The Utility of Rorschach Assessment

Rorschach assessment can bring considerable utility to the practice of clinical and forensic psychology. In clinical work, Rorschach findings facilitate differential diagnosis and treatment planning by identifying psychological characteristics commonly associated with various patterns of psychopathology and by measuring a broad range of personality strengths and limitations relevant to setting goals and monitoring progress in therapy. In forensic work, personality characteristics reflected in Rorschach responses often have a bearing on psycholegal issues in criminal, personal injury, and child custody cases. The present article reviews these applications of Rorschach assessment and comments on some issues that have been raised about its utility in these respects.

Clinical Utility

Rorschach assessment can often help clinicians assess the presence and nature of psychological disorder and the extent to which a troubled person needs, is amenable to, and is benefiting from various forms of treatment.

Differential Diagnosis

Many types of psychological disturbance are defined at least in part by personality characteristics that are reflected in Rorschach variables. As three examples commonly encountered in clinical practice, schizophrenia spectrum disorders are marked by disordered thinking and poor reality testing, depressive disorders involve components of dysphoria and negative self-attitudes, and paranoia is characterized by suspiciousness and mistrust of others. Standard Rorschach textbooks (e.g., Exner, 2003; Weiner, 2003a) identify test findings that are likely to indicate disordered thinking (elevated WSum6), poor reality testing (low XA%, low WDA%, low P), dysphoria (elevated C’, Col-Shd Blds), negative self-attitudes (elevated MOR, V > 0, low Egocentricity Ratio), and suspiciousness and mistrust (positive HVI). In these and other instances in which the Rorschach Inkblot Method (RIM) identifies personality characteristics associated with various kinds of symptomatic or characterological disorder, Rorschach assessment can assist clinicians in arriving at a differential diagnosis. Recent research validating these and other contributions of Rorschach variables to differential diagnosis is reported by Baity and Hilsenroth (1999), Blais, Hilsenroth, Castlebury, Fowler, and Baity ((2001), Fowler, Piers, Hilsenroth, Holdwick, and Padawer (2001), Janson and Stattin (2003), Jorgensen, Andersen, and Dam (2000), Perry, Minassian, Cadenhead, Sprock, and Braff (2003), and Viglione (1999).

To apply Rorschach assessment properly in differential diagnosis, however, clinicians must keep three cautions in mind. First, the RIM is not a diagnostic test. It can assist in arriving at diagnoses, as just mentioned, by identifying personality characteristics associated with certain conditions, but it does not provide a direct or specific measure of any of these conditions. For example, the impaired reality testing indicated by a low XA% could be a manifestation of schizophrenia, but it also could be associated with psychotic depression, organic brain dysfunction, mental retardation, or severe antisocial or borderline personality disorder. The RIM is best used as part of a multifaceted test battery that includes self-report as well as performance-based measures, and test results are best interpreted as part of an integrated assessment that takes account as well of interview, observational, and case history data (see Beutler & Groth-Marnat, 2003; Weiner, 2003b, 2005).

Second, some Rorschach indices of adjustment difficulty are better at identifying the presence of psychological disturbance than indicating its absence. These are indices that contribute to differential diagnosis by providing dependable true positive results, but may also generate a fair number of false negative findings as well. Exner (2003, chap. 18), for example, examining the Perceptual Thinking Index (PTI) in the records of 115 nonpatients, 170 schizophrenia patients, and 325 patients with affective or personality disorder, found 98 protocols with PTI > 3, of which 95 (97%) had been given by the schizophrenia patients (i.e., very few false positives). On the other hand, 44% of the schizophrenia patients showed PTI < 4 (i.e., many false negatives). Lowering the cut score to PTI > 2 reduced the false negatives among the schizophrenia patients from 44% to 26% but also increased the false positive rate to 22%, mostly among the affective disorder group.

Similarly, elevations on the Depression Index (DEPI) and the Suicide Constellation (S-CON), although not diagnostic of depressive disorder or imminent suicidal risk, are dependable markers of substantial emotional turmoil. On the other hand, however, persons known to be clinically depressed or actively suicidal may for various reasons produce low scores on these indices, and these low scores seldom warrant ruling out depression or suicide risk. To avoid mistaken inferences, examiners need to familiar themselves with which Rorschach variables are likely to operate in this unidirectional way.

Third, guarded Rorschach protocols rarely reveal a full measure of respondents’ coping capacities or of their adaptive difficulties. A guarded record is defined as one that is long enough to be valid (R > 13) but is also short (R = 14-16) and narrowly focused (Lambda > 0.99). Score elevations in such records can usually be interpreted to indicate what they typically signify; for example, a low XA% identifies poor reality testing whatever the R and Lambda happen to be. Low score frequencies in guarded records can be misleading, however, because the respondents are taking care not to reveal very much about themselves. Many of the low scores in a guarded record should accordingly be interpreted cautiously, if at all.

Insufficient attention to these cautions can lead not only to erroneous clinical inferences, but also to misleading research results. For example, the findings in a DEPI validity study in which false negative and false positive findings are given equal weight, and the sample includes numerous guarded records (which tends to reduce the number of true positives), are likely to yield data suggesting that this index is ineffective in diagnosing depression. In fact, however, all that will have been demonstrated in such a study is an inappropriate application of the DEPI variable, not its ineffectiveness when properly used (Weiner, 2000). Invalidation of an appropriately applied DEPI would require evidence that respondents with elevations on this index are generally free from features of mood disorder (i.e., numerous false positives)—and there is no such evidence.

Treatment Planning and Outcome Evaluation

An extensive literature documents that personality characteristics have considerable bearing on whether and how people are likely to respond to various kinds of psychological intervention (see Clarkin & Levy, 2004). By virtue of measuring personality characteristics, the RIM can accordingly facilitate various decisions in the course of planning, implementing, and monitoring progress in psychotherapy. To begin with, whether patients’ XA% and WSum6 scores indicate serious cognitive dysfunction, and whether they are experiencing disorganizing anxiety or overwhelming stress (as shown in part by their D-scores), have implications for whether they should be hospitalized or can be adequately treated on an outpatient basis.

With respect to the anticipated impact of psychotherapy, certain personality characteristics measured by Rorschach variables have a bearing on patients’ prospects for participating effectively in psychological treatment and deriving benefit from it. Personality characteristics typically associated with amenability to psychotherapy include being open to experience (as indicated on the RIM by Lambda < 1.00), cognitively flexible (a balanced active:passive ratio [a:p]), emotionally responsive (adequate WSumC and Affective Ratio [Afr]), interpersonally receptive (T > 0, sufficient human content [SumH > 2]), and introspective (FD > 0), each of which facilitates engagement and progress in treatment. By contrast, having an avoidant or guarded approach to experience, being set in one’s ways, having difficulty recognizing and expressing one’s feelings, being interpersonally aversive or withdrawn, and lacking psychological mindedness are often obstacles to progress in psychotherapy (Clarkin & Levy, 2004).

As elaborated elsewhere (Weiner, 2004a), these obstacles do not preclude beneficial treatment. However, the Rorschach indices that identify them do alert therapists to the likelihood that patients may progress slowly in the treatment, at least initially. In addition, Rorschach indications of these and other maladaptive attitudes and orientations can be useful in clarifying what the goals of treatment should be. For example, most people whose Rorschach responses suggest that they are emotionally inhibited or out of touch with their feelings (low WSumC) would function more effectively and enjoy their lives more fully if they could be helped to experience and express feelings more readily. Similarly, any Rorschach finding that appears to reflect an area of concern (e.g., numerous m as a sign of feeling helpless to control the events in one’s life) or a potentially maladaptive disposition (e.g., a large Zd- as an indication of being generally hasty and careless in examining situations and coming to conclusions about them) can be translated into a worthwhile treatment target (e.g., gaining a better sense of mastery or becoming more thorough in problem solving and circumspect in decision making).

When treatment planning includes Rorschach assessment to help identify treatment targets, the stage is set for effective use of retesting to monitor progress and outcome in therapy. Thus a highly distressed patient who enters therapy with a D = -3 and on retesting at some later point shows a D = 0 is likely to have made substantial strides toward managing stress more effectively than before and becoming a more comfortable person. Consider, by contrast, an interpersonally distant and withdrawn person with a pre-therapy Rorschach protocol showing T = 0, Cooperative Movement (COP) = 0, and an elevated Isolation Index (ISOL), and whose re-examination 6 months later shows these same findings. This patient is unlikely to have made much progress in treatment, at least with respect to becoming interpersonally engaged and forming an effective working alliance. Retest findings of this latter kind may indicate the advisability of making a change in either the therapist or the therapist’s approach. By reflecting the amount of progress that has been made toward achieving the treatment goals, repeated Rorschach testing can also be helpful in deciding when an appropriate termination point has been reached.

A recent meta-analysis by Gronnerod (2004) involving 38 samples of patients who were re-examined during or following psychotherapy has provided substantial empirical support for the utility of the RIM in monitoring progress in psychotherapy. Illustrative studies demonstrating the validity of Rorschach indicators of change and the effectiveness of various treatment approaches in promoting positive behavior change are reported by Blatt and Ford (1994), Exner and Andronikof-Sanglade (1992), Fowler, Ackerman, Speanburg, Bailey, Blagys, and Conklin (2004), and Weiner and Exner (1991).

Clinical Issues Raised by Critics

Despite the volume of research demonstrating the clinical utility of Rorschach assessment, some critics have questioned the reliability and validity of the RIM and the extent to which examiners can agree in coding it. With respect to the reliability of the instrument, these critics have contended that only a portion of the variables in Exner’s (2003) Rorschach Comprehensive System (CS) have been included in reports of retest studies, thus leaving reliability yet to be demonstrated (Garb, Wood, Nezworski, Grove, & Stejskal, 2001). In fact, however, a summary of Rorschach retest data published by Viglione and Hilsenroth (2001) includes, either individually or within some combinations, virtually all of the CS variables. These data show that the retest correlations for all regularly occurring Rorschach variables with interpretive significance for trait dimensions of personality compare favorably with the reliability data for other widely used assessment instruments, including scales of the Wechsler Adult Intelligence Scale-III (WAIS-III) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2).

Specifically, among adults the stability of most CS variables over intervals ranging from 7 days to 3 years exceeds .75, and 19 core variables with major interpretive significance have shown 1-year or 3-year retest correlations of .85 or higher (Exner, 2003, chap. 11; Gronnerod, 2003). The only Rorschach summary scores with low retest correlations are those associated with state rather than trait personality characteristics (e.g., m and Y). Among children, retesting over brief intervals yields stability coefficients similar to those found for adults. When retested over 2-year intervals between ages 8 and 16, children fluctuate considerably in their Rorschach scores early on but show steadily increasing long-term stability as they grow older. Retest correlations found between ages 14 and 16 closely resemble the long-term correlations shown by adults (Exner, Thomas, & Mason, 1986).

As for the validity of Rorschach assessment, Rorschach critics have contended that the data are not sufficient to warrant its use (Lilienfeld, Wood, & Garb, 2000). This contention has persisted despite contrary findings from an extensive meta-analytic study of Rorschach validity conducted by Hiller, Rosenthal, Bornstein, Berry, and Brunell-Neuleib (1999). These investigators examined data from 2,276 Rorschach protocols and 5,007 MMPI protocols in a random sample of research studies in which some likely associations had been posited between test and nontest variables. Hiller et al. obtained almost identical unweighted mean validity coefficients of .29 for Rorschach variables and .30 for MMPI variables, thereby indicating no significant difference between the overall validity estimates for these two instruments.

Hiller et al. did find an interesting difference between the RIM and MMPI in certain types of effect sizes, however. On the average, Rorschach variables did somewhat better than MMPI variables in predicting behavioral outcomes, such as whether patients remain in or drop out of treatment (mean validity coefficients of .37 and .20, respectively). On the other hand, the MMPI correlated more highly than the RIM with psychiatric diagnosis and self-reports (.37 vs. .18). These differences probably reflect the particular sensitivity of the RIM to persistent behavioral dispositions and the reliance of the MMPI on self-report methodology similar to that on which psychiatric diagnosis are based. However this may be, Hiller et al. concluded that “both instruments [RIM and MMPI] have validity effect sizes of substantial magnitude” that are “about as good as can be expected for personality tests” (p. 291 & 292), and furthermore that both instruments warrant examiner confidence in using them for their intended purposes.

Rorschach critics customarily ignore the Hiller et al. data or, alternatively, contend that these investigators lacked an adequate grasp of meta-analytic procedures: “The Hiller et al. (1999) meta-analysis is flawed,” according to Garb et al. (2001, p. 440). The former is regrettable, and the latter seems unlikely, given the methodological sophistication of Hiller et al. and the care with which they conducted their meta-anlaysis (see Rosenthal, Hiller, Bornstein, Berry, & Brunell-Neuleib, 2001; Rosenthal & DiMatteo, 2000). More likely is the following conclusion drawn by Meyer and Archer (2001) from their review of the available empirical evidence:

The global and focused meta-analyses clearly indicate Rorschach scales can provide valid information. Like all tests, the Rorschach is more valid for some purposes than for others. Given this evidence and the limitations inherent in any assessment procedure, there is no reason to single out the Rorschach for praise of criticism” (p. 499).

As for intercoder agreement, recent research leaves little doubt that adequately trained examiners can achieve substantial reliability in their coding of Rorschach responses. Using four different samples comprising 219 protocols 4,761 responses, Meyer et al. (2002) found a median intraclass correlation (ICC) of .93 for intercoder agreement across 138 regularly occurring Rorschach variables, with 134 of these variables falling in the excellent range for chance-corrected agreement. Examining coder concurrence for 84 protocols with 1,732 responses, Viglione and Taylor (2003) found a median ICC of .92 for 68 variables considered to be of central interpretive significance in the CS. Earlier meta-analytic reviews and studies with patient and nonpatient samples identified mean kappa coefficients ranging from .79 to .88 across various CS coding categories, which for kappa coefficients is generally regarded as being in the good to excellent range (Acklin, McDowell, Verschell, & Chan, 2000).

Some critics of the RIM have dismissed these laboratory studies of intercoder agreement as failing to demonstrate “field” reliability, that is, an adequate level of coding agreement among individuals in practice (Hunsley & Bailey, 1999; Lilienfeld, Wood, & Garb, 2000). However, field reliability data are provided in one of the samples in the Meyer et al. (2002) study and for a sample reported by McGrath et al. (in press). In both of these samples, patient protocols that had initially been coded in clinical practice, without any anticipation of their becoming part of a research project, were later coded independently for research purposes. The obtained correlation coefficients for intercoder agreement were more than adequate in both samples to demonstrate the field reliability of Rorschach scoring.

Forensic Utility

Rorschach assessment facilitates decision-making in forensic settings by measuring personality characteristics that are relevant to resolving psycholegal issues. Some of these personality characteristics, particularly those associated with serious psychological disturbance, are likely to have broad implications in providing forensic psychological consultations, whereas the relevance of other characteristics is specific to particular questions arising in criminal, personal injury, and child custody cases.

Criminal Cases

Forensic consulting in criminal cases most commonly calls for addressing whether defendants should be considered incompetent to stand trial or not guilty by reason of insanity. In legal terms, being competent consists of defendants’ being able to understand the charges they are facing and participate effectively in their defense. Competence is best assessed by asking defendants directly about these matters (e.g., “Do you know what you are charged with?”), often with the assistance of forensic assessment instruments designed for this purpose (see Stafford, 2003). However, courts considering a determination of incompetence typically seek to establish the basis for a defendant’s limited grasp of the proceedings, and defendants are rarely found incompetent in the absence of evidence of mental retardation or serious psychological disturbance. With respect to the latter case, the previously mentioned Rorschach indices of disordered thinking and poor reality testing can help forensic psychologists explain to the court why a seriously disturbed or “psychotic” defendant is having difficulty demonstrating competence.

Defendants pleading insanity are contending through their attorneys that they were not criminally responsible at the time they committed their offense, for one of two reasons. Either they were unable to appreciate the wrongfulness of their conduct, which is commonly referred to as the cognitive prong of an insanity defense and is universally accepted in the United States, or they were unable to refrain from committing the illegal act, which is known as the volitional prong and is allowed in some but not all U.S. jurisdictions. The Rorschach indices of disordered thinking and poor reality testing have a bearing on assessing the cognitive prong of legal insanity, which is basically a matter of being unable to distinguish right from wrong. The volitional prong, which is basically a matter of losing self-control, can be assessed in part by Rorschach indications of acute or chronic stress overload (D < 0, AdjD < 0). The farther the D-scores in a record fall below zero, the more likely they are to be associated with limited frustration tolerance, intemperate outbursts of affect, and episodes of impulsive behavior.

Unlike competence, however, criminal responsibility is determined according to a defendant’s state of mind at the time of an alleged offense, not at the time of a present examination. To offer a defensible opinion concerning criminal responsibility, examiners must accordingly integrate Rorschach evidence of cognitive or volitional incapacity with other types of information, especially reports of how a defendant was behaving just before, during, and immediately following the alleged offense. Nevertheless, certain features of a Rorschach protocol increase the likelihood that any currently measured disturbance was present at some previous point in time. These features include the apparent severity of the disturbance, as reflected in how much the relevant Rorschach scores deviate from normal expectation, and the chronicity of the disturbance, as measured by indications of stability and self-satisfaction (for which the key Rorschach finding is D => 0).

Personal Injury Cases

When plaintiffs in personal injury cases complain of being emotionally distressed as a result of allegedly irresponsible behavior on the part of a defendant, Rorschach assessment of personality characteristics often becomes relevant to evaluating the type and extent of whatever psychic damage they may have incurred. The two types of emotional distress most frequently claimed in these cases are depressive disorder and anxiety reactions, especially in the form of posttraumatic stress disorder. The utility of certain Rorschach variables in identifying cognitive and affective features of depression (i.e., dysphoria and negative self-attitudes) was mentioned in discussing differential diagnosis. As for posttraumatic stress disorder, both flooded and constricted Rorschach protocols are consistent with the presence of this condition, although neither is by itself diagnostic of it.

Flooded protocols are notable for pervasive indications of anxiety. These indications include evidence that people are experiencing intrusive ideation (elevation in FM+m); a considerable stress overload in which they cannot manage the demands in their life without becoming unduly upset by them (D < -1, AdjD < -1); and troubling preoccupations with incurring bodily harm (frequent Aggression, Anatomy, Blood, Morbid, and Sex responses, which constitute Armstrong’s [1991] Trauma Content Index). When produced by persons who have experienced potentially traumatic events, flooded protocols are usually associated with manifestations of stress disorder in hyperarousal and re-experiencing phenomena.

Constricted protocols are characterized by evasion and such hallmarks of guardedness as low R, high Lambda, low WSumC, low Affective Ratio (Afr), and bland content. A constricted Rorschach protocol given by persons who are suspected of having been traumatized suggests a stress disorder characterized by defensive avoidance. Instead of becoming excitable, easily upset, and troubled by flashbacks, nightmares, and other types of re-experiencing, traumatized persons who are defensively avoidant seek urgently to escape or withdraw from thoughts, feelings, and situations that might precipitate or exacerbate an episode of distress (known as shutting down). Research concerning these and other Rorschach correlates of anxiety and stress disorder has recently been reviewed by Luxenberg and Levin (2004).

As in clinical work with the RIM, forensic consultation calls for cautious and informed application of Rorschach findings. With respect to personal injury cases, for example, neither flooded nor constricted Rorschach protocols are specific to anxiety and stress disorder, nor do they provide conclusive evidence that such a disorder is present. Moreover, as in the case of evaluating sanity, the results of a personal injury examination are useful only if they can be interpreted in the context of past events to determine whether present distress or dysfunction constitutes a decline in functioning capacity from some previously higher level prior to the alleged misconduct by the defendant.

Child Custody Cases

Judges faced with determining how supervisory and visitation rights should be allocated between separated or divorced parents commonly solicit information about the personality strengths and weaknesses of these parents. Several personality characteristics are commonly regarded as having implications for how well parents are likely to meet the developmental needs of their children. Prominent among these characteristics are the parent’s general adjustment, coping skills, and interpersonal accessibility.

With respect to adjustment level, serious psychological disturbance often compromises the judgment, impulse control, energy, and peace of mind necessary for a person to function effectively in a parental capacity. Such limitations are suggested by sufficiently deviant scores on several previously mentioned Rorschach variables to identify prominent thinking disorder (WSum6), substantially impaired reality testing (XA%, WDA%, P), pervasive dysphoria and negative cognitions (C’, Col-Shd Blds, MOR, V, Egocentricity Index), overwhelming anxiety (D, AdjD), and marked suicide potential (S-CON).

As for coping skills, Rorschach respondents who show normal range XA% (adequate reality testing), Zd (adequate ability to take in relevant information before coming to conclusions), a:p ratio (cognitive flexibility), and D-score (adequate stress tolerance) are, other things being equal, relatively likely to show the kind of sound judgment, careful decision-making, flexible problem-solving, and effective stress management that facilitate good parenting. Conversely, respondents with subnormal scores on these variables are at relative risk for exercising poor judgment, making decisions carelessly, dealing with problems in an inflexible manner, and managing stressful situations in excitable and impulsive ways, each of which is likely interfere with their functioning effectively as parents.

Regarding interpersonal accessibility, children usually thrive when their parents are nurturant, caring, and empathic individuals who are genuinely interested in people, comfortable in interpersonal relationships, and sensitive to the needs and concerns of others. Conversely, parents who are detached, self-absorbed, insensitive individuals who dislike socializing with other people and being responsible for their welfare are limited in the love, affection, and care they can provide their children. Accordingly, Rorschach protocols with adequate SumH (indicating interest in people), more H than Hd+(H)+(Hd) (indicating interpersonal comfort), a low ISOL (indicating involvement with people), T > 0 (indicating capacity to form attachments), numerous COP (indicating collaborative perspectives on interpersonal relationships), and accurate Human Movement responses (M; indicating empathic capacity) speak positively for parental potential. On the other hand, parents with a low SumH, fewer H than Hd+(H)+(Hd), an elevated ISOL, T = 0 (especially when HVI is positive), COP = 0, and numerous M responses with minus form quality are likely to display limited interpersonal accessibility.

As an interpretive caution, however, such Rorschach inferences about parental attributes are only suggestive with respect to how parents are likely to interact with their children, not conclusive. The RIM can identify probable strengths and limitations in parental capacities and indicate their likely impact, for better or worse, on child-rearing practices. Test findings can accordingly call attention to possibilities that should be pursued further, but only direct observation or dependable reports of actual parental conduct are sufficient to translate these possibilities into established fact.

Forensic Issues Raised by Critics

Despite the demonstrable value of these forensic applications of the RIM, some Rorschach critics have questioned whether the instrument is suitable for use in legal cases. These criticisms, some of which are relevant to clinical as well as forensic evaluations, include assertions that Rorschach assessment overpathologizes, by suggesting psychological disorder when none is present (Wood, Nezworski, Garb, & Lilienfeld, 2001); that “because appropriate norms have not been developed, it is doubtful whether the Comprehensive System should be used to evaluate members of American minority groups” (Wood & Lilienfeld, 1999, p. 341); and that testimony based on Rorschach findings is unlikely to be admitted into evidence in courts of law (Grove & Barden, 1999).

As elaborated by Meyer (2001) and Weiner (2001), the assertion that the RIM overpathologizes is based on compilations of data from small and unrepresentative samples of respondents who were inadequately screened for mental health problems, tested by inexperienced examiners, and in some cases required to take view the cards under unusual circumstances (e.g., while wearing electrodes on their head or being instructed not to touch the cards). In a demographically diverse nonpatient reference sample of 600 reasonably well-functioning adults tested by well-trained examiners, Exner (2003, chap. 12) obtained results for core CS indices of psychopathology that clearly negate allegations of overpathologizing. Among these 600 respondents, none showed an elevation in the Perceptual Thinking Index (PTI), just 5% had an elevated DEPI, the CDI was elevated in only 4%, and just 3% had a positive HVI. Because these nonpatient reference data were collected some 20 years ago, Exner is currently conducting a replication of this normative study. Among the first 350 persons examined in this new study, the results confirm that elevations in these Rorschach indices of serious psychological disturbance or adjustment problems rarely occur in well-functioning adults: 0.2% with PTI > 3, 11% with DEPI > 5, 7% with CDI > 3, and 3% with HVI positive (Exner, 2002).

With respect to cultural diversity, recent research findings contradict the assertion that Rorschach assessment is inappropriate for minority groups. Presley, Smith, Hilsenroth, and Exner (2001) examined the records of 44 African Americans and 44 demographically matched Caucasian Americans in the CS nonpatients reference sample and found significant differences between them on only 1 of 23 core Rorschach variables. Meyer (2002), comparing the records of demographically matched European American, African American, Hispanic American, Asian American, and Native American respondents in a multicultural sample of 432 patients consecutively evaluated in a hospital-based psychological testing program, found no association at all between ethnicity and any of 188 Rorschach summary scores. There is no substantial empirical basis for disagreeing with Meyer’s (2001) conclusion that “the available data clearly support the cross-ethnic use of the Comprehensive system” (p. 127).

As for assertions that Rorschach testimony is unlikely to be admitted into evidence, McCann (1998), Ritzler, Erard, and Pettigrew (2002), and Hilsenroth and Stricker (2004) among others have to the contrary delineated precisely how and why a properly conducted Rorschach assessment satisfies applicable legal standards for admissibility. Specifically, the RIM is widely used in the professional community, is the second most extensively researched personality assessment instrument (after the MMPI), is a testable procedure that yields reliable results with known error rates, and has been the subject of thousands of articles in peer-reviewed journals, which taken together make Rorschach testimony eminently admissible by all prevailing legal standards.

Of further significance, survey findings indicate that the RIM is in fact frequently used in forensic cases and rarely challenged in the courtroom. Among forensic practitioners surveyed, 30% have reported using the RIM in competence evaluations, 32% in assessing criminal responsibility, 41% in personal injury cases, and almost 50% in evaluating adults in custody cases (Ackerman & Ackerman, 1997; Boccaccini & Brodsky, 1999); Borum & Grisso, 1995; Bow, Quinnell, Zaroff, and Assemany, 2002). Examining the cases of 134 young people evaluated in the course of juvenile court proceedings, Budd, Felix, Poindexter, Naik-Polan, and Sloss (2002) found that over 90% had been given performance-based personality assessment measures.

As for how the RIM is received in the courtroom, a survey of almost 8,000 cases involving Rorschach-based testimony identified only six instances in which the appropriateness of the instrument was challenged, and in only one of these instances was the testimony ruled inadmissible (Weiner, Exner, & Sciara, 1996). Of 247 cases in which Rorschach evidence was presented in federal courts of appeal, 90% proceeded without challenge to the either the admissibility of the Rorschach findings or their import (Meloy, Hansen, & Weiner, 1997). When the relevance or utility of the Rorschach findings was challenged in 10% of these appellate cases, the challenges were typically directed at how the data were being interpreted rather than at the appropriateness of the method itself.

Summary

In summary abundant research findings as reviewed in this article document that Rorschach assessment is a reliable procedure with considerable validity for clinical and forensic purposes. These purposes include assisting in differential diagnosis and treatment planning and facilitating decision-making in criminal, personal injury, and child custody cases. The RIM is widely used for these purposes, and Rorschach testimony is regularly accepted into evidence in the courtroom. Although some critics have questioned the psychometric soundness and legal suitability of Rorschach assessment, their criticisms lack any solid conceptual or empirical basis.

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