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Clinical
Psychology (PSY401)
VU
LESSON
20
THE
PROJECTIVE PERSONALITY
TESTS
PROJECTIVE
TESTS
Projective
test represents the second
broad approach to the assessment of
personality, one that is
radically
different from the methods
used in objective personality
tests. The format,
items,
administration,
and scoring of projective personality
tests are all distinct
from that of objective
tests,
whereas
objective tests require
responses to explicit verbal questions or
statements, projective tests
ask
for
responses to ambiguous and unstructured stimuli.
Indeed, a major distinguishing
feature of
projective
techniques is the use of a relatively unstructured
task that permits an almost
unlimited
number
of responses.
The
development and use of virtually
all projective personality
tests are based on the
projective
personality
tests are based on the
projective
hypothesis, i.e.
projective techniques were
essentially
psychological
X-rays.
According
to the projective hypothesis, when faced
with ambiguous stimuli,
respondents
will project aspects of
their personalities onto the
stimuli in an effort to make
sense of them.
The
examiner then can work
backward from the persons' responses to
gain insight into the
personality
dispositions.
THE
NATURE OF PROJECTIVE
TESTS
Projective
techniques, taken as a whole, tend to
have the following distinguishing
characteristics.
1.
In response to an unstructured or ambiguous stimulus,
examinees are forced to impose
their own
structure
and, in so doing, reveal something of
themselves (such as needs,
wishes, or conflicts).
2.
The stimulus material is
unstructured.
This
is a very tenuous criterion, even
though it is widely
assumed
to reflect the essence of projective
techniques. For example, if 70% of
all examinees
perceive
Card
V on the Rorschach as a bat, then we
can hardly say that the
stimulus is unstructured. Thus,
whether
a test is projective or not
depends on the kinds of responses
that the individual is encouraged
to
give
and on how those responses
are used. The instructions
are the important element. If a
patient is
asked
to classify the people in a set of TAT
cards as men or women, then
there is a great deal of struc-
ture--the
test is far from ambiguous.
However, if the patient is asked
what the people on the card
are
saying,
the task has suddenly become
quite ambiguous indeed.
3.
The method is indirect.
To
some degree or other,
examinees are not aware of
the purposes of the
test;
at
least, the purposes are disguised.
Although patients may know
that the test has something to do
with
adjustment-maladjustment,
they are not usually-aware
in detail of the significance of their
responses.
There
is no attempt to ask patients directly
about their needs or
troubles; the route is indirect, and
the
hope
is that this very indirectness
will make it more difficult for patients
to censor the data they
provide.
4.
There is freedom of
response.
Whereas
questionnaire methods may
allow only for a "yes" or a
"no,"
projective
permit a nearly infinite range of
responses.
5.
Response interpretation deals
with more variables.
Since
the range of possible responses is so
broad,
the
clinician can make interpretations
along multiple dimensions (needs,
adjustment, diagnostic
category,
ego defenses, and so on).
Many objective tests, in contrast,
provide but a single score
(such as
degree
of psychological distress), or scores on
a fixed number of dimensions or
scales.
MEASUREMENT
AND STANDARDIZATION
The
contrasts between objective tests and
projective tests are
striking. The former, by
their very nature,
lend
themselves to an actuarial interpretive
approach. Norms, reliability, and even
validity seem easier
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Clinical
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to
manage. The projective, by
their very nature, seem to
resist psychometric evaluation. Indeed,
some
clinicians
reject even the suggestion that a test
such as the Rorschach should be subjected
to the
indignities
of psychometrics; they would see
this as an assault upon
their intuitive art. In this
section, we
offer
several general observations about the difficulties
involved in evaluating the psychometric
proper-
ties
of protective tests.
Standardization:
Should
projective techniques be standardized?
There are surely many
reasons for
doing
so. Such standardization
would facilitate communication and
would also serve as a check
against
the
biases and the interpretive zeal of
some clinicians. Furthermore, the
enthusiastic proponents of
projective
usually act as if they have
norms (implicit though these
may be), so that there seems to be
no
good
reason not
to
attempt the standardization of those
norms. Of course, research problems
with
projective
can be formidable.
The
dissenters argue that interpretations
from projectives cannot be standardized.
Every person is
unique,
and any normative descriptions will
inevitably be misleading. There
are so many
interacting
variables
that standardized interpretive approaches
would surely destroy the
holistic nature of protective
tests.
After all, they say,
interpretation is an art.
Reliability:
Even
the determination of reliability turns
out not to be simple. For
example, it is surely
too
much
to expect an individual to produce, word
for word, exactly the same
TAT story on two
different
occasions.
Yet how many differences
between two stories are permissible? Of
course, one can
bypass
test
responses altogether and deal
only with the reliability of the
personality interpretations made
by
clinicians.
However, this may confound
the reliability of the test with the
reliability of the judge.
Also,
test-retest
reliability may be affected by
psychological changes in the
individual--particularly when
dealing
with patient populations. It is
true that clinicians can
opt for establishing
reliability through
the
use
of alternate forms. However, how do
they decide that alternate forms for TAT
cards or inkblots are
equivalent?
Even split-half reliability is
difficult to ascertain because of the
difficulty of demonstrating
the
equivalence of the two halves of each
test.
Validity:
Because
projective have been used
for such a multiplicity of
purposes, there is little point
in
asking
general questions: Is the TAT valid? Is the Rorschach
a good personality test? The
questions
must
be more specific: Does the TAT predict
aggression in situation A? Does
score [from the
Rorschach
correlate
with clinical dents of
anxiety?
With
these issues in mind, we
turn now to a discussion of several of
the more popular projective
tests.
THE
RORSCHACH
The
prototypic example of projective
personality tests is the Rorschach
Inkblot Test, developed
by
Swiss
psychiatrist Herman Rorschach in
1921.indeed, the Rorschach Inkblot
Test `has the dubious
distinction
of being, simultaneously, the most
cherished and the most reviled of
all psychological
assessment
instruments'.
Description:
The
Rorschach consists of ten cards on
which are printed inkblots
that are symmetrical
from
right to left. Five of the ten
cards are black and white
(with shades of gray), and the
other five are
colored.
Administration:
There
are various techniques for
administering the Rorschach. However,
for many
clinicians,
the process goes something like
this. The clinician hands
the patient the first card
and says,
"Tell
me what you see--what it
might be for you. There
are no right or wrong
answers. Just tell me
what
it looks like to you." All of the
subsequent cards are
administered in order. The
clinician takes
down
verbatim everything the patient
says. Some clinicians also
record the length of time it takes
the
patient
to make the first response to
each card, as well as the
total rime spent on each
card. Some
patients
produce many responses per card, others
very few. The clinician
also notes the position of
the
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Clinical
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card
as each response is given
(right side up, upside down,
or sideways). All spontaneous remarks
or
exclamations
are also recorded. Following
this phase, the clinician
moves to what is called the
Inquiry.
Here
the patient is reminded of all
previous responses, one by one, and asked
what it was that
prompted
each
response. The patient is
also asked to indicate for
each card the exact location of the
various re-
sponses.
This is also a time when the
patient may elaborate or clarify
responses.
Scoring:
The
scoring of responses converts the important
aspects of each response
into a symbol system
related
to location areas, determinants, content
areas, and popularity
Location:
Location
is scored in terms of which
portion of the blot was used
as a basis for a
response
(e.g.
the whole blot, a common detail of the
blot, an unusual detail of the blot, an
area of white space).
Attention
to the whole blot with
accurate form perception reflects
good organizational ability and
high
intelligence.
Over attention to detail is common in
obsessive and paranoid
subjects.
Determinants:
the
determinants of each response reflect the
Features of the blot that
made it look the
way
the patient thought it Looked (e.g.
form, shading, colures, and movement of either
humans or
animals,
inanimate movements). Overemphasis on
form suggests rigidity and
constriction of the
personality.
Color responses relate to the
emotional reactions of the person to the
environment and to
the
control of affect.
Interpretation:
The
Rorschach test is particularly
useful as an aid in diagnosis. The
subjects thinking
and
association patterns are brought
clearly into focus because
the ambiguity of the stimulus
provides
relatively
few cues about what
are conventional, standard, or
normal Responses. Proper
interpretation,
however,
requires a great deal of Experience.
There is a high reliability among
experienced clinicians
who
administer the test. In proper
hands, the test is extremely
useful, especially in
eliciting
psychodynamic
formulations, defense mechanism, and
subtle disorders of thinking.
Reliability
and Validity: Research-oriented
clinical psychologists have questioned the reliability
of
Rorschach
scores for years, at the
most basic level one should
be confident that Rorschach
responses
can
be scored reliably across
raters. If the same Rorschach
responses cannot be scored similarly
by
different
raters using the same scoring
system, then it is hard to
imagine that the instrument
would have
much
utility in clinical prediction
situations. Unfortunately, the extent to
which Rorschach scoring
systems
meet acceptable standards
for this most basic and
straightforward form of reliability
remains
contentious.
Interscorer
reliability is important to address, we
must evaluate the consistency of an
individual's scores
across
time or test conditions, as
well as the reliability of
interpretations of scores.
As
for validity of Rorschach
scores and interpretations, there have
been many testimonials the
years,
from
the vast Rorschach literature, it is
apparent that the test is not
equally valid for all
purposes. In a
very
real sense, the problem is
not one of determining whether the
Rorschach is valid, but of
differenti-
ating
the conditions under which it is
useful from those under
which it is not. For many
years, a
procedure
involving interpretation of a Rorschach
with almost no other information
about the patient
was
used to assess Rorschach
validity
Utility
of Rorschach: The
debate over the utility of the
Rorschach in clinical assessment
continues.
Rorschach
is useful when the focus is on the
unconscious functioning and
problem-solving styles of
individuals.
However, critics remain
skeptical of the clinical utility of
Rorschach scores or
their
incremental
validity.
Rorschach
Inkblot "Method." Recently,
Weiner 11994) has argued
that the Rorschach is best
con-
ceptualized
as a method
of
data collection, not a test.
The Rorschach is not a test
because it does not
test
anything.
A test is intended to measure
whether something is present or
not and in what quantity. . .
.
But
with the Rorschach, which
has traditionally been
classified as a test of personality, we
do not
measure
whether people have a personality or
how much personality they
have.
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Several
implications follow. First,
Weiner argues that data
generated from the Rorschach
method can be
interpreted
from a variety of theoretical
positions. These data
suggest how the respondent
typically
solves
problems or makes decisions (cognitive
structuring processes) as well as the
meanings that are
assigned
to these perceptions (associational processes).
Weiner calls this an "integrationist"
view of the
Rorschach,
because the method provides data
relevant to both the structure and dynamics of
personality.
According
to Weiner, a second, practical
implication is that viewing the
Rorschach as a method allows
one
to fully use all aspects of
the data that are generated,
resulting in a more thorough
diagnostic
evaluation.
The
influence and utility of this
reconceptualization remains to be seen.
In any case, empirical
data
supporting
the utility and incremental validity of
data generated by the Rorschach
"method" are still
necessary
before its routine use in
clinical settings can be
advocated.
THEMATIC
APPERCEPTION TEST
The
Thematic Apperception Test
(TAT) was introduced by
Morgan and Murray in 1935. It
purports to
reveal
patients' basic personality
characteristics through the
interpretation of their
imaginative
productions
in response to a series of pictures.
Although the test is designed to reveal
central conflicts,
attitudes,
goals, and repressed material, it
actually produces material
that is a collage of these
plus
situational
influences, cultural stereotypes,
trivia, and so on.
Most
clinicians use the TAT as a method of
inferring psychological needs
(achievement, affiliation,
dependency,
power, sex, and so on) and of
disclosing how the patient interacts
with the environment.
TAT
is used to infer the content of
personality and the mode of social
interactions. With a TAT,
clinicians
are likely to make specific
judgments, such as "This patient is
hostile toward authority
figures,
yet
seeks their affection and
approval." The TAT is less
likely to be used to assess the
degree of
maladjustment
than to reveal the locus of problems, the nature of
needs, or the quality of
interpersonal
relationships
Description:
There
are 31 TAT cards (one is a
blank card); most depict
people in a variety of
situations,
but
a few contain only objects.
Some are said to be useful
for boys and men, some for
girls and women,
and
some for both genders.
Murray suggested that 20 of the 31
cards be selected for a
given examinee.
As
a test, the TAT does not
appear to be as ambiguous or unstructured as the
Rorschach. However,
though
the figures in the pictures may clearly
be people, it is not always clear
what their gender is,
exactly
who they are, what
they are doing, or what
they are thinking.
Administration:
In
practice, clinicians typically select
somewhere between 6 and 12 cards
for ad-
ministration
to a given patient. Although the exact
instructions used will vary
from clinician to
clinician,
they
go something like this: "Now, I
want you to make up a story
about each of these pictures.
Tell me
who
the people are, what they
are doing, what they
are thinking or feeling,
what led up to the scene,
and
how
it will turn out. OK?
The patient's productions
are transcribed by the clinician. In some
instances,
patients
may be asked to write out
their stories, but this
can result in shorter than
normal stories.
Scoring:
Several
scoring systems have been developed
for the TAT, for example, rate
each story on
several
scoring categories, including unconscious structure
and drives of the subject, relationship to
the
others,
significant conflicts, defenses
used, and ego strength.
Another scoring system for TAT
was
designed
to assess object relations,
that is, respondent's mental representations of
people, of other
people.
Four dimensions of object relations were
assesses; complexity of representation of
people,
affect-tone
of relationships, capacity for
emotional investment in relationships and
moral standards, and
understanding.
Reliability
and Validity: It is very
difficult to evaluate the reliability and
validity of the TAT in any
formal
sense. There are so many
variations in instructions, methods of
administration, number of cards
used,
and type of scoring scheme
(if any) that hard conclusions
are virtually impossible.
The same
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methodological
issues arise when studying
reliability. For example,
personality changes may
obscure
any
conclusions about test-retest
reliability, or there may be uncertainty
about equivalent forms
when
trying
to assess alternate-forms reliability. It
is possible to investigate theme
reliability, but since
one
cannot
expect word-for-word similarity from one
occasion next, one is usually
studying the reliability of
judges'
interpretations. When there is an
explicit, theoretically derived
set of scoring instructions
interjudge
agreement can reach
acceptable proportions. Interjudge
reliability can also be achieved
when
quantitative
ratings are involved .But
broad, global interpretations
can present problems.
Some
attempts have been made to establish the
validity of the TAT. Methods have
included
(1)
Comparison of TAT interpretations with
case data or with therapist
evaluations of the patient;
(2)
Matching techniques and analyses of
protocols with no additional
knowledge about the
patient;
(3)
Comparisons between clinical diagnoses
derived from the TAT and psychiatrists'
judgments; and
(4)
Establishment of the validity of certain general
principles of interpretation (for
example, the
tendency
of the person to identify with the
hero of the story, or the probability
that unusual themes
are
more
significant than common
ones).
The
typical clinical use of the TAT
suggests that it remains
basically a subjective instrument.
Although
it
is possible to identify general principles of
interpretation, these can
serve only as guides--not as
exact
prescriptions
for interpretation. Adequate
interpretation depends upon
some knowledge of the
patient's
background.
As the clinician examines the test
protocol, attention must be
paid to the frequency
with
which
thematic elements occur, the
unusualness of stories, the manner in
which plots are
developed,
misrecognitions,
the choice of words, identifications with
plot characters, and so on.
The clinician will
want
to look closely at the nature of the TAT
heroes or heroines and at their needs and
goals. The
environmental
presses are also important,
as is the general emotional ambiance of the
themes.
SENTENCE
COMPLETION TECHNIQUES
A
very durable and serviceable, yet
simple, technique is the sentence
completion method. The
most
widely
used and best-known of the many versions
is the Rotter
Incomplete Sentences Blank.
The
Incomplete
Sentences Blank (/SB)
consists of 40 sentence stems--for
example, "I like . . . ."
"What
annoys
me? ..." I wish . . . and
"Most girls . . . ." Each of the
completions can be scored
along a 7-point
scale
to provide a general index of
adjustment-maladjustment. The ISB has
great versatility, and scoring
schemes
for a variety of variables have
been developed.
The
ISB has several advantages.
The scoring is objective and reliable,
due in part to extensive scoring
examples
provided in the manual. The
ISB can be used easily
and economically, and it appears to be
a
good
screening device. Although it can be
scored objectively, it also
allows considerable freedom of
response.
Thus the ISB falls somewhere between the
two extremes of the
objective-projective
dimensions.
It represents a fairly direct approach to
measurement that does not
require the degree of
training
that is necessary, to example, to
score the Rorschach. Some
clinicians may be disturbed by
the
[SB's
relative lack of disguise. Perhaps
because of this, the ISB
does not typically provide
information
that
could not be gleaned from a reasonably
extensive interview. In many ways,
then, the ISB provides
a
cognitive
and behavioral picture of the patient
rather than a "deep, psychodynamic"
picture.
WORD-ASSOCIATION
TECHNIQUE
The
word association technique was devised by
Carl Gustav Jung, who
presented stimulus words to
patients
and had them respond with the first
word that came to mind.
After the initial administration
of
the
list, some clinicians repeat
the list, asking the patient to
respond with some words that
he/she used
previously
discrepancies between the two
administrations may reveal associational
difficulties.
Complex
indicators include long
reaction times, blocking difficulties in
making responses, unusual
responses,
repetition of the stimulus words,
appearance Misunderstanding of the word,
clang
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association,
preservation of earlier responses, and
ideas or unusual mannerism of
movements
accompanying
the responses. Because it is easily
qualified, the test has
continued to be used as a
research
instrument, although its
popularity has diminished
greatly over the
years.
ADVANTAGES
OF PROJECTIVE TECHNIQUES
First
advantage is the amount, richness and
accuracy of information that is
collected. Another advantage
is
that a variety of projective techniques
are frequently used in the
context of individual interviews
or
conventional
focus group discussions (breaking the
ice). Projective techniques also
help to open
discussions
around socially sensitive issues, where
the client may be
embarrassed, or feel a lake
of
knowledge.
These techniques are also
useful in encouraging in subjects a
state of freedom and
spontaneity
of expression, where they may hesitate to
express their opinion
directly for fear of
disapproval
or when they find them
threatening for some other
reasons.
DISADVANTAGES
Primary
disadvantage is the complexity
of data and the
corresponding skills required of the
researcher.
Interpreters
need to be very trained and
skilled. They are expensive
to administer because highly
trained
staff
is needed to be employed.
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