Re:Projective Testing

Henry,

While I share your concerns about the omission of Adlerian projective methods in the Scientific American article, I am more concerned about Scott O. Lilienfield, James M. Wood, and Howard N. Garb's research review methodology. I have followed their work in this area for five years or so and, in light of this and similar articles, am glad that they haven't discovered Adler yet! The following are excerpts from an article in press which addresses many of these issues. It is included here with permission of Carl B. Gacono, the major author.

Carroll

In Press, Journal of Personality Assessment, 2001

Rorschach and Psychopathy: Toward a More Accurate Understanding of the Research Findings

Carl B. Gacono, Ph.D.
Austin, Texas

James L. Loving, Jr., Psy.D.
Philadelphia, Pennsylvania

Robert H. Bodholdt, Ph.D.
Bastrop, Texas [snip]

In this article we endeavor to present the reader with an understandable essay on the relationship between the Rorschach and psychopathy. Some degree of sophistication and applied knowledge of the PCL-R (Hare, 1991) and Rorschach (1942) are necessary to wade through the literature, weigh the relative merits of arguments made by proponents and detractors of Rorschach assessment, and meaningfully interpret the findings of relevant studies. Often, studies reviewing the Rorschach’s utility in assessing ASPD and psychopathy exhibit a flawed or superficial understanding of essential theoretical and methodological issues. Argument derived from a suspect or specious premise, such as the notion that the Rorschach was designed or aspires to correspond with formal DSM-based diagnosis, vitiates conclusions based on such a premise. This article discusses theoretical and methodological issues which can aid the reader or reviewer in achieving a more accurate understanding of this body of research. [snip]

Considering reviews of various debates surrounding the utility of the Rorschach (see dedicated issues of Psychological Assessment: Vol 11, No 3 and Volume 12, Meyer, 1999, in press), we are sometimes struck by discrepancies between “camps” that presumably have access to the same data but interpret those data in largely incompatible ways. We suggest that different interpretations of these same data sets inhere at least partly as a function of some level of undue skepticism; in other words, what one is willing to see. Over 40 years ago the philosopher Feigl (1992) proposed that resolution of such debate would require a return to the data, with the exclusion of what he termed “metaphysical doubt”:

“We might show the philosopher that he has illegitimately extended ordinary or empirical doubt and thus fallen into metaphysical doubt. Ordinary empirical doubt may occasionally be hard to settle. But if it is transformed into metaphysical doubt, then there is no conceivable way of settling it by either logical argument or by empirical demonstration (p. 45).

Some degree of sophistication and applied (rather than textbook or academic) knowledge of the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991) and Rorschach (Rorschach, 1942; Exner, 1993) are essential to forming relevant questions for debate (Borstein, in press). In order to wade through the literature, weigh the relative merits of arguments made by proponents and detractors of Rorschach assessment, and meaningfully interpret the findings of relevant studies, at a minimum the reader must understand the following concepts in relation to psychopathy and its assessment:

(1) that Antisocial Personality Disorder (ASPD; American Psychiatric Association,1994) and psychopathy are related but distinct constructs, differing from each other along important historical, theoretical, and definitional lines;
(2) that psychopathy may be conceptualized both in dimensional terms (i.e., along a continuum of severity) and in categorical terms (i.e., as a taxon or discrete syndrome), and that applying one of these approaches versus the other to PCL-R scores affects research findings;
(3) that psychopathy may manifest in varying forms across various populations, for example across gender or throughout development from youth into adulthood;
(4) how “personality testing,” which is only one facet of both psychological assessment and diagnosis, contributes to the assessment of the dimensional aspects of psychopathy–and how assessment research relates to clinical application of testing and assessment;
(5) that whereas methodological limitations inherent to certain Rorschach/psychopathy studies may limit our ability to generalize these particular findings to other settings, they in no way invalidate the compendium of well-designed studies -- as certain rather persistent Rorschach detractors would have us believe.

Often, studies reviewing the Rorschach’s utility in adding to our understanding of ASPD and psychopathy exhibit a flawed or superficial understanding of one or more of these issues. This impacts the validity and generalizability of their conclusions. Thus, we endeavor to draw the reader’s attention to a number of potential errors present in certain recent critiques of the Rorschach, with particular attention to helping the reader achieve informed conclusions regarding the merits of extant Rorschach-psychopathy research. [snip]

The evaluation of the Rorschach/psychopathy literature requires much greater sophistication than understanding the psychometric properties of the individual tests. When key issues such as the differences between ASPD and psychopathy, the implications of taxon versus dimensional uses of psychopathy, the fundamental differences between psychological assessment and diagnosis, and the various confounds and methodological issues related to psychopathy and Rorschach research are not understood, the reader or reviewer is more vulnerable to being unduly influenced by the current deluge of “Rorschach bashing” wherein plausible sounding but fallacious arguments about the weaknesses in Rorschach validation research are “designed to convince readers of a conclusion, regardless of its accuracy” (Meyer, 2000; p. 77). “As theRorschach evidence base continues to grow and develop, sound and balanced criticism of the literature will help advance scientific knowledge and applied practice. Conversely, publishing assertions that are known to be wrong or misleading can only serve political purposes that thwart the goals of science and retard genuine evolution in the field” (Meyer, 2000; p. 78).

Meloy and Gacono (2000) were correct when they stated: “The Rorschach is ideally suited for the contribution to the assessment of psychopathy (p. 236),” and; “We have validated the use of the Rorschach as a sensitive instrument to discriminate between psychopathic and nonpsychopathic (ASPD) subjects (p237).” Certain Rorschach variables, in well-designed studies, appear to have some level of discriminative strength in differentiating psychopathic ASPDs from nonpsychopathic ASPDs within the nomothetic paradigm inherent to the necessarily quasi-experimental (i.e., non-random assignment to group) designs used in the studies described. It should be clear to any reader that the Rorschach was never designed to establish a diagnosis of psychopathy, but rather the Rorschach can and does contribute valuable information to the assessment process.

When reviewing Gacono & Meloy (1994) and otherwell designed studies--and not taking isolated comments out of context -- what can be seen is that the Rorschach has been useful in providing nomothetic data consistent with the differences between ASPD and psychopathy (psychopaths more detached and self-focused; Gacono & Meloy, 1991; Gacono, Meloy; Heaven, 1990; Gacono, Meloy, & Berg, 1992; Loving, 1998; Smith et al., 1995; Young et al, 2000). Idiographically, we have provided ample guidance and suggestions for the integration of Rorschach data in aiding our understanding of ASPD and psychopathic individuals (Meloy & Gacono, 1995; Gacono, 1998). Future research may demonstrate that the Rorschach along with other instruments such as the MMPI-2 will be useful in defining subgroups among PCL-R delineated psychopaths (Gacono, 1997, 1998, 2000b). It should be noted, however, that while the Rorschach aids in assessing ASPD and psychopathy and perhaps, someday, delineating subgroups among these groups, it would never be used to render a diagnosis of ASPD or psychopathy as the DSM and the PCL-R were designed for and are well-suited to those aspects of assessment.

Resonant with the logic of Feigl (1992), Weiner (in press) writes:

“Scientific debate often proceeds with one side arguing that something is so or something works, while the other side argues that it is not so or does not work. If the proponents base their arguments on accumulating evidence of its efficacy, and the opponents base their arguments on being unconvinced by this evidence there comes a time when being unconvinced exceeds the boundaries of appropriate skepticism. Those who take issue with the abundant and compelling evidence that Rorschach assessment works very well indeed for certain purposes for which it is intended must sooner or later present equally abundant and compelling evidence that it does not work for these purposes, or else put their case to rest.”

When key assumptions underlying a “critical review” are based on erroneous premises, predetermined biases, or misinformation (see Meyer, 2000), subsequent conclusions must either be discounted or viewed with skepticism.

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