Measuring Implicit Motives with the Picture Story Exercise (PSE): Databases of Expert-Coded German Stories, Pictures, and Updated Picture Norms.

We present two openly accessible databases related to the assessment of implicit motives using Picture Story Exercises (PSEs): (a) A database of 183,415 German sentences, nested in 26,389 stories provided by 4,570 participants, which have been coded by experts using Winter's coding system for the implicit affiliation/intimacy, achievement, and power motives, and (b) a database of 54 classic and new pictures which have been used as PSE stimuli. Updated picture norms are provided which can be used to select appropriate pictures for PSE applications. Based on an analysis of the relations between raw motive scores, word count, and sentence count, we give recommendations on how to control motive scores for story length, and validate the recommendation with a meta-analysis on gender differences in the implicit affiliation motive that replicates existing findings. We discuss to what extent the guiding principles of the story length correction can be generalized to other content coding systems for narrative material. Several potential applications of the databases are discussed, including (un)supervised machine learning of text content, psychometrics, and better reproducibility of PSE research.

Postgraduate Assessment Approaches Across Surgical Specialties: A Systematic Review of the Published Evidence.

PURPOSE: Ensuring competence for surgical trainees requires holistic assessment of the qualities and competencies necessary to practice safely and effectively. To determine the next steps toward achieving this aim, the authors conducted a systematic review to summarize and appraise the available evidence related to any assessment approach to postgraduate surgical training and to identify the dominant themes for assessment approaches across different specialties or countries. METHOD: Medline and Embase were searched on January 10, 2019, without language or time restrictions. Any peer-reviewed study that described an assessment framework (in practice or novel) throughout postgraduate surgical training globally was included. An iterative review and thematic analysis were performed on full-text articles to determine assessment themes. Studies were then grouped by assessment themes. A tailored quality assessment of the studies included in the final analysis was conducted. Assessment themes and validity were compared across surgical specialties and countries. RESULTS: From an initial 7,059 articles, 91 studies (evaluating 6,563 surgical trainees) were included in the final analysis. Ten defined assessment themes were extracted. Ten studies (11.0%) were deemed low risk of bias based on the quality assessment tool used and thus were determined to be high quality. Minor differences in assessment themes were observed between specialties and countries. Assessment themes neglected by individual surgical specialties and assessment themes that need validated assessment tools were identified. CONCLUSIONS: This review highlights the low quality of evidence and fragmented efforts to develop and optimize surgical assessments. The minor differences observed demonstrate a common approach, globally and across specialties, related to surgical assessments. A paradigm shift in assessment approaches, which will require national and international collaboration, is required to optimize design and validation so that a comprehensive assessment of surgical competence can be implemented.

Low- and Middle-Income Country Host Perceptions of Short-Term Experiences in Global Health: A Systematic Review.

PURPOSE: Stakeholders have expressed concerns regarding the impact of visiting trainees and physicians from high-income countries (HICs) providing education and/or short-term clinical care in low- and middle-income countries (LMICs). This systematic review aimed to summarize LMIC host perceptions of visiting trainees and physicians from HICs during short-term experiences in global health (STEGH). METHOD: In September 2018 then again in August 2020, the authors searched 7 databases (PubMed, Embase, Scopus, Web of Science, ERIC, Cochrane Library, Global Index Medicus) for peer-reviewed studies that described LMIC host perceptions of STEGH. They extracted information pertaining to study design, participant demographics, participant perceptions, representation of LMICs and HICs, and HIC visitors' roles and used thematic synthesis to code the text, develop descriptive themes, and generate analytical themes. RESULTS: Of the 4,020 studies identified, 17 met the inclusion criteria. In total, the studies included 448 participants, of which 395 (88%) represented LMICs. The authors identified and organized 42 codes under 8 descriptive themes. They further organized these descriptive themes into 4 analytical themes related to STEGH: (1) sociocultural and contextual differences, (2) institutional and programmatic components, (3) impact on host institutions and individuals, and (4) visitor characteristics and conduct. CONCLUSIONS: STEGH can have both beneficial and detrimental effects on LMIC host institutions and individuals. The authors translated these findings into a set of evidence-based best practices for STEGH that provide specific guidance for LMIC and HIC stakeholders. Moving forward, LMIC and HIC institutions must work together to focus on the quality of their relationships and create conditions in which all stakeholders feel empowered to openly communicate to ensure equity and mutual benefit for all parties.

TAT: normas aperceptivas en pacientes institucionalizados con trastorno mental grave y prolongado / TAT: apperceptive norms in hospitalized patients with severe and prolonged mental disorders

El Test de Apercepción Temática (TAT) es un test proyectivo inventado en 1935. Repasamos su origen, fundamento y utilidad a través del uso que del test han realizado diversos autores a lo largo de su historia. Asimismo, revisamos sus aplicaciones más recientes y reflexionamos sobre sus posibilidades. Por último, replicamos el estudio del que se sirvió Saul Rosenzweig para establecer normas de apercepción temática que se disponen en población general. En el presente estudio, con una metodología más rigurosa que la descrita por Rosenzweig, sugerimos un patrón de respuesta al test en sujetos con trastorno mental grave (fundamentalmente, esquizofrenia) que podría emplearse en análisis actuales de las respuestas al test

The Thematic Apperception Test (TAT) is a projective test created in 1935. In this article, its origin, bases and the usefulness that has shown throughout its history are reviewed. In addition, we examine its more recent applications and reflect on its possibilities. Finally, we replicate the study conducted by Saul Rosenzweig in order to establish adult apperceptive norms in the general population. In this paper, with a more rigorous methodology than that of Rosenzweig, we suggest a response pattern in individuals with severe mental disorders (mostly, schizophrenia)

'When you are a data collector you must expect anything'. Barriers, boundaries and breakthroughs: insights from the South African data-collection experience.

The impact of the research process on the researcher is an emerging topic of interest. Data collection in most low- and middle-income countries (LMICs) is often the responsibility of community members who are identified and trained specifically for data collection. When research involves data on mental health and social well-being, data collectors may have specific competency needs and the task of data gathering may impact data collectors. This study aims to explore the experiences and needs of data collectors within South Africa using qualitative methods to examine the impact of data collection on data collectors. Nineteen data collectors, involved in face-to-face data collection, completed semi-structured interviews exploring their insights, attitudes and experiences. Thematic analysis revealed barriers and challenges associated with research, complexities regarding boundaries within the participant-data collector relationship and the benefits of being involved with research for the individual and the community. Numerous challenges and opportunities are outlined. Findings expose the beneficial and often overlooked contribution of data collectors and warrants key considerations in the planning and implementation of future research to ensure adequate support and standardization of practice.

Stimulus Characteristics in Picture Story Exercise Cards and Their Effects on the Social Cognition and Object Relations Scale-Global Rating Method.

This study examined the effects of stimulus characteristics from the Picture Story Exercise (PSE; Smith, 1992) on the quality of social cognition and object relational functions as expressed in narrative responses. A nonclinical sample of 140 adults told stories to five PSE cards. Three trained raters scored the narratives using the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein & Slavin-Mulford, 2018). Data were then analyzed to determine the extent to which different PSE cards elicited more pathological or more adaptive ratings on the 8 SCORS-G dimensions. Results showed that different cards produced reliable and significant differences in ratings on different SCORS-G dimensions. These results extend findings of previous research (Siefert et al., 2016; Stein et al., 2014) that used the SCORS-G with Thematic Apperception Test (Murray, 1943) cards to a unique and previously unexplored stimulus set. The implications of these findings on the use and interpretation of the PSE and SCORS-G are discussed.

Defense Mechanism Card Pull in TAT Stories.

This study investigates the question of whether different Thematic Apperception Test (TAT; Murray, 1943 ) cards are likely to prompt stories that are characterized by different defense mechanisms. This condition is known as card pull and refers to the probability that different TAT cards elicit different personality scores for the same variable. If so, the assessment of defense use would be importantly influenced by the TAT cards used in an assessment. TAT stories from 3 different community samples were examined (Ns = 91, 98, 121), using a statistical method developed by Stein et al ( 2014 ). The results indicated that different TAT cards pull for different defenses, as assessed by the Defense Mechanism Manual (DMM: Cramer, 1991b ). However, the nature of card pull was not always consistent across samples. These dissimilarities could be due to group differences, or to the presence of different TAT cards used in the test battery, indicating that card pull is importantly determined by context.

SCORS-G stimulus characteristics of select thematic apperception test cards.

There has been surprisingly little research into the stimulus properties of the Thematic Apperception Test Cards (TAT; Murray, 1943). This study used the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011 ; Westen, 1995 ) to explore the stimulus properties of select TAT cards in a clinical sample. The SCORS-G is a theoretically based and empirically validated measure of object relations that has widely been used in TAT research. A sample of 80 patients referred for psychological assessment at a large Northeastern hospital were administered the TAT (Cards 1, 2, 3BM, 4, 13MF, 12M, and 14) as part of their assessment battery. Trained raters scored the narratives using the SCORS-G. The SCORS-G ratings were analyzed to determine the nature and degree of object representation "pull" both across and within the TAT cards. The results showed that Cards 3BM and 13MF exhibited the greatest card pull for negative pathological object representations, and Card 2 displayed the highest card pull for adaptive and mature object representations. Both clinical and research related implications are discussed.

Differences of prefrontal cortex activity between picture-based personality tests: a near-infrared spectroscopy study.

This study reports on brain activity induced by picture-based personality tests. Near-infrared spectroscopy is a newly developed, noninvasive technology in neuroimaging that can measure brain activity through blood volume changes. We measure the prefrontal cortex (Brodmann Area 10 [BA10]) activities of adolescents during the Rorschach (1921), the Rosenzweig Picture-Frustration Study (PFS; Hayashi, 1964), and Thematic Apperception Test (TAT; Murray, 1943). BA10 showed that the PFS was left-hemisphere dominant and significantly different from the Rorschach and TAT, which showed a tendency to be right-hemisphere dominant. We believe that this tendency reflects emotion and sociality.

The assessment of the social cognition and object relations scale on TAT and interview data.

This study examines the reliability and convergent validity of 2 versions of the Social Cognition and Object Relations Scale (SCORS), one for use with Thematic Apperception Test narratives (SCORS-TAT; Westen, 1990) and one for use with clinical interview data (SCORS-CDI; Westen, Barends, Leigh, Mendel, & Silbert, 1990 ). Four SCORS dimensions were evaluated. Data were collected in a psychiatric sample (N = 74). Results show that although interrater reliability was good for all dimensions, internal consistency was low, especially for the affective dimensions. Structural equation modeling, in which a model with 2 factors (i.e., SCORS-TAT and SCORS-CDI) and 4 dimensions each was tested, indicated low convergence between corresponding dimensions of SCORS-TAT and SCORS-CDI. Correlational analyses suggested that this was due to a strong method factor. Regression analyses, however, revealed that the presence of a personality disorder operated as a moderator for convergence between corresponding cognitive-structural dimensions.

Convergent validity of the Defense Mechanisms Manual and the Defensive Functioning Scale.

We examined the convergent validity of Cramer's Defense Mechanisms Manual (DMM; Cramer, 1991b) by comparing it to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Defensive Functioning Scale (DFS). A total of 60 low income urban women from a primary care medical facility responded to four Thematic Apperception Test (TAT; Murray, 1943) cards and an interview of early memories and descriptions of significant others. We scored the TAT narratives with the DMM, and we coded the interview narratives with the DFS. DMM Denial and Projection scales were negatively correlated with the DFS Overall Defensive Functioning scale (r = -.28, p< .01 and r = -.22, p< .10, respectively) and were positively correlated with a DFS pathological composite score (r = .36, p< .01 and r = .32, p< .05, respectively). These findings support the convergent validity of the DMM Denial and Projection scales.

Defense and object relational maturity on Thematic Apperception Test scales indicate levels of personality organization.

Psychoanalytic theories describe defense mechanisms and object relations as psychological structures that have functions vital to personality regulation. In theory, these structures develop in stages and emerge as a coordinated, stable system in early adulthood. However, different levels of maturity of systemic function predominate in various individuals so that people exhibit levels of personality organization (LPO; Kernberg, 1975) differing in degree of maturity. Moreover, the various LPO of adults parallel various developmental stages of maturity of these structures in childhood and predispose to varying psychopathologies. We call this the parallelism hypothesis: Adult LPO parallels the stages of childhood development of these structures. In 2 studies (Study 1, students, n = 301; Study 2, diagnosed and presumed normal people, n = 155), we compared indicators of LPO with relative maturity of defenses and object relations using Thematic Apperception Test (Murray, 1943) scales (Cramer, 1991; Westen, Lohr, Silk, Kerber, & Goodrich, 1989). We compared scores to other indicators of participants' LPO. The parallelism hypothesis was largely supported in both studies.

The thematic apperception test: toward a standard measure of the big three motives.

The application of the Thematic Apperception Test to the assessment of motives has been heralded as an important milestone in personality psychology. However, although this approach is well established, there is at present no standard battery of cues for measuring the Big Three motives (achievement, affiliation, power). Furthermore, the extent to which scoring subcategories contribute to overall motive scores has been neglected. Our research with students and managers examined the effectiveness of picture cues in eliciting motive imagery and the prevalence of scoring subcategories within each motive scoring system. Results from 2 data sets comprising 547 men and women suggested that there were 3 cues that should be retained for future research and that motive scoring systems could be refined through removal of redundant subcategories. Further research is needed to systematically investigate the effectiveness of a standard battery of cues and the validity of revised motive scoring systems.

Comparison of Egyptian and Canadian children on a picture apperception test.

Individualism-collectivism theory predicted that Egyptian and Canadian children's performance would differ on relevant scales of the Roberts Apperception Test for Children (RATC). The RATC was administered to 34 Egyptian and 34 Canadian children ages 6-13 years. Canadian children scored higher on autonomy and lower on receiving support from others and parental limit setting. At older ages, Egyptian children manifested less rejection, desire for help from others, and aggression. There were no cultural differences in anxiety or depression and few differences on indicator and resolution scales related to understanding the task and resolving problems. The findings validated cross-cultural use of the RATC and demonstrated that the increasingly general theory of collectivism allowed meaningful predictions about personality and clinical traits.

Convergent validity of Rorschach and TAT scales of object relations.

The Rorschach Mutuality of Autonomy Scale (MOA) and the Social Cognition and Object Relations Scale (SCORS) have been shown to be reliable and valid measures of interpersonal functioning. Utilizing a sample of 57 outpatients with a Diagnostic and Statistical Manual of Mental Disorders Axis II diagnosis, this study extends the findings of previous research demonstrating the reliability and convergent validity of each measure. Analyses focused on the convergent validity between the Rorschach MOA Scale and 8 SCORS variables (complexity, affect, emotional investment in relationships, emotional investment in values and morals, understanding of social causality, management of impulses/aggression, self-esteem, identity/coherence of self) ratings of Thematic Apperception Test narratives. The conceptual nature and clinical utility of these findings are discussed in relation to psychological assessment.

How was this story told in the mother tongue? An integrative perspective.

Most of the psychoanalytic literature on the mother tongue has focused on the clinical therapeutic encounter. The authors applied findings from therapy research using the Thematic Apperception Test (TAT) to tease out differences and similarities in how stories are told in the mother tongue versus the acquired language. This projective test provides a rich medium to explore the individual's inner world, fantasies, thoughts, wishes, sense of self, and self-in-relation-to-other via a narrative that is spontaneously produced in response to standardized stimuli. The TAT was administered to four participants in both the mother tongue and the acquired language. The narratives were then analyzed using two different rating systems. Differences in sense of self, self-in-relation-to-other, and level of pathology were identified using one participant's narratives. Although no global generalizations can be made from one study, the authors suggest that people tell their story differently when speaking in the mother tongue versus the acquired language.

Differential validity of the Defense Mechanism Manual for the TAT between Asian Americans and Whites. Thematic Apperception Test.

Thematic Apperception Test (Murray, 1943) responses of 69 Asian American (hereafter, Asian) and 83 White students were coded for defenses according to the Defense Mechanism Manual (Cramer, 1991b) and studied for differential validity in predicting paper-and-pencil measures of relevant constructs. Three tests for differential validity were used: (a) differences between validity coefficients, (b) interactions between predictor and ethnicity in criterion prediction, and (c) differences between groups in mean prediction errors using a common regression equation. Modest differential validity was found. It was surprising that the DMM scales were slightly stronger predictors of their criteria among Asians than among Whites and when a common predictor was used, desirable criteria were overpredicted for Asians, whereas undesirable ones were overpredicted for Whites. The results were not affected by acculturation level or English vocabulary among the Asians.