Rorschach Week 1 - 5 (and coding stuff) Flashcards
1
Q
What was the parlor game that inspired the Rorschach?
A
“Blotto” (Klecksographie)
2
Q
Who created the Rorschach?
A
Hermann Rorschach
3
Q
Who influenced/mentored Rorschach?
A
Konrad Gehrig - taught intermediate school when Hermann was in medical residency
Bleuler - created the concept “dementia praecox”
Syzmond - spurred Rorschach to investigate different responses with inkblots; compared responses of 100 children to 100 adults to 100 patients with psychosis
4
Q
Hermann Rorschach did not think of the inkblots as a projective technique but rather as a
A
Cognitive Perceptive Test
(more concerned about perception and the characteristics it showed about the individual)
5
Q
How many inkblots did Rorschach originally use?
A
40 inkblots
6
Q
What were Rorschach’s original scoring codes?
A
- Part of blot used
- What features being used
- Content
7
Q
Why did Rorschach bring down the amount of cards (40) to 10?
A
Publishers requested him to submit fewer cards; called it “form interpretation test”
8
Q
What parts of the Rorschach are helpful and what reasons do we use it?
A
- Standardized sample of perceptual and verbal problem-solving behaviors
- Inkblots were carefully selected and pilot-tested
- Stimuli are structured to provide multiple suggestive perceptual likenesses that form competing visual images
9
Q
Samuel Beck and Marguerite Hertz developed…
A
A major scoring system for the Rorschach after doing a standardized dissertation with different populations
10
Q
Who developed a scoring system in conflict with Beck (empirical)?
A
Bruno Klopfer (psychoanalytic)
11
Q
In 1950 _________ ____________ published his own approach to the test
A
Zygmunt Piatrowski
12
Q
Overall, what were the 5 scoring systems in 1960?
A
- Samuel Beck (empirical)
- Bruno Klopfer (psychoanalytic)
- Marguerite Hertz (empirical)
- Zygmunt Piatrowski (psychoanalytic)
- David Rapaport/Merton Gill/Roy Schafer
13
Q
What did John Exner do to set standards?
A
Compared and combined efficacy across 5 coding systems; used only empirically validated
14
Q
What standards did the Rorschach have to meet?
A
Inter-rater reliability
- scoring was only included if it had a .85 interrater reliability
Requirements for validity
- required predictive and concurrent validity; indicators must be shown in 5 good studies to remain
15
Q
Criticisms (and how they were addressed) of the Rorschach
A
- Lack of good norms (Shaffer introduced a large international sample)
- Overpathologizes (people are trained to prevent over pathologizing; SCZI was revised)
- Low Inter-rater reliability (improved training and Viglione book promotes greater precision in scoring)
- Lack of Relationship to Diagnoses (but that’s not the intention; replication is an issue, but not the focus)
- Lack of Incremental Validity (depends on assessment)
- The Problem of R (improve training, use Holtzman Inkblot Method, convert indicators to ratios, develop norm table, new admin system)
16
Q
Meyer, Viglione, Mihura, Erdberg, and Erard developed….
A
A new system called Rorschach Performance Assessment System (RPAS)
17
Q
What are the constants in the tester’s role during testing?
A
- Voyeuristic
- Autocratic aspect
- Oracular
- Saintly
18
Q
What is the Voyeuristic Aspect of the tester’s role?
A
Peeps into the interior of many without committing themself
19
Q
What is the Autocratic aspect?
A
Tester dominates, controls the situation, is the ringmaster
20
Q
What is the Oracular aspect?
A
Tester given magical powers, omniscient; we must cope with constant stimulation of this longing
21
Q
What is the Saintly aspect?
A
We are pulled to do good things for others; subdue own needs to save the other
22
Q
What are the values and dangers of a tester with uncertain sense of personal identity?
A
- concerns is that this may cause anxiety, demand too much, or show favoritism
- values: increase perceptiveness, greater variety of solutions, foster tolerance, contribute to growth
23
Q
What are the values and dangers of a socially inhibited and withdrawn tester?
A
- dangers is that they may become too personal and create anxiety
- values is that they are hypersensitive to emotional nuances
24
Q
What are the values and dangers of a dependent tester?
A
- Dangers are they feed on the patient to meet their needs and fear displeasure from the patient
25
What are the values and dangers of a tester with rigid defenses against dependency needs?
1. dangers are that they force patients into a passive role; too cold, too maternal, too saintly
2. values are that they increase empathy for patient's needs and increase tolerance of patients need-denying defenses
26
What are the values and dangers of a rigidly intellectual tester?
1. dangers are they may become too detached, complicate unnecessarily, interpret everything in sight, and may be communicated to patients who will interpret it as narcissistic self-absorption
2. the values are that they make it possible to deal with disturbing material, support reasonable skepticism, and oppose mechanical interpretations
27
What are the values and dangers of a sadistic tester?
1. dangers: sadistic assault, may become a means of finding the weak, debasing, humiliating aspects of others
2. values: need freedom to call it like you see it, easier to see sadism in patient, not easily taken in, not compelled to have to be gentle
28
What are the values and dangers of a tester with rigid defenses against hostility?
1. blind to malignant implications; saintliness can be a powerful sadistic weapon
2. enhances perceptiveness of strengths, potential, strivings
29
What are the values and dangers of a masochistic tester?
1. exacerbate behavior; cause anxiety in patient
2. makes it possible to spend time with the patient
30
What are some of the psychological positions for patients?
1. Self-exposure in the absence of trust
2. Loss of control in the interpersonal relationship
3. Dangers of self-confrontation
4. Regressive temptations
31
Projection versus performance
Performance-based tests are nomothetic; scored into meaningful categories
32
What is usually missed with self-report tests?
Maturity
Narcissism
Intelligence
Trauma
33
The Values of the Rorschach
- Applies meaning to stimuli
- Filters and organizes information
- Gives us an idea of how people perceive, logically think and communicate, and how they handle inconsistencies, contradictions, and ambiguity
34
Rorschach results do not correlate highly with...?
Self-report measures
35
Self-report measures tend to tape in....
Explicit aspects of a person (how they see themselves)
36
Performance based measures tend to tap in....
Implicit (underlying) aspects of a person
37
What are the true components of a stimulus field?
Critical Distal Bits (Distal properties like a chair has legs, seat, and back)
Critical distal bits create the parameters that limit range of possible objects
38
Performance based measures
- Rorschach
- Wartegg Drawing Completion Test
- Adult Attachment Projective
- Thurston-Cradock Test of Shame
39
Projective Tests
- Thematic Apperception Test
- Roberts Apperception Test
- Tell Me a Story
- House-Tree-Person Drawing
- Sentence Completion tests
40
What areas of the brain are memories and affect states connected with trauma located?
Right hemisphere to limbic areas
41
What part of the brain completes self-report tests?
Right and limbic areas
42
What are trauma memories and affect states tied to?
Anxiety or shame
43
If memories and affect states tied to trauma are activated by the right hemisphere and cannot be reached through self-report measures, what types of tests would be effective?
Projective/performance-based tests have shown to activate the right hemisphere and subcortical areas involved in emotional activation and regulation
44
What are the four principles of administration?
1. Follow standardized procedures
2. The examiner in non-directive
3. Capture the client's performance accurately
4. Focus on what the client sees and how they see it
45
What materials do you need to administer?
10 Rorschach cards
2 location sheets (at least)
Paper/laptop (response sheet)
Two pens
Clipboard
46
For the setting, what should you do to prepare for the Rorschach?
- Have at least an hour for the test
- Quiet area with no distractions
- Establish rapport
- Ask what they know about the Rorschach
- Investigate their knowledge of the Rorschach
- Clarify any misunderstandings
- “I want you to tell me what they look like to you”
- Move to side-by-side seating, slightly behind
- Have the cards face down in order with card 1 at the top
47
What should you do if there is possible coaching or motivated distortion?
Ask directly about preparation
If so, decide whether to proceed
If proceed, ask client if willing to be honest and spontaneous
Be familiar with public availability of materials
48
What are the two phases in administration?
1. Response phase (RP) - what might this be?
2. Clarification phase (CP) - carefully worded questions to resolve coding ambiguities
49
Name three possible issues during the administration
Not allowing long silence when needed
Your location sheets are visible
You're feeling ill and unable to focus
50
What are some things you should not say or do?
Avoid saying “ambiguous” or “unstructured”
Avoid saying there is no right or wrong answer (can say “different people see different things”)
Avoid saying “most people…can or should say or do something”
Do not mislead the client into thinking that imagination or creativity is be tested
51
What are some "don'ts" during the CP?
●Don’t ask questions that don’t have a purpose.
○ Target one or more specific coding categories
●Don’t ask too many questions
●Don’t keep going after a score you “know” must be there
●Don’t ask leading questions (“is it moving?” “are you using color?”)
52
What is most often the reason for coding problems?
Clarification problems
53
What are some common coding problems?
- Code how client saw this cloud at the time (not clouds in general)
- Code what is articulated and sometimes gestures (rubbing the card)
- Code what is on the card, not something off the card (although it doesn’t have to be seen, as long as it resides on the card)
- Code categories independent of each other
- Code what was seen in the RP - ignore CP information that contradicts the RP
- The goal is to code accurately, not necessarily to see it the way they do
- The Reasonably Certain Standard - if “reasonably certain,” code it (practice)
- Coding competence is necessary to know what needs clarification
54
How many studies have been done on Reliability of Rorschach scoring/coding over the years?
Over 85
55
Which study has been the most thorough and meticulous related to the reliability of the Rorschach?
Acklin, McDowell, Verschell, & Chan (2000)
56
What is the most critical aspect of coding for the Rorschach?
Interrater agreement (Inter-rater reliability)
57
What did studies/research find about test-retest reliability?
Stable over long intervals; especially strong for Y (anxiety) and m (powerlessness)
Control group (same responses) and experimental group (different responses) of children showed correlations between groups
58
What are the 3 factors for depress reliability?
1. Low prevalence
2. Poor inquiry
3. Ambiguous coding criteria
59
True or False: Viglione, Blume-Marcovici, Miller, Giromini, and Meyer (2012) shared that after administering the Rorschach to adults and children, their results were: Mean ICC of all 62 RPAS indicators = .95
False
It was .88 (SD = .11; Median = .92)
60
Pignolo et al (2017) sought to fine standard scores and complexity-adjusted scores in what population? What were the results?
Italian population
Most scores were in good to excellent range (raw score .78, SD .14, and complexity mean .74)
61
What are some reasons to code orientation?
Help code FQ
Help interpret reflections
62
True/False: Both Rorschach and MMPI have criterion-related validity effect sizes of substantial magnitude
True
63
Which assessment has more construct validity meta-analyses documenting their validity than any other multiscale assessment measure?
R-PAS
64
What is the most complex feature to scoring?
Determinants
65
What are the different ways information can be relayed when scoring determinants?
Directly - The shading gives an impression
Indirectly - Key words
66
Name 7 determinants
Movement
- M
- FM
- m
Color
- FC
- CF
- C
Shading
- C'
- T
- V
- Y
Form Dimension
Reflections
Form
67
What are three suggestions of a determinant?
1. Communication (consider all words and gestures)
2. Prototypical imagery (the real-world attributes of an object suggestive)
3. Permissive card location (common determinant location)
68
What determinant would you give "a worm crawling along?"
FM
69
Can you code movement for past actions?
No, it should be in the moment
70
Do we code props (provides rationale to responses but not seen in blots)?
No
71
What are some movements labeled as active?
Fighting
Spinning
A person lifting a heavy weight
Arguing
Kissing
Walking
Flames leaping up
72
In the Rorschach, what is the biggest threat to reliability and validity?
Clarification
73
What thematic codes should be scored independently (only once per response)
ABS
AGM
AGC
COP
MOR
GHR
PHR
PER
74
What is the five point scale with deciding FQ?
5-point scale:
1 = No. I can't see it at all. Clearly, it's a distortion.
2 = Not really. I don't really see that...
3 = A little. If I work at it, I can sort of see that.
4 = Yes. I can see that. It matches the blot pretty well.
5 = Definitely... it looks exactly or almost exactly like that.
75
What is the 4 S's interpretive strategy?
Scan, sift, synthesize, and summarize
76
While looking at the complexity variable, what should we consider?
What does it mean for the individual?
Recognize its likely impact on other scores
77
When the complexity variable is high, what should we consider or attend to?
Look at variables that are not elevated
78
When the complexity variable is low, what should we attend to and use?
Attend to codes and what is elevated
Use complexity adjusted score
79
When inkblot is oriented and interpreted turned to the left, you mark it as?
<
80
What does "@" mean for the orientation of a card?
Card was rotated around before responding, but response was given in the upright position
81
What should you do if an individual gives 4 responses (or more)?
Pu
Pull and remind client to not go over 4 responses; "remember..."
82
How should you respond if the client tries to give you the inkblot back but only gave 1 response?
Pr
Prompt them to give 2 or 3 responses
If they say "I just can't see anything else"
Don't push it and take the card
83
If a single unified object is seen and it uses the entire blot, code...
W
84
If a single unified object is seen and it occupies a listed D location, code...
D
85
If a single unified object is seen and it does not fit within a D location, code...
Dd
86
If multiple objects are seen that use the whole inkblot, you should code...
W
87
Two people looking at each other is an example of...
Synthesis
88
Synthesis is...
Sy; distinct and separate objects in a relationship; requires 2+ objects and (ANY) interaction
89
Vague is...
Vg; objects with a vague or indistinct outline or boundary; objects that do not have a specific form and the respondent does not communicate any particular form
90
Pair is...
2; identical objects based on the symmetry of the blot; NOT component parts of the same object (e.g. eyes, hands, feet of a whole person) (do not code Sy or 2 if coming from same obj, like praying hands)
91
Name 7 content codes
H
(H)
Hd
(Hd)
A
(A)
Ad
(Ad)
An
Art
Ay
Bl
Cg
Ex
Fi
Sx
NC
92
When should we code H?
Whole human, including realistically described religious or historical figures Also code figures described as humans but with non-human parts
93
When should we code (H)?
Imaginary, fictional, quasi-, or supernatural whole human
94
When should we code Hd?
Human detail, for an incomplete human form but not those percepts better captured as Anatomy
95
When should we code (Hd)?
Imaginary or fictional human detail
96
When should we code A?
Whole animal
97
When should we code (A)?
Imaginary, fictional, or cartoon whole animal
98
When should we code Ad?
Animal detail, for an incomplete form but not those percepts better captured as anatomy
99
When should we code (Ad)?
Imaginary or fictional animal detail
100
When should we code An?
Anatomy, for internal body parts and structures that are not visible from the outside; Also for perceptions of anatomy from medical imaging devices, including MRI, PET scan, X-ray, or ultrasound technology; Internal human or animal body parts that are coded An are not also coded Hd or Ad unless external body parts are also included
101
When should we code Art?
Art, for objects of art or for objects that are, or described as being decorative or ornamental
102
When should we code Ay?
Anthropology, for references to a specific historical or cultural context
103
When should we code Bl?
Blood
104
When should we code Cg?
Clothing
105
When should we code Ex?
Explosion
106
When should we code Fi?
Fire
107
When should we code Sx?
Sexual organs, activity, or clothing
108
When should we code NC?
objects and contents that are not classified in other categories, including abstractions like depression and sensory experiences
109
What are the three principles for extrapolation?
1. Systematic extrapolation from the FQ tables if preferable to independent code judgment
2. All FQ extrapolations must share shape and spatial orientation
3. Extrapolate using the resources in its entirety
110
Name 7 determinants
M (a, p, a-p)
FM
m
FC
CF
C
C'
T
V
Y
FD
r
F
111
What are the determinants that involve color?
FC
CF
C
C'
112
When do you code M?
human activity, experience, sensation, and emotion; any experience, activity, or motion that is distinctly human
113
Examples of Ma?
explosion, fighting, spinning, a person lifting a heavy weight; two people sitting at a table debating politics
114
Examples of Mp?
talking, sitting, resting, gliding, murmur
115
Examples of Ma-p?
one person looking on as this person dances
116
When do you code FM?
animal activity and experience; animal in motion
117
When do you code FC?
color contributes to a response, but form is dominant (certain response)
118
When do you code CF?
form contributes to a response, but color is dominant
119
What is a deviant verbalization 1 (DV1)?
mistakes in word use involving odd, nonstandard, but understandable verbalizations
120
What is a deviant verbalization 2 (DV2)?
an incomprehensible or very difficult to understand word or phrase misuse that interferes with communication
121
What is the two step guideline for deviant responses?
To code DR, at least TWO statements or ideas should be offered and the second one should NOT be closely related to the response/task.
122
What counts as a deviant response 1 (DR1)?
contained and brief examples of inappropriate or task-unrelated language that are nonetheless clear, consistent, and understandable
123
What counts as a deviant response 2 (DR2)?
markedly confusing communication or communication failures that are clearly off task
124
What counts as peculiar logic?
peculiar, strained, confused, or overly concrete reasoning; two elements: 1. used to justify or elaborate a response, 2. offered spontaneously and not prompted by the examiner; doesn’t add up (needs to be definitive)
125
What are the cognitive codes for language and reasoning?
DV
DR
PEC
126
What are the cognitive codes for perception?
INC
FAB
CON
127
When should you code INC1?
implausible but fairly understandable combination of parts or features
128
When should you code INC2?
illogical combinations of attributes or features
129
When should you code FAB1?
implausible and illogical relationships that are understandable and described in a coherent and organized manner
130
When should you code FAB2?
more bizarre or impossible departure from what is realistic, and typically lack the playfulness of FAB1
131
When should you code CON?
rare; restricted to the perception of two mutually exclusive response objects that are visually superimposed on each other in the same blot area
132
Name 7 thematic code
ABS
PER
COP
MAH
MAP
AGM
AGC
MOR
ODL
133
When should you code abstract representation (ABS)?
concrete blot features are representational and symbolize an abstract, higher order construct or concept
134
When should you code personal knowledge justification (PER)?
personal knowledge or experiences is used to justify a response (offered spontaneously, not prompted)
135
When should you code Cooperative Movement (COP)?
cooperative, positive, or pleasant interactions are occurring between two objects; two types: 1. mutually enhancing/satisfying interactions, 2. teamwork/helping (has to have movement)
136
When should you code Mutuality of Autonomy-Health (MAH)?
two objects are mutually and autonomously engaged in a reciprocally interactive activity
137
When should you code Mutuality of Autonomy - Pathology (MAP?
an agent or object intentionally compromises the autonomy or integrity of another object or is destructive to it
138
When should you code Aggressive Movement (AGM)?
aggressive or hostile activity, intent, ideation is occurring
139
When should you code Aggressive content (AGC)?
response content involves aggressive, dangerous, harmful, injurious, malevolent, or predatory elements
140
When should you code morbid content (MOR)?
objects are damaged or states of distress or dysphoria are attributed to them
141
When should you code oral dependent language (ODL)?
response phase only; verbalizations linked to oral activity and content or interpersonal passivity and dependence (cannot code if in CP, HAS TO BE ONLY IN RP)
