Weighing evidence for the Rorschach's validity: a response to Wood et al. (1999).

Wood, Nezworski, Stejskal, Garven, and West (1999) challenged Ganellen's (1996) characterization of the revised Rorschach Depression Index (DEPI; Exner, 1991) as a promising psychometric marker of depression that deserves serious attention by researchers and clinicians. To the contrary, however, a careful examination of existing studies indicates that no compelling empirical evidence exists indicating that Ganellen's conclusions should be modified at the present time, although no firm conclusions about the DEPI can be reached until further evidence accumulates. Furthermore, although Wood et al. (1999) suggested that evidence supporting the reliability and validity of the Rorschach in general is weak, ample evidence exists demonstrating that the Rorschach can be scored reliably (Meyer, 1997), that Rorschach variables in general have respectable levels of criterion-related validity (Bornstein, 1996; Hiller, Rosenthal, Bornstein, Berry, & Brunnel-Neuleib, 1999), and that the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and Rorschach have comparable levels of criterion-related validity, with the MMPI outperforming the Rorschach in certain respects and the Rorschach outperforming the MMPI in others (Bornstein, 1999; Hiller et al, 1999).

Exploring MMPI-Rorschach relationships.

Limitations exist in the current literature examining Minnesota Multiphasic Personality Inventory (MMPI)-Rorschach interrelationships. In this article I attempt to identify several issues to be addressed by researchers in this area. These include restricting conclusions about MMPI-Rorschach relationships to research using the Comprehensive System; considering the relative reliability and validity of these tests; comparing the predictive power of the Rorschach and MMPI; examining the effects extreme outliers have on statistical analyses; and determining the appropriate level of analysis for research, the level of individual test scores, or psychological constructs. The implications of these issues for research design, statistical analysis, and applied clinical work are discussed.

Comparing the diagnostic efficiency of the MMPI, MCMI-II, and Rorschach: a review.

The diagnostic efficiency of the Minnesota Multiphasic Personality Inventory (MMPI), Millon Clinical Multiaxial Inventory-II (MCMI-II), and Rorschach Comprehensive System for detecting depressive and psychotic disorders were compared. Studies examining the diagnostic performance of these measures published in the Journal of Clinical and Consulting Psychology, Psychological Assessment, and the Journal of Personality Assessment were included in this review. The methodological limitations of these studies are identified and suggestions for improving future research are offered. Although only limited conclusions can be reached because of the small number of existing studies and methodological problems, several preliminary observations were made. First, the MMPI, MCMI-II, and Rorschach are comparable in their sensitivity to detecting depression. However, high MMPI and MCMI-II scores are not specific to depression and misclassify a substantial percentage of nondepressed patients as being depressed. The Rorschach has a lower rate of false positives and higher specificity than the MMPI and the MCMI-II. Second, the Rorschach was more sensitive and specific to psychotic disorders than either the MMPI or MCMI-II. The MCMI-II did not detect psychosis at a rate above chance and frequently inaccurately classified psychotic patients as nonpsychotic. Overall, these preliminary findings suggest that Rorschach indices are promising psychometric markers for depression and psychotic disorders. The clinical implications of these preliminary findings are discussed.

Can psychosis be malingered on the Rorschach? An empirical study.

Can psychosis be faked on the Rorschach? We examined this question by comparing 2 groups of subjects with a high incentive to malinger, persons accused of serious crimes. All subjects were administered both the Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach and were assigned to honest (N = 35) and malingered (N = 13) groups on the basis of MMPI validity scales. The Rorschach protocols of these 2 groups were compared to assess how successfully malingerers could deliberately produce records that appeared psychotic on empirically derived Rorschach indices of psychosis. Despite an attempt to portray themselves as psychotic on the MMPI, subjects in the malingered group did not differ from honest responders on Rorschach variables that distinguish psychotic from nonpsychotic patients, but did differ in the number of dramatic responses produced. Our data suggest that the combination of the MMPI and Rorschach provides a powerful psychometric technique for detecting deliberate malingering of psychosis.

Impaired insight in Alzheimer's disease.

We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired insight score was developed by measuring discrepancies between patient report and caregiver report on standard instruments of activities of daily living. Insight was more impaired in subjects with greater dementia severity and subjects with paranoid delusions. In a multivariate analysis, the best neuropsychological predictors of impaired insight were the Continuous Performance Test and the Visual Reproduction Test. We speculate that the impaired insight of Alzheimer's disease has two components: confabulation reflecting prefrontal dysfunction and anosognosia reflecting right-hemisphere dysfunction.

Panic disorder, agoraphobia, and anxiety-relevant cognitive style.

We attempted to identify factors differentiating Agoraphobia with Panic Attacks (AG) from Panic Disorder (PD) patients. Twenty-three AG and 27 PD patients were compared. No significant difference in severity of illness was found. As predicted, the groups differed on a measure of anxiety-relevant cognitions developed for this study, the Anxious Thoughts and Tendencies scale (AT&T) (P less than 0.02). We suggest that differences in interpretation of panic attacks account for the development of of phobic avoidance behavior in some but not all PD patients. The intercorrelations among measures suggest that Panic Disorder may be conceptualized as having several independent although related components (panic attacks, general anxiety, phobic anxiety, and cognitive distortions).

Pessimistic self-preoccupation, performance deficits, and depression.

Three studies are presented testing a model of the cognitive performance deficits shown in depression. The model proposes that such deficits occur as an interaction of expectancy and focus of attention variables, that is, in the presence of both low expectancy of success and high self-focus. Study 1 was a pilot study which documented that depressed undergraduates evidence poorer anagram performance, greater self-focus, and lower pretask expectancies than do nondepressed subjects. Study 2 showed that nondepressed undergraduates evidence performance deficits only when both expectancy is lowered and self-focus is increased. Study 3 suggested that depressed undergraduates' performance deficits are overcome either by lowering self-focus or by raising expectancy. Discussed are discrepancies between self-report and performance data, the relevance of these studies to the test anxiety literature, the need to integrate literature concerning the effects of depression, anxiety, and self-esteem on performance, and how the interactive roles of positive expectancy and focus of attention may be related to effective coping in a variety of situations.

Depression and cognitive style: comparisons between measures.

Several instruments have been developed recently to measure cognitive styles associated with depression. At least four of them appear to have an underlying similarity. Each appears to reflect a tendency for respondents to infer a general lack of self-worth (or a continued likelihood of bad events) on the basis of a single discrete failure. The present research was a comparative test of one of these scales against the other three in terms of associations with Beck Depression Inventory (BDI) scores. Though all instruments were significantly correlated with BDI, partial correlations revealed that our generalization scale was a more robust predictor of BDI than were (a) a measure of characterological self-blame, (b) a measure of cognitive bias, and (c) a measure of attributional style.

Stress, externality, and depression.

Previous research has found mixed support for the possibility that locus of control moderates the effects of life stress on depression. Two methodological choices may have influenced previous findings: the use of a unidimensional rather than a multidimensional locus of control scale, and reliance on linear statistical methods using median splits. We attempted to correct these choices by using the Levenson IPC scale (1974) and multiple regression analyses in a female undergraduate population (N = 158). The results supported use of a multidimensional scale, since Stress, Internality, and Powerful Others were found to have main effects on depression whereas Chance interacted with life stress. The question of whether locus of control refers to responsibility for causing an event, i.e., self-blame, or belief in control over future events, i.e., coping behavior, was discussed.