Interrelationship between MMPI-2 and Rorschach variables in a sample of Vietnam veterans with PTSD

Hypervigilance or shutdown? Electrophysiological processing of trauma-unrelated aversive stimuli after traumatic life events

Post-Traumatic Stress Disorder (PTSD) research indicates that hyper-reactivity to trauma-related stimuli reflects reduced prefrontal cortex (PFC) modulation of amygdala reactivity. However, other studies indicate a dissociative "shutdown" reaction to overwhelming aversive stimuli, possibly reflecting PFC over-modulation. To explore this, we used an Event-Related Potential (ERP) oddball paradigm to study P3 responses in the presence of the following: 1. Trauma-unrelated morbid distractors (e.g., "injured bear") related to the Rorschach inkblot test, and 2. Negative distractors (e.g., "significant failure"), among participants with high post-traumatic stress symptoms (PTS; n = 20), low PTS (n = 17), and controls (n = 15). Distractors were presented at 20% frequency amongst the more frequent (60%) neutral standard stimuli (e.g., "desk lamp") and the equally frequent (20%) neutral trauma-unrelated target stimulus ("golden fish"). P3 amplitudes were high in the presence of morbid distractors and low in the presence of negative distractors only amongst the control group. Possible mechanisms underlying the lack of P3 amplitude modulation after trauma are discussed.

The Scientific Status of Projective Techniques

Although projective techniques continue to be widely used in clinical and forensic settings, their scientific status remains highly controversial. In this monograph, we review the current state of the literature concerning the psychometric properties (norms, reliability, validity, incremental validity, treatment utility) of three major projective instruments: Rorschach Inkblot Test, Thematic Apperception Test (TAT), and human figure drawings. We conclude that there is empirical support for the validity of a small number of indexes derived from the Rorschach and TAT. However, the substantial majority of Rorschach and TAT indexes are not empirically supported. The validity evidence for human figure drawings is even more limited. With a few exceptions, projective indexes have not consistently demonstrated incremental validity above and beyond other psychometric data. In addition, we summarize the results of a new meta-analysis intended to examine the capacity of these three instruments to detect child sexual abuse. Although some projective instruments were better than chance at detecting child sexual abuse, there were virtually no replicated findings across independent investigative teams. This meta-analysis also provides the first clear evidence of substantial file drawer effects in the projectives literature, as the effect sizes from published studies markedly exceeded those from unpublished studies. We conclude with recommendations regarding the (a) construction of projective techniques with adequate validity, (b) forensic and clinical use of projective techniques, and (c) education and training of future psychologists regarding projective techniques.

Brief therapy of civil war-related trauma: a case study

The incidence of posttraumatic stress disorder is widespread among refugees who have been exposed to violence or torture. Many families struggle with side effects of this condition, such as recurrent nightmares, flashbacks, emotional detachment, and difficulty trusting people. Some unwittingly become involved in a pattern of alcoholism, family violence, and somatic illness that is rooted in traumatization. Service providers must often struggle with overwhelmed clients whose multiple needs make long-term therapy impractical. Thus, brief treatment appears to be especially well suited to this population. This article describes a case study using short-term psychotherapy (10 to 20 sessions) that aims to restore refugees who are in reasonable emotional health to their premorbid level of functioning. A 4-stage treatment process involving specific tools is described, and the case study is used as an illustration. Contraindications for time-limited therapy are also outlined.

The Rorschach test in clinical diagnosis: a critical review, with a backward look at Garfield (1947)

The present article comments on a classic study by Garfield (1947) then reviews research on the Rorschach and psychiatric diagnoses. Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool. Deviant verbalizations and bad form on the Rorschach, and indices based on these variables, are related to Schizophrenia and perhaps to Bipolar Disorder and Schizotypal Personality Disorder. Patients with Borderline Personality Disorder also seem to give an above-average number of deviant verbalizations. Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or psychopathy.

Racial differences on psychological measures in combat veterans seeking treatment for PTSD

In this article, we examined racial differences in psychometric data on 4 commonly used self-report inventories administered to a group of 206 combat veterans evaluated at a Veterans Affairs Medical Center outpatient posttraumatic stress disorder (PTSD) treatment program. Patients completed the Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, Dissociative Experiences Scale (DES), and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Black veterans showed greater elevations than White veterans on the DES, and the F-K index and Scales 6 and 8 of the MMPI-2. In addition, normative data are presented for the entire sample on each measure. Results suggest that, consistent with studies using the original MMPI, these patients endorse severe levels of psychopathology across a broad range of symptoms, including depression and disturbed thinking. Implications for clinical practice and future research are addressed.