Skip to main content
Original Article

The Specific Uses of the Rorschach in Clinical Practice

Preliminary Results From an International Survey

Published Online:https://doi.org/10.1027/1192-5604/a000155

Abstract. Our study addresses the question, “In what settings, with what age groups, and for what purposes is the Rorschach used internationally?” We present preliminary results from 342 Rorschach users representing 36 different countries from a survey created as part of the US contribution to a larger international project on teaching and using the Rorschach in different countries. The survey was distributed to R-PAS account holders with a request to forward to non-R-PAS users. Of the respondents, 80% used R-PAS, 35% used the CS, and 17% used both. Overall, 91% used the Rorschach with adults, and 43% and 69% with children and adolescents, respectively. The most common setting was private practice (63%). The most common reason for using the Rorschach was differential diagnosis (65%), with psychosis (58%) and personality disorders (56%) as the main diagnoses. US respondents were more likely to use the Rorschach to assess for psychosis (65% vs. 48%), especially emerging psychosis in adolescents (46% vs. 25%). We discuss the strong meta-analytic support for using the Rorschach to assess psychosis, a use supported by even the test’s staunchest critics. We close by discussing study limitations and future directions, such as translating the survey to different languages and implementing a wider distribution.

References

  • Biagiarelli, M., Roma, P., Comparelli, A., Andraos, M. P., Di Pomponio, I., Corigliano, V., Curto, M., Masters, G. A., & Ferracuti, S. (2015). Relationship between the Rorschach Perceptual Thinking Index (PTI) and the Positive and Negative Syndrome Scale (PANSS) in psychotic patients: A validity study. Psychiatry Research, 225(3), 315–321. https://doi.org/10.1016/j.psychres.2014.12.018 First citation in articleCrossrefGoogle Scholar

  • Biederman, J., Petty, C., Faraone, S. V., & Seidman, L. (2004). Phenomenology of childhood psychosis: Findings from a large sample of psychiatrically referred youth. Journal of Nervous and Mental Disease, 192(9), 607–614. https://doi.org/10.1097/01.nmd.0000138228.59938.c3 First citation in articleCrossrefGoogle Scholar

  • Boyette, L.-L., & Noordhof, A. (2021). A commentary on “Developments in the Rorschach assessment of disordered thinking and communication” (Kleiger & Mihura, 2021). Rorschachiana, 42(2), 281–288. https://doi.org/10.1027/1192-5604/a000145 First citation in articleLinkGoogle Scholar

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge. First citation in articleGoogle Scholar

  • Dao, T. K., Prevatt, F., & Horne, H. L. (2008). Differentiating psychotic patients from nonpsychotic patients with the MMPI-2 and Rorschach. Journal of Personality Assessment, 90(1), 93–101. https://doi.org/10.1080/00223890701693819 First citation in articleCrossrefGoogle Scholar

  • Dzamonja-Ignjatovic, T., Smith, B. L., Jocic, D. D., & Milanovic, M. (2013). A comparison of new and revised Rorschach measures of schizophrenic functioning in a Serbian clinical sample. Journal of Personality Assessment, 95(5), 471–478. https://doi.org/10.1080/00223891.2013.810153 First citation in articleCrossrefGoogle Scholar

  • Eblin, J. J., Meyer, G. J., Mihura, J. L., Viglione, D. J., & O’Gorman, E. T. (2018). Development and preliminary validation of a brief behavioral measure of psychotic propensity. Psychiatry Research, 268, 340–347. https://doi.org/10.1016/j.psychres.2018.08.006 First citation in articleCrossrefGoogle Scholar

  • Exner, J. E. (2003). The Rorschach: A comprehensive system (4th ed). John Wiley & Sons. First citation in articleGoogle Scholar

  • Garb, H. N. (1999). Call for a moratorium on the use of the Rorschach Inkblot Test in clinical and forensic settings. Assessment, 6(4), 313–317. https://doi.org/10.1177/107319119900600402 First citation in articleCrossrefGoogle Scholar

  • Garb, H. N., Wood, J. M., Lilienfeld, S. O., & Nezworski, M. T. (2005). Roots of the Rorschach controversy. Clinical Psychology Review, 25(1), 97–118. https://doi.org/10.1016/j.cpr.2004.09.002 First citation in articleCrossrefGoogle Scholar

  • Jørgensen, K., Andersen, T. J., & Dam, H. (2000). The diagnostic efficiency of the Rorschach Depression Index and the Schizophrenia Index: A review. Assessment, 7(3), 259–280. https://doi.org/10.1177/107319110000700306 First citation in articleCrossrefGoogle Scholar

  • Jørgensen, K., Andersen, T. J., & Dam, H. (2001). The diagnostic efficiency of the Rorschach Depression Index and the Schizophrenia Index: A review [Erratum]. Assessment, 8(3), 355. https://doi.org/10.1177/107319110100800311 First citation in articleGoogle Scholar

  • Jørgensen, K., Andersen, T. J., & Dam, H. (2001). The diagnostic efficiency of the Rorschach depression index and the schizophrenia index: A review. Assessment, 8(3), 355. First citation in articleGoogle Scholar

  • Kleiger, J. H. (2017). Rorschach assessment of psychotic phenomena: Clinical, conceptual, and empirical developments. Routledge/Taylor & Francis Group. First citation in articleCrossrefGoogle Scholar

  • Kleiger, J. H., & Mihura, J. L. (2021). Developments in the Rorschach assessment of disordered thinking and communication. Rorschachiana, 42(2), 265–280. https://doi.org/10.1027/1192-5604/a000132 First citation in articleLinkGoogle Scholar

  • Meyer, G. J. (2000). On the science of Rorschach research. Journal of Personality Assessment, 75(1), 46–81. https://doi.org/10.1207/S15327752JPA7501_6 First citation in articleCrossrefGoogle Scholar

  • Meyer, G. J., & Mihura, J. L. (2021). Rorschach Performance Assessment System (R-PAS) for assessing disordered thought and perception. In I. B. WeinerJ. H. KleigerEds., Psychological assessment of disordered thinking and perception (pp. 151–168). American Psychological Association. https://doi.org/10.1037/0000245-010 First citation in articleGoogle Scholar

  • Meyer, G. J., Viglione, D. J., Mihura, J. L., Erard, R. E., & Erdberg, P. (2011). Rorschach Performance Assessment System: Administration, coding, interpretation, and technical manual. Rorschach Performance Assessment System, LLC. First citation in articleGoogle Scholar

  • Mihura, J. L., & Meyer, G. J. (2021). The Rorschach Performance Assessment System (R-PAS) in multimethod assessment. In J. L. MihuraEd., The Oxford Handbook of Personality and Psychopathology Assessment (2nd ed.). Oxford University Press. First citation in articleGoogle Scholar

  • Mihura, J. L., Meyer, G. J., Dumitrascu, N., & Bombel, G. (2013). The validity of individual Rorschach variables: Systematic reviews and meta-analyses of the comprehensive system. Psychological Bulletin, 139(3), 548–605. https://doi.org/10.1037/a0029406 First citation in articleCrossrefGoogle Scholar

  • Mihura, J. L., Meyer, G. J., Viglione, D. J., Kletzka, N., Eblin, J. J., Boyette, L.-L., Kleiger, J. H., & Ales, F. (2021). Validating a standardized measure of disorganized thinking using the Rorschach. Manuscript in preparation. First citation in articleGoogle Scholar

  • Mihura, J. L., Roy, M., Dumitrascu, N., & Meyer, G. J. (2016, March 12). A meta-analytic review of the MMPI (all versions) ability to detect psychosis. Paper presented at the Annual Meeting of the Society for Personality Assessment, Chicago, IL, USA. First citation in articleGoogle Scholar

  • Mihura, J. L., Roy, M., & Graceffo, R. A. (2017). Psychological assessment training in clinical psychology doctoral programs. Journal of Personality Assessment, 99(2), 153–164. https://doi.org/10.1080/00223891.2016.1201978 First citation in articleCrossrefGoogle Scholar

  • Ritsher, J. B. (2004). Association of Rorschach and MMPI psychosis indicators and schizophrenia spectrum diagnoses in a Russian clinical sample. Journal of Personality Assessment, 83(1), 46–63. https://doi.org/10.1207/s15327752jpa8301_05 First citation in articleCrossrefGoogle Scholar

  • Rorschach, H. (2021). Hermann Rorschach’s psychodiagnostics: Newly translated and annotated 100th anniversary edition (P. J. KeddyR. SignerP. ErdbergA. Schneider-StockingTrans. & Eds.. Hogrefe Publishing. (Original work published 1921) First citation in articleGoogle Scholar

  • Stentebjerg-Olesen, M., Pagsberg, A. K., Fink-Jensen, A., Correll, C. U., & Jeppesen, P. (2016). Clinical characteristics and predictors of outcome of schizophrenia-spectrum psychosis in children and adolescents: A systematic review. Journal of Child and Adolescent Psychopharmacology, 26(5), 410–427. https://doi.org/10.1089/cap.2015.0097 First citation in articleCrossrefGoogle Scholar

  • Su, W.-S., Viglione, D. J., Green, E. E., Tam, W.-C. C., Su, J.-A., & Chang, Y.-T. (2015). Cultural and linguistic adaptability of the Rorschach Performance Assessment System as a measure of psychotic characteristics and severity of mental disturbance in Taiwan. Psychological Assessment, 27(4), 1273–1285. https://doi.org/10.1037/pas0000144 First citation in articleCrossrefGoogle Scholar

  • Wood, J. M., Nezworski, M. T., Lilienfeld, S. O., & Garb, H. N. (2003). What’s wrong with the Rorschach?: Science confronts the controversial inkblot test. Jossey-Bass. First citation in articleGoogle Scholar

  • Wood, J. M., Nezworski, M. T., & Stejskal, W. J. (1996). The comprehensive system for the Rorschach: A critical examination. Psychological Science, 7(1), 3–10. https://doi.org/10.1111/j.1467-9280.1996.tb00658.x First citation in articleCrossrefGoogle Scholar

  • Wright, C. V., Beattie, S. G., Galper, D. I., Church, A. S., Bufka, L. F., Brabender, V. M., & Smith, B. L. (2017). Assessment practices of professional psychologists: Results of a national survey. Professional Psychology: Research and Practice, 48(2), 73–78. https://doi.org/10.1037/pro0000086 First citation in articleCrossrefGoogle Scholar