Legal Admissibility of the Rorschach and R-PAS: A Review of Research, Practice, and Case Law

The special issue editors selected us to form an "adversarial collaboration" because our publications and teaching encompass both supportive and critical attitudes toward the Rorschach and its recently developed system for use, the Rorschach Performance Assessment System (R-PAS). We reviewed the research literature and case law to determine if the Rorschach and specifically R-PAS meet legal standards for admissibility in court. We included evidence on norms, reliability, validity, utility, general acceptance, forensic evaluator use, and response style assessment, as well as United States and selected European case law addressing challenges to mental examination motions, admissibility, and weight. Compared to other psychological tests, the Rorschach is not challenged at unusually high rates. Although the recently introduced R-PAS is not widely referenced in case law, evidence suggests that information from it is likely to be ruled admissible when used by a competent evaluator and selected variables yield scores that are sufficiently reliable and valid to evaluate psychological processes that inform functional psycholegal capacities. We identify effective and ethical but also inappropriate uses (e.g., psychological profiling) of R-PAS in criminal, civil, juvenile, and family court. We recommend specific research to clarify important aspects of R-PAS and advance its utility in forensic mental health assessment.

Using a Mixed-Methods Approach to Analyze Traumatic Experiences and Factors of Vulnerability Among Adolescent Victims of Bullying

A number of studies have analyzed the bullying phenomenon among adolescent victims. Relatively few studies, however, have specifically addressed the associated post-traumatic stress disorder (PTSD). Our clinical practice and therapeutic encounters with adolescents reveal that the majority of bullied adolescents suffer from high levels of PTSD. The objective of this study is to further explore bullied adolescents' traumatic experiences. In an attempt to analyze these experiences, this article presents a mixed-methods approach. Such an approach will allow to analyze the PTSD that results from bullying as well as subjects' psychic and family-relevant vulnerabilities. First, bullying will be defined in the context of adolescence. Then the main studies on bullying will be presented. The objectives, tools and methods of analysis will be presented. The interviews will be analyzed according to the Interpretative Phenomenological Analysis (IPA) method. Projective tools, family drawings, Rorschach and Thematic Apperception Test (TAT), will be analyzed using a psychoanalytic interpretation method. Each qualitative tool will be used alongside a validated quantitative tool. The Clinical Administered PTSD Scale (CAPS-CA-5 questionnaire) and the interviews conducted will thus allow to analyze PTSD and traumatic experiences. The Family Assessment Device (FAD) and the family drawing test will enable to assess family functioning; lastly, the Symptom Check List (SCL-90) that will be used alongside Rorschach and TAT tests will allow to analyze individual psychological vulnerabilities. This approach will increase data validity. The originality of this research study is based on a mixed-methods approach, our methodology which is based on clinical psychology, and the choice of certain research tools which have received little attention to date. Ultimately, this study may help improve how bullying is identified and could contribute toward the reinforcement or revision of the criteria that characterize bullying. Lastly, it may help us explore various unexamined dimensions of bullying. A possible limitation is the complexity associated with such a protocol.

Does the Rorschach Performance Assessment System (R-PAS) Differ from the Comprehensive System (CS) on Variables Relevant to Interpretation?

We examined the impact of the changes in administration and coding introduced by the Rorschach Performance Assessment System (R-PAS) relative to the Comprehensive System (CS) on the Rorschach response process, as manifested in variables relevant to interpretation. We also examined the efficiency of each system to obtain protocols in an optimal range of responses (R) for interpretation. As hypothesized, when comparing 50 CS and 50 R-PAS nonpatient protocols, R-PAS produced many more protocols in the optimal R range (18-27) than the CS (78% vs. 24%) and it eliminated the need for re-administration, which was required for five CS protocols. As expected, R was less variable with R-PAS, as were two variables derived from it, R8910% and Complexity. In addition, as expected because of different Form Quality tables, R-PAS showed notably fewer and less variable perceptual distortions than the CS, and an increase in more conventional perceptions. The other 58 variables showed no reliable differences in means or standard deviations, though modest power precluded definitive inferences about equivalence. Overall, our results support previous findings about the benefit of R-PAS to obtain protocols in an optimal range for interpretation, while keeping the core manifestations of the response process unchanged.

Rorschach Assessment in Suicide Survivors: Focus on Suicidal Ideation

Background: The study of Suicidal ideation (SI) in people bereaved through suicide (Suicide Survivors, SSs) could be hampered by the person's willingness to admit it, or by their limited awareness of it. Our main hypothesis is that SI is common in these people, especially if they are parents or children of the victim. For its potential in shedding light on specific unconscious processes, Rorschach test was chosen for our investigation, for the first time in SSs literature. Rorschach suicide ideation and selected variables were further analyzed to better delineate their psychological profile. Method: Rorschach according to Exner's Comprehensive System was administered to 21 people bereaved through suicide presenting as outpatients at SOPROXI Project Service-Padova Mental Health Center- and 23 healthy controls. Beck Depression Inventory (BDI) was routinely administered to SSs and considered in the study. Results: T-tests showed significantly higher mean SI score (S-Con) as it emerged from the Rorschach test S-Con scores in SSs compared to control participants. SI found only weak correlation with the BDI item in which SSs can explicitly state the desire for their death. Within-group analysis revealed higher S-Con mean scores in bereaved children and parents of the victim compared to other kind of kinships. Morbid content (MOR) has been fund as the most characterizing variable in SSs' S-Con in terms of effect size, followed by a low number of responses with an ordinary form (X +%). Human movements (M), Special Scores related to thought slippage (ALOG, FABCOM2, INCOM2, and CONTAM) and poor human representations (PHR) have been shown to be more significantly present in SSs compared controls. Discussion: Psychodynamic interpretations of our results are provided. Clinical practice should consider Rorschach as one of eligible tools of investigation on this field.

An examination of generalized anxiety disorder and dysthymia utilizing the Rorschach inkblot method

This study examined transdiagnostic features of generalized anxiety disorder (GAD) and dysthymia in an outpatient clinical sample. Fifteen patients who met DSM-IV criteria for GAD and twenty-one patients who met DSM-IV criteria for dysthymia but who did not have comorbid anxiety disorder were evaluated utilizing the Rorschach. Salient clinical variables were then compared. Results showed that patients with GAD scored significantly higher on variables related to cognitive agitation and a desire/need for external soothing. In addition, there was a trend for patients with GAD to produce higher scores on a measure of ruminative focus on negative aspects of the self. Thus, not surprisingly, GAD patients' experienced more distress than the dysthymic patients. The implications of these findings are discussed with regards to better understanding the shared and distinct features of GAD and dysthymia.

The Effects of Using the International Versus Comprehensive System Rorschach Norms For Children, Adolescents, and Adults

Currently, there is some debate about whether to use Comprehensive System norms (CS; Exner, 2003 ) or the Composite International Reference Values (CIRV; Meyer, Erdberg, & Shaffer, 2007 ) when interpreting Rorschach Inkblot Method (RIM; Rorschach, 1921 ) protocols administered with the CS method. The goal of this study is to assist clinicians in making this decision by providing information about the effects of choosing one option or the other. Accordingly, this research evaluates the effects of using the CS versus CIRV norms with children, adolescents, and adults. First, we identified 43 variables for which the CS and the CIRV for children and adolescents differ from each other by at least a Cohen's d value of .50. Next, we evaluated whether these divergent variables are the same as those previously identified as divergent for the adult population. Results showed that for both children and adolescents, as well as for adults, relying on CS norms versus CIRV would result in interpretations that are more pathological in terms of (a) perception and thinking, (b) psychological resources and cognitive and emotional abilities, and (c) representations of human relationships. A discussion on the clinical effects of using one versus the other set of norms follows.

Identification of suicidal ideations with the help of projective tests: a review

Identification of the presence of suicidal ideations in an individual is crucial for the timely intervention. However, these ideations may remain unidentified as an individual with serious intentions of self-harm may not express them explicitly. Various projective tests can provide crucial clues to clinicians about the presence of suicidal ideations in an individual's mind. The present review is intended to update clinicians working in the field of suicide prevention about salient findings on these tests which can serve as a ready reckoner for them. We also highlight the status of research in this domain.

Addressing Issues in the Development and Use of the Composite International Reference Values as Rorschach Norms for Adults

This article describes 3 studies evaluating normative reference data for the Rorschach Comprehensive System (CS; Exner, 2003, 2007), with a particular focus on the viability of the Composite International Reference Values (CIRVs) that were compiled from 21 adult studies by Meyer, Erdberg, and Shaffer (2007). Study 1 documented how the CIRV norms are virtually identical when organized into 3 groups differentiated by the quality of their data collection effort, including an optimal group of 4 samples that relied on multiple experienced examiners and provided ongoing quality control over administration and coding. Analyses also showed that relative to the group of more optimal samples, the group of less optimal samples did not produce more variability in summary scores within or across samples or lower interrater reliability for coding. Study 2 used the existing CS reference norms to generate T scores for the CIRV means and documented how the CS norms make other samples of healthy nonpatients look psychologically impaired in multiple domains. Study 3 documented with examples from 4 different countries how 2 sets of within-country local norms produced notably different results on some variables, which compromises the ability of local norms to be used instead of the CIRVs. Taken together, the 3 studies provide support for the use of CIRVs in clinical practice as norms that are generalizable across samples, settings, languages, and cultures and that account for the natural variability that is present when clinicians and researchers contend with the ambiguity contained in the standard CS reference materials concerning the proper ways to administer and code. We conclude by urging CS users to rely on the CIRVs when making clinical inferences and to adopt alternative methods of ensuring they are following cohesively standardized administration and coding guidelines.

Introducing a Bayesian Approach to Determining Degree of Fit With Existing Rorschach Norms

This article offers a new methodological approach to investigate the degree of fit between an independent sample and 2 existing sets of norms. Specifically, with a new adaptation of a Bayesian method, we developed a user-friendly procedure to compare the mean values of a given sample to those of 2 different sets of Rorschach norms. To illustrate our technique, we used a small, U.S. community sample of 80 adults and tested whether it resembled more closely the standard Comprehensive System norms (CS 600; Exner, 2003), or a recently introduced, internationally based set of Rorschach norms (Meyer, Erdberg, & Shaffer, 2007 ). Strengths and limitations of this new statistical technique are discussed.

The association of gender, ethnicity, age, and education with Rorschach scores

We examined the association of gender, ethnicity, age, and education with 60 Rorschach scores using three clinical and nonclinical samples of adults and youths (ns = 640, 249, and 241). As anticipated for our data sets, there were no reliable associations for gender, ethnicity, or adult age. However, in adults years of education was associated with variables indicative of complexity, the articulation of subtlety and nuance, cognitive synthesis, and coping resources. In the clinical sample of youths, increasing age was primarily associated with more conventional perception and less illogical thought processes. Limitations are discussed in conjunction with further research that could address them, along with implications for applied practice.

Estudo parcial da validação do Atlas do Rorschach Sistema Compreensivo em amostra de pacientes psiquiátricos de São Paulo

Este trabalho é parte do estudo de validação do atlas de localização e da lista de qualidade formal brasileiros do Rorschach Sistema Compreensivo em amostra de pacientes psiquiátricos da cidade de São Paulo, comparando as variáveis X+%, XA%, WDA%, X-% e Xu% dos pacientes com os valores encontrados na amostra normativa brasileira. Foram avaliados 45 pacientes, e os instrumentos de seleção foram a entrevista clínica estruturada para diagnóstico do DSM-IV (SCID-I) e a Escala das Síndromes Positiva e Negativa (PANSS). 23 pacientes preencheram critério pela SCID-I para transtornos psicóticos e, destes, 19 foram considerados psicóticos pela PANSS. Todos os protocolos foram classificados segundo as classificações norte-americanas e brasileiras. Foi realizada ANOVA, comparando amostras normativas e o grupo de pacientes. As variáveis XA% e X-% mostraram-se sensíveis para detectar as nuances perceptivas entre as pessoas. As áreas de localização e lista de qualidade formal brasileiras se mostraram válidas para discriminar graus de comprometimento perceptivo.

Rorschach score validation as a model for 21st-century personality assessment

Recent conceptual and methodological innovations have led to new strategies for documenting the construct validity of test scores, including performance-based test scores. These strategies have the potential to generate more definitive evidence regarding the validity of scores derived from the Rorschach Inkblot Method (RIM) and help resolve some long-standing controversies regarding the clinical utility of the Rorschach. After discussing the unique challenges in studying the Rorschach and why research in this area is important given current trends in scientific and applied psychology, I offer 3 overarching principles to maximize the construct validity of RIM scores, arguing that (a) the method that provides RIM validation measures plays a key role in generating outcome predictions; (b) RIM variables should be linked with findings from neighboring subfields; and (c) rigorous RIM score validation includes both process-focused and outcome-focused assessments. I describe a 4-step strategy for optimal RIM score derivation (formulating hypotheses, delineating process links, generating outcome predictions, and establishing limiting conditions); and a 4-component template for RIM score validation (establishing basic psychometrics, documenting outcome-focused validity, assessing process-focused validity, and integrating outcome- and process-focused validity data). The proposed framework not only has the potential to enhance the validity and utility of the RIM, but might ultimately enable the RIM to become a model of test score validation for 21st-century personality assessment.

Developing Continuous Variable Composites for Rorschach Measures of Thought Problems, Vigilance, and Suicide Risk

Using a multiple regression approach with a large developmental sample ( N = 460) of Rorschach protocols from psychiatric, forensic, and nonclinical control groups, the authors created continuous multivariable Composite scores corresponding to the Comprehensive System (CS) Perceptual-Thinking Index, Hypervigilance Index, and Suicide Constellation. Within a validation sample ( N = 230), these three new scores, called the Thought and Perception Composite, Vigilance Composite, and Suicide Concern Composite were strongly associated with the three original CS Indices. Additional analyses suggest that the new Composite scores were more reliable than and at least as valid as the original Indices. Interpretive guidelines are offered.

Rorschach inkblot method data at baseline and after 2 years treatment of consecutively admitted patients with first-episode schizophrenia

BACKGROUND

The Rorschach Inkblot Method is regarded as an important clinical instrument for detailed diagnostic description of the integrative capacities of individuals in psychotic states and as an instrument for measuring progression in the course of treatment.

AIMS

To describe relevant Rorschach variables at baseline in a group of consecutively admitted patients with first-episode schizophrenia. Furthermore, to describe the changes in these variables from baseline to year 2 for the group of patients given psychiatric standard treatment, and to compare these changes with changes in other outcome measures [Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Strauss-Carpenter and socio-demographic variables].

METHODS

In a prospective study, 34 patients consecutively admitted to treatment for a first episode of schizophrenia were tested using Exner's Rorschach Comprehensive System at inclusion and after 2 years.

RESULTS

Core variables of the Rorschach, assumed to show changes (e.g. reality testing, perceptual and thought disorders) in patients with a first episode of schizophrenia, all improved but revealed no significant changes after 2 years of treatment, while other measurements (PANSS, GAF) did. Furthermore, discrepancies were found between the Perceptual-Thinking Index (PTI) and PANSS(positive) symptoms of delusions and hallucinations.

CONCLUSION

The small sample limits the conclusions, but the Rorschach variables may have problems reflecting major changes in psychotic symptoms and social functioning. With short protocols, PTI seems at risk of being unnecessarily insensitive and PTI may benefit from changes in the scoring procedures.

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.

One more datum on Rorschach form quality

The central purpose of this work is to examine to what extent Form Quality (FQ) scoring of Rorschach responses, using Exner's (2003) Table A, is the reason for lower FQ to often be found in normative data outside the United States. The Rorschach protocols of 180 Portuguese boys and girls between 6 and 10 years of age were codified with respect to Form Quality in accordance with Exner's table of objects classified as ordinary, unusual, and minus, based on frequencies seen among U.S. adults and on an analogous Portuguese table (Table P) constructed from the protocols of 400 nonpatient children. Mean differences between the various FQ variables of the 2 tables were found to be insignificant. However, use of Janson's (2003) iota coefficient to evaluate agreement between the 2 approaches to scoring on the same protocols revealed that the more striking differences occurred in the FQu variable when agreement was assessed on the basis of each individual response. In view of these results, the authors recognize the possibility of Rorschach normative data to be universally applied, but still consider the possible advantage of each country or culture to build its own FQ table that will permit preservation of its particularities.

Self-regulation and internal resources in school-aged children with ADHD symptomatology: an investigation using the Rorschach inkblot method

This study assesses the capacity for emotional self-regulation and internal resources in a sample of urban children with ADHD symptomatology using the Rorschach Inkblot Method (RIM). Because these children have profound difficulty with modulating their affect, it is hypothesized that this difficulty would be reflected on RIM variables that have traditionally been thought to reflect the internal resources necessary for these children to regulate emotions. Children with greater ADHD symptoms were found to display lower scores on variables indicating internal resources for emotional self-regulation and stress tolerance (M, EA) relative to a comparison group with fewer ADHD symptoms. The research and clinical implications of these findings are discussed.

Rorschach correlates of adolescent self-mutilation

The present study examined various Rorschach variables of aggression, dysphoric affect, and disordered thinking in relation to self-mutilation in samples of self-mutilating (SM; n=16) and nonself-mutilating (N-SM; n=26) adolescent inpatients. Categorical comparisons indicated that SM patients had significantly higher mean scores for Aggressive Past (AgPast), but not for Aggressive Content (AgC), Aggressive Movement (AG), Morbid Content (MOR), Inanimate Movement (m), Sum Shading (SumY), and the Perceptual-Thinking Index (PTI), than N-SM patients. Additionally, logistic regression results suggested that PTI and AgPast were the most robust predictors of group membership. The authors propose that self-mutilating adolescents may struggle with internally directed aggression and victimized sense of self that, when coupled with disordered thinking, significantly predicts self-mutilation.

Perceptual-Organizational Characteristics of the Rorschach Task

The present study was designed to begin to explore the perceptual and visuospatial organization required to respond to the Rorschach task. Previous research has shown a relative independence of Rorschach scores from other measures of neurocognitive functioning (e.g., Zillmer & Perry, 1996). However, many of the neuropsychological measures used in previous studies did not require the patient to organize a complex visuospatial stimulus in the same way that the Rorschach does. In this study, data from 27 children and adolescents administered the Rorschach and the Rey-Osterreith Complex Figure Test (ROCF) were examined. Results of analyses indicated that, accounting for age and Full Scale IQ, there were a number of significant relationships between accuracy of ROCF renditions and Rorschach measures of developmental quality and perceptual accuracy. Implications for the understanding the nature of the Rorschach response process and its utility in clinical neuropsychology are discussed.

Performance-Based Assessment in Schools

This article addresses a 2006 article by Hojnoski, Morrison, Brown, and Matthews on the use of performance-based measurement among school-based practitioners. Their results suggest that many of their survey respondents favor the use of this form of measurement. This line of research is important and addresses an important issue in current clinical practice. However, they offer a critique of this form of assessment, in response to which the author raises four issues. First, there is a difference between tests and techniques. Second, assessment tools do not make decisions or diagnoses; clinicians do. Third, actuarial prediction and clinical expertise are mutually enhancing. Last, the relationship between science and practice should be bidirectional and integrative. These points are discussed in terms of the utility and appropriateness of performance-based measurement tools and techniques for helping psychologists answer diagnostic, placement, and treatment questions in the school setting.

A cientificidade das técnicas projetivas em debate

O objetivo deste trabalho é rever uma série especial de artigos antagônicos sobre a validade e o status científico dos métodos projetivos, uma vez que o foco dos debates atuais recai novamente sobre o mérito das técnicas projetivas em contraposição às objetivas, principalmente no que diz respeito ao pouco rigor metodológico nos estudos de validação e ausência de validade incremental, o que, conseqüentemente, repercute na credibilidade dos profissionais e pesquisadores que as utilizam. Neste artigo, dá-se destaque ao que há de procedente em tais discussões, bem como nas distorções ou falácias geradas nesta última década sobre os três procedimentos mais utilizados para avaliação da personalidade, no Brasil e exterior: o Método de Rorschach no Sistema Compreensivo, RCS; o Teste de Apercepção Temática, TAT e o Desenho da Figura Humana, DFH. Os referenciais apresentados sobre a utilidade clínica e diagnóstica desses instrumentos mostram-se igualmente úteis na ponderação de estudos e na discussão de questões relativas às técnicas projetivas de modo geral.

A Rorschach Stability Study in a Nonpatient Adult Sample

The objective of this study was to provide new primary data on Rorschach Comprehensive System stability levels. To achieve this, we tested 75 French nonpatient adults twice on the Rorschach with a 3-month interval between the tests. Interrater reliability was in the excellent range for most of the variables studied. The overall stability level in a selected set of previously studied variables was below expectations (median r = .53). Personality, cognitive or self/relational variables yielded higher test-retest correlations than emotional and coping variables. Moderators of stability could be identified: (a) overall level of Task Engagement (TE) in F, m, FM + m, a, FC, Sum C', Sum V, Sum Shd, Fr + rF, INC + FAB, COP, es, Adj es, EGO, and Blends; (b) variations in TE in F, FM, and p; (c) state distress in Zd, m, FM + m, a, C, CF + C, WSumC, FD, and es; (d) variables derived from the number of responses impacted stability in P, Zf, m, FC, CF + C, Sum C', Sum V, MOR, EA, es, and Blends. These results provide further support for the reliability of several measures. Examiner effects as an influence on productivity and TE were identified as an important area for future research.

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.

Food Intake With an Antiobesity Drug (Sibutramine) Versus Placebo and Rorschach Data: A Crossover Within-Subjects Study

We related the effect of the satiety enhancing drug sibutramine (Meridia, Reductil) on food intake to Rorschach Comprehensive System (Exner, 1991, 1993) personality factors. A placebo-controlled crossover, within-subjects design (n = 36) was used. Food intake after 2 weeks in the sibutramine and placebo conditions was assessed with a test meal using the VIKTOR (Cabmek, Stockholm, Sweden) setup, a computerized eating monitor. Building on baseline VIKTOR measurements, we had earlier studied the microstructure of eating (Elfhag, Barkeling, Carlsson, & Rossner, 2003). In this study, a model including Afr, MOR, and Populars could explain the variance in the effect of sibutramine. Sibutramine may reduce food intake in single test meals for participants whose appetite is prompted by external stimuli including food cues, suggested by the Affective ratio. Distress related to the body in obesity seen in damaged self-imagery (MOR) and adjustment to social expectations (Populars) could also have a moderating effect on the participants' consumption of test meals in an experimental design. Bodily concern (An + Xy) was also related to sibutramine response in univariate analyses.

Differences in Comprehensive System Rorschach Variables Between Groups Differing in Therapy Suitability

Dans les deux études présentées ici, nous avons fait des prédictions conceptuelles sur l'aptitude de patients à suivre une psychothérapie d'orientation dynamique à partir de variables Rorschach. Dans la première étude, nous avons sélectionné rationnellement des variables prédictives Rorschach (SI) (Exner, 1991, 1993) pour trois groupes de patients de divers diagnostics (n = 30, 43, 25). Les groupes ont été comparés à l'aide de l'ANOVA non paramétrique de Kruskall-Wallis puis nous avons procédé à des comparaisons par paire entre les groupes avec le test U de Mann-Whitney. Dans l'étude II, on a prédit des différences de scores entre deux désordres de personnalité (n = 35 et 25) et testés à l'aide du U de Mann-Whitney. Les résultats de ces deux études on confirmé les prédictions pour le EA, les blends, l'activité d'organisation (Zf), le mouvement humain de forme ordinaire (Mo), la dimension formelle (FD), le mouvement agressif (AG) et de coopération (COP) comme de bonne indication pour une psychothérapie d'orientation dynamique. De même, nous avons trouvé comme indicateurs négatifs le pourcentage des réponses purement formelles (F%), un score D > 0 et un indice d'incompétence sociale positif (CDI > 3). Les prédictions portant sur la couleur dominée par le forme (FC), l'estompage de diffusion non dominé par la forme (YF, Y), le mouvement d'objet (m), la somme pondérée des cotations spéciales critiques (WSum6), la distorsion formelle (X–%), l'espace blanc (S), les reflets (Fr, rF) et les réponses personnalisées (PER) n'ont pas été confirmées.

Incremental validity of new clinical assessment measures

The authors address conceptual and methodological foundations of incremental validity in the evaluation of newly developed clinical assessment measures. Incremental validity is defined as the degree to which a measure explains or predicts a phenomenon of interest, relative to other measures. Incremental validity can be evaluated on several dimensions, such as sensitivity to change, diagnostic efficacy, content validity, treatment design and outcome, and convergent validity. Indices of incremental validity can vary depending on the criterion measures, comparison measures, and individual differences in samples. The authors review the rationale for, principles, and methods of incremental validation, including the selection of comparison and criterion measures, and address data analytic strategies and the conditional nature of incremental validity evaluations in the selection of measures. Incremental validity contributes to, but is different from, cost-benefits, which reflect the cost of acquiring the data and the benefits from the data. The impact of an incremental validity index on whether a measure is selected will be moderated by the cost of acquiring the new data, the importance of the measured phenomenon, and the clinical utility of the new data.

Let's Call the Whole Thing Off: A Response to Dawes (2001)

There has been a recent controversy regarding the validity of the Rorschach test. This comment is in response to criticism levied by R. M. Dawes (2001) on the incremental validity of the Ego Impairment Index (EII), a Rorschach-derived measure of cognition, perception, and reasoning. The Dawes articles (1999 and 2001) serve as an example of the recent practice of placing extraordinary challenges on the Rorschach test. Dawes's arguments are examined and parallel examples are provided that demonstrate the bias used to judge the validity of the EII, the Rorschach, and psychological assessment. Still, in the face of criticism, the results (see Dawes, 2001) support the incremental validity of the EII. Thus, the conclusion presented in this Comment is that it is time for us to "call the whole thing off" and end the Rorschach controversy that has occupied so much recent attention and generated so few new ideas.

Refinements in the Rorschach Ego Impairment Index incorporating the human representational variable

The Ego Impairment Index (EII; Perry & Viglione, 1991) is a composite measure of psychological impairment and thought disturbance developed from the empirical and theoretical literature on the Rorschach. In this article, we summarize reliability and validity data regarding the EII. Our major goal was to present the rationale and empirical basis for recent refinements in the EII. Among the subcomponents of the original EII was the Human Experience variable (HEV), which has recently been revised and replaced with the Human Representational variable (HRV; Viglione, Perry, Jansak, Meyer, & Exner, 2003). In this study, we replaced the HEV with the HRV to create the EII-2. This was accomplished by recalculating the factor coefficients with a sample of 363 Rorschach protocols. We present additional validity data for the new EII-2. Research recommendations and interpretive guidelines are also presented.

Prediction of adolescent and adult delinquency from childhood Rorschach ratings

Relatively few studies have predicted adolescent or adult delinquency from childhood Rorschach data. Incremental validity of Rorschach measures over other known consistent and more easily obtained predictors has typically not been investigated. We addressed Rorschach data's incremental validity over mother's reports of externalizing behavior and mother-child relations for predicting officially registered adolescent and adult delinquency in a longitudinal study of 122 Swedish men. The Rorschach measures we used were aggregates of blind, prospectively performed, global expert ratings based on a holistic evaluation of protocols. An aggregate of Rorschach-based ratings of ego strength significantly improved the prediction of delinquency in adolescence and adulthood over and above earlier identified best predictors (mother's ratings of mother-child relations and externalizing problem behavior).