Projective Testing

Started by Doc Samson
Panacea Financial Contract Review
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From one superhero to another, the rorschach should never be used as a projective test................
 
psisci said:
From one superhero to another, the rorschach should never be used as a projective test................
Click to expand...

I'm sure there's a lot you could tell me about why that's so, since testing is entirely outside of the bailiwick of a psychiatrist, but in broad terms the rorschach is uniformly referred to as a projective test. Try typing "projective test" into PubMed, you're going to get a lot of results about the rorschach.

BTW, if you wanted to assume a super-hero avatar, Rorschach is a pretty iconic one (misogynistic and psychotic, but iconic nonetheless).

Comic book fun
 
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psisci said:
From one superhero to another, the rorschach should never be used as a projective test................
Click to expand...

I'm going to disagree with you PS. Although it has been badly misused, and many try to make it do things it can't, I still think it has validity. Particularly for teasing out psychosis. Which of course goes back to what it was intended to do.
 
BTW, great video. I love it. I'm surprised he uses so many of the actual blots even if they are just "part" of the picture.
 
I want to bring up one more thing, it isn't surprising to me taht you see brain structures in the blots DS, you are a psychiatarist with medical training and often study neuroanatomy. But think of how different a picture it paints (pun intended) if an uneducated high school drop out were to come in and state that all he saw were brain structures, anatomical features, etc.....

Just something to think about.
 
Doc Samson said:
Pretty cool video. I knew I'd been reading too much neuroanatomy when I kept seeing brain structures in the blots. "Ooooh... its the putamen!" :scared:

gnarls barkley video
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Cool video. I also tend to see physiological structures on the Rorschach.

'Anatomy' responses are very common, though, in physicians. It carries a different interpretation if a non-physician gives the same responses.
:meanie:
 
I saw a lot of brain structures, and vertebrae - but didn't any of you see the creepy scary monsters? IM SERIOUS - DAMMIT SOMEONE ELSE BETTER HAVE SEEN THEM!
 
Isn't the scoring system -- Exner or whatever -- unsupported? I have read the Rorschach is useful in patients with suspected thought disorder and that Exner scoring is useful in this regard. What is the current status concerning Exner scoring?

A quick pubmed search yields 3,407 hits for the Rorschach. Some recent reports, including an application in oral cenesthopathy!:

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16594938&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/..._uids=15596082&query_hl=1&itool=pubmed_DocSum

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16557639&query_hl=1&itool=pubmed_DocSum

http://www.ncbi.nlm.nih.gov/entrez/..._uids=15694756&query_hl=1&itool=pubmed_DocSum
 
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Anasazi23 said:
Cool video. I also tend to see physiological structures on the Rorschach.

'Anatomy' responses are very common, though, in physicians. It carries a different interpretation if a non-physician gives the same responses.
:meanie:
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Well its good to have the mod agree with you every once in awhile.
 
PublicHealth said:
Isn't the scoring system -- Exner or whatever -- unsupported? I have read the Rorschach is useful in patients with suspected thought disorder and that Exner scoring is useful in this regard. What is the current status concerning Exner scoring?
Click to expand...

There is alot of controversy surrounding the test. But much of it is political. It can't be avoided since it is used in so many custody cases. And you are right, it's original intention was to test for psychosis. Psychology (maybe iatry too, I don't know) fights constantly about test, this one in particular. And if you are familiar with getting research published, there can be a heavy politcal component to it, so even if you find good results with one measure or another, it may be difficult to find someone who will give it a favorable review. I've seen studies that show very reliable work being done with the rorschach, Interrater agreement levels for diagnosis at .90. There is an enourmous body of literature surrouding this test, much of it in support, but much of it blasting it.

One really must take a deep look at the articles in determining if you agree with the findings.

Which brings up a question, not to be insulting, but PH do you ever read beyond the abstract? With the ammount of literature you find I would be very impresed if you did. But many studies, do to thier methodology aren't worth the paper tehy are printed on.
 
I'll be starting a clinical program in the fall so forgive my naivete, but I thought the TAT was more widely used to acquire projective data. What do practitioner's out there prefer?
 
In the world of practice where one is only protacted by their own license the rorschach is rarely used here on the west coast. It has consistently proven to have bad reliability, and is generally regarded as unethical to use. Plus it takes too long. Exner scoring is a non-projective, standardized scoring system for the rorschach that boasts moderate relaibility and validity coeffecients and is defenseable both clinically and legally. I personally do not use it, and I would never use it as a projective test not using the Exner scoring system. I have the test and may use it in an eval some day if i really want to some data on the structure of one's psyche to add to my data on the content of one's psyche. Exner can do that.

😎
 
Exner (RIP) is the most widely used method, although there are others. I think the test gets a bad rap, having been used unethically for so many years. BUt I think if it is used within its bounds it can be ethically valid. As for incrimental validity? I don't know that it would be worth it, I'd rather give a PAI.
 
I completed an APA accredited internship in clinical psychology at a medical school a few years ago. In my area, we are very into CBT and everything evidence based. We regularly used the Rorschach (Exner) on the acute inpatient psychiatric unit. At that time, the Rorschach was among the most commonly used psychological test in hospitals in the US. I have not used the Rorschach since then, but the issue is not validity, reliability, inter rater reliability, legal issues, etc. The test takes too long to administer. With the new CPT codes, I can have 5 patients completing a MMPI at the same time, thus answering more referral questions (and making more money).
 
mmcarson said:
I'll be starting a clinical program in the fall so forgive my naivete, but I thought the TAT was more widely used to acquire projective data. What do practitioner's out there prefer?
Click to expand...

YOu know what is interesting abou the TAT is that it is composed of images from advertisements, magazines, etc. from the time it was made.
 
Psyclops said:
Which brings up a question, not to be insulting, but PH do you ever read beyond the abstract? With the ammount of literature you find I would be very impresed if you did. But many studies, do to thier methodology aren't worth the paper tehy are printed on.
Click to expand...

Oh no, the PubMed police! When the article interests me, I usually do, though I agree that the methodologies can be poor. I think it is due to there being way too many journals out there that need something to fill their pages and will accept crappy papers.

I usually try to post abstracts that are published in higher-tier journals.
 
psisci said:
In the world of practice where one is only protacted by their own license the rorschach is rarely used here on the west coast. It has consistently proven to have bad reliability, and is generally regarded as unethical to use. Plus it takes too long. Exner scoring is a non-projective, standardized scoring system for the rorschach that boasts moderate relaibility and validity coeffecients and is defenseable both clinically and legally. I personally do not use it, and I would never use it as a projective test not using the Exner scoring system. I have the test and may use it in an eval some day if i really want to some data on the structure of one's psyche to add to my data on the content of one's psyche. Exner can do that.

😎
Click to expand...

I recall reading somewhere that the person scoring the Rorschach projects him or herself into the scoring as well. Is this true? If so... :laugh:
 
Psyclops said:
Exner (RIP) is the most widely used method, although there are others. I think the test gets a bad rap, having been used unethically for so many years. BUt I think if it is used within its bounds it can be ethically valid. As for incrimental validity? I don't know that it would be worth it, I'd rather give a PAI.
Click to expand...

This concept of the Rorschach being 'unethical' to use is somewhat surprising. As a practitioner, I can use the test if I wish, and with proper documentation, there is no legal problem with this, as long as it is part of a larger evaluation.

I had the psychologist use the Rorschach on a patient a few weeks ago that "cleans up well" for the unit, and wasn't endorsing much pathology. Lo and behold, a tremendous amount of disorganized pathology became quickly evident. The test is provocative, and it difficult to guard against - if the patient is cooperative and not giving "canned" answers.

I was impressed with the thoroughness of the Exner scoring system when I learned it....although I agree - it's unbelievably long and tedious. Diagnoses matched up surprisingly well with validated norms according to his data.
I imagine only someone in a 'boutique' practice would have the time to fully administer, record, and score the test in its entirety.
 
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Psyclops said:
YOu know what is interesting abou the TAT is that it is composed of images from advertisements, magazines, etc. from the time it was made.
Click to expand...

That's an interesting factoid, those pics certainly are a bit outdated. It seems that similar results to the TAT could be attained with picture drawing or sentence completion, the latter of which I have seen most regularly in the clinical settings in which I have worked.
 
Well, again, when it comes to testing it's important to know what the test is capable of measuring, which can usually be determined empirically. So tests like the TAT, in my experience, are best used for things like measuring acheivement striving. ANd the sentance completion task best used for ego development or maturity. Draw a person, I don't know much about but I am skeptical. The problems arise when you want to reliably measure things like past abuse, or other highly consequence related constructs.
 
Where can I learn more about these tests- they fascinate me. Is there a book I can add to my library that woudl be beneficial for residency too?
 
Handbook of Psychological Assessment, 4th Edition
Gary Groth-Marnat
ISBN: 0-471-41979-6
Hardcover
862 pages
March 2003

US $100.00
 
This isn't meant to be an inflamitory remark, but are MDs allowed to buy psychological tests?
 
Sure they can, and not just psychiatry. Go to any stand alone children’s hospital in the US and developmental pediatricians are administering your WISC-IV right now. If their trained to do it, I certainly have no objection.
 
Thanks guys!

I'll probably go with the book since if i get the tests themselves, I'll be tempted to use them on myself and psychoanalyze my own thoughts, ending up in a psychotic state from self actualization. 🙄 😛 😳
 
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