Irving B Weiner. European Journal of Psychological Assessment. Volume 15, Issue 1. 1999.
In the last 20 years the advent of the Comprehensive System has developed the Rorschach Inkblot Method (RIM) into a standardized and psychometrically sound personality assessment instrument with numerous indices that can be reliably coded, show considerable test-retest stability, and have abundant valid corollaries. Rorschach assessment has demonstrated utility in contributing to clinical diagnosis of psychopathology, providing guidelines for treatment planning and outcome evaluation, and identifying adaptive and maladaptive features of how people attend to their experience, use ideation, modulate affect, manage stress, view themselves, and relate to others. The RIM can also be effectively integrated with more structured self-report inventories in a complementary way that describes personality functioning in greater depth than would otherwise be possible. The RIM remains at present a widely used and extensively researched measure in many parts of the world. Although the inkblot method is essentially a culture-free instrument with universal applicability, further research is needed to establish cross-cultural normative data concerning its variables.
Hermann Rorschach was both a conscientious scholar and a sensitive clinician, and he developed an assessment method that measures personality characteristics common to all people and taps as well the unique personality qualities of each individual (Rorschach, 1921/1942). Unfortunately, Rorschach died in 1922, just one year after publishing his monograph on the inkblot method, leaving his test incomplete and its potential unrealized. Over the next 50 years, assessment psychologists of various persuasions elaborated and extended Rorschach’s ideas, giving rise to disparate schools of Rorschach methodology and countless individual variations in Rorschach technique. As a result, the systematic objectivity envisioned by Rorschach fell by the wayside. The Rorschach Inkblot Method (RIM) flourished as a rich and often helpful source of information in the individual case, especially in the hands of astute clinicians, but Rorschach assessment became a chaotic field of endeavor with little claim to scientific status.
Since the early 1970s, however, with the advent of the Rorschach Comprehensive System (Exner, 1991, 1993; Exner & Weiner, 1995; Weiner, 1998a), Rorschach assessment has evolved into a carefully standardized and scientifically respectable procedure that demonstrates good reliability, abundant valid corollaries, and considerable practical utility. These advances in Rorschach methodology have been accomplished without sacrificing the capacity of the instrument to identify uniquely experienced as well as commonly shared aspects of personality functioning has been sacrificed (see Weiner, 1998b). The present review addresses the current state of the Rorschach art with respect to the scientific and professional status of the instrument, the practical applications that demonstrate the utility of Rorschach assessment, and the benefits that derive in clinical practice from integrating Rorschach findings with data from other kinds of personality tests.
Scientific and Professional Status of the RIM
The current scientific and professional status of the RIM are defined by (a) the manner in which Rorschach methodology has been standardized by the Comprehensive System; (b) the psychometric foundations of Rorschach assessment when conducted according to the Comprehensive System; (c) present and future directions of research involving the RIM; and (d) facts and attitudes concerning the use and teaching of Rorschach assessment.
During the decades of Rorschach chaos prior to the advent of the Comprehensive System, there were almost as many different Rorschach tests as there were examiners administering and coding the instrument. To end this chaos, Exner (1993, chap. 3) prescribed an invariant set of instructions to be used in all Rorschach administrations. Strict adherence to these instructions ensures that Rorschach data are obtained in the same manner from all respondents and creates possibilities for cumulating Rorschach results for research purposes.
Exner (1993, chaps. 4-10) also formulated detailed guidelines for coding individual Rorschach responses and combining these codes into various percentages, ratios, and indices. To promote reliable coding, the Comprehensive System was limited to response codes that could show an interrater agreement of at least 80%. Numerous studies have demonstrated that examiners with minimal training can in fact achieve greater than 90% agreement for most of the variables in the Comprehensive System and better than 85% agreement for almost all of them (McDowell & Acklin, 1996; Meyer, 1997a; Weiner, 1997).
The standardization of Rorschach methodology by the Comprehensive System included the compilation of extensive normative data. For each of its codes and summary scores there are descriptive statistics based on a sample of 700 nonpatient adults, age 19 to 70, who are roughly representative of the United States population with respect to education, marital status, race, socioeconomic level, and place of residence. Reference data are also available for 1,390 nonpatient young people age 5 to 16 and for four groups of adult psychiatric patients, including 320 schizophrenic inpatients, 315 depressed inpatients, 440 psychiatric outpatients, and 180 patients with diagnosed character disorder (Exner, 1993, chap. 12).
Although the Comprehensive System normative data are derived from a United States sample, there is good reason to believe that general principles of Rorschach interpretation are universally applicable and only slightly affected by cross-cultural differences (Butcher, Nezami, & Exner, 1998; Weiner, 1996; 1998b, chap. 2). Large-scale normative studies of Rorschach variables underway in many parts of the world have begun to confirm these expectations, while also identifying some adjustments in coding criteria that might be required in certain countries (see, e. g., Mattlar & Fried, 1993; Miralles Sangro, 1997; Pires, 1996). As matters now stand, the size and diversity of the existing normative and reference samples provide more standardization information than is available for most psychological assessment measures and, at a minimum, establish the RIM as adequately normed for a U. S. population.
Anastasi and Urbina (1997, chaps. 3-6) identify four questions to be asked in judging whether a test is psychometrically sound. First, can trained examiners agree reasonably well in their scoring of the test? Second, are there adequate normative data for the test to allow comparisons of individuals to appropriate reference groups? Third, do estimates of the test’s reliability indicate that it provides reasonably accurate information, that is, do the scores it yields minimize error variance and closely approximate actual or true scores? And fourth, does the test have demonstrated corollaries that identify purposes for which its scores are reasonably valid? In response to the first two questions, the standardization of the RIM as just noted has established good interrater agreement in the coding of responses and a substantial normative base for reference purposes. Concerning the second two questions, research findings have documented as well that Rorschach assessment using the Comprehensive System yields reliable data that prove valid for numerous purposes.
The reliability of Rorschach Comprehensive System has been demonstrated in a series of retest studies with both children and adults over intervals ranging from 7 days to 3 years (Exner & Weiner, 1995, pp. 21-27). Almost all of the variables coded in the system that relate to trait characteristics of individuals have shown substantial short-term and long-term stability in adults. Most of these variables demonstrate stability coefficients above 0.75, and some (e. g., the Affective Ratio and the Egocentricity Index) approach 0.90. The only variables showing low retest correlations in studies of adults are Inanimate Movement (m) and Diffuse Shading (Y), both of which are conceptualized as indices of situational distress. Among children, 3-week retest studies identify stability coefficients similar to those found in adults. However, as would be expected from the evolving nature of personality during the developmental years, nonpatient young people do not begin to show much Rorschach stability over a 2-year period until they reach age 14 (Exner, Thomas, & Mason, 1985).
As noted by McCann (1998), the substantial stability coefficients demonstrated by Rorschach indices of trait variables provide further evidence of the reliability of coding within the Comprehensive System. These large stability coefficients could not have been achieved in the absence of good interrater agreement among the many persons who participated in coding these records. Moreover, both the increasing stability of trait variables over time among developing children and the low retest correlations of the state variables m and Y speak to the validity of these indices as measures of psychological maturation and either trait or state aspects of personality functioning (see Weiner, 1996b).
With further respect to its validity, the RIM yields numerous summary scores and, like other multi-faceted instruments, can be described as more or less valid only in relation to the criterion or construct validity demonstrated by these individual scores. In addition to yielding stability coefficients that accurately reflect maturational changes and that differentiate trait from state characteristics, Rorschach indices have in fact been demonstrated to provide valid descriptions of many other aspects of personality functioning. These include numerous aspects of how people attend to their experience, use ideation, modulate affect, manage stress, view themselves, and relate to other people (see Exner, 1993, chaps. 16-19; Weiner, 1998b, chap. 5). Also of note are successful efforts to validate Rorschach scales measuring such specific personality dimensions as dependency (Bornstein, 1996), ego strength (Perry & Viglione, 1991; Perry, Viglione, & Braff, 1992), defense mechanism preferences (Cooper, Perry, & Arnow, 1988), and quality of object relatedness (Stricker & Healey, 1990).
Other research has demonstrated the validity of specific Rorschach indices in facilitating differential diagnosis and treatment planning. With respect to differential diagnosis, certain patterns of Rorschach findings, when appropriately formulated, show significant correlations with independently diagnosed schizophrenia, mood disorder, and antisocial personality (Exner & Weiner, 1995, chaps. 5-6; Gacono & Meloy, 1994; Ganellen, 1996a, b; Hilsenroth, Fowler, & Padawer, 1998). Longitudinal studies of patients in psychotherapy indicate that pretreatment Rorschach data, when correctly applied, can predict the likelihood of patients remaining in and benefiting from treatment; moreover, retesting during the course of psychotherapy has confirmed that selected Rorschach variables accurately monitor change and improvement during the course of treatment (Abraham, Lepisto, Lewis, Schultz, & Finkelberg, 1994; Blatt & Ford, 1994; Colson, Eyman, & Coyne, 1994; Exner & Andronikof-Sanglade, 1992; Hilsenroth, Handler, Toman, & Padawer, 1995; Meyer & Handler, 1997; Weiner & Exner, 1991).
The scientific status of the RIM has been attested over the years by a steady and substantial volume of published research concerning the nature and utility of the instrument. In the 1970s Reynolds and Sundberg (1976) reported that the RIM and the MMPI were the two most extensively researched personality assessment instruments, and Buros’ (1974) Mental Measurements Yearbook identified 4,580 Rorschach references through 1971, with an average yearly rate of 92 references. In the 1990s Butcher and Rouse (1996) found an almost identical trend continuing from 1974 to 1994: An average of 95.8 Rorschach research articles appeared annually during this 20-year period, and the RIM was second only to the MMPI among personality assessment measures in the volume of research it generated.
As noteworthy as the Butcher and Rouse literature search may be, however, it was limited to journals published in the United States. There exists outside of the United States a flourishing international community of Rorschach scholars and practitioners whose research is also making important contributions to knowledge of the instrument. Some of this research appears in such international English-language publications as Rorschachiana: Yearbook of the International Rorschach Society and the European Journal of Psychological Assessment. Rorschach research is presently being published in many other languages as well, including Finnish, French, German, Italian, Japanese, Portuguese, Russian, Spanish, Swedish, among others. As a contemporary development of note in this regard, recently organized regional alliances like the European Rorschach Association (ERA) and the Latin American Rorschach Association (ALAR) are engaged in promoting multinational collaboration in various research projects.
The steady volume of Rorschach research in the United States and elsewhere in the world has been accompanied over the last 20 years by substantial advances in research design. Aided by the Comprehensive System standardization of Rorschach methods, researchers have become increasingly sophisticated in applying basic principles of research methodology to their planning and execution of Rorschach studies. This increased methodological sophistication has enhanced both the reliability of Rorschach research findings (i. e., how accurate they are likely to be) and the validity of these findings (i. e., how strongly they support generalized conclusions based on them). Recent literature includes detailed guidelines to assist Rorschach researchers in employing sound methodology in their study designs (see Exner, 1995; Weiner, 1995a).
Looking ahead, three directions will merit special attention in future Rorschach research. First, despite the essentially cultural-free nature of the RIM and its universal applicability, continued work is needed to establish cross-cultural normative data concerning its variables. There may be cross-cultural variations that require adjusted coding of three variables for which the coding criteria depend on normative frequency of occurrence—Popular responses (P), Common Detail responses (D), and Ordinary Form responses (FQo). Only large-scale data collection can provide adequate basis for specifying whether and how coding adjustments for these variables should be made for which groups of people. There may also be national or ethnic differences in certain normative personality characteristics that influence whether these characteristics are more or less adaptive within a particular subculture. Only after sufficient normative data have been obtained from a subcultural group it can be determined whether such differences exist.
Second, additional longitudinal research is needed to enhance the utility of Rorschach assessment in relation to the onset and course of psychological disorders. Little is presently known about the types of Rorschach responses people give in the premorbid or early stages of some condition (e. g., schizophrenia), before they become overtly or diagnosably disturbed, or when they are on the verge of behaving in ways that will be harmful to themselves or others (e. g., becoming drug dependent or violently aggressive). Little is similarly known about the Rorschach patterns of people who are recovering from an episode of psychological disorder or gaining control over addictive or aggressive tendencies. New empirical data in these areas would facilitate early identification and preventive intervention for people with emerging disorders or behavior problems and would also expand our knowledge of the natural course of untreated psychopathology and of personality change and treatment progress in disturbed persons who receive care.
The third future direction for Rorschach research involves refinements in the interpretation of relationships among variables. For example, respondents who give more than 50% pure F, and thereby have a Lambda > 0.99, have long been known to demonstrate a narrow frame of reference and a preference for economical, overly simplified approaches to dealing with their experience. However, recent research suggests additionally that these implications of an elevated Lambda vary in relation to record length. Specifically, Lambda > 0.99 in a record with fewer than 20 responses appears to indicate situational guardedness and a likelihood that the protocol, even if valid, will not be particularly revealing. By contrast, an elevated Lambda with R > 20 usually signifies a persistent personality style based on narrowness and simplification, and such a record reveals just about as much as about an individual as there is to see (see Exner, 1993, chap. 17; Weiner, 1998b, chap. 5).
A further example of interrelationships among variables concerns the implications of the Affective Ratio (the percentage of responses given to the last three cards) for receptivity to emotional stimulation and affective interchange. Traditionally, an Affective Ratio < 0.50 has been considered indicative of emotional withdrawal. However, the normative range for the Affective Ratio has been found to run lower among persons with an introversive EB style, who generally prefer ideational modes of dealing with experience, than among those with an extratensive EB style, whose preference runs to expressive modes. Hence introversive and extratensive persons probably differ in the point at which a low Affective Ratio becomes maladaptive for them, and a cutting score of 0.40 may be more appropriate for introversives than 0.50. Findings of this type have led Exner (1993, chap. 12) to publish separate normative data for high Lambda and EB style groups, whose basic personality orientation may point to refinements in the interpretive significance of numerous other variables as well. Future studies along these lines, aimed at increased understanding of how the processes underlying different Rorschach variables influence each other, will hold promise for broadening the scope and increasing the accuracy of inferences based on Rorschach findings.
The professional status of the RIM is reflected primarily in the frequency with which it is used. Repeated surveys of psychological test usage from 1961 to 1989 consistently found Rorschach assessment being utilized in more than 80% of responding mental health agencies in the United States (Lubin, Larsen, & Matarazzo, 1984; Lubin, Wallis, & Paine, 1971; Piotrowski & Keller, 1989; Sundberg, 1961). More recently, Watkins, Campbell, Nieberding, and Hallmark (1995) published a survey in which 82% of 412 clinical psychologists engaged in providing assessment services reported using the RIM in their work. Current findings indicate that Rorschach assessment has also gained an established place in forensic practice. Surveys have found the RIM being used in 32% of criminal responsibility evaluations, 30% of evaluations of competency to stand trial, and 48% of evaluations of adults involved in custody disputes (Ackerman & Ackerman, 1997; Borum & Grisso, 1995). There is additional evidence that Rorschach findings are regularly considered admissible into evidence in courtroom proceedings, are rarely challenged as to their relevance, and are given legal weight in appellate courts in the United States (McCann, 1998; Meloy, Hansen, & Weiner, 1997; Weiner, Exner, & Sciara, 1996). Like Rorschach research, moreover, Rorschach assessment is an international affair involving widespread teaching and use of the instrument in many countries other than the United States. Noteworthy in this regard is the roster of the International Rorschach Society, which presently includes over 2,400 members from 23 different countries. Also of note is a recent survey of test use in Spain, Portugal, and Latin American countries by Muniz, Prieto, and Almeida (1998), in which the Rorschach emerged as the third most widely used instrument, following the Wechsler scales and the Minnesota Multiphasic Personality Inventory.
Despite the information presented here concerning the scientific and professional status of the RIM, not all psychologists look favorably on the instrument. Particularly in academic circles around the world, there are some who remain unconvinced of the psychometric soundness of the instrument and argue against its being taught or studied in university programs. The present communication is not the place to review and refute these arguments (but see McCann, 1998; Meyer, 1996a; Weiner, 1997). Let it be said, however, that intractable Rorschach critics often appear immune to persuasion by the continuing accumulation of research data confirming the scientific merit of the instrument, and they often seem unacquainted with the practical utility of Rorschach findings, which would not exist if it were an unreliable or invalid instrument.
Practical Applications: The Utility of Rorschach Assessment
Rorschach data provide clinically sensitive and scientifically sound information about personality functioning. The RIM accordingly contributes to understanding and predicting any pattern of behavior that is determined in substantial part by personality processes. This utility of Rorschach assessment can be elucidated by indicating briefly why the RIM is useful and what practical purposes it can serve.
Why Rorschach Assessment Is Useful
Rorschach testing proves useful because four basic features of the instrument combine to generate a comprehensive assessment of diverse aspects of personality functioning. First, the delivery of Rorschach responses requires some perceptual-cognitive structuring of the inkblots, in order for respondents to indicate where they are seeing something and why it looks as it does. How people go about this process of focusing their attention and drawing inferences from the stimulus characteristics of the inkblots, as coded in structural variables, indicates a good deal about how they generally perceive, organize, and modulate their experience.
Second, Rorschach responses involve an associational process in which the inkblots serve as a stimulus to a respondent’s fantasy. The thematic imagery with which people consequently embellish their responses provides clues to their underlying needs, attitudes, conflicts, and concerns. By tapping aspects of personality functioning that lie outside of conscious awareness and are rarely identified by diagnostic interviews or self-report instruments, the RIM can make unique contributions to comprehensive personality evaluation.
Third, Rorschach administration is an interpersonal interaction in which a respondent’s test-taking attitudes and manner of relating to the examiner indicate a good deal about how the person generally behaves in problem-solving and social situations. Fourth, the Rorschach response process comprises a sequence of responses involving various kinds of cognitive-perceptual structuring, thematic imagery, and test behaviors. Response sequences accordingly provide clues to sources of distress in a respondent’s experience, the nature of the impact of this distress on the person’s functioning, and the type and effectiveness of the defenses or coping efforts this individual employs to overcome and recover from experienced distress. One or the other of these four features of Rorschach data—structure, thematic imagery, test behavior, and sequence—may at times be emphasized in the interpretive process. However, contemporary developments in Rorschach interpretation stress basing inferences on an integrated analysis of all four sources of information (see Weiner, 1998b).
The Purposes Rorschach Assessment Serves
The sensitivity and accuracy of the RIM as a measure of personality processes makes it useful for a variety of purposes for which research has demonstrated its validity. An illustrative but by no means complete list of such purposes includes clinical diagnosis, treatment planning and outcome evaluation, and identification of personality strengths and weaknesses.
With respect to clinical diagnosis, the RIM is better conceived as a personality assessment instrument than as a diagnostic test, and there are few isomorphic relationships between Rorschach variables and conventional diagnostic categories. Nevertheless, elevations in the Schizophrenia Index (SCZI) and the Depression Index (DEPI) are highly likely to identify the presence of schizophrenia-spectrum or affective disorders, respectively, primarily because these indices measure personality characteristics that are associated with these conditions. Specifically, SCZI provides sensitive indices of the disordered thinking and impaired reality testing associated with schizophrenic disorder, and DEPI comprises reliable clued to the dysphoric affect and negative cognitions associated with depression. Proceeding in similar fashion with information about personality characteristics associated with other conditions, Rorschach examiners can use the inkblot method effectively as one aspect of judging whether one of these conditions is present.
In treatment planning and outcome evaluation, personality characteristics identified by Rorschach data can contribute to selecting appropriate treatment modalities, identifying treatment targets and obstacles to progress, and monitoring change and improvement over time. As elaborated by Weiner (1994, 1997), for example, patients identified by the Rorschach as being relatively ideational (i. e., introversive) appear more likely to drop out of behavioral therapy than those who are more action-oriented (i. e., extratensive). Deviations from normative expectation on indices of good adjustment assist in specifying the goals of therapy, and the relative magnitude of these deviations can help to establish priorities among these treatment goals. Thus a patient with a dramatically low Affective Ratio and a slightly low frequency of Popular responses needs help to become more comfortable with feelings and more cognizant of conventional reality, with emotional withdrawal being the more pressing problem.
Some maladaptive tendencies constitute distinct obstacles to progress in psychological treatment. In particular, people who are rigid or set in their ways, who are satisfied with themselves and free from subjectively felt distress, who are disinclined to be introspective, and who are averse to close and trusting interpersonal relationships are likely to have difficulty becoming engaged and participating effectively in most forms of psychotherapy. Each of these potential obstacles to progress has valid corollaries in Rorschach indices of personality functioning that can be identified to good effect prior to beginning treatment. Once treatment is underway, the capacity of the RIM to identify needs for change and corresponding treatment targets makes it suitable for follow-up assessment of a patient’s progress, readiness for termination, and eventual benefit received.
As for identifying personality strengths and weaknesses, the RIM as already noted yields reliable information concerning adaptive and maladaptive features of how respondents attend to their experience, use ideation, modulate affect, manage stress, view themselves, and relate to others. Aside from contributing to differential diagnosis and treatment planning in clinical practice, this Rorschach information can be usefully applied in any decision-making situation in which personality characteristics make a difference. In forensic cases, for example, assessment of criminal responsibility addresses psychotic impairment of reality testing; estimates of violence potential take account of evidence of anger and impulsivity; and judgments concerning parental suitability depend in part on capacities for nurturance and attachment to others. In personnel selection, as another example, managerial and executive potential is gauged in part by such qualities as organizational ability, productivity, flexibility, and assertiveness. Rorschach data provide valid indices of each of these personality characteristics, as well as many others that may have implications for finding helpful answers to practical questions.
Integrating Test Data: Advantages of Conjoint Assessment
Conjoint assessment refers in the present context to integrating data obtained with the RIM, which is a relatively unstructured instrument, with results obtained with relatively structured self-report inventories like the MMPI-2. Weiner (1995b) has addressed this matter previously in terms of three ways in which tests can be used together in a battery: additive, confirmatory, and complementary.
Additive Use of Tests
Additive use of tests involves a battery in which instruments that measure different aspects of psychological functioning help assessors describe a respondent’s characteristics broadly. For example, conjoint administration of a personality test, an intelligence test, and an academic skills test can contribute to a comprehensive assessment of a school learning problem. When tests are used additively in psychological assessment, each contributes a particular and unique kind of information. Such additive testing can also consist of using two or more personality assessment instruments that measure dimensions of personality functioning from different perspectives. For example, there is evidence to suggest that relatively unstructured instruments like the RIM are more helpful than self-report inventories in identifying an individual’s underlying traits or dispositions and predicting long-term behavioral tendencies; relatively structured instruments, on the other hand, usually prove more accurate than projective tests in identifying a person’s current manifest symptoms of disorder and predicting short-term behavioral tendencies (see Bornstein, 1995; Bornstein, Rossner, Hill, & Stepanian, 1994; Masling, 1997; McClelland, Koestner, & Weinberger, 1989).
Confirmatory Use of Tests
Confirmatory use of tests involves a battery in which instruments that measure similar aspects of psychological functioning converge to help assessors describe a respondent’s characteristics conclusively. Thus, an elevated Schizophrenia Index (SCZI) on the Rorschach and a spike Scale 8 (Sc) with an elevated Bizarre Mentation Scale (BIZ) on the MMPI-2 may make it more likely that a respondent has a schizophrenic disorder than either of these findings by itself.
Some researchers argue that purely confirmatory use of two assessment instruments constitutes poor practice and unnecessary testing. Unless conjoint testing increases the percentage of respondents who would be correctly identified in the present example as being schizophrenic or not, this argument runs, one of the instruments is providing all of the necessary information and the other one, by virtue of not improving the accuracy of diagnostic inference, lacks incremental validity. Which of the two measures in such a scenario is considered informative and which to be lacking in incremental validity tends to depend on which is the personal favorite of the researcher drawing this conclusion.
However this may be, research oriented concerns about incremental validity bear little relationship to the needs, concerns, and obligations of applied psychological assessors. In the first place, having confirmation from multiple measures lends certainty to the conclusions that clinicians draw from their assessment data and communicate to others. Psychologists reporting at a case conference or testifying in court that a person they evaluated probably has a schizophrenic disorder can make a more compelling case for their impression when they can say that both Rorschach and MMPI-2 findings point in this direction than when they are basing their conclusion on just a single measure. Secondly, whether or not different measures of similar phenomena will be confirmatory in the individual case cannot be determined in advance of actually administering the measures. As experienced practitioners know, different measures of the same personality characteristics do in fact converge in some cases but at other times appear to suggest contrary conclusions. Such divergence provides the basis for the complementary use of two or more tests in conjoint assessment.
Complementary Use of Tests
Complementary use of tests involves a divergence among instruments measuring similar aspects of personality functioning, as a result of which assessors can describe respondents’ characteristics in greater depth than would otherwise be possible. Consider, for example, two circumstances familiar to most examiners. In one, various Rorschach indices suggest significant psychological difficulties in a person whose MMPI-2 validity, clinical, and content scales fall within normal limits; in the other circumstance, respondents give a markedly abnormal MMPI-2 while producing a Rorschach protocol that contains little evidence of adjustment problems.
An older and regrettably still influential view interprets such divergence to signify that one or both of these instruments are invalid, at least in this instance, as a measure of psychological adjustment. As a corrective to this view of divergence, contemporary perspectives identify the Rorschach and MMPI-2 as vastly different instruments with respect to the level of conscious awareness at which they tap personality characteristics, the extent to which they are susceptible to impression management, and the aspects of adjustment they measure most accurately. Clinically, in fact, psychologists can learn as much or more about a person they are examining when Rorschach and MMPI-2 findings diverge in certain respects than when they are convergent (see Finn, 1996; Ganellen, 1996b; Meyer, 1996b, 1997b; Weiner, 1993).
For example, respondents who appear disturbed on the RIM but reasonably well adjusted on the MMPI-2 may be people who have particular difficulty coping with unstructured situations but can maintain adequate psychological functioning in relatively well-structured situations that leave little doubt concerning what is expected of them. They may have significant underlying disturbance of which they have limited awareness and can therefore not indicate on a self-report measure comprised of numerous face valid items. They may be hesitant to report the full extent of their adjustment difficulties on an instrument in which obvious items carry considerable weight. As inferred from this RIM/MMPI-2 discrepancy, limited self-awareness, unwillingness to disclose, and an adjustment that crumbles in the absence of structure all have important implications for differential diagnosis and treatment planning.
What about the respondent who looks disturbed on the MMPI-2 but reasonably well adjusted on the RIM? Such persons may have needs to appear more distressed than they actually are, as a cry for help or for purposes of exaggeration, or may have more difficulty revealing their problems in an interpersonal interaction (of which a Rorschach examination is one) than in the relatively impersonal situation of responding to a self-report questionnaire. These inferences also speak to the clinical utility of a balanced assessment battery in which Rorschach findings are integrated with the results of more structured, self-report inventories. In the absence of such conjoint assessment, and specifically without complementary utilization of Rorschach findings, superficially well-adjusted, self-unaware, and nondisclosing respondents, together with those who are effectively exaggerating their psychological difficulties, may be difficult to evaluate adequately with the MMPI-2 alone.
Although Rorschach evaluation has been practiced for over 75 years, only since the advent of the Comprehensive System has the Rorschach Inkblot Method (RIM) evolved into a carefully standardized and scientifically respectable instrument with good reliability, abundant valid corollaries, and considerable practical utility. The numerous areas of application described in the preceding paragraphs, and the special richness of the RIM when used in combination with self-report inventories to paint three-dimensional pictures of personality strengths and weaknesses, offer promise for its continued development and future contributions to sophisticated psychological assessment.