Rorschach blots available on Wikipedia

[cara susanna]

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Where did you hear this? The Ror is no better at detecting psychosis than the MMPI II, a clinical interview, talking with a patient for 30 minutes, the SCL-90, and a plethora of other validated tests.

My Assessment professor.

I think it's more that it's hard to fake psychosis on it, so it lessens the possibility of malingering. Though, uh, not so much now that the answers are online.

I'm not crazy about the Rorschach, I'm just saying what I was told one of its strengths was.

 

[erg923]

My Assessment professor.

I think it's more that it's hard to fake psychosis on it, so it lessens the possibility of malingering. Though, uh, not so much now that the answers are online.

I'm not crazy about the Rorschach, I'm just saying what I was told one of its strengths was.

Why do you think it would be hard to fake psychosis on it?

Even on the surface, this would seem like an easy feat. 1.) look at card. 2.) provide goofy, off-the-wall response. Lots of synthesis and lots of "u" and "-" form qualities. Done.

And again, I would ask why one might need that to determine or extract psychosis? Please see my previous response to you post for the full version. Im not being antagonist or anything, I'd really like you to ask your professor using the points I brought up in my previous response. Im curious to know his/her counter.

 

[Therapist4Chnge]

See ERG's post.

The test is junk science. I can't beleive that your supervisor taught it to you. It predicts nothing.

It isn't meant to be predictive.

If the purpose of the test is to find out how the patient sees the world, why would scoring the test be necessary? What does a patient's test score mean/predict?

Extner attempted to apply a quantitative method to the scoring, but I'm not sold on it. I've voiced my issues in the past with Extner, so I'll leave that alone for this discussion. I think a Rorschach IS useful for "grist for the mill"/therapy, but not as an assessment measure. In conjunction with other assessments it has shown some use, but I think there are better assessments out ther....particularly in regard to time v. benefit.

 

[cara susanna]

erg, I'll have to see what he says. I'm not even sure we'll be learning the Rorschach though--they haven't decided yet if they'll teach it to us.

 

[busi26]

I'm not even sure we'll be learning the Rorschach though--they haven't decided yet if they'll teach it to us.

Lets all hope that your department won't waste your time.

 

[busi26]

Slow down cowboy. I didnt say all that. The norms are bad and flawed, I assume you know the issues with them and the revelations in recent years, no? ...But still, I'd much prefer to get the info somewhere else and in half the time.....

Sorry about my vitriolic statements on this topic. I stand by my points, but I could have softened my tone. I guess I get really riled up by the continued insistance of some clinical psyc programs in teaching unproven/disproven/useless tests and requiring students to learn treatments that are unproven/disproven/useless. Bad tests and treatments hurt our field. Magical tests included. We owe our patients the best possible tests and treatments.

 

[erg923]

Well like i said, i dont think its a waste of time for the reasons i mentioned in my initial repsonse to your comments.

 

[busi26]

Well like i said, i dont think its a waste of time for the reasons i mentioned in my initial repsonse to your comments.

So it is your opinion that schools should focus time on teaching students to use this test?

 

[erg923]

Yes

 

[busi26]

Yes

Why? Wouldn't it be a better use of students' limited time to focus on more empirical tests?

 

[erg923]

Well I didnt say how much time, and i ddnt say at the replacement or expense of anything else.

 

[IT514]

To bring up a purely pragmatic point, last time I checked, 60% of internship sites use the Roschach. Not sure I'll be applying to any of those sites, being in neuro, but who knows. So while I would rather spend the time doing something else, I'm glad I learned the Exner system. It was interesting enough.

 

[busi26]

To bring up a purely pragmatic point, last time I checked, 60% of internship sites use the Roschach. Not sure I'll be applying to any of those sites, being in neuro, but who knows. So while I would rather spend the time doing something else, I'm glad I learned the Exner system. It was interesting enough.

What are you citing? I would appreciate a recent citation. At one place I interviewed (Boston Consortium) learning the test would have been optional on one rotation. It is important to clarify if your citation states that 60% of internship sites use the Rorschach for diagnosis and treatment planning or just for fun.

I didn't apply to any internship sites where I thought I might have to give a Rorschach. It is my belief that internships that offer the Rorschach are not adequately based in theory and would have been a waste of my time.

 

[busi26]

Well I didnt say how much time, and i ddnt say at the replacement or expense of anything else.

Well, then we agree. It should not be taught.

Spending the hours required to learn the Rorschach could be better spent on learning a validated test. For instance, your program could focus more time on teaching the WIPPSI, Weschler Memory Scale, SCID, SCID II, WAIS, WISC, BDI, PPVT, PAI, Woodcock Johnson, BAI, Conners, Vineland,...

 

[erg923]

Well, then we agree. It should not be taught.

I didnt say that. And I think I already made it clear why I think learning it is a valuable and meaningful experience. If you disagree, then we simply have different views of what constitutes meaningful and valuable intellectual experiences...maybe even a different philosophy of what grad school can be about.

 

[Therapist4Chnge]

I didn't apply to any internship sites where I thought I might have to give a Rorschach. It is my belief that internships that offer the Rorschach are not adequately based in theory and would have been a waste of my time.

Fair enough, though there are a number of excellent sites (typically in major cities like NYC, Boston, etc) that stupport the Rorschach.

As an aside, I am not a fan of the Exner system because of the flawed data supporting it, but I think the assessment can still have some clinical value if used outside of the Exner system.

 

[busi26]

As an aside, I am not a fan of the Exner system because of the flawed data supporting it, but I think the assessment can still have some clinical value if used outside of the Exner system.

This begs my previous question. Why use the blots then? Why not take pictures of clouds and ask the patient what they see?

 

[busi26]

And I think I already made it clear why I think learning it is a valuable and meaningful experience. If you disagree, then we simply have different views of what constitutes meaningful and valuable intellectual experiences...maybe even a different philosophy of what grad school can be about.

The strawman cometh.

You make my point. I agree learning is "VALUABLE" and should be "MEANINGFUL." However, teaching tests that are not valuable or meaningful wastes students' time! Simple as that.

Let me ask this in a different way. Would you go to a doctor that X-rayed your leg everytime you had a cold? Probably not, because you know that an X-ray is not a valid test for for a cold. Then why should patients see psychologists that administer tests that have no validity? Do you think patients would approve of paying money for the Rorschach if they knew that the test was not valid/useless?

 

[erg923]

The strawman cometh.

You make my point. I agree learning is "VALUABLE" and should be "MEANINGFUL." However, teaching tests that are not valuable or meaningful wastes students' time! Simple as that.

Let me ask this in a different way. Would you go to a doctor that X-rayed your leg everytime you had a cold? Probably not, because you know that an X-ray is not a valid test for for a cold. Then why should patients see psychologists that administer tests that have no validity? Do you think patients would approve of paying money for the Rorschach if they knew that the test was not valid/useless?

arg! I think I have already enumerated that I dont view the test as having no validity at all. Troublesome and flawed (normatively), and difficult to quantify, yes. However, the conceptual notion of what the test is based upon is useful for exploring the dynamics and associations made by the human psyche (ie.,the way people look at and describe their world drives how they feel about and act toward it). As I stated before, the underlying rationale for its existence is a valid and important one for the work we do with humans. That is, The Rorschach provides a systematic method for assessment of how people look at and describe their world, as compared with the perceptual descriptions of people from known groups. Just because that systematic method doesnt work very well psychometrically right now doesn't mean it should be academically abandoned forever. Perhaps clinically abandoned for the time being though. Just as Wood and Garb called for the moratorium on its use until a better sytem is devised. (Note that didnt call on a ban of teaching it or reseaching it, right?). But I for one am happy to have learned it and spent time "intellectually masterbating" to the way in which the underlying theory of the test may be brought to life in a better way. I do NOT view this as waste of my time at all. Again, I have a heavy philosophy background and very philosphical mindset/brain, and I think our disagreement mainly roots from different views of what is meaningful to learn and what grad school training can be about.

 

[busi26]

However, the conceptual notion of what the test is based upon is useful for exploring the dynamics and associations made by the human psyche (ie.,the way people look at and describe their world drives how they feel about and act toward it).

I guess we fundamentally disagree that the Rorschach does this. Why not just use a more accurate measure of how people look at and describe their world? Why is it necessary to use a test that proports to examine the unconscious?

Just because that systematic method doesnt work very well psychometrically right now doesn't mean it should be academically abandoned forever. Perhaps clinically abandoned for the time being though.

AGREE 100%. Just as teaching phrenology has been abandoned! At least I don't know of any clinical psyc programs that train their students in phrenology.

Again, I have a heavy philosophy background and very philosphical mindset/brain, and I think our disagreement mainly roots from different views of what is meaningful to learn and what grad school training can be about.

I guess we agree to disagree on this. With this line of reasoning though, do you think it would be beneficial for clinical psyc students to learn how to do phrenology? There is very little difference in the amount of value in the results of a Phrenology exam and a Rorschach test.

 

[erg923]

With this line of reasoning though, do you think it would be beneficial for clinical psyc students to learn how to do phrenology? There is very little difference in the amount of value in the results of a Phrenology exam and a Rorschach test.

If you know that we fundamentally disagree on the potential usefulllness of what lies within the test, then why would you even ask that question?

Anyway, I dont see how or why you have developed the notion that you absolutely cannot get anything of value out of a rorschach. Even its most ardent critics dont make this narrow-minded assumption. I mentioned before that there are lots of way to get information. I think I could learn alot about a person from listening to them talk about shapes in a cloud. I think I could learn alot about a person by watching a video of the wedding, etc. These things doent lend themselves very well to quantification though, and I wouldn't want to write a report on these things, but that doesn't mean that they cant supply any useful information, right? The same can be said for the rorschach.

Rorschach in its current form (exners system) is psychometrically flawed and problematic. But remember, exners system is just one way of quantifying and looking at the data one gets from a rorschach. So, the test as a whole, useless? I think not. We haven't exhausted it potentials yet. There are a multitude of other systems that can be explored that may make it more useful, valid, reliable, etc. But hey, maybe not. I dont know. I know what I dont know. That is, I dont know if the rorschach can ever be useful. But I think the fun in psychology is getting to explore and research those ambiguous difficult questions, dont you? If no one ever teaches us those things, how are we suppose to research them and improve on them?

 

[busi26]

Rorschach in its current form (exners system) is psychometrically flawed and problematic. So, the test as a whole, useless? I think not. We haven't exhausted it potentials yet. There are a multitude of other systems that can be explored that may make it more useful, valid, reliable, etc. But hey, maybe not. I dont know. I know what I dont know. That is, I dont know if the rorschach can ever be useful.

Ok, you make a good arguement for not teaching the Rorschach and the Exner scoring system to grad students. What other tests, with so many flaws and poor validity, were you taught to administer in grad school?

But I think the fun in psychology is getting to explore and research those ambiguous difficult questions, dont you? If no one ever teaches us those things, how are we suppose to research them and improve on them?

I agree overall. However, I disagree that a clinical psyc programs should teach students on how to administer unsupported and invalid tests. Some of these students might acutally administer the test and draw invalid conclusions about their patients. This would be a waste of the student's and patient's time and could lead to inappropriate treatment. Thus squandering an opportunity to help the patient.

 

[erg923]

Ok, you make a good arguement for not teaching the Rorschach and the Exner scoring system to grad students. What other tests, with so many flaws and poor validity, were you taught to administer in grad school?

All the tools we use to assess personality (and IQ as well) have significant flaws and limitations. We can't even agree on what intelligence is for goodness sake, much less claim that the Wechslers are true measures of it. So my answer would be.....every single one I've learned thus far.

However, to more directly answer your question, I think the worst by far would be the Hamilton Depression Rating Scale. It sucks! Bagby (2005) has a great meta-analysis that gives a big thumbs down.

 

[busi26]

All the tools we use to assess personality (and IQ as well) have significant flaws and limitations. We can even agree on what intelligence is for goodness sake, much less claim that the Wechslers are true measures of it. So my answer would be.....every single one I've learned thus far.

No doubt, personality measures don't provide much actionable information (except for the PAI, it is much better than the MMPI2). However, the measures you listed do have much more validity than the rorschach.

Actually, IQ is the best measure/predictor we have for all sorts of things (e.g., short-term performance in school, mental ******ation, job performance).

I think the worst by far would be the Hamilton Depression Rating Scale. It sucks! Bagby (2005) has a great meta-analysis that gives a big thumbs down.

I learned about the Hamilton in grad school, but we were not taught to administer it. At least it is face valid. I am not familiar with the other psychometrics of the test though.

 

[busi26]

I think the worst by far would be the Hamilton Depression Rating Scale. It sucks! Bagby (2005) has a great meta-analysis that gives a big thumbs down.

Also, it is funny that you will say that the Hamilton "sucks," but you have not said that about the Rorschach.

 

[Therapist4Chnge]

I learned about the Hamilton in grad school, but we were not taught to administer it. At least it is face valid. I am not familiar with the other psychometrics of the test though.

It's interesting that you bring up the Hamilton, as it is really popular with pharmacology research, but it is generally a poor selection. It drives me nuts when I see that as one of the main measures, but it is monkey see monkey do in most cases.

 

[cara susanna]

Haha, right now I am most bothered by the GAI index of the WAIS. It's not shown to exist in the actual population, but everyone uses it!

 

[erg923]

Also, it is funny that you will say that the Hamilton "sucks," but you have not said that about the Rorschach.

The rorschach sucks.....😀

 

[erg923]

Actually, IQ is the best measure/predictor we have for all sorts of things (e.g., short-term performance in school, mental ******ation, job performance).

Yes, yes, well aware, well aware....🙄Good predictors. But you have to admit that there are varying theories of intelligence, all of which have some support, and the that construct of "IQ" is shakey at best. For a long time we thought there was such a thing as "VIQ" and "PIQ." But we know now (actually for quite sometime) that we were just fooling ourselves. Perhaps the same will be said for the construct of "IQ" 50 years from now. Perhaps the Wechsler scales will be looked upon much as the notion of unconcious projections are to you in 50 years......

 

[erg923]

It's interesting that you bring up the Hamilton, as it is really popular with pharmacology research, but it is generally a poor selection. It drives me nuts when I see that as one of the main measures, but it is monkey see monkey do in most cases.

I recently did a factor analysis of the HAM-D that is in submission to the Journal of Affective Disorders. Fingers crosssed everyone. It was such a pain staking process and so dissappointing that I have eliminated it from my disssertation due to my fear that its so misleading (and inconsistently rated, at least in our clinic). Im using archival data, so im searching for something else we gave to use instead.

 

[busi26]

The rorschach sucks.....😀

Well said.

 

[busi26]

Perhaps the Wechsler scales will be looked upon much as the notion of unconcious projections are to you in 50 years......

Doubtful. The difference is that IQ does predict lots of things and "unconscious projections" never predicted anything. We have known for some time that measuring "unconscious projections" is pseudoscience.

 

[PsyDGrrrl]

Well, then we agree. It should not be taught.

Spending the hours required to learn the Rorschach could be better spent on learning a validated test. For instance, your program could focus more time on teaching the WIPPSI, Weschler Memory Scale, SCID, SCID II, WAIS, WISC, BDI, PPVT, PAI, Woodcock Johnson, BAI, Conners, Vineland,...

If you need to be "taught" how to use the BDI and BAI, you have no business using them. Same goes for the SCID/SCID II as well, actually...

 

[erg923]

If you need to be "taught" how to use the BDI and BAI, you have no business using them. Same goes for the SCID/SCID II as well, actually...

I beg to differ about the SCID. Its not just about circling 1 or 2 or 3!

There is a considerable amount of clinical judegment needed during a scid, and an extensive knowledge of the DSM and what the criteria truley mean is needed in order to conduct a good SCID. It took 10 or so before I really felt comfotable with that massive thing.....Not only that...but each patient is different and our lab constantly struggles with diagnostic issues and ambiguties that come up with our participants. I dont know any supervisor that would recommed a graduate student just go in and do a full SCID "cold" without having some formal training on it and probably shadowing 1 or 2 before hand as well.

 

[PsyDGrrrl]

I beg to differ about the SCID. Its not just about circling 1 or 2 or 3!

There is a considerable amount of clinical judegment needed during a scid, and an extensive knowledge of the DSM and what the criteria truley mean is needed in order to conduct a good SCID. It took 10 or so before I really felt comfotable with that massive thing.....Not only that...but each patient is different and our lab constantly struggles with diagnostic issues and ambiguties that come up with our participants. I dont know any supervisor that would recommed a graduate student just go in and do a full SCID "cold" without having some formal training on it and probably shadowing 1 or 2 before hand as well.

Well, yes, you need to have good clinical interviewing skills to use the SCID. But as a "test," it's not difficult...and learning those interviewing skills can happen independent of the SCID. I guess I'm also speaking from a position of having worked in the field now for several years and having learned the SCID after 7+ years of experience interviewing patients with just about the entire DSM range of diagnoses...

 

[futurepsydoc]

I have enjoyed reading this thread. Its a good debate. I thought I would throw in my thoughts on the matter and see how others view them.

First, I thought it noteworthy to consider the position of the Society of Personality Assessment, as this group would "arguably" be the most educated on the issue of personality theory and assessment. While they are an organization with an agenda and constituents (e.g., everyone's biased to some degree), they do provide a brief review of the literature that addresses many of the concerns raised in this thread. I have seen SDN members cite a variety of studies, but a larger synthesis of the literature seems warranted given the issue at hand. Please have a look at this brief position paper if you are interested:

http://www.rorschach.nu/artiklar/SPA_Rorschach_White_Paper.pdf

Second, I think we all need to remember that each personality measure relies on patient self-report. This already intrduces error and bias into the results. If you couple that with a complicated scoring system, the level of error is bound to increase. It is not a stretch to say that many psychologists are not be adequately taught the Exner system by their programs or professors. The combination of these two issues represent the largest problem for Rorschach in my opinion. But, if we than add the current "lack of security" regarding the test stimuli, the test becomes even more problematic. At least with standardized measures, with clear scoring systems, we remove clinician error/bias from the equation.

I beg to differ about the SCID. Its not just about circling 1 or 2 or 3!

There is a considerable amount of clinical judegment needed during a scid, and an extensive knowledge of the DSM and what the criteria truley mean is needed in order to conduct a good SCID. It took 10 or so before I really felt comfotable with that massive thing.....Not only that...but each patient is different and our lab constantly struggles with diagnostic issues and ambiguties that come up with our participants. I dont know any supervisor that would recommed a graduate student just go in and do a full SCID "cold" without having some formal training on it and probably shadowing 1 or 2 before hand as well.

With regards to the SCID and SCID-II, I agree with ERG regarding the importance of training. I have observed well educated individuals, with the best of intentions, just circle a 3 when a client says yes to a given question. It takes clinical acumen and training to anchor their response in terms of normative functioning vs. "clinically significant impairment." Follow up questions, knolwedge of the DSM and psychopathology, and sound clinical judgement all are necessary to use these tools. The same holds true for other clinical interviews, such as the ADIS, EDE-Q, CIDI, or the Hamilton Scales.

 

[KillerDiller]

Second, I think we all need to remember that each personality measure relies on patient self-report. This already intrduces error and bias into the results. If you couple that with a complicated scoring system, the level of error is bound to increase. It is not a stretch to say that many psychologists are not be adequately taught the Exner system by their programs or professors. The combination of these two issues represent the largest problem for Rorschach in my opinion. But, if we than add the current "lack of security" regarding the test stimuli, the test becomes even more problematic. At least with standardized measures, with clear scoring systems, we remove clinician error/bias from the equation.

Thanks for the link to the article, that was an interesting read.

Bringing this thread back to the topic of the blots being shared on wikipedia, I think the lack of security greatly affects the first concern you list here. Theoretically, the use of self-report on the Rorschach should be less of an issue than on more face valid measures because social desirability bias and the ability to "fake good" or "fake bad" do not come into play. However, now that the internet contains information on popular responses, the door is opened to these biases and the resulting error.

Of course, as you mentioned, scoring error will always be more of an issue for the Rorschach than for the MMPI or the PAI.