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370157633-Rorschach-Test

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RORSCHACH TEST

The Rorschach test is a psychological test in which subjects' perceptions

of inkblots are recorded and then analyzed using psychological interpretation,
complex algorithms, or both. Some psychologists use this test to examine a person's
personality characteristics and emotional functioning. It has been employed to detect
underlying thought disorder, especially in cases where patients are reluctant to
describe their thinking processes openly. The test is named after its creator, Swiss
psychologist Hermann Rorschach. In the 1960s, the Rorschach was the most widely
used projective test.
Although the Exner Scoring System (developed since the 1960s) claims to have
addressed and often refuted many criticisms of the original testing system with an
extensive body of research, some researchers continue to raise questions. The areas
of dispute include the objectivity of testers, inter-rater reliability, the verifiability and
general validity of the test, bias of the test's pathology scales towards greater
numbers of responses, the limited number of psychological conditions which it
accurately diagnoses, the inability to replicate the test's norms, its use in court-
ordered evaluations, and the proliferation of the ten inkblot images, potentially
invalidating the test for those who have been exposed to them.

HISTORY
Using interpretation of "ambiguous designs" to assess an individual's personality is an
idea that goes back to Leonardo da Vinci and Botticelli. Interpretation of inkblots was
central to a game, Gobolinks, from the late 19th century. Rorschach's, however, was
the first systematic approach of this kind. The ink blots were hand drawn by
Rorschach.

It has been suggested that Rorschach's use of inkblots may have been inspired by
German doctor Justinus Kerner who, in 1857, had published a popular book of poems,
each of which was inspired by an accidental inkblot. French psychologist Alfred
Binet had also experimented with inkblots as a creativity test, and, after the turn of
the century, psychological experiments where inkblots were utilized multiplied, with
aims such as studying imagination and consciousness.

After studying 300 mental patients and 100 control subjects, in 1921 Rorschach wrote
his book Psychodiagnostik, which was to form the basis of the inkblot test (after
experimenting with several hundred inkblots, he selected a set of ten for their
diagnostic value), but he died the following year. Although he had served as Vice
President of the Swiss Psychoanalytic Society, Rorschach had difficulty in publishing
the book and it attracted little attention when it first appeared.

In 1927, the newly founded Hans Huber publishing house purchased Rorschach's
book Psychodiagnostik from the inventory of Ernst Bircher. Huber has remained the
publisher of the test and related book, with Rorschach a registered trademark of Swiss
publisher Verlag Hans Huber, Hogrefe AG. The work has been described as "a densely
written piece couched in dry, scientific terminology".

After Rorschach's death, the original test scoring system was improved by Samuel
Beck, Bruno Klopfer and others. John E. Exner summarized some of these later
developments in the comprehensive system, at the same time trying to make the
scoring more statistically rigorous. Some systems are based on the psychoanalytic
concept of object relations. The Exner system remains very popular in the United
States, while in Europe other methods sometimes dominate, such as that described in

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the textbook by Evald Bohm, which is closer to the original Rorschach system and
rooted more deeply in the original psychoanalysis principles.

Rorschach never intended the inkblots to be used as a general personality test, but
developed them as a tool for the diagnosis of schizophrenia. It was not until 1939 that
the test was used as a projective test of personality, a use of which Rorschach had
always been skeptical. Interviewed in 2012 for a BBC Radio 4 documentary, Rita
Signer, curator of the Rorschach Archives in Bern, Switzerland, suggested that far
from being random or chance designs, each of the blots selected by Rorschach for his
test had been meticulously designed to be as ambiguous and "conflicted" as possible.

METHOD
The Rorschach test is appropriate for subjects from the age of five to adulthood. The
administrator and subject typically sit next to each other at a table, with the
administrator slightly behind the subject. Side-by-side seating of the examiner and the
subject is used to reduce any effects of inadvertent cues from the examiner to the
subject. In other words, side-by-side seating mitigates the possibility that the
examiner will accidentally influence the subject's responses. This is to facilitate a
"relaxed but controlled atmosphere".
There are ten official inkblots, each printed on a separate white card, approximately
18 by 24 cm in size. Each of the blots has near perfect bilateral symmetry. Five
inkblots are of black ink, two are of black and red ink and three are multicolored, on a
white background. After the test subject has seen and responded to all of the inkblots
(free association phase), the tester then presents them again one at a time in a set
sequence for the subject to study: the subject is asked to note where he sees what he
originally saw and what makes it look like that (inquiry phase). The subject is usually
asked to hold the cards and may rotate them. Whether the cards are rotated, and
other related factors such as whether permission to rotate them is asked, may expose
personality traits and normally contributes to the assessment. As the subject is
examining the inkblots, the psychologist writes down everything the subject says or
does, no matter how trivial. Analysis of responses is recorded by the test
administrator using a tabulation and scoring sheet and, if required, a separate location
chart.

The general goal of the test is to provide data

about cognition and personality variables such as motivations, response tendencies,
cognitive operations, affectivity, and personal/interpersonal perceptions. The
underlying assumption is that an individual will class external stimuli based on person-
specific perceptual sets, and including needs, base motives, conflicts, and that this
clustering process is representative of the process used in real-life situations. Methods
of interpretation differ. Rorschach scoring systems have been described as a system
of pegs on which to hang one's knowledge of personality. The most widely used
method in the United States is based on the work of Exner.

Administration of the test to a group of subjects, by means of projected images, has

also occasionally been performed, but mainly for research rather than diagnostic
purposes.

Test administration is not to be confused with test interpretation. The interpretation of

a Rorschach record is a complex process. It requires a wealth of knowledge concerning
personality dynamics generally as well as considerable experience with the Rorschach
method specifically. Proficiency as a Rorschach administrator can be gained within a
few months. However, even those who are able and qualified to become
Rorschach interpreters usually remain in a "learning stage" for a number of years.

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FEATURES OR CATEGORIES
The interpretation of the Rorschach test is not based primarily on the contents of the
response, i.e., what the individual sees in the inkblot (the content). In fact, the
contents of the response are only a comparatively small portion of a broader cluster of
variables that are used to interpret the Rorschach data: for instance, information is
provided by the time taken before providing a response for a card can be significant
(taking a long time can indicate "shock" on the card) as well as by any comments the
subject may make in addition to providing a direct response.

In particular, information about determinants (the aspects of the inkblots that

triggered the response, such as form and color) and location (which details of the
inkblots triggered the response) is often considered more important than content,
although there is contrasting evidence. "Popularity" and "originality" of responses can
also be considered as basic dimensions in the analysis.

Content
The goal in coding content of the Rorschach is to categorize the objects that the
subject describes in response to the inkblot. There are 27 established codes for
identifying the name of the descriptive object. The codes are classified and include
terms such as "human", "nature", "animal", "abstract", "clothing", "fire", and "x-ray",
to name a few. Content described that does not have a code already established
should be coded using the code "idiographic contents" with the shorthand code being
"Idio." Items are also coded for statistical popularity (or, conversely, originality).

More than any other feature in the test, content response can be controlled
consciously by the subject, and may be elicited by very disparate factors, which
makes it difficult to use content alone to draw any conclusions about the subject's
personality; with certain individuals, content responses may potentially be interpreted
directly, and some information can at times be obtained by analyzing thematic trends
in the whole set of content responses (which is only feasible when several responses
are available), but in general content cannot be analyzed outside of the context of the
entire test record.

Location
Identifying the location of the subject's response is another element scored in the
Rorschach system. Location refers to how much of the inkblot was used to answer the
question. Administrators score the response "W" if the whole inkblot was used to
answer the question, "D" if a commonly described part of the blot was used, "Dd" if an
uncommonly described or unusual detail was used, or "S" if the white space in the
background was used. A score of W is typically associated with the subject's
motivation to interact with his or her surrounding environment. D is interpreted as one
having efficient or adequate functioning. A high frequency of responses coded Dd
indicate some maladjustment within the individual. Responses coded S indicate an
oppositional or uncooperative test subject.

Determinants
Systems for Rorschach scoring generally include a concept of "determinants": These
are the factors that contribute to establishing the similarity between the inkblot and
the subject's content response about it. They can also represent certain basic
experiential-perceptual attitudes, showing aspects of the way a subject perceives the
world. Rorschach's original work used only form, color and movement as
determinants. However currently, another major determinant considered

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is shading, which was inadvertently introduced by poor printing quality of the inkblots.
Rorschach initially disregarded shading, since the inkblots originally featured uniform
saturation, but later recognized it as a significant factor.

Form is the most common determinant, and is related to intellectual

processes. Color responses often provide direct insight into one's emotional
life. Movement and shading have been considered more ambiguously, both in
definition and interpretation. Rorschach considered movement only as the
experiencing of actual motion, while others have widened the scope of this
determinant, taking it to mean that the subject sees something "going on".

More than one determinant can contribute to the formation of the subject's
perception. Fusion of two determinants is taken into account, while also assessing
which of the two constituted the primary contributor. For example, "form-color"
implies a more refined control of impulse than "color-form". It is, indeed, from the
relation and balance among determinants that personality can be most readily
inferred.

VALIDITY
When interpreted as a projective test, results are poorly verifiable. The Exner system
of scoring (also known as the "Comprehensive System") is meant to address this, and
has all but displaced many earlier (and less consistent) scoring systems. It makes
heavy use of what factor (shading, color, outline, etc.) of the inkblot leads to each of
the tested person's comments. Disagreements about test validity remain: while the
Exner proposed a rigorous scoring system, latitude remained in the actual
interpretation, and the clinician's write-up of the test record is still partly
subjective. Reber (1985) comments ".. there is essentially no evidence whatsoever
that the test has even a shred of validity."

Nevertheless, there is substantial research indicating the utility of the measure for a
few scores. Several scores correlate well with general intelligence. Interestingly, one
such scale is R, the total number of responses; this reveals the questionable side-
effect that more intelligent people tend to be elevated on many pathology scales,
since many scales do not correct for high R: if a subject gives twice as many
responses overall, it is more likely that some of these will seem "pathological". Also
correlated with intelligence are the scales for Organizational Activity, Complexity,
Form Quality, and Human Figure responses. The same source reports that validity has
also been shown for detecting such conditions as schizophrenia and other psychotic
disorders; thought disorders; and personality disorders (including borderline
personality disorder). There is some evidence that the Deviant Verbalizations scale
relates to bipolar disorder. The authors conclude that "Otherwise, the Comprehensive
System doesn't appear to bear a consistent relationship to psychological disorders or
symptoms, personality characteristics, potential for violence, or such health problems
as cancer". (Cancer is mentioned because a small minority of Rorschach enthusiasts
have claimed the test can predict cancer.)

RELIABILITY
It is also thought that the test's reliability can depend substantially on details of the
testing procedure, such as where the tester and subject are seated, any introductory
words, verbal and nonverbal responses to subjects' questions or comments, and how
responses are recorded. Exner has published detailed instructions, but Wood et
al. cites many court cases where these had not been followed. Similarly, the
procedures for coding responses are fairly well specified but extremely time-
consuming leaving them very subject to the author's style and the publisher to the
quality of the instructions (such as was noted with one of Bohm's textbooks in the

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1950s) as well as clinic workers (which would include examiners) being encouraged to
cut corners.
United States courts have challenged the Rorschach as well. Jones v Apfel (1997)
stated (quoting from Attorney's Textbook of Medicine) that Rorschach "results do not
meet the requirements of standardization, reliability, or validity of clinical diagnostic
tests, and interpretation thus is often controversial". In State ex rel H.H. (1999) where
under cross examination Dr. Bogacki stated under oath "many psychologists do not
believe much in the validity or effectiveness of the Rorschach test" and US v
Battle (2001) ruled that the Rorschach "does not have an objective scoring system."

POPULATION NORMS
Another controversial aspect of the test is its statistical norms. Exner's system was
thought to possess normative scores for various populations. But, beginning in the
mid-1990s others began to try to replicate or update these norms and failed. In
particular, discrepancies seemed to focus on indices measuring narcissism, disordered
thinking, and discomfort in close relationships. Lilienfeld and colleagues, who are
critical of the Rorschach, have stated that this proves that the Rorschach tends to
"overpathologise normals".Although Rorschach proponents, such as Hibbard, suggest
that high rates of pathology detected by the Rorschach accurately reflect increasing
psychopathology in society, the Rorschach also identifies half of all test-takers as
possessing "distorted thinking", a false positive rate unexplained by current research.

The accusation of "over-pathologising" has also been considered by Meyer et al.

(2007). They presented an international collaborative study of 4704 Rorschach
protocols, obtained in 21 different samples, across 17 different countries, with only 2%
showing significant elevations on the index of perceptual and thinking disorder, 12%
elevated on indices of depression and hyper-vigilance and 13% elevated on persistent
stress overload—all in line with expected frequencies among nonpatient populations.

APPLICATIONS
The test is also controversial because of its common use in court-ordered
evaluations. This controversy stems, in part, from the limitations of the Rorschach,
with no additional data, in making official diagnoses from the Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV). Irving B. Weiner (co-developer with
John Exner of the Comprehensive system) has stated that the Rorschach "is a
measure of personality functioning, and it provides information concerning aspects of
personality structure and dynamics that make people the kind of people they are.
Sometimes such information about personality characteristics is helpful in arriving at a
differential diagnosis, if the alternative diagnoses being considered have been well
conceptualized with respect to specific or defining personality characteristics". In the
vast majority of cases, anyway, the Rorschach test wasn't singled out but used as one
of several in a battery of tests, and despite the criticism of usage of the Rorschach in
the courts, out of 8,000 cases in which forensic psychologists used Rorschach-based
testimony, the appropriateness of the instrument was challenged only six times, and
the testimony was ruled inadmissible in only one of those cases. One study has found
that use of the test in courts has increased by three times in the decade between
1996 and 2005, compared to the previous fifty years. Others however have found that
its usage by forensic psychologists has decreased. Exner and others have claimed
that the Rorschach test is capable of detecting suicidality.

PROTECTION OF TEST ITEMS AND ETHICS

Psychologists object to the publication of psychological test material out of concerns
that a patient's test responses will be influenced ("primed") by previous exposure.
The Canadian Psychological Association takes the position that, "Publishing the
questions and answers to any psychological test compromises its usefulness" and

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calls for "keeping psychological tests out of the public domain." The same statement
quotes their president as saying, "The CPA's concern is not with the publication of the
cards and responses to the Rorschach test per se, for which there is some controversy
in the psychological literature and disagreement among experts, but with the larger
issue of the publication and dissemination of psychological test content".

From a legal standpoint, the Rorschach test images have been in the public
domain for many years in most countries, particularly those with a copyright term of
up to 70 years post mortem auctoris. They have been in the public domain in
Hermann Rorschach's native Switzerland since 1992 (70 years after the author's
death, or 50 years after the cut-off date of 1942), according to Swiss copyright
law. They are also in the public domain under United States copyright law where all
works published before 1923 are considered to be in the public domain. This means
that the Rorschach images may be used by anyone for any purpose. William
Poundstone was, perhaps, first to make them public in his 1983 book Big Secrets,
where he also described the method of administering the test.

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