Association Techniques (The Rorschach

test:
The Rorschach test is made up of ten inkblots created in the early 1900s by Herman Rorschach
(1884–1922).
He made the inkblots by splattering ink on a sheet of paper and folding it in half, resulting in
relatively symmetrical bilateral designs. Five of the inkblots are black or grayscale, while the
other five are colored; each is displayed on a white background.
The Rorschach is appropriate for people aged 5 and up, but it is most commonly used with
adults. Unfortunately, Rorschach died before completing his scoring methods, so the
systematization of Rorschach scoring was left to his disciples. Five American psychologists—
Samuel Beck, Marguerite Hertz, Bruno Klopfer, Zygmunt Piotrowski, and David Rapaport—
created overlapping but independent approaches to the test.
The nuances of scoring differed predictably from one scoring method to the next. In 1991, John
Exner and his colleagues began to codify and syntheses the scoring approaches into the
Rorschach Comprehensive System.
Because it was more clearly grounded in empirical research, the Comprehensive System (CS)
supplanted all previous methods and became the preferred scoring system. Nonetheless,
concerns about the Rorschach in general, and the CS in particular, lingered in the trade.
The Rorschach Performance Assessment System (R-PAS) is a development and expansion of the
CS (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). The examiner first establishes rapport
and then sits to the side of the client or patient to minimise body language communication
when using the R-PAS. The examiner instructs the respondent to look at the stimulus and
respond to each card.
What could it be?” The examiner requests “two, maybe three responses” per card prior to the
test. If only one response is given during the test, the examiner prompts for additional
responses and pulls the card after four responses are given. This is known as response
optimization, and it typically elicits 18 to 28 responses. This technique significantly reduces both
short and long records (protocols with up to 100 responses have been encountered), resulting
in a better fit with norms. The R-PAS incorporates several commendable enhancements.
• Evidence-based variable selection for scoring
• Extensive instructions for administering tests
• Strategies for increasing the number of responses
 Guidelines for resolving coding ambiguities
International samples' normative reference values
Create quality tables for consistency and accuracy.

• Low-cost scoring via a web-based programme

• Easy-to-read graphs with standard scores
Several language translations

 The scoring process begins after the test is administered and the responses are
recorded. This is a complex procedure that necessitates extensive training. Here,
we can only refer to the highlights. Responses are graded on a variety of factors,
including location, content, form quality, thought processes, and determinants.
Determinants are different aspects of the blot that appear to have influenced
examinee responses, such as colour, shading, and form.
 R-PAS scores have excellent interrater reliability. The median intra class correlation
coefficient (an index of agreement between raters) for 60 variables was.92 using a
diverse sample of 50 Rorschach records randomly selected from ongoing research
(Viglione, Blume-Marcovici, Miller, Giromini, & Meyer, 2012). The availability of
an international reference sample for standardisation of scoring variables is another
useful feature of this new approach to Rorschach scoring. This sample of 1,396
protocols came from 15 countries, including Australia, Brazil, Japan, Israel, and
.
Spain, just to give you an idea of the global distribution
 The validity of the Rorschach as scored by the R-PAS (or any other scoring system)
is difficult to summarise in a straightforward manner. Individual studies show good
validity for some applications but limited validity for others. Complexity scores, for
example, were correlated with functional capacity (r =.30) and social skills capacity
(r =.34) in a sample of 72 middle-aged and older outpatients with schizophrenia
using the R-PAS (Moore, Viglione, Rosenfarb, Patterson, & Mausbach, 2012). The
Complexity score assesses the mental effort, intricacy, and integration evident in
responses, with higher scores indicating better coping skills. Thus, it stands to
reason, both theoretically and empirically, that psychological complexity would
have positive correlations with functional and social capacities. These findings
support the Rorschach variable's validity.
 .
 The F+ percent, for example, is the proportion of total responses that use pure
form as a determinant. There is a substantial literature on the meaning of this
index, but it appears safe to hypothesise that when the F+ percentage falls below
Once the entire protocol has been coded, the examiner computes a number of
 summary scores that serve as the primary foundation for hypothesising about the
examinee's personality 70%, the examiner should consider the possibility of severe
psychopathology, brain impairment, or intellectual deficit in the examinee (Exner,
1993).
 The F+ percent is also regarded as an indicator of ego strength, with higher scores
indicating a greater ability to deal with stress.
 According to Frank (1990), formal Rorschach scoring is insufficient for some
purposes, such as schizophrenia diagnosis. He emphasises the importance of
analysing the patient's thinking for the presence of highly personal, illogical, and
bizarre associations to the blots in order to make a psychodiagnosis. In his opinion,
the Rorschach is more of a supplement to the interview than a test in and of itself.
 Bornstein and Masling (2005) remind us that neither the CS nor the R-PAS are
synonymous with "the Rorschach." After all, there are numerous other useful and
validated methods for scoring the test. Their book, Scoring the Rorschach: Seven
Validated Systems (2005), is an excellent collection of alternative scoring systems
for answering specialised assessment questions.
 The Rorschach Prognostic Rating Scale (RPRS; Handler & Clemence, 2005) is an
example of a promising and validated system for predicting who will and will not
benefit from psychotherapy. The RPRS scoring system is complicated, consisting of
assigning or subtracting points for various categories of clearly defined responses.
A positive score is given, for example, if a response depicts a human dancing,
running, talking, or pointing, whereas a zero score is given if humans are seen
sleeping, lying down, sitting, or balancing. The use of colour in the response that is
meaningful also contributes to a positive score, whereas using colour to depict
explosions or diseases results in points being subtracted.
 A total score ranging from –12 to +17 is calculated by scoring several categories.
The following interpretations are then assigned to various RPRS score ranges:
 17 to 13: The individual is almost able to assist himself. A very promising case that
only requires minor assistance.
 12 to 7: Not quite as capable as the previous case to solve his problems on his
own, but with some assistance, he is likely to do quite well.

 6 to 2: More than a 50–50 chance; any treatment will be beneficial.

 1–2: 50–50 chance.
 3–6: A difficult case that may be somewhat helped but is generally a poor
treatment prospect.
 7–12: A hopeless case.
 Meyer and Handler (1997) used meta-analysis to synthesise the findings of 18
RPRS validity studies involving a total of 752 participants. Their findings equated to
a 78 percent success rate in psychotherapy for clients with high RPRS scores, but
 only a 22 percent success rate for clients with low RPRS scores. The RPRS is a
promising scale that should be used more frequently in clinical practise.
 The Thought Disorder Index (TDI), which assesses formal thought disorder, is
another useful Rorschach scoring system (Holtzman, Levy, & Johnston, 2005).
Thought disorder ranges from mild slippage to bizarre disorganisation and is
particularly common in patients with schizophrenia. Thus, assessing thought
disorder is critical in the diagnosis and treatment of people suffering from
schizophrenia or other serious mental illnesses.
 Holzman et al. provide the following examples of thought disorder (2005).
examples include clients who speak in a strange manner and use stilted,
inappropriate, or odd expressions. In response to the Rorschach, a patient with
mild thought disorder might say things like, "He's organising in his organs,"
"There's a segregation between mouth and nose," or "Red is trouble, and Africa
being red symbolises that maybe the origin of man was in Africa, and that's why it
looks red."
 Rorschach responses reveal increasingly strange and perplexing characteristics as
thought disorder becomes more prominent. Parts of the blot may be described as
"A foxed comic dog," "The adhesive adjunctive extensions," or "These are the
posterior pronunciations" by the patient.
 Extreme examples of thought disorder include incoherent statements such as
"Blood, and break their neck, you know, reject" or the invention of words such as
"The property is more closely centulated to the trailroads."
 The TDI is calculated by assigning a score to each response for the severity level of
thought disorder, ranging from none to extreme, with possible scores of
0,.25,.50,.75, and 1.0. The average score is then calculated across all responses.
This figure is multiplied by 100 to get the final score on a scale of 0 to 100.
 Thus, an overall score of 0 indicates that no response revealed any thought
disorder, whereas a score of 100 indicates that every response, without exception,
was highly bizarre and disorganised.
 The TDI has a reasonable level of reliability, with split-half correlations around.80
and interrater reliability coefficients of.90 and higher. Validity has been
demonstrated in a variety of ways, including significant improvements in scores
when patients with schizophrenia are tested before and after comprehensive
interventions, including drug therapies.
 The TDI scoring criteria are far easier to learn than the Comprehensive System.
Because the TDI provides valuable information about the extent of thought
disorder—one of the primary reasons practitioners use the Rorschach—we can
expect to see greater reliance on this approach to test scoring. We are unable to
summarise validated scoring systems due to space constraints.
 Comment on the Rorschach
 The Rorschach has sparked more debate in the assessment field than
any other personality test or instrument. Opinions are often polarised,
with both supporters and detractors citing studies and analyses to
back up their points. For example, critics of the test point to a
fascinating study by Albert, Fox, and Kahn (1980) on the Rorschach's
susceptibility to faking.
 In this study, they submitted the Rorschach protocols of 24 people to a
panel of experts, who asked for each examinee's psychiatric diagnosis.
The 24 Rorschach protocols consisted of results from four groups of six
persons each:
 Patients in a mental institution who have been diagnosed with paranoid
schizophrenia
 Uninformed fakers were given instructions to impersonate a paranoid
schizophrenic's responses.
 Fakers who were well-informed after listening to a detailed audiotape
about paranoid schizophrenia

 Normal controls who took the test according to standard procedures

The uninformed fakers, informed fakers, and normal controls were all
students who had passed an MMPI screening and were deemed reasonably
normal during the interview. Each protocol was evaluated by a panel of six
to nine judges, all of whom were members of the Society for Personality
Assessment. The judges were instructed to provide a psychiatric diagnosis
as well as other information not included in this report. The judges were
not informed of the study's purpose, but were instructed to determine
whether any profiles appeared to be tainted.
 The informed forgers must have done an excellent job, because they were
more likely to be diagnosed as psychotic than the actual patients (72
percent versus 48 percent, respectively).
 With a 46 percent rate of diagnosed psychosis, the uninformed fakers were
also quite convincing.
 24 percent of the time, the normal controls were diagnosed as psychotic.
Given the magnitude of the diagnostic challenge in this study, it is troubling
that the expert judges classified 24 percent of the normal protocols as
psychotic, while correctly identifying psychosis in only 48 percent of the
actual psychotic protocols.
 A more recent study, conducted by Netter and Viglione (1994), concluded
that the Rorschach was susceptible to psychosis faking. Critics generally
portray the test as having low reliability and a general lack of predictive
validity (Lilienfeld, Wood, & Garb, 2000).
 Garb, Florio, and Grove (1998) concluded in their meta-analytic review that
the Rorschach explained only 8 to 13% of the variance in client
characteristics, compared to the MMPI, which explained 23 to 30% of the
variance. Supporters of the test point to improvements in scoring provided
by the R-PAS approach as reasons for their optimism.

Completion Techniques (Sentence Completion

Tests)
 A sentence completion test presents the respondent with a series of stems
containing the first few words of a sentence, and the task is to provide an
ending. The examiner assumes, as with any projective technique, that the
completed sentences reflect the respondent's underlying motivations,
attitudes, conflicts, and fears. Typically, sentence completion tests can be
interpreted in two ways: subjective-intuitive analysis of the underlying
motivations projected in the subject's responses, or objective analysis
through the use of scores assigned to each completed sentence.
 In that the stems are very short and limited to a small number of basic
themes, this test is very similar to existing instruments. The reader will
notice that three topics (the respondent's self-concept, mother, and father)
appear three times in this short test. As a result, the examinee has multiple
chances to reveal underlying motivations about each topic. Of course, most
sentence completion tests are much longer (40 to 100 stems) and contain
more themes (four to fifteen topics).
 There have been dozens of sentence completion tests developed; the
majority are unpublished and unstandardized instruments created to meet
 a specific clinical need. Loevinger's Washington University Sentence
Completion Test is the most sophisticated and theory-based of these
instruments (e.g., Weiss, Zilberg, & Genevro, 1989). The Rotter Incomplete
Sentences Blank, on the other hand, has the most empirical support and is
the most widely used in clinical settings. We take a closer look at this
instrument.
Rotter Incomplete Sentences Blank
 The Rotter Incomplete Sentences Blank (RISB) is divided into three forms:
high school, college, and adult, each of which contains 40 sentence stems
written mostly in the first person.
 Although the test can be subjectively interpreted in the usual way through
qualitative analysis of needs projected in the subjects' responses, it is the
RISB's objective and quantitative scoring that has garnered the most
attention.
 Each completed sentence receives an adjustment score ranging from 0
(good adjustment) to 6 (poor adjustment) in the objective scoring system
(very poor adjustment). These scores are initially determined by
categorising each response as follows:
 Omission—no response or a response that is too brief to be meaningful
 Conflict response—indicative of hostility or unhappiness, for example I
despise... the entire world. (response to conflict)
 Positive response—indicates a positive or hopeful attitude, for example,
The best is yet to come... (Affirmative response)

 Neutral response—a declarative statement that has no positive or negative
affect, such as "Most girls... are women." (Neutral reaction)
 Conflict responses are graded on a scale of 4 to 6, with 4 representing the
least amount of conflict expressed and 6 representing the most amount of
conflict expressed. Positive responses are assigned a score of 2, 1, or 0,
ranging from the least to the most positive. Neutral responses and
omissions are not graded. Each scoring category is illustrated in the manual.
The overall adjustment score is calculated by multiplying the weighted
ratings in the conflict and positive categories by two. The adjustment score
 can range between 0 and 240, with higher scores indicating more
maladjustment.
 The adjustment score's reliability is exceptional, even when calculated by
assistants with little psychological expertise. Interscorer reliabilities are
typically in the.90s, and split-half coefficients are in the.80s.
 Numerous studies using the RISB as a screening device with a
“maladjustment” cutoff score have been conducted to investigate the
validity of this index. For example, a cutoff score of 135 has been found to
correctly screen delinquent youths 60% of the time while correctly
identifying non-delinquent youths 73% of the time.
 Using the same cutoff, heavy drug users are identified 80 to 100 percent of
the time (Gardner, 1967). These and other findings support the adjustment
index's construct validity, but they also show that classification rates are
much lower than required for individual decision making or effective
screening. It also appears that the adjustment index norms are out of date.
Lah and Rotter (1981) discovered that student scores differ significantly
from those obtained in Rotter and Rafferty's original study (1950). New
normative, scoring, and validity data for the RISB are provided by Lah
(1989) and Rotter et al. (1992).
 According to P. Goldberg (1965), the single adjustment score's simplicity is
both the test's strength and weakness. True, the test provides a quick and
efficient way of obtaining an overall index of how respondents function on
a daily basis. A single score, on the other hand, cannot possibly capture all
of the nuances of personality functioning. Furthermore, the RISB is
susceptible to the same types of bias as other self-report measures, in that
the information will reflect primarily what the respondent wants the
examiner to know.
Construction Techniques :The Thematic Apperception Test
(TAT)
 The TAT is made up of 30 black-and-wh ite drawings and photographs
depicting a variety of subjects and themes; one card is blank. The majority
of the cards show one or more people engaged in ambiguous activities.
Some cards are used for adult males (M), adult females (F), boys (B), or girls
(G), or a combination of the three (e.g., BM). As a result, each examinee will
 receive exactly 20 cards. The examiner asks the examinee to make up a
dramatic storey for each picture, telling what led up to the current scene,
what is happening now, how the characters are thinking and feeling, and
what the outcome will be.
 Henry Murray and his colleagues at the Harvard Psychological Clinic created
the TAT (Morgan & Murray, 1935; Murray, 1938). Originally, the test was
intended to assess constructs such as needs and press, which are central to
Murray's personality theory. Murray claims that needs organise perception,
thought, and action and energise behaviour in the direction of satisfaction.
 Examples of needs include the needs for achievement, affiliation, and
dominance. In contrast, press refers to the power of environmental events
to influence a person. Alpha press is objective or “real” external forces,
whereas beta press concerns the subjective or perceived components of
external forces. Murray (1938, 1943) developed an elaborate TAT scoring
system for measuring 36 different needs and various aspects of press, as
revealed by the examinee’s stories.
 Other clinicians began to develop alternative scoring systems almost as
soon as Murray released the TAT (e.g.,Dana, 1959; Tomkins, 1947). The
literature on the administration, scoring, and interpretation of the TAT
grew rapidly, as evidenced by reviews (Aiken, 1989, chap. 12; Groth-
Marnat, 1997; Weiner & Kuehnle, 1998). By the 1950s, there was no single
preferred mode of administration, no single preferred scoring system, and
no single preferred method of interpretation, a situation that persists to
this day. Clinicians will even change the wording of the instructions for each
client and will usually select an individualised subset of TAT cards.
 Examples of needs include the needs for achievement, affiliation, and
dominance. In contrast, press refers to the power of environmental events
to influence a person. Alpha press is objective or “real” external forces,
whereas beta press concerns the subjective or perceived components of
external forces. Murray (1938, 1943) developed an elaborate TAT scoring
system for measuring 36 different needs and various aspects of press, as
revealed by the examinee’s stories.
 Examples of needs include the needs for achievement, affiliation, and
dominance. In contrast, press refers to the power of environmental events
 to influence a person. Alpha press is objective or “real” external forces,
whereas beta press concerns the subjective or perceived components of
external forces. Murray (1938, 1943) developed an elaborate TAT scoring
system for measuring 36 different needs and various aspects of
press, as revealed by the examinee’s stories.
 Examples of needs include the needs for achievement, affiliation,
and dominance. In contrast, press refers to the power of
environmental events to influence a person. Alpha press is
objective or “real” external forces, whereas beta press concerns
the subjective or perceived components of external forces.
Murray (1938, 1943) developed an elaborate TAT scoring system
for measuring 36 different needs and various aspects of press, as
revealed by the examinee’s stories.

 What stands out in this response is the repeated denial of danger or

trauma. However, later in the testing, the denial of trauma is no longer
maintained. Read how the examinee responded to the blank card by telling
a storey about a young man who is traumatised at school and drives his car
down to the river: When he sees the bridge, he is completely depressed. He
recalls hearing stories about people jumping off cliffs and killing
themselves. He'd never understand why they did it. Now that he
understands, he jumps and dies... he should have waited because things
always get better at some point. But he didn't wait, and he died. Ryan
(1987) defined formalized.

 Most clinicians would conclude that the examinee who generated these
stories was traumatised and was attempting to protect himself from self-
destructive impulses. Similarly, the clinician in psychotherapy would be
wise to address these issues. The TAT's psychometric adequacy is difficult
to determine due to the abundance of scoring and interpretation methods.
 Clinicians make anecdotal arguments for the test, citing remarkable and
confirmatory findings like the one shown here. Researchers who rely on
 data, on the other hand, are more cautious. With a reported median value
of r =.28, the formally scored TAT protocols have very low test–retest
reliability.

 Furthermore, an astounding 97 percent of test users interpret the TAT

using subjective and "personalised" procedures; that is, only a small
percentage of clinical practitioners rely on a standardised scoring system
(Lilienfeld, Wood, & Garb, 2001). This is concerning because a recurring
theme in projective testing research is that intuitive interpretations are
likely to overdiagnose psychological disturbance.
 In addition to clinical applications, the TAT has seen extensive use in
research. Turk, Brown, Symington, and Paul (2010), for example, looked at
the content of TAT stories from 22 people who had agenesis of the corpus
callosum (ACC), a congenital brain disorder in which the pathways
connecting the two cerebral hemispheres are either partially or completely
absent. They counted words in psychologically meaningful categories using
James Pennebaker's linguistic inquiry software. When compared to age-
and IQ-matched controls, ACC participants used fewer words related to
emotion, cognitive processes, and social processes, indicating that they had
a harder time imagining and inferring the mental and emotional states of
others The TAT was useful in this research application for improving our
understanding of the unique characteristics of people with ACC.
 Children’s Apperception Test
 The Children's Apperception Test (CAT), designed as a direct extension of
the TAT, consists of ten pictures and is appropriate for children aged three
to ten.
 The preferred version (CAT-A) for younger children depicts animals in
unmistakably human social settings.
 The test creators used animal drawings because they assumed that young
children would identify more with animals than with humans.
 For older children, a human figure version (CAT-H) is available. There is no
formal scoring system for the CAT, and no statistical information on
reliability or validity is provided. Instead, the examiner develops a diagnosis
 or personality description based on (1) main theme; (2) main hero; (3)
hero's main needs and drives; (4) hero's conception of environment (or
world); (5)+ perception of parental, contemporary, and junior figures; (6)
conflicts; (7) anxieties; (8) defences; (9) adequacy of superego; (10) ego
integration (including originality of storey and nature of outcome) (Bellak,
1992).
 Most testing specialists are troubled by the CAT's lack of attention to
psychometric issues such as scoring, reliability, and validity.a synthesis of
ten variables recorded for each story.
 Expression Techniques The Draw-A-Person Test
 The Draw-A-Man task was used by Goodenough (1926) to estimate
intelligence. Following that, psychodynamically minded psychologists
adapted the procedure to projective personality assessment. Karen
Machover (1949, 1951) was a trailblazer in this emerging field. The Draw-A-
Person Test was named after her procedure (DAP). Her test was popular in
its early days and is still widely used as a clinical assessment tool today.
According to Watkins, Campbell, Nieberding, and Hallmark (1995),
projective drawings such as the DAP are the eighth most popular among
clinicians in the United States.
 The DAP is given to the examinee by handing him or her a blank sheet of
paper and a pencil with an eraser, then asking them to "draw a person."
When the drawing is finished, the examinee is usually told to draw another
person of the opposite sex to the first figure. Finally, the examinee is
instructed to “create a storey about this person as if he [or she] were a
character in a novel or a play” (Machover, 1949).
 The DAP is interpreted entirely clinically intuitively, guided by a number of
tMachover, for example, claimed that examinees were more likely to
project acceptable impulses onto the same-sex figure and unacceptable
impulses onto the opposite-sex figure. She also believed that the relative
sizes of the male and female figures revealed information about the
examinee's sexual orientation. Drawing a man with large eyes and lashes,
for example, was thought to indicate a homosexually inclined male. These
interpretive premises are vibrant, intriguing, and credible. They are,
however, entirely based on psychodynamic theory and anecdotal
observations. Machover made few attempts to validate the
interpretations.entative psychodynamically based hypotheses (Machover,
1949, 1951).