Figure 4.1 MMPI-2 Profile Reflecting Scores on Clinical Scales and Validity Scales
Source: MMPI®-2 (Minnesota Multiphasic Personality Inventory®-2) Manual for Administration, Scoring, and Interpretation, Revised Edition. Copyright © 2001 by the Regents of the University of Minnesota. Used by permission of the University of Minnesota Press. All rights reserved. “MMPI” and “Minnesota Multiphasic Personality Inventory” are trademarks owned by the Regents of the University of Minnesota.
Projective Tests
Projective instruments are assessment tests composed of ambiguous stimuli. They can range from seemingly random patterns such as an inkblot to ambiguous drawings of individuals or objects. The individual is asked to describe what the patterns look like, what they remind him or her of, or what is being depicted in the drawing.
projective instruments: assessment tests that use ambiguous stimuli to elicit the internal cognitive and emotional organization of a person’s primary thought processes
The basic idea of projective testing is based on the theoretical ideas of Sigmund Freud and others who sought to understand the dynamics of the mind. One important distinction Freud made was between types of thinking (Erdelyi, 1985; Westen, Gabbard, & Ortigo, 2008). Primary process thought, which is seen in dreams or letting your mind wander, is not organized logically but in terms of associations between thoughts and feelings. Secondary process thought, on the other hand, is logically organized. Freud suggested that it was possible to understand the cognitive and emotional connections of a person’s mind in terms of primary process. Freud’s technique for exploring these connections was free association and dream analysis.
The basic technique of free association was to have a person lie on a couch and say whatever came into his or her mind. Since the therapist sat behind the client, there was little in the environment for the client to react to. It was the therapist’s job to notice how a person’s thoughts and emotions were connected. During free association over a period of months, it was assumed that patterns of responding would emerge. It could be, for example, that whenever a client talked about his pet, he would feel sad, or whenever someone began to describe a certain event, he would change the topic.
The Rorschach and its scoring is a complicated process that continues to be the focus of scientific debate.
Lewis J. Merrim/Science Source
Projective techniques were formally introduced in the first half of the 1900s as a means of detecting primary process types of thinking and feeling including instinctual and motivational processes. Since there were few techniques for understanding the connections in one’s mind at this time, professionals saw projective techniques as having potential for understanding how thoughts and feelings formed a cognitive network. It was assumed that projective techniques would give a window into the thought processes of those with mental disorders and how they differ from the thought processes of healthy individuals.
Two of the most well-known projective techniques are the Rorschach inkblot and the Thematic Apperception Test (TAT). Both of these tests have a long history of use, although various researchers have been critical of the Rorschach and other projective techniques and suggest clinical situations in which these types of techniques are not useful (Garb, Wood, Lilienfeld, & Nezworski, 2005).
Rorschach Inkblots
During the early part of the 1900s, Herman Rorschach, a Swiss psychiatrist, experimented with using inkblots. The Rorschach inkblots were made by simply dripping ink on a piece of paper and then folding it in half to create a symmetrical design. Some of the inkblots were in black and white (see Figure 4.2), and others were in color (see Figure 4.3). He initially gave his inkblots to a large number of schoolchildren (Ellenberger, 1970). Rorschach was interested in the sensory processing of these images, which he connected with Carl Jung’s idea of introversion and extraversion.
Rorschach Inkblots: a projective test using inkblots; an individual’s interpretation of the ambiguous ink patterns is evaluated to identify patterns in underlying thoughts and feelings
Rorschach saw introversion as focusing on the inner world of kinesthetic images and creative activity. Extraversion, on the other hand, was a focus on color, emotion, and adjustment to reality. For Rorschach, the content of what was seen in the inkblot was less the focus of the interpretation than the elements used, such as whether the person saw whole images or focused on small details of the blot. Viewing the image as containing movement and the use of the colors was also seen as important. A limited number of 10 plates were selected, and Rorschach published a book on the subject in German, Psychodiagnostics, in 1921. He died some months later at age 37. His book was translated into English in 1942.
Figure 4.2 When You Look at This, What Do You See?
Following Rorschach’s death, various clinicians used the inkblot test in their clinical practice. For a number of years, there was little scientific data concerning the reliability and validity of the measure. Since the late twentieth century, there has been a movement to standardize the presentation of the test and the manner in which it is scored. Exner (1986, 2003) offered one such system. Various studies have examined the reliability and validity of the measure with specific diagnostic groups and theoretical constructs (Hunsley & Mash, 2007; Meyer, 2001; Meyer & Archer, 2001). In 2001, a special issue of the journal Psychological Assessment was devoted to clarifying the utility of the Rorschach along with its problems from an evidence-based position. In order to address questions of reliability and validity, a series of norms using the Exner system based on more than 5,800 people from 17 countries has been published (Meyer, Erdberg, & Shaffer, 2007). The Meyer et al. review showed consistency across samples for adult Rorschach responses but problems with data from children. Overall, the Rorschach and its scoring is a complicated process that continues to be the focus of scientific debate.
Figure 4.3 When You Look at This, What Do You See?
In order to respond to the problems of the Exner scoring system, professionals interested in the Rorschach created a simpler scoring system referred to as the Rorschach Performance Assessment System (R-PAS) (http://www.r-pas.org/Docs/Manual_Chapter_1.pdf). The basic idea was to create a scoring system with strong psychometric properties such as reliability and validity. The developers of the R-PAS state their goals as follows:
1 Selecting and highlighting those variables with the strongest empirical, clinical, and response process/behavioral representational support while eliminating