Rorschach response process. Contemporary information processing models are described. The Rorschach Technique is conceived of as a complex process involving all areas of the cerebral hemispheres, encompassing various aspects of visual attention and perception, object recognition, associative memory, language production, and executive functioning. Exner's model of the response process is delineated, including both Association and Inquiry phases, in terms of requisite underlying neuropsychological abilities and anatomical substrates. The question of the Rorschach Technique's status, utility, and potential as a neuropsychological assessment, tool is discussed. Understanding the Rorschach in terms of contemporary cognitive psychological and neuropsychological models heightens appreciation of the technique's complexity and provides a heuristic and conceptual foundation for empirical research.     

Potential space and the Rorschach: an application of object relations theory

This article examines the concept of potential space, developed by Winnicott (1971), and its relevance for Rorschach assessment. I propose that the response process can be viewed as occurring in the potential space between reality and fantasy and that various forms of psychopathology can be conceptualized as forms of the collapse of potential space. I suggest that this model can be of utility in interpreting the Rorschach protocols of a variety of difficult-to-diagnose patients. Examples from the Rorschach of a patient diagnosed with a dissociative disorder are presented to illustrate these points.     

Maria Rickers-Ovsiankina: a Russian expatriate in America. A review of Rorschach Psychology

This article is a review and reassessment of Rorschach Psychology, edited by Maria Rickers-Ovsiankina. The various chapters in the book are written with an attempt to tie Rorschach conceptualization to academic psychology and to various theoretical approaches. A wide range of theories are considered, including a gestalt psychology approach, an experiential-phenomenological approach, and several psychodynamic approaches (e.g., Freudian and Jungian theory). In addition, information is included about Rickers-Ovsiankina's early life and background, and the contents of many of the individual chapters are described and evaluated.     

Methodological issues in cross-cultural and multicultural rorschach research

Hermann Rorschach researched the utility of his inkblot experiment to understand psychopathology and cultural differences. Contemporary research with the Rorschach has evaluated its utility as a test, although it may more properly represent a clinical method with somewhat different evaluation criteria. Recent controversy regarding the adequacy of the Rorschach as a test and the adequacy of its normative data has at times distorted and oversimplified important methodological issues inherent in the study of cultural difference. Cultural processes remain a central and inadequately examined variable in Rorschach research; an important emergent area of inquiry is the Rorschach's clinical utility as a cross-cultural assessment instrument. We review multicultural and cross-cultural methodological issues intrinsic to contemporary Rorschach research here. Consideration of cultural issues enlarges and enriches the Rorschach clinical utility debate and suggests underexplored research strategies that can contribute to its resolution.     

On the Rorschach M response and monotheism

The Rorschach human movement (M) response has recently been debated (Exner, 1991a, Kramer, 1991a, 1991b) with additional wider implications for Rorschach psychology. The objective of this discourse is twofold: (a) to elaborate on the contributions of perceptanalysis (Piotrowski, 1957) to this debate and (b) to develop the thesis that diversity is desirable for the long-term advancement of the field of Rorschach psychology and personality assessment. These motifs are illustrated with an interpretation of a clinical case example and with rationale from the theoretical literature and implications for interpreting short Rorschach protocols. The conclusion is proffered that some degree of diversification is more beneficial than requiring the adoption of a single Rorschach approach (i.e., monotheism).     

On the Rorschach M Response and Monotheism

The Rorschach human movement (M) response has recently been debated (Exner, 1991a, Kramer, 1991a, 1991b) with additional wider implications for Rorschach psychology. The objective of this discourse is twofold: (a) to elaborate on the contributions of perceptanalysis (Piotrowski, 1957) to this debate and (b) to develop the thesis that diversity is desirable for the long-term advancement of the field of Rorschach psychology and personality assessment. These motifs are illustrated with an interpretation of a clinical case example and with rationale from the theoretical literature and implications for interpreting short Rorschach protocols. The conclusion is proffered that some degree of diversification is more beneficial than requiring the adoption of a single Rorschach approach (i.e., monotheism).     

Construct Validation of Scales Derived From the Rorschach Method: A Review of issues and Introduction to the Rorschach Rating Scale

I suggest the main goal of Rorschach validation should be a refined understanding of what each score means. Toward this end, I review general issues in construct validity, hurdles unique to the Rorschach, and general limitations with validation criteria. I then recommend two approaches for improving criteria so they can begin approximating the gold standards that are necessary for a refined understanding of what scores actually measure. The first is a method for improving expert clinical judgment, and the second is a method for aggregating data across diverse judges. Finally, the Rorschach Rating Scale (RRS) is presented as a criterion tool to be used with either of these approaches to validation. The RRS is a fairly comprehensive summary of the constructs thought to be measured by various Rorschach scoring systems. The utility of the RRS for research and training are discussed, as are other practical, theoretical, and psychometric issues in its application.     

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.     

Rorschach Aggressive Content (AgC) variable: a study of criterion validity

This study adds to the existing literature on the clinical utility of the Aggressive Content (AgC) variable proposed by Gacono and Meloy (1994). Criterion validity is evaluated by examining the relation between AgC and behavior. Rorschach and clinical chart material taken from psychological assessments were examined for 94 patients in Exner's (1993) psychiatric reference groups. An Aggression Chart Rating Scale (ACRS) was created to score the level of aggressiveness of each patient's diagnostic report. Analyses revealed good interrater reliability (intraclass correlation coefficient = .73) for ACRS scores and Aggressive Movement (AG; kappa = .73) and excellent reliability for AgC (kappa =.88) and Morbid Content (MOR: kappa = .79). Pearson's correlation revealed significant relations between AgC and both AG and MOR. All 3 Rorschach variables were significantly related to scores on the ACRS. A stepwise regression analysis utilizing these 3 variables resulted in AgC being the only nonredundant predictor of scores on the ACRS. This suggests that AgC was more strongly related to more aggressive ACRS scores than either AG or MOR. The continued support for the clinical utility of AgC as well as recommendations for the addition of the AgC variable to Exner's (1993) Comprehensive System's list of Special Scores are discussed.     

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.     

The rorschach search for the borderline Holy Grail: an examination of personality structure, personality style, and situation

Much of the research on the use of the Rorschach to diagnose borderline disturbance has sought to discover a specific borderline pattern or Rorschach configuration. Given our increased understanding of borderline functioning representing a level of personality organization (or personality structure), this single pattern approach is excessively simplistic. It fails to consider the complex interaction between personality structure, personality style, and situational variables. An approach to the Rorschach assessment of borderline functioning is presented using a clinical example. The patient was tested at the onset of psychotherapy and then some 4 years into treatment. Results from the two testings were compared using Weiner and Exner's (1991) Rorschach variable clusters for assessing change in psychotherapy.     

Barren Rorschachs: A Conceptual Approach

A discussion is presented of five Rorschach protocols that appear to meet the criteria proposed by Exner and Weiner (1982, p. 31) for "brief and barren" Rorschach protocols. The protocols were obtained from a social service agency treating abused, neglected, disturbed, and delinquent youths. An attempt is made to bring to bear a conceptual approach to these Rorschachs, so that they may be seen as clinically valuable and revealing, hence not "invalid" diagnostic protocols. Emphasis is placed on the subjects' approach to the task, the subject-examiner interaction, and the meaning of the subjects' ostensibly peripheral comments. Recommendations are offered regarding ways to maximize the clinical utility of such protocols.