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Journal of Projective Psychology and Mental Health: Volume 25, Number 1, Jan 2018 Editorial

1. Editorial: 25 Years in Promoting Projective Assessment: A Silver Jubilee Tribute, pages 1-4.

Historically, projective techniques have left an impressive, yet contentious, footprint worldwide (Groth-Marnat, 2009; Handler & Thomas, 2014; Musewicz et al., 2009; Piotrowski, 2015; Piotrowski, Keller, & Ogawa, 1993; Teglasi, 2010; Wood et al., 2011). Interestingly, survey data from recent ‘test use’ studies point to a rather bleak view regarding the status of projective techniques. Ready and Veague (2014) reported that no projective tests ranked among the top 10 tests being taught in clinical psychology programs. Wright et al. (2016), in a national sample of professional psychologists, found that the Rorschach was the only projective method used frequently (ranked in top 13 tests) among a myriad of psychological assessment domains. But do these reports provide an accurate portrait regarding the extent of clinical emphasis devoted to projective techniques in both training and practice? Undoubtedly, there is a perennial need to empirically address the clinical breadth and status of specific projective methods and their place in contemporary assessment practices.

As 2018 denotes the 25th year of continuous publication of the SIS Journal of Projective Psychology & Mental Health, this editorial attempts to elucidate the issue regarding the extent of current usage and emphasis on projective techniques in the mental health field. To that end, I provide data-based evidence in support of the sustainability of projective testing in contemporary professional psychology, based on data reported in very recent studies, from 2013-2017, on a) training in psychological testing, and b) assessment practices by professionals. Moreover, to provide a complete composite on the use of projective methods, survey-based findings in the periodicals literature as well as data reported in recent dissertation research are presented.

First, an objective appraisal regarding research interest in projective techniques seems in order. An online search of the database PsycINFO (conducted September 28, 2017), on the term ‘projective techniques’, yielded 1,857 articles, 43 dissertations, and 73 book chapters since the year 2000. Based on this search, Table 1 presents the top journals, in rank order, where major research findings on projective techniques have been published. Surely this illustration does not reflect a moribund state of affairs regarding projective assessment.

Pertinent to the debate regarding projective tests, an interesting Delphi poll study on “discredited” tests, found that Human-Figure-Drawings, H-T-P, TAT, Rorschach, and Sentence completion methods were not considered ‘probably discredited’ (Norcross et al., 2006). Although some lesser-known projective instruments have fallen out-of-favor, a recent study reported that the Somatic Inkblot Series has attracted robust research attention worldwide (Piotrowski, 2017a; see Dubey et al. in this issue, for a review). Thus, while projective techniques have lost some of their luster over the decades, based on recent survey-based findings, there is still avid interest on projective approaches in mental health assessment by devoted clinicians.

Table 2 presents 10 survey-based studies, reported over the past 5 years, on the topic of assessment practices in both professional training and practice settings. Given the proliferation of broad-band personality tests and brief, symptom-focused scales that have been introduced in the professional literature over the past 2 decades, it is rather commendable that several projective techniques continue to rank among the top 50 most popular psychological tests. Moreover, while projective methods have indeed been de-emphasized in graduate clinical training (Piotrowski, 2015b), several projective tests continue to be embraced by clinical faculty at internship sites (see Bates, 2016; Ready et al., 2016; Stedman et al., 2017). In fact, internship directors encourage pre-internship instruction, obtained during doctoral clinical training; in projective assessment methods (see Faith, 2016). The key factor, in terms of sustainability of projective techniques, will be centered on the status of personality assessment in the professional curriculum (Evans & Finn, 2017; Piotrowski, 2017b).

Thus, based on the findings of these recent reports, Projective methods indeed have a worthwhile place in the clinical armamentarium- Undoubtedly, not as lofty a place as in the decades past, but still cherished by a select minority of proponents who appreciate the challenge in trying to understand the complexities of how individuals perceive and deal with both internal and external reality.

So as SIS celebrates its 25th Jubilee, projective assessment is represented well in this commemorative issue on topics such as the Somatic Inkblot Series, the Rorschach, the TAT, Sentence Completion methods, and assessment training. Indeed, verbal expressive techniques (Panek et al., 2013) and idiographic assessment (Beltz et al., 2016) continue to attract both research and clinical attention. It is apparent that the projective assessment enterprise is not moribund—well exemplified by Teglasi (2013, p. 113), “Insofar as variation in projective test responses are caused by constructs’ capturing phenomena that matter in the lives of individuals, projective techniques are legitimate tools for science and practice.”

2. Somatic Inkblot Series and the Journal of Projective Psychology & Mental Health: Inception to Silver Jubilee, Bankey L. Dubey, Rakesh Kumar and Anand Dubey, pages 5-34.

Somatic Inkblot Series (SIS) emerged as an extension to the existing inkblot techniques, including the Rorschach Inkblot Test. This unique assessment method relies heavily on content analysis to understand the inner cry of a person and penetrates deeper layers of unconscious in order to elicit underlying conflicts and intra-psychic processes which contribute to emotional and interpersonal issues in one’s life. The Series has also made conceptual and procedural advancements by introducing the concept of inkblots into three major forms: (i) Card Form (ii) Booklet Form and (iii) Screen/Video Form. An interview assessment of an examinee focused on image rejection, distorted perceptions of easy to perceive inkblot forms allow an easy access to perturbing areas into the psyche. To make Somatic Inkblot Series available worldwide and promote the projective assessment, Somatic Inkblot Society was formed in 1989 and a peer-reviewed bi-annual publication of Journal of Projective Psychology and Mental Health was launched in 1994 which has a track record of timely publications since its inception. The journal has stimulated researches and applications in Somatic Inkblot Series and related projective techniques and proved to be a major bibliometric resource to academicians, researchers and practitioners of inkblot techniques. In the course of applications, it became apparent that Somatic Inkblot Series is a reliable tool to map personality attributes that are conducive to management and organizational contexts. The present paper is an attempt to summarize and elucidate various aspects of Somatic Inkblot Series and provide an overview of related inkblot techniques. Future directions for the field of assessment are noted.

3. Two Contemporary Rorschach Systems: Views of Two Experienced Rorschachers on the CS and R-PAS, Anthony D. Bram and Jed Yalof, pages 35-43.

There are two prominent evidence-based systems of the Rorschach currently in practice: the Comprehensive System (CS; Exner, 2003), which dominated the field for nearly four decades, and the more recently published Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). The existence of two systems has raised questions and dilemmas for assessment clinicians and educators. In this article, as experienced psychoanalytic assessors and supervisors, we offer commentary regarding our view on the differences between the CS and R-PAS, their strengths and limitations, the tradeoffs inherent in choosing one system over the other, and suggestions for advancing the Rorschach forward in a way that is meaningful for practitioners and students involved in clinical personality assessment.

4. The Rorschach in Research on Neurocognitive Dysfunction: An Historical Overview, 1936-2016, Chris Piotrowski, pages 44-53.

The status of the Rorschach and its role in neurophysiological assessment has had a rather erratic and not so cherished historical journey. Seminal research in this area largely focused on the Rorschach ‘sign’ approach in the study of organic brain disorders, while later research investigated mediating factors such as IQ and affective states. At times, research efforts in this area lay dormant or encountered tepid scholarly reviews. Interestingly, there has been a flurry of recent enthusiasm and research activity on the potential of Rorschach analysis in the study of neurocognitive dysfunction. The current investigation provides a historical review of key research findings in this area, based on 58 studies identified via a bibliometric analysis of the extant mental health literature. The presentation traces the key milestones and findings reported in scholarly research over the past 80 years. The author offers tentative conclusions, based on this provocative body of literature. 5. Projective Personality Assessment: Evidence for a Decline in Training Emphasis, James M. Stedman, Joshua Essery and Cindy A. McGeary, pages 54-59.

The following paper provides an overview and discussion of past and present trends in training related to projective personality assessment. The authors summarize the historical use of projective testing (particularly the Rorschach) and emerging research examining the use of projectives in both graduate and internship training programs. The current state of the research suggests a decrease in emphasis in training with projective techniques across both graduate and internship training programs. This paper further discusses the University of Texas Health San Antonio clinical psychology internship program as one that continues to value and train interns in projective assessment. The authors end this paper with a brief discussion of the reasons for the decline in projective assessment across graduate schools and internship sites.

6. Sentence Completion Methods: A Summary Review, of 70 Survey-based Studies of Training and Professional Settings, Chris Piotrowski, pages 60-75.

In a recent editorial, Piotrowski (2017) contends that the fate of projective techniques will be linked to the precarious status of personality assessment in clinical training settings. Moreover, since 1990, projective techniques, as a class, have been the target of extensive criticism in the scholarly literature (e.g., Lilienfeld et al. 2000). This prompts the question: Have Sentence completion methods and tests(SCTs) lost their luster as a major component of the assessment process? Since scholarly reviews of the extant literature on SCTs have rarely appeared in the recent literature (see Holaday et al., 2000; Sherry et al., 2004), an examination on the status of SCTs would be informative. Thus, the intent of the current study is to determine whether recent shifts in testing practices and research attention in the field of assessment have had a deleterious impact on the popularity of SCTs in graduate training programs and professional usage worldwide. To that end, the author identified, through an extensive literature review, published survey research with regard to SCTs that reported on assessment training and test usage patterns from 1989-2015. The 70 identified survey-based or records-based studies served as the data pool in the current review (Training=16; Practice=54). This analysis indicated that, from a historical perspective, sentence completion methods have been popular assessment tools, evident in that 35 of the70 studies (50%) reported that SCTs have been relied upon to at least a ‘moderate’ degree. However, reliance on SCTs has been more prominent in academic assessment training (69% of studies) than in practice settings (44% of studies). Quite apparent in this review, was the obvious diminution of SCT usage since 2003 in both professional clinical academic programs and in applied settings. One noteworthy exception is that several very recent (since 2014) surveys of internship settings confirm continued emphasis on SCTs. Regardless, supplemental data point to the reality that coursework and training emphasis with SCTs have been rather cursory and unstructured. In addition, these vast survey-based findings suggest that SCTs are embraced more by child clinicians and school psychologists than in mental health assessment of adults. However, based on the evidence in this exhaustive review, it appears that current usage of SCTs is waning. Thus, the future status of SCTsin the assessment enterprise appears rather limited, but certainly not moribund.

7. Efficacy of Cognitive Drill Therapy in Treatment of Multiple Phobias: A Case Study, Sandhya Verma, Bhavana Arya, Neetu Kandhari and Rakesh Kumar, pages 76-79.

Cognitive Drill Therapy (CDT) is a novel form of verbal exposure that allows access and exposure to thoughts of threat perception triggered by objects of irrational fears. This paper reports a case study on the application of CDT in a seven years old child, having two irrational fears (a) darkness, and (b) height. Cognitive drill was implemented based upon this child’s unique danger ideations. Clinical outcome was successful in that the brief CDT intervention rapidly resolved his fears. Additional studies on CDT intervention are suggested.

8. SIS Indices in Parents of Children with ADHD and Intervention Steps, Mahesh Kumar Singh and Anjana Mukhopadhyay, pages 80-85.

The literature indicates that psychopathology of parents of ADHD is a crucial component of failure in the management of ADHD-affected children. The present study aimed to explore parental psychopathological indices in parents of children with ADHD to find out the reason of failure in management which promote psychopathology reciprocally, and frame some systematic intervention steps in parental education. Twenty diagnosed children with ADHD symptoms (5-12years) were studied from clinical centres, Lucknow (India). Children were rated by their parents on the basis of ADHD symptoms. The SIS-I was administered to these parents and result indicated high animal and anatomical response indicating lack of socialization, frustration and preoccupation to inner body parts thereby projecting somatic anxiety. Higher percentage of typical responses and human response denotes a balance between the personality and family pathology of parents of ADHD children.

9. Cognitive Drill Therapy in Illness Anxiety Disorder: A Case Study, Noor Shabina, Tarana Jain, Preeti Singh and Rakesh Kumar, pages 86-91.

We are presenting a case of 37 years old male suffering from illness anxiety disorder for one and half years who was treated with Cognitive Drill Therapy. Following outcome measures were used to map the status of illness anxiety on baseline, termination and follow up. (i) Sheehan Patient Rated Anxiety Scale (ii) Health Anxiety Questionnaire and (iii) Overall anxiety severity and impairment scale. The results revealed a significant reduction on all three outcome measures which were maintained on follow up. A person with Illness Anxiety Disorder (IAD) presents with excessive concern about having or developing a serious and undiagnosed general medical disease. According to DSM-5 (American Psychiatric Association, 2013) in IAD, there is a preoccupation with having or acquiring a serious illness. There is an absence of somatic symptoms and if present they are of mild intensity. The individual has high levels of anxiety about health and performs excessive health-related behaviors of repeated checking of body for signs of illness and may exhibit maladaptive avoidance of hospitals.

10. Implicitly Measured Self Definition and Social Definition Relate to Self-Reported Interpersonal Problems Circumplex Scales, Katherine M. Weber, Jeffrey Vance, Alana Harrison and Sharon Rae Jenkins, pages 92-101.

Social definition and self definition are implicit personality styles in which individuals either adopt or may not conform to societal norms when defining their identity, respectively. The content validity of the scoring categories for this thematic apperceptive technique (TAT) scoring system suggests that self-defining people’s worldview are causally organized and reason-driven, whereas the socially defined worldview includes random events, ineffectual actors, and mental-state preoccupations. One’s implicit style may predict life directions, shape one’s ability to cope, and be related to the types of interpersonal problems one encounters. The Inventory of Interpersonal Problems Circumplex Scales (IIP-C) were designed to describe the types of interpersonal problems one tends to encounter, organized around two orthogonal axes: Dominant-Nonassertive and Self-Sacrificing-Cold, with eight subscales arranged in octants. The bidirectional self-defining versus socially defined scale score was correlated positively with self-reported Domineering problems and negatively with Socially-Inhibited problems. These findings suggest that at the maladaptive extremes of the self-defining versus socially defined continuum, characteristic interpersonal concerns are excessive dominance and interpersonal avoidance, respectively.
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