Winter Project 6

Debra O’Neill Unit 6 project-outline Article: Weiner, I.B. (2005). The utility of Rorschach assessment in clinical and forensic practice. Independent Practitioner, Spring, 21-43. Introduction: Is the Rorschach Inkblot Test a Reliable and Valid Test to Measure Individuals Suspect to Forensic Psychology and Criminal Behavior? Thesis Statement: 1) My thesis statement : The literature review will examine reliability issues of the Rorschach Inkblot Test in the arena of Forensic Psychology. 2) Article thesis statement:

Utility of the Rorschach in both forensic and clinical practices.

Description of the Rorschach Inkblot Test: According to O’Reilly (2007) the Rorschach inkblot test is a method of psychological evaluation. Psychologists use this test to try to examine the personality characteristics and emotional functioning of their patients. The Rorschach is currently the second most commonly used test in forensic assessment, after the MMPI, and has been employed in diagnosing underlying thought disorder and differentiating psychotic from non-psychotic thinking in cases where the patient is reluctant to openly admit to psychotic thinking. The Rorschach technique is used to elicit information about the structure and dynamics of an individual's personality functioning. The test provides information about a person's thought processes, perceptions, motivations, and attitude toward an individual’s environment and it can detect internal and external pressures and conflicts as well as illogical or psychotic thought patterns. The Rorschach technique can also be used for specific diagnostic purposes. Some scoring methods for the Rorschach elicit information on symptoms related to depression, schizophrenia, and anxiety disorders. Also, the test can be used to screen for coping deficits related to developmental problems in children and adolescents. Historical Information:

The history of the inkblot procedure is not easily traced. It is traceable only through Rorschach's own writing, and through the writings of Emil Oberhalzer, Walter Morgenthaler and George Roemer. Research indicates that the concept of formless stimuli, used in inkblot techniques to stimulate the imagination, can be traced back to Leonardo Da Vinci and Botticelli in the fifteenth century (O’Reilly, 2007). While working in a psychiatric hospital with adolescents, Rorschach noticed that certain children gave characteristically different answers to a popular game known as blotto (Klecksographie). In his original publication he characterized the blots as a Form Interpretation Test, and cautioned that his findings were preliminary, stressing the importance of much more experimentation (Exner, 1993). Rorschach died in 1922 at the age of 37. He had invested short of four years in his inkblot test. In summary, it can be said that the beginning of inkblot use may be traced back to the fifteenth century and that a sizable amount of work was done towards the end of the nineteenth century. Inkblot procedures have been used for studying imagination, thought processes, reflex hallucinations, intelligence and personality. Test reliability: Projective tests tend to have lower validity and reliability than objective tests. That is, they are less stable, and have lower relationships with other criteria. However, the information which they provide tends to be richer and more varied. Tests with open-ended responses must be scored subjectively which raises the question for consistency between various raters (Hess et al., 2001). Finding evidence for better reliability for the Rorschach is necessarily because the test has so many categories. Regarding the Comprehension System, trained scorers agree with expert scores between 88% and 99% of the time. The test-retest is supposed to be stable over time (Hess et al., 2001). Many variables in the Comprehension System show reliability estimates at or above .70 at both 1-year and 3-year intervals (Exner & Weiner, 1995). The test re-test reliability estimates the Comprehension System with children is low, however increases as participants approach adolescence. This is attributed to the rapid development changes occurring during childhood. With this in mind, the test re-test is significantly higher.

According to Wood, Nezworski, & Lilienfeld (2003) the Rorschach's inter-rater reliability has been questioned. Their research reveals that in some studies the scores obtained by two independent scorers do not match with great consistency. It is claimed that the reliability is over 0.85 for all scales; but this is at best percentage of agreement and not true for all scales. 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,2003 ). However Wood et al. (2003) cites many court cases where it was found they have not been followed. Such cases, of course, point toward the failure of some psychologists to follow prescribed procedures. Similarly, the procedures for coding responses are fairly well specified but extremely time-consuming to inexperienced examiners, and corners may be cut by a psychologist who allows haste to take precedence over accuracy. It seems that with validity in question to begin with, any psychologist using the test should be extremely careful about following all rules of administration and interpretation to the letter. Another area of controversy is the test's norms. A great strength of Exner’s system was thought to be the availability of normative scores for various populations. However, beginning in the mid-1990s others began to attempt to replicate or update these norms, and found they could not. In particular, discrepancies seemed to focus on indices measuring narcissism, disordered thinking, and discomfort in close relationships (Wood et al., 2003). Those who are critical of the Rorschach, have stated that this proves that the Rorschach tends to "overpathologise normals." However, they may have failed to account for norm changes in the population that may have been drifting in a pathological direction - in other words, that the Rorschach may be accurately reflecting increasing psychopathology in the society. Additional concerns regarding the norms that the Rorschach tests use are unrepresentative of the general population, and therefore are subject to over-diagnosing psychiatric conditions. This may be more detrimental for minorities, who are often unrepresentative in norms (Wood et al, 2002). The test is also especially controversial because it has been commonly used in court-ordered evaluations: as a major factor in assigning custody, granting or denying parole, and so on. 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), (American Psychiatric Association (1994). This fact alone does not render the test without value for diagnostic purposes. Irving Weiner (co-developer with John Exner (2002) 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". Supporters of the test try to keep the actual cards secret so that the answers are spontaneous. This practice is consistent with the American Psychological Association's ethical standards of preserving test security. The official test is sold only to licensed professionals, unfortunately the ethics of this test were violated first by William Poundstone in his book Big Secrets (1983), which described the method of administering the test and gave outlines of the ten official images. The images have since been leaked to the Internet (Hibbard, 2000). This reduced the value of projective testing for those individuals who have become familiar with the material, potentially impacting their care. The Rorschach Society claims the blots are copyrighted; this has been disputed by others who state that the blots are in the public domain under U.S. copyright law based upon when they were first created and how long Rorschach has been dead. Summary: Usefulness of this test with its appointed population. My area of study is forensic psychology, therefore the area I will present information at this point will reflect this; specifically the test usefulness in forensic psychology. Rorschach assessments can bring considerable utility to the practice of forensic psychology. In forensic testing, Rorschach findings facilitate differential diagnosis and treatment planning by identifying psychological characteristics commonly associated with various patterns of psychopathology and by measuring a broad range of personality strengths and limitations relevant to setting goals and monitoring progress in therapy. Additionally in forensic work, personality characteristics Alreflected in Rorschach responses often have a bearing on psycho-legal issues in criminal, personal injury, and child custody cases. The present article reviews these applications of Rorschach assessment and comments on some issues that have been

raised about its utility in these respects. Also it is important to keep in mind that in forensic works, personality characteristics that are reflected in the Rorschach responses often have a bearing on psycho-legal issues in criminal, personal injury, and child custody cases. The present article reviews these applications of Rorschach assessment and comments on some issues that have been raised about its utility in these respects. Conclusion: There are numerous points that need to be brought out in the conclusion of this paper which are specific to forensic testing. a) The specific population with which this test was developed for, versus the use of this test today. b) The issues of the skilled and trained clinicians who administer this particular test; they MUST be trained in the administration, recording of responses, interviewing techniques, scoring of this assessment as a measurement in intelligence and additional venues of its ability. c) Due to the fact that this test can bring considerable utility to the practice of forensic psychology, the results of this test, in forensic testing, can often have a bearing on psychological issues in criminal cases- as well as custody cases and dynamic behavioral issues. d) The use of this measurement as a diagnostic instrument in forensic consulting is generally used to consider individuals incompetent to stand trial or being diagnosed as ‘not guilty’ by reason of insanity. Hence, they would not be able to stand trial by reason of insanity. In legal terms, being incompetent consists of defendants being able to understand the charges they are facing and participate effectively in their defense. e) Competence is often best assessed by asking defendants directly about these matters, ie. “Do you understand what you have been charged with?”. f) Unlike competence, criminal behavior and responsibility is determined according to a defendant’s state of mind at the time of the alleged offense, therefore offering a defensible opinion concerning criminal responsibility remains in accordance to the integration of this test regarding evidence of their cognitive and/or volitional incapacity with other types of information. g) Although some value the forensic applications of the RIM, due to the facts that the norms have not been developed, question the assertions that the RIM are not founded. However, the Comprehensive Systems have allowed, due to the

nature of the evaluation for forensic evidence, to be allowed in a legal and criminal setting. The article I selected responded to the many issues contingent to the consultutation regarding using the Rorschach test in a forensic setting. Each of the arenas addressed in this paper are of subsequent necessity when considering the utilization of this measurement as a forensic instrument. Although there is abundant research regarding findings, this article documents that the Rorschach is a reliable procedure with considerable validity for forensic purposes. Other projective tests include the Thematic Apperception Test (TAT), in which the patient tells stories about pictures, the Sentence Completion test, Draw-A-Person, and House-Tree-Person. The TAT is often used in a test battery in conjunction with the Rorschach. The TAT provides information about important themes in a person's life or the content of their thinking, whereas the Rorschach provides information about the process and form of a person's thoughts.

References: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC. Exner, J.E. (2002). The Rorschach: Basic Foundations and Principles of Interpretation: Volume 1. Hoboken, NJ: Wiley. Hibbard, S. (2003). A critique of Lilienfeld et al. Journal of Personality Assessment v. 80, pp. 260-271, 2003". Lillenfeld, S.O., Wood, J.M., Garb, H.N. (2000). The scientific status of projective techniques, Psychological Science in the Public Interest (1) pp. 27-66. O’Reilly, G.P.(2007). Rorschach inkblot test. Journal of Human Disorders, January (8).

Weiner, I. B. (1999). What the Rorschach can do for you: Incremental validity in clinical applications. Assessment 6,p. 327-338. Weiner, I.B. (2005). The utility of Rorschach assessment in clinical and forensic practice. Independent Practitioner, Spring. Wood, James M, M Teresa Nezworski, Acott O. Lilienfeld, and Howard N. Garb. (1995). What's wrong with the Rorschach?". San Francisco, CA: John Wiley & Sones, Inc.