Received: by alpheratz.cpm.aca.mmu.ac.uk id KAA18648 (8.6.9/5.3[ref pg@gmsl.co.uk] for cpm.aca.mmu.ac.uk from fmb-majordomo@mmu.ac.uk); Wed, 21 Feb 2001 10:40:27 GMT Message-ID: <2D1C159B783DD211808A006008062D3101745C9E@inchna.stir.ac.uk> From: Vincent Campbell <v.p.campbell@stir.ac.uk> To: "'memetics@mmu.ac.uk'" <memetics@mmu.ac.uk> Subject: RE: What's in an Inkblot? Some Say, Not Much Date: Wed, 21 Feb 2001 10:39:42 -0000 X-Mailer: Internet Mail Service (5.5.2650.21) Content-Type: text/plain; charset="iso-8859-1" Sender: fmb-majordomo@mmu.ac.uk Precedence: bulk Reply-To: memetics@mmu.ac.uk
All I ever see is nasty monsters or pretty butterflies...
> ----------
> From: Wade T.Smith
> Reply To: memetics@mmu.ac.uk
> Sent: Wednesday, February 21, 2001 4:37 am
> To: SKEPTIC-L; Memetics Discussion List
> Subject: Fwd: What's in an Inkblot? Some Say, Not Much
>
> What's in an Inkblot? Some Say, Not Much
>
> By ERICA GOODE
>
> Psychology has produced few more popular icons than the Rorschach inkblot
> test.
>
> Devised 80 years ago by a young Swiss psychiatrist, the Rorschach has
> entered the language as a synonym for anything ambiguous enough to invite
> multiple interpretations. And beyond its pop culture status, it has
> retained a central role in personality assessment, administered several
> hundred thousand times a year, by conservative estimates, to both
> children and adults.
>
> In custody disputes, for example, the test is used to help determine the
> emotional fitness of warring parents. Judges and parole boards rely on it
> for insight into a prisoner's criminal tendencies or potential for
> violence. Clinicians use it in investigating accusations of sexual abuse,
> and psychotherapists, as a guide in diagnosing and treating patients.
>
> Yet almost since its creation, the inkblot test has also been
> controversial, with early critics calling it "cultish" and later ones
> deeming it "scientifically useless."
>
> And in recent years, academic psychology departments have been divided
> over the merits of the test, and some have stopped teaching it.
>
> The debate is likely to become even more heated with the publication of
> an article provoking discussion and anger among clinicians who routinely
> use the Rorschach. In the article, three psychologists conclude that the
> inkblot test and two others commonly used < the Thematic Apperception
> Test or T.A.T. and the Draw-a-Person test < are seriously flawed and
> should not be used in court or the consulting room.
>
> "There has been a substantial gap between the clinical use of these tests
> and what the research suggests about their validity," said Dr. Scott O.
> Lilienfeld, an associate professor of psychology at Emory University and
> the lead author of the article. "The research continues to suggest that
> they are not as useful for most purposes as many clinicians believe."
>
> The review, by Dr. Lilienfeld and two colleagues, Dr. James M. Wood of
> the University of Texas at El Paso and Dr. Howard Garb of the University
> of Pittsburgh, appears in the current issue of the journal Psychological
> Science in the Public Interest, a publication of the American
> Psychological Society.
>
> The three tests are known as "projective" because they present people
> with an ambiguous image or situation and ask them to interpret or make
> sense of it. The test taker's responses are assumed to reflect underlying
> personality traits and unconscious conflicts, motives and fantasies.
>
> In the T.A.T., test takers are shown a series of evocative pictures
> depicting domestic scenes and are asked to tell a story about each one.
> The figure-drawing test requires drawing a person on a blank sheet of
> paper and then drawing a second person of the opposite sex.
>
> While the Rorschach and the other projective techniques may be valuable
> in certain specific situations, the reviewers argue, the tests' ability
> to diagnose mental illnesses, assess personality characteristics, predict
> behavior or uncover sexual abuse or other trauma is very limited.
>
> The tests, which often take hours to score and interpret, add little
> information beyond what can be gleaned from far less time-consuming
> assessments, the psychologists say. They recommend that practitioners
> refrain from administering the tests for purposes other than research "or
> at least limit their interpretations to the very small number of indexes
> derived from these techniques that are empirically supported."
>
> Dr. Lilienfeld said that the review was written to raise awareness of the
> problems with the tests in the legal field and with "the hope that maybe
> we can reach a small number of open-minded people, and in particular
> students, who have yet to make up their minds on this issue."
>
> But he added, "I'm confident that many will take issue with our
> conclusions."
>
> One of those is Dr. Irving B. Weiner, a clinical professor of psychiatry
> and behavioral medicine at the University of South Florida and the
> president of the International Rorschach Society, who said the authors of
> the journal report took research findings out of context to bolster their
> case.
>
> Dr. Lilienfeld and his colleagues do not really understand how clinicians
> use the tests, Dr. Weiner said. They "have been used for a long time very
> effectively, with very good results and a great deal of scientific
> support," he said.
>
> Dr. Gregory J. Meyer, an associate professor of psychology at the
> University of Alaska at Anchorage, who has studied the Rorschach, said
> admonishing psychologists against using the tests was "not in the spirit
> of advancing our science."
>
> He said the journal's decision to run the psychologists' article was like
> asking "someone who believes in creationism to review evolutionary theory
> and make recommendations about it."
>
> A History of Controversy
>
> Projective tests are no strangers to controversy. The Rorschach, in
> particular, has inspired intense passion in defenders and critics over
> the decades, leading two scientists to observe in a 1999 paper that the
> test had "the dubious distinction of being, simultaneously, the most
> cherished and the most reviled of psychological assessment instruments."
>
> Dr. Hermann Rorschach, a Swiss psychiatrist who worked with schizophrenic
> patients, is believed to have gotten the idea for the test from a popular
> European parlor game called Klexographie, which involves making inkblots
> and telling stories about them. As a child, Dr. Rorschach was so good at
> the game that he earned the nickname Klecks, or Blot. He died of
> peritonitis a year after the test's publication in 1921. He was 37.
>
> The Rorschach's champions have often been almost worshipful in their
> belief in its ability to pare back the layers of the psyche, and the test
> is generally regarded as offering a richness of information about a
> person's psychological world that cannot be gained from interviews or
> from "self-report" tests like the Minnesota Multiphasic Personality
> Inventory or M.M.P.I.
>
> The test has used the same 10 images since it was developed. Responses to
> the inkblots can be scored using more than 100 criteria, including how
> common or unusual the responses are, what areas of the blots are focused
> on, whether movement is seen in the images, and so on.
>
> In an earlier era, clinicians who demonstrated special skill in
> interpreting the test were dubbed Rorschach "wizards," and the technique
> sometimes was referred to as "an X- ray of the mind."
>
> Over the years, the test's detractors have also been zealous, making at
> times brutal attacks on its scientific validity, especially in the 1950's
> and 1960's, when practitioners varied greatly in the ways they
> administered and scored the tests.
>
> Some of the criticism abated in the mid-1970's, when Dr. John E. Exner,
> then a professor of psychology at Long Island University, developed
> systematic rules for giving and scoring the Rorschach and established
> norms against which the responses of test takers could be compared.
>
> Dr. Exner's "comprehensive system" is used by a majority of psychologists
> who administer the Rorschach. Dr. Exner says that Rorschach Workshops, a
> North Carolina research foundation which he directs, trains an average of
> 300 clinicians a year in the method in the United States and several
> hundred more in Europe and Japan. The foundation charges $650 for five
> days of intense training in the technique.
>
> With the comprehensive system, the test can yield a complex picture of
> people's psychological strengths and weaknesses, the Rorschach's
> proponents say, including their intelligence and overall mental
> functioning, their ability to relate appropriately to other people, their
> sexuality, and their fantasies, fears and preoccupations.
>
> Below the Surface
>
> The test is considered particularly powerful in situations in which
> people may not be expected to volunteer negative information about
> themselves.
>
> For example, Dr. Carl F. Hoppe, a clinical psychologist who does
> psychological evaluations for the Los Angeles Superior Court's family law
> division, said he administered the Rorschach about 130 times a year in
> "high-conflict" custody disputes.
>
> In a custody evaluation, Dr. Hoppe said, parents are often motivated to
> present themselves positively and to deny any sort of difficulties, and
> the Rorschach is a way to look beyond the way people present themselves.
>
> "We take some of the familiar away," he said, "and look at patterns of
> perceptions in a highly statistical manner."
>
> But even with Dr. Exner's scoring system, the embrace of the Rorschach,
> and other projective tests, has been far from universal.
>
> "There is widespread criticism, there's no doubt about it," said Dr.
> Wayne H. Holtzman, Hogg professor of psychology at the University of
> Texas at Austin, who in 1956 developed his own inkblot test to correct
> deficiencies he saw in the Rorschach.
>
> Dr. Lilienfeld and his colleagues argue, for example, that there is
> "virtually no evidence" that the Rorschach can accurately diagnose
> depression, anxiety, post-traumatic stress disorder or some other
> emotional problems, calling into question the test's usefulness in
> custody hearings or as a diagnostic tool in psychotherapy.
>
> (The Rorschach is such a common feature of custody disputes that Fathers'
> Right to Custody, a nonprofit organization, includes advice on its Web
> site on the best ways to respond to the inkblots. Describing one
> Rorschach card, for example, the site counsels, "This blot is supposed to
> reveal how you really feel about your mother." In another case it
> advises, "Schizophrenics sometimes see moving people in this blot.")
>
> Equally scant, Dr. Lilienfeld and his colleagues conclude, are the data
> supporting the test's use in parole and sentencing hearings to evaluate
> whether prisoners are prone to violence or likely to commit future
> crimes. Research suggesting a relationship between certain Rorschach
> indicators and psychopathic tendencies and violent behavior has been
> contradicted by later studies, the authors say.
>
> "It just doesn't work for most things that it's supposed to," Dr. Wood
> said.
>
> And the psychologists argue that even when the Rorschach appears to have
> greater validity < for example, in assessing intelligence, diagnosing
> schizophrenia and predicting a patient's success in psychotherapy < it is
> not clear how much additional knowledge is gained from the test.
>
> In some studies, they point out, the ability of clinicians to predict
> behavior or diagnose mental disorders actually went down when data from
> the Rorschach were added to information derived from other tests.
>
> "The critical question is what, if anything, does this measure buy you
> above information that could be more easily collected," Dr. Lilienfeld
> said.
>
> Detecting Abnormality
>
> Another problem with the Rorschach, the psychologists say in their
> review, is that the test tends to "overpathologize," making even normal
> people look maladjusted.
>
> In a study, which they reviewed, of 123 subjects with no psychiatric
> history who were given the test, most at a California blood bank, 16
> percent scored in the abnormal range on the test's schizophrenia index <
> far higher than the 1 percent incidence of the illness in the general
> population indicated in other surveys. Eighteen percent showed signs of
> clinical depression on the test, and 29 percent had indicators of extreme
> narcissism.
>
> Empirical backing for the validity of the other two projective measures,
> the T.A.T. and the human figure drawing test, was sketchy at best, the
> review's authors found, with the drawing test "the weakest" of the three
> tests.
>
> Psychologists like Dr. Weiner, the author of "Principles of Rorschach
> Interpretation" and another book on the test, strongly disputed the
> conclusions drawn in the review.
>
> They said a diagnosis was never made on the basis of the test alone.
>
> "There are plenty of studies that show the Rorschach can help you
> identify people who have schizophrenia or whether people are depressed,"
> Dr. Weiner said, "but the test doesn't make the diagnosis. No single test
> that a clinician uses makes the diagnosis. If you're going to use this
> instrument effectively, you're going to take a lot of things into
> consideration."
>
> He added: "Tests don't `overpathologize.' That's done by the person who
> interprets them."
>
> Dr. Meyer, of the University of Alaska, said that while more research
> needed to be done on some of the issues raised by Dr. Lilienfeld and his
> colleagues, their views did not fairly reflect what is known about the
> validity of the Rorschach and other tests.
>
> In an article to be published in the journal American Psychologist, Dr.
> Meyer and other researchers conclude that the validity of psychological
> tests, including the Rorschach and the T.A.T., is comparable to that of
> medical tests, like ultrasounds and M.R.I.'s. The article is based on a
> review of 125 meta-analyses of the validity of psychological and medical
> tests.
>
> But even Dr. Exner, the developer of the comprehensive system, agreed
> that the test "can be abused unwittingly by the ill-trained person," and
> he said he was uncomfortable with the use of the test in "adversarial"
> settings, like custody disputes, unless the psychologist was working for
> the court, rather than for one parent or the other.
>
> "It takes a long time to learn the Rorschach and you've got to work at
> it, it's not simple," said Dr. Exner, who is also the curator of the
> Rorschach archives.
>
> The real question for clinicians in using the test, he said, is, "What do
> you want to know about the individual?"
>
> "If you're interested only in some diagnostic labeling," Dr. Exner said,
> "I don't know that the Rorschach is worth doing, not simply because of
> time but because you're flooded with information that you're not going to
> use. On the other hand, if you're going to treat someone, I think the
> Rorschach is a pretty sturdy instrument.
>
> "The strength of the test," he continued, "is that it helps the really
> capable interpreter to develop a picture of an individual."
>
> Copyright 2001 The New York Times Company
>
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