The Projective Hypothesis

1
Projective Tests
2
The Projective Hypothesis

• The projective hypothesis (Lawrence Frank, 1939)
  When people try to understand vague or ambiguous
  unstructured stimuli, the interpretation they
  produce reflects their needs, feelings,
  experience, prior conditioning, thought processes
• Shakespeare, Hamlet, II.ii "Nothing is either
  good or bad, but thinking makes it so."

3
The Problem

• The difficulty is answering Which 'needs,
  feelings, experience, prior conditioning, thought
  processes' are reflected?
• Projective tests can (by their own claim) draw
  equally upon the imagined and real, the conscious
  and unconscious, the recent and old, the
  important and the trivial, the revealing and the
  obvious
• Much room for interpretation is left given to the
  tester, making test validation almost impossible
• These tests flourished more in the
  psychoanalytical era, 1940-1960

4
The Rorschach Inkblot Test

• The Rorschach Inkblot Test is the most commonly
  used projective test
• In a 1971 survey of test usage, it was used in
  91 of 251 clinical settings survey
• It is one of the most widely used tests that
  exists According to recent surveys by the
  American Psychological Association, 82 percent of
  its members ''occasionally'' and 43 percent
  ''frequently'' use the test

5
The Rorschach Inkblot Test

• It is widely cited in research, third only to the
  MMPI and the NEO Personality Inventory (a
  five-factor personality measure)
• It is estimated to be administered to 6 million
  people per year
• No general discussion of psychological tests is
  complete without reference the Rorschach, despite
  its scientific inadequacies.
• Kaplan Saccuzzo / Psychological Testing

6
History

• The earliest use of inkblots as projective
  surfaces was J. Kerner's (1857)
• He was the first to claim that some people make
  idiosyncratic or revealing interpretations
• In 1896, Alfred Binet suggested that inkblots
  might be used to assess personality (not
  psychopathology)
• Some work was done on this suggestion
• The first response set was published by G. M.
  Whipple (1910)

7
History

• Herman Rorschach, a Swiss psychiatrist, was the
  first to suggest (1911) the use of inkblot
  responses as a diagnostic instrument
• In 1921 he published his book on the test,
  Psychodiagnostik (and soon thereafter died, age
  38)

8
History

• Rorschach's test was not well-received,
  attracting little notice in Switzerland or
  elsewhere
• David Levy brought it to the States
• His student, Samuel Beck, popularized its use
  here, writing several papers and books on it
  starting with Configurational Tendencies in
  Rorschach Responses (1933)
• Several other early users also published work on
  he Rorschach
• Several offered their own system of
  administration, scoring, and interpretation, each
  finding his or her own followers, leading to
  problems in standardization that continue to this
  day

9
What is the Rorschach?

• The stimuli were generated by dropping ink onto
  a card and folding it
• They are not, however, random the ten cards in
  the current test were hand-selected out of
  thousands that Rorschach generated
• He selected 5 black/white, 2 red/gray (II III)
  and 3 color (VIII X)

10
Administering the Rorschach

• The test is usually administered with as little
  instruction and information as possible
• The tester asks 'What might this be?' and gives
  no clues or restrictions on what is expected as a
  response
• Anxious subjects often do ask questions, and
  vague answers are offered
• Some advocate sitting beside the subject to avoid
  giving clues by facial expression
• If only one response is given, some hint to find
  more may be offered "Some people see more than
  one thing."
• The orientation of the card and subject RT is
  recorded

11
Administering the Rorschach

• The cards are shown twice
• The first time responses are obtained (the
  inquiry) the second time they are elaborated
  (the elaboration)
• The test administrator asks about
• i.) Location Where did the subject see each
  item?
• A location chart is used to mark location
• W whole D Common detail Dd Unusual
  detail DW Confabulatory response
• ii.) Determinant What determined the response?
• Form (F)?
• Perceived movement? Human (M) Animal (FM)
  Inanimate (m)
• Color (C) shading (T texture)

12
Administering the Rorschach

• The test administrator asks about
• iii.) Form quality How well-matched is the
  response to the blot?
• F good match F match F- poor match
• iv.) Content What was seen?
• Human (H) animal (A) nature (N)?
• The test administrator also scores
  popularity/originality How frequently is the
  percept seen?
• Norm books are available (i.e. Exner, 1974) but
  are not always well-received in clinical settings

13
Scoring the Rorschach

• Some quantitative information is obtained i.e.
  percent of W, D, Dd, and DW responses
• Deviation from norms can mean an invalid
  protocol, or brain damage, or emotional problems,
  or a low mental age (or just an original person)
• These quantitative measures can be validated
• i.e. of W responses has been linked to general
  intelligence (r 0.4) Movement responses are
  said to suggest strong impulses or high motor
  activity DW (confabulatory) responses are taken
  as signs of a disordered state low response rate
  is associated with mental retardation,
  depression, and defensiveness
• Alas, many attempts to validate signs are unclear
• Often there is fail to replicate, or the findings
  contradict expert claims

14
Scoring the Rorschach

• Most scoring is qualitative i.e. analyzing
  content
• There are no hard and fast rules
• All but the most ardent proponents suggest that
  the protocol be analyzed in the context of other
  tests results and clinical information

15
Exners Comprehensive System

• Exner (1974, 1995, 2003) scores location,
  developmental quality, determinants form
  (quality), movement, color (chromatic/achromatic),
  texture, dimensionality, diffuse shading,
  popular responses more
• He normed his system on five groups nonpatient,
  outpatient nonpsychotic, inpatient character
  problem, inpatient depressive, inpatient
  schizophrenic
• His original norms were flawed 221/700 were
  entered twice (this was fixed in the 1995
  revision).
• It is claimed they over-diagnose pathology

16
Exners Comprehensive System

• In the first edition of this book, published in
  1982, we predicted that the 21st century would
  see the Rorschach elevated to a position of
  scientific respectability because of Exners
  Comprehensive System. Over the years we backed
  away from this position. Now, more than 20 years
  later, we must acknowledge that we were
  mistaken. Kaplan Saccuzzo / Psychological
  Testing, 6th Ed.

17
Psychometric Properties of the Rorschach

• Obviously, it is almost impossible to measure any
  of the usual psychometric properties in the usual
  way
• Validity and reliability are both rendered
  meaningless by the open-ended multiplicity of
  possibility that is allowed and by the lack of
  universally-accepted standardized instructions,
  administration protocol, and scoring procedure
  (but see Exner, 1974.if allowed)

18
Validity reliability of the Rorschach

• One approach to validity Assess blind diagnosis
  made from a protocol alone
• In one study, 85 of protocols were matched to
  case descriptions, in batches of 5
• Why might this be dubious?
• Studies have suggested that changing instructions
  can change what you get (Blais et al., 1995)- not
  good for validity!
• Average correlation of Rorschach with validity
  measures hovers low, around 0.30 (Garb, Florio,
  and Grove, 1998 Hiller et al., 1999)
• Reliability studies that have been done find
  r-values varying from 0.1 to 0.9
• One was done on cases after electroshock, because
  it "wipes out memory for the first test but does
  not change personality"
• Protocols were reported to be very similar

19
Validity reliability of the Rorschach

• The test does not consistently measure
  depression, anxiety disorders, psychopathy,
  impulsiveness, criminality, or sexual abuse
• In a 1999 study of random people (at a California
  blood bank) one in six came up with Rorschach
  protocols supposedly indicative of schizophrenia
  a hugely improbable finding!
• Other evidence suggests that there may be
  cultural biases in the Rorschach
  African-Americans, Native Americans, American
  Hispanics, and Central and South Americans all
  produce Rorschach scores that differ from the
  Exner norms

20
Validity reliability of the Rorschach

• In forensic settings, Rorschach interpretations
  can still have huge consequences, changing prison
  or even death sentences, or child custody
  decisions
• Studies that support the validity of the
  Rorschach have been denounced for being
  methodologically flawed and inconsistent, and are
  almost always unreplicated
• It is alleged by some that rare master
  interpreters exist that interpretation is an
  art that cannot be systematized

21
Projective tests as non-psychometric tools

• The test can give you objective data, like a
  blood work. But we all know that some physicians,
  for whatever reason, are skillful diagnosticians
  beyond the tests, in seeing the way the patient
  looks or moves. The Rorschach is a stimulus that
  generates a lot of information. You may generate
  hypotheses that aren't in the hard data yet, but
  that doesn't mean this is the same thing as
  reading tea leaves.
• Irving Weiner, clinical professor of psychiatry
  and behavioral medicine at the University of
  South Florida

22
Projective tests as non-psychometric tools

• The test can give you objective data, like a
  blood work. But we all know that some physicians,
  for whatever reason, are skillful diagnosticians
  beyond the tests, in seeing the way the patient
  looks or moves. The Rorschach is a stimulus that
  generates a lot of information. You may generate
  hypotheses that aren't in the hard data yet, but
  that doesn't mean this is the same thing as
  reading tea leaves.
• Irving Weiner, clinical professor of psychiatry
  and behavioral medicine at the University of
  South Florida

However, I have know self-proclaimed master
interpreters who failed to convince me of the
mastery of which they were convinced
23
A few final points

• A MC version of the Rorschach was tried but was
  useless
• Note this is a very time-consuming and difficult
  test
• A lot of effort is required for the return on
  data, both in terms of test-administration and of
  training (some say at least 1 -2 years is
  required just to learn, and much more to master,
  the Rorschach)

24
The Thematic Apperception Test (TAT)

• Introduced in 1930s by Christina Morgan and Henry
  Murray
• It has been called a clinicians delight and a
  statisticians nightmare.
• 30 grayscale pictures one blank for elicitation
  of stories
• Not all are (though all may be) seen by everyone
  some are suggested for men, some for women, some
  for youth, some for elderly
• Most subjects see 10-12 cards, over two sessions
• Based on Murray's (1938) theory of 28 social
  needs (sex, affiliation, dominance, achievement
  etc.)
• Thema Interaction between needs and
  environmental determinants

25
The Thematic Apperception Test

• Scoring takes into account many things
• Roles, press (environmental forces), needs
  (forces from the hero), themes (interact with
  press/needs), outcomes
• Congruence with picture stimuli
• Conformity with directions
• Conflict
• Literal Story Content

26
The TAT Validity and reliability

• Standardization of administration and scoring is
  minimal (Only 3 of psychologists use standard
  scoring systems)
• As with the Rorschach, studies suggest that
  directions make a difference loaded words
  produced more distress in several studies.
• Internal consistency is low
• 2 month test-retest r .80 10 month test-retest
  r .50
• Inter-rater reliability varies with studies
  between 0.3 to 0.9
• A meta-analysis by Spangler (1992) found average
  correlations between TAT and other criteria
  around 0.20

27
The Thematic Apperception Test

• As with the Rorschach, studies suggest that
  directions make a difference loaded words
  produced more distress in several studies.
• Many variations on this 'story-telling' test exist

28
Rotter Incomplete Sentences Blank (RISB)

• The Incomplete sentences test (Julian Rotter,
  1950) is designed as a screening tool for one
  construct over-all emotional adjustment
• This is a well-standardized projective that
  requires subjects to complete 40 short sentence
  stems in a way that expresses your real
  feelings

29
Rotter Incomplete Sentences Blank (RISB)

• Example sentence stems
• I like ..
• My greatest fear .
• I am .
• Men .
• Dancing .
• Sports .

30
Rotter Incomplete Sentences Blank

• Three forms high school, college, adult
• 40 incomplete sentences/stems, usually only 1-2
  words long
• Takes 20-25 minutes
• The use of directed stems allows one to probe the
  subject explicitly for locus of control
  (internal/external), interests, likes, hopes,
  fears etc.
• Each item scored on 7-point scale where higher
  numbers indicate more severe maladjustment
• The scoring system is well defined, and as a
  result

31
Rotter Incomplete Sentences Blank

• There is good inter-rater reliability (about
  0.90)
• Cronbachs alpha 0.69
• Test-retest reliability close to 0.80 after 1-2
  weeks 0.50 after months 0.38 after 3 years
• Validity studies have tended to support the idea
  that the RISB measures adjustment

32
Other common projective tests

• House-Tree-Person Test (Buck, 1948)
  Draw-A-Person (Machover, 1949) Subject is asked
  to draw
• Scoring is based on many aspects
• Absolute relative size of elements
• Sequence of elements
• Omissions and detailing/emphasis/erasures
  (especially of body parts)
• Verbalizations while drawing
• Size placement of figures on the page
• Amount of action depicted
• Systematization in doing the task
• Shading

33
"If there is a tendency to over-interpret
projective test data without sufficient empirical
grounds, then projective drawing tests are among
the worst offenders." Kaplan Saccuzo
Psychological Testing, 1993
34
The problem with drawing tests

• - Among the plausible but empirically invalid
  relations that have been claimed
• - Large size Emotional expansiveness or acting
  out
• - Small size emotional constriction
  withdrawal, or timidity
• - Erasures around male buttocks long eyelashes
  on males homoeroticism
• - Overworked lines tension, aggression
• - Distorted or omitted features Conflicts
  related to that feature
• - Large or elaborate eyes Paranoia

35
Chapman Chapman- Test Results Are What You
Think They Are

• Main point People tend to over-estimate the
  frequency of correlations they believe in (i.e.
  of associations) -or, equivalently, people tend
  to confuse correlation with semantic association
• This confusion is very resistant to change
• It remains even when the actual correlation is
  negative, or when there are cash rewards for
  accurate estimations of correlation

36
Chapman Chapman- Test Results Are What You
Think They Are

• Holzberg Wexler tested whether paranoid
  subjects draw elaborate or exaggerated eyes
• 18 paranoid patients were compared to 76 student
  nurses
• No effects were found
• Chapman Chapman conducted a forced-choice
  survey, which found that that 91 (!) of
  clinicians believe that a suspicious person would
  draw large or otherwise atypical eyes
• 82 believed that a person worried about his
  intelligence would draw a large or otherwise
  emphasized head, although there is no evidence.

37
Illusory correlation

• This is an example of an illusory correlation, in
  which subjects believe two things that are
  semantically associated must also be correlated
• Chapman and Chapman showed subjects word pairs
  that were either semantically associated or not
• They controlled the pairs so that all pairs
  occurred equally often (25 of the time)
• However, subjects reported that the associated
  pairs came up on average 47 of the time.

38
Illusory correlation

• The same results were found with Draw-A-Person
  results in naïve subjects Subjects who did not
  know the test insisted that semantic associations
  were more common than chance, even when they were
  controlled in a set of drawings
• A 20 reward for accuracy did not reduce the
  illusory correlation
• Allowing for direct comparisons of drawings, and
  measuring, and scratch paper, and no time limit,
  plus the 20 reward for accuracy did reduce
  error, but not to nothing instead of 76
  reporting an (nonexistent) illusory correlation,
  45 reported it.

39
Illusory correlation

• On a similar study of the Rorschach, clinician
  subjects found (non-existent) correlations
  between homosexuality and semantically-associated
  objects buttock, male genitals, female clothing
• Naïve non-clinicians then reported non-existent
  correlations of these with patient descriptions
  of homosexuality and precisely these same signs
• Even when a negative correlation was built in
  (homosexuality never appeared with these signs),
  subjects reported a positive correlation

40
Illusory correlation life Forer, 1949

• Forer (1949) gave each student a personality
  profile based on a questionnaire he had
  administered to each of them
• Students rated their profile on a scale of 1
  (inaccurate) to 5 (accurate)
• The average rating was 4.2

41
Illusory correlation life Forer, 1949

• Gave each student a personality profile based on
  a questionnaire he had administered to each of
  them
• Students rated their profile on a scale of 1
  (inaccurate) to 5 (accurate)
• The average rating was 4.2
• The catch Everyone had exactly the same profile,
  compiled from a book of horoscopes The Barnum
  Effect

42
Illusory correlation is an illusion!

• We do not hold it against ourselves if we see an
  optical illusion
• Illusory correlation is a cognitive illusion we
  should not moralize or fret about it, but take
  sensible precautions to guard against it
• "senses are fallibleclinical judgments must be
  checked continually against objective measures"

43
So what?

• Illusory correlations are rampant in real life in
  ways that matter
• We easily over-weight events that are
  (especially, negatively) emotionally-marked
  criticism from our parents or partners personal
  failures errors superstition correlations
• It helps to realize that, just like the lines are
  straight but we see them straight, our self-views
  are systematically incorrect we should all
  probably distrust any views that says we are
  extremely bad in any way
• Cognitive-behavioral Psychotherapy can use this
  box scores for real life

44
The hermeneutic circle

• Hermeneutics is the art of interpretation,
  especially texts (and the study of that
  interpretation)
• Hermes was a Greek God of boundaries and
  therefore of messengers and poetry, and was
  himself a messenger of the gods to humans.
• There are several kinds of hermeneutic circles
  but one is that those who do the interpreting are
  themselves open to interpretation
• What we read into anything is as much about the
  reader as it is about what is read
• Critics of projective tests have argued that
  this hermeneutic circle applies directly to
  projective tests- those who interpret say as much
  about themselves in their act of interpreting as
  they do about the one they interpret

45
The hermeneutic circle
"Objectivity in human relationships is
impossible. Therapists affect the behaviour and
feelings of patients, and patients affect
therapists. When a chart notes that a patient is
'hostile', it should also note, in the interests
of balance, that the therapist is 'paranoid'. If
a therapist calls a patient 'defensive', chances
are that the patient would call the therapist
'aggressive'. Both should be noted in a chart, if
either is, since both are equally probable.
" Shelagh Lynne Supeene As For The Sky, Falling
46
Projective tests as non-psychometric tools

• Projective tests are clearly not so great as
  psychometric tools they violate almost
  everything psychometric principle we have learned
  in this class!
• However, they may nevertheless serve an important
  and useful clinical purpose as interview aids
• They allow people to say what they cannot say
• They open up issues that might otherwise never be
  raised.
• They provide a broad overview of main foci of
  attention