Stimulus Features of the Object Relations Technique Affecting the Linguistic Qualities of Individuals' Narratives

Previous studies on projective techniques have investigated the effects of variation in stimulus features on individuals' response behavior. In particular, the influence of chromatic colors and form definition on the images elicited by the stimuli has been tested. Most studies have focused on the Rorschach and TAT and have examined effects in terms of variables such as reality testing and reactions to perceptual details. This is the first study to examine the effects of variation in visual stimuli as represented in features of the Object Relations Technique (ORT) cards on linguistic indicators of connection to emotional experience using measures of the referential process. The ORT was administered to 207 Italian non-clinical participants to explore effects of color, form and content variation on language style. The sample was stratified by age, gender, marital status and education to be representative of the Italian population. The stories told in response to the card images were rated using computerized linguistic measures, including the Weighted Referential Activity Dictionary-Italian version (IWRAD) which indicates the degree to which language is connected to nonverbal experience, and the Weighted Reflection/Reorganization List-Italian version (IWRRL) which detects a linguistic style of personal re-elaboration of emotional experience. The results provide support for the color-affect and form-reality testing hypotheses. Cards with better form definition, including color definition, and with fewer silhouettes of people elicited responses that were higher in IWRAD and lower in IWRRL, and also higher in the degree to which the two measures varied together. Implications of the results for use of ORT in clinical assessment and intervention are discussed.

Factors associated with utilization of emotion and personality instruments among neuropsychologists

Historically, assessment of emotion and personality functioning was not emphasized by clinical neuropsychologists, who instead focused almost exclusively on the evaluation of cognitive functioning. This study examined current practices regarding clinical neuropsychologists' usage of instruments for assessing emotion and personality, along with factors that may mediate their choice of measures and their beliefs about evaluating emotion and personality. Participants were 117 board-certified neuropsychologists as recognized by the American Board of Professional Psychology (ABPP-CN), many of whom had been practicing for over 20 years (39%). Participants generally indicated that examining emotion and personality is essential to evaluations. There was variability among participants as to whether assessment of emotion and personality functioning is challenging, as well as whether or not clinical interview was better suited than instruments. Patients' lack of self-awareness, purposeful over- and under-exaggeration, and lack of sensitivity and specificity of the assessment instruments for neurologic disorders/conditions were identified as the greatest challenges in this area of assessment. Results of the survey suggest that further advancement in the construction and availability of emotion/personality instruments is necessary.

When's a story a story? Determining interpretability of Social Cognition and Object Relations Scale-Global ratings on Thematic Apperception Test narratives

The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) measures the quality of object relations in narrative material. The reliability and validity of this measure have been well established. However, a psychometric oddity of this scale is that default ratings are given to select dimensions when the relevant construct is not present. This can result in narrative 'blandness' and may impact clinical findings. The aim of these two studies is to understand these phenomena both psychometrically and clinically. In the first study, we identified 276 outpatients who had SCORS-G ratings for TAT Cards 1, 2, 3BM, and 14, set criteria for narrative 'blandness' across all eight dimensions, and examined group differences. In Study 2, we used a subset (N = 99) of Study 1 and examined how percentage of formal default ratings for Emotional Investment in Values and Moral Standards (EIM), Experience and Management of Aggressive Impulses (AGG), Self-Esteem(SE), and Identify and Coherence of Self (ICS) impacted robustness of correlations across tests of intelligence, psychopathology, and normal personality functioning. Taken together, we identified clinical characteristics of patients who are more likely to produce 'bland' narratives and increased percentages of formal default ratings. Also, an excess of default ratings per protocol impacts robustness of correlations and weakens significant correlations. As cut-off scores increase (>25% and >28.12%), the likelihood of being able to interpret EIM, AGG, SE, and ICS decreases. Psychometric and clinical implications are discussed.

The empirically derived Violence and Aggression Risk Index from the Personality Assessment Inventory: Development, validation, and application in general psychiatric settings

The current study developed a new index of violence risk from scales within the Personality Assessment Inventory (PAI). Clinical patients from inpatient and outpatient settings completed the PAI along with reports of violence history and arrest record. A forward-selection hierarchical logistic regression was employed (N = 388) to identify the PAI scales (AGG-P, AGG-A, NON, PAR-H, and ANT-A) that could effectively distinguish patients with and without a history of violence. These indicators were then aggregated into a single index, labeled the Violence and Aggression Risk Index (VARI). The VARI modestly incremented other PAI subscales and indices in an independent clinical sample (N = 387). The authors discuss how the VARI can be incorporated with the other PAI scales to assess violence risk.

Evaluating chronic suicide risk with the Personality Assessment Inventory: Development and initial validation of the Chronic Suicide Risk Index (S_Chron)

The current study sought to develop and validate a new measure of chronic suicide risk (the S_Chron) from the Personality Assessment Inventory in a mixed sample of psychiatric inpatients and outpatients. In an initial development sample (N=397), hierarchical logistic regression identified six PAI variables uniquely associated with multiple versus single/no prior suicide attempts after controlling for sample demographics: Negative Impression Management, Situational Stress, Mania - Grandiosity, Borderline - Negative Relationships, Borderline - Self-Harm, and Antisocial Behaviors. These indicators were then aggregated into a single index (S_Chron) and evaluated in terms of validity in an independent clinical sample (N=398). Results indicated the S_Chron effectively differentiated between groups with multiple versus single/no prior suicide attempts, even after controlling for the effects of the PAI Suicidal Ideation (SUI) and Suicide Potential (SPI) indices, with moderate to large effect sizes observed (range of Cohen's d's=0.30-0.91). Further, the S_Chron incremented all other PAI indices and SUI in predicting multiple suicide attempts. The potential clinical application and ways in which the S_Chron may augment other existing measures of suicide risk are discussed.

An examination of generalized anxiety disorder and dysthymia utilizing the Rorschach inkblot method

This study examined transdiagnostic features of generalized anxiety disorder (GAD) and dysthymia in an outpatient clinical sample. Fifteen patients who met DSM-IV criteria for GAD and twenty-one patients who met DSM-IV criteria for dysthymia but who did not have comorbid anxiety disorder were evaluated utilizing the Rorschach. Salient clinical variables were then compared. Results showed that patients with GAD scored significantly higher on variables related to cognitive agitation and a desire/need for external soothing. In addition, there was a trend for patients with GAD to produce higher scores on a measure of ruminative focus on negative aspects of the self. Thus, not surprisingly, GAD patients' experienced more distress than the dysthymic patients. The implications of these findings are discussed with regards to better understanding the shared and distinct features of GAD and dysthymia.

Factors discriminating creative engagement on an unstructured task: Creativity and the Rorschach

In an attempt to find variables that would discriminate between creativity and psychopathology on the Rorschach, Rorschach data from two groups were compared. The first group was an inpatient sample of creative individuals who also carried a diagnosis of psychosis. The second was a group of creative writers. Both groups were engaged in intensive psychoanalytic psychotherapy. Comparing the most creative versus the least creative of the protocols in each group showed that more creative engagement was characterized by a higher response rate and greater and more idisosyncratic elaboration. Differences also emerged between groups: Whereas the inpatient sample relied more heavily on ideational coping, the writers relied more heavily on affective resources.

Differences in Brain Hemodynamics in Response to Achromatic and Chromatic Cards of the Rorschach: A fMRI Study

In order to investigate the effects of color stimuli of the Rorschach inkblot method (RIM), the cerebral activity of 40 participants with no history of neurological or psychiatric illness was scanned while they engaged in the Rorschach task. A scanned image of the ten RIM inkblots was projected onto a screen in the MRI scanner. Cerebral activation in response to five achromatic color cards and five chromatic cards were compared. As a result, a significant increase in brain activity was observed in bilateral visual areas V2 and V3, parietooccipital junctions, pulvinars, right superior temporal gyrus, and left premotor cortex for achromatic color cards (p < .001). For the cards with chromatic color, significant increase in brain activity was observed in left visual area V4 and left orbitofrontal cortex (p < .001). Furthermore, a conjoint analysis revealed various regions were activated in responding to the RIM. The neuropsychological underpinnings of the response process, as described by Acklin and Wu-Holt (1996), were largely confirmed.

Colour influences perception of facial emotions but this effect is impaired in healthy ageing and schizophrenia

INTRODUCTION

Social cognition is commonly assessed by identification of emotions in facial expressions. Presence of colour, a salient feature of stimuli, might influence emotional face perception.

METHODS

We administered 2 tests of facial emotion recognition, the Emotion Recognition Test (ER40) using colour pictures and the Penn Emotional Acuity Test using monochromatic pictures, to 37 young healthy, 39 old healthy and 37 schizophrenic men.

RESULTS

Among young healthy individuals recognition of emotions was more accurate and faster in colour than in monochromatic pictures. Compared to the younger group, older healthy individuals revealed impairment in identification of sad expressions in colour but not monochromatic pictures. Schizophrenia patients showed greater impairment in colour than monochromatic pictures of neutral and sad expressions and overall total score compared to both healthy groups. Patients showed significant correlations between cognitive impairment and perception of emotion in colour but not monochromatic pictures.

CONCLUSIONS

Colour enhances perception of general emotional clues and this contextual effect is impaired in healthy ageing and schizophrenia. The effects of colour need to be considered in interpreting and comparing studies of emotion perception. Coloured face stimuli may be more sensitive to emotion processing impairments but less selective for emotion-specific information than monochromatic stimuli. This may impact on their utility in early detection of impairments and investigations of underlying mechanisms.

The Impact of an Ego Depletion Manipulation on Performance-Based and Self-Report Assessment Measures

We investigated the impact of ego depletion on selected Rorschach cognitive processing variables and self-reported affect states. Research indicates acts of effortful self-regulation transiently deplete a finite pool of cognitive resources, impairing performance on subsequent tasks requiring self-regulation. We predicted that relative to controls, ego-depleted participants' Rorschach protocols would have more spontaneous reactivity to color, less cognitive sophistication, and more frequent logical lapses in visualization, whereas self-reports would reflect greater fatigue and less attentiveness. The hypotheses were partially supported; despite a surprising absence of self-reported differences, ego-depleted participants had Rorschach protocols with lower scores on two variables indicative of sophisticated combinatory thinking, as well as higher levels of color receptivity; they also had lower scores on a composite variable computed across all hypothesized markers of complexity. In addition, self-reported achievement striving moderated the effect of the experimental manipulation on color receptivity, and in the Depletion condition it was associated with greater attentiveness to the tasks, more color reactivity, and less global synthetic processing. Results are discussed with an emphasis on the response process, methodological limitations and strengths, implications for calculating refined Rorschach scores, and the value of using multiple methods in research and experimental paradigms to validate assessment measures.