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Projective Measures of Personality/Psychopathology

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DOI: 10.1002/9781118625392.wbecp035

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Projective Measures of
Personality/
Psychopathology
Steven Tuber1 and Kevin B. Meehan2
1 The City College of the City University of New York,
U.S.A. and 2 Long Island University, Brooklyn Campus,
U.S.A.
Projective measures of personality, such as
the Rorschach Inkblot Method (RIM), the
Thematic Apperception Test (TAT), and the
sentence completion and figure drawing tasks,
challenge the subject to perceive, organize,
and give meaning to sets of standardized,
ambiguous stimuli. They are predicated on
the assumption that the subjects’ responses to
these stimuli reflect aspects of their personality
organization. We respond to ambiguous stim-
uli all of the time in our daily interactions. For
example, when we look across the room and
see our coworkers whispering intently to one
another, we may begin to formulate hypotheses
about what must be going on among them.
Assuming that we are unable to hear the actual
conversation, we use a combination of visual
data (i.e., gestures and facial expressions) and
our own internal schemas of such interactions
(i.e., what people tend to talk about in hushed
tones) to reach a tentative conclusion regarding
the nature of the conversation. However, two
people looking at this exact scene might arrive
at very different conclusions. It is the assump-
tion of projective measures that such individual
variations reflect personality differences, and
that such differences may be codified.
For this reason, it has been noted that the
term “test” is erroneous (Weiner, 1994); the
projective instruments that will be discussed
are best conceptualized as methods or pro-
cedures for capturing the processes used to
make sense of the social world. This conceptu-
alization emphasizes how an individual makes
The Encyclopedia of Clinical Psychology, First Edition. Edited by Robin L. Cautin and Scott O. Lilienfeld.
© 2015 John Wiley & Sons, Inc. Published 2015 by John Wiley & Sons, Inc.
DOI: 10.1002/9781118625392.wbecp035
sense of data; the content of a participant’s
response is often not as important as the
method of structuring the response, including
the strategies, assumptions, and biases that led
to its formation.
This entry discusses the history of projective
testing and its central principles, and describes
the most commonly used projective measures:
the Rorschach Inkblot Method (RIM), the The-
matic Apperception Test (TAT), and the sen-
tence completion and figure drawing tasks.
Principles of Projective Testing
Projective measures of personality have been
central to the diagnostic testing process for
clinical psychologists in the United States
since World War II, and were well within the
province of research psychologists for 20 years
prior to that. These procedures rest on two
principles. First, the experience of perceiv-
ing and then attending to a visual stimulus
sets off an interpretive process that actively
combines sensation, memory, and associa-
tion. Consistent with contemporary social
cognitive research, this perspective notes that
people quite naturally try to organize and
make sense of ambiguous information based
on existing cognitive and affective schemas.
Though conscious deliberation may contribute
at a later stage of perception formation, the
first (and most influential) steps in processing
information occur quite quickly and outside
of conscious awareness (Hassin, Uleman, &
Bargh, 2005). Second, as the inherent ambi-
guity of the stimuli becomes greater, the
interpretive process becomes more taxing and
reliant on implicit memories and associations
as opposed to declarative recall of known
information. Thus presenting a subject with
a common water bottle, for example, and
asking the respondent “what could this be?”
is unlikely to elicit a response that relies on
implicit association (“it’s a cantaloupe”) unless
2 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY
the respondent is floridly delusional or humor-
ously pulling the examiner’s leg. The familiar,
objective nature of the water bottle exerts such
a strong pull on the respondent’s declarative
memory of prior such objects that there is
little room for implicit association (Hassin,
Uleman, & Bargh, 2005). Conversely, the use
of an inherently ambiguous stimulus prevents
the respondent from relying on an easily
retrieved, more objectively derived response.
The process by which the subject produces
implicit associations, the content therein and
the dialectical relationship between process
and content thus become the material through
which an assessment of personality can be
made. When this assessment is further situated
within the context of the respondent’s develop-
mental history and current social functioning,
the result can be a phenomenologically alive
“portrait” of the individual with meaning-
ful heuristic applicability to the respondent’s
ongoing life.
The term “projective” used to describe
these measures is an historic artifact and
overly simplistic. Derived from Frank’s (1939)
description of the “projective hypothesis,”
which states that one is likely to project onto
ambiguous stimuli various reparative efforts to
make the stimuli less foreign, it has remained
linked with any diagnostic measure of an
ambiguous nature. Projection may indeed be
one part of the interpretive process with these
measures, but it is far more likely that a more
complex interplay among a variety of adaptive
and defensive processes occurs whenever a
respondent is asked to make sense of stimuli to
which there is no “easy” or linear association
or meaning. The use of projective measures
is best employed in conjunction with tests of
intelligence, neuropsychological functioning
and/or self-report (Weiner & Greene, 2007).
This conjoint usage balances both relatively
objective and subjective response–demands,
minimizing an overreliance on assessing
respondents with either one or the other type
of assessment procedure.
The Rorschach Inkblot Method
The most commonly used projective mea-
sure and, simultaneously, the oldest and most
controversial of the measures, is the RIM.
Although the use of inkblots as projective
measures has been reported as early as the
1850s, it is the work of the Swiss psychiatrist
Hermann Rorschach (1884–1922) that is seen
as generative in the development of projective
methods. In the first two decades of the twenti-
eth century, Rorschach assessed the responses
of severely disturbed inpatients to a variety
of inkblots he created. The task was first and
foremost a visual one, in that patients were
shown the cards one at a time and asked what
they looked like. At the end of the viewing of all
10 cards, the examiner then asked patients to
justify how they saw each of their responses. By
standardizing the inkblots shown and present-
ing them in a prescribed sequence, Rorschach
began accumulating a systematic conception
of what various responses meant diagnostically
and prognostically. He reported two broad
dimensions of personality: (a) subjects whose
“introversive” responses focused on the move-
ment of perceived human or animal figures in
the blots and (b) subjects whose “extratensive”
responses focused on the brightly colored parts
of the blots, often with affectively enlivened
reactions to these areas. The first type of sub-
jects were linked to Carl Jung’s (1875–1961)
novel and recently developed conception of
personality types he called “introverts” and
“extroverts,” respectively. Rorschach suggested
that an examination of the balance between
a subject’s movement responses and color
responses to the inkblots could parallel and
enhance Jung’s conception of this key organiz-
ing principle for understanding personality.
This introverted/extroverted continuum could
then be linked to the broader diagnostic
categorical depictions advanced during that
era of placing patients along a continuum
of hysteric/obsessional cognitive styles and
pathologies.
Rorschach died in 1922, shortly after the
publication of his original work, with the
 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY
inkblots he chose named after him. A protégé,
Emil Oberholzer, took over the usage and
promulgation of the procedure, which con-
tinued to be linked conceptually to a broadly
psychodynamic framework for understanding
both adaptive and pathological cognitive pro-
cesses. By World War II, at least five different
scoring systems had been created to system-
atize RIM responses, and the seminal work
of David Rapaport, Marguerite Hertz, Bruno
Klopfer, and Samuel Beck each independently
provided a complex rationale for how and why
responses to these 10 inkblots could be used
in personality assessment. Each of the scoring
systems systematically coded responses as to
their use of form (the shape of the percept),
movement (human, animal and inanimate),
color (chromatic and achromatic), shading
(texture, dimension, and diffusion), and con-
tent (human, animal, plant, object, etc.). Each
system also evaluated the accuracy of the
response compared with consensual findings
for a given area of a particular blot. Each was
also interested in the degree of cognitive con-
trol the respondent had over the nature of their
usage of movement, color, and the like. That is,
respondents differ as to whether being drawn
to a colorful area of a blot evokes an association
to a percept with a specified shape (a red rose,
for example) or whether a more vague or even
amorphous form is given to a percept (e.g.,
“some kind of flower” as a vague response or
“just a black mass” as an amorphous response).
Responses with a greater degree of specificity,
which are consensually seen as accurate, are
thought to reflect respondents’ greater cogni-
tive control over their associative processes. At
the pathological end of the cognitive contin-
uum are responses indicative of disruptions in
the appropriate boundaries between ideas and
affects. A person may personalize a response
(“it looks like my mother”); ascribe malevo-
lence to a percept (“it’s evil and will do harm”);
and/or attach bizarre ideas to it (“it’s two hypo-
dermic needles getting high off one another”).
Similarly, responses may also compromise
boundaries so that two different percepts may
3
be fused impossibly into one (“it’s by itself and
red so it’s a bloody island”).
Despite flourishing in clinical practice
through the middle of the twentieth cen-
tury, research support for the method lagged
far behind. The sparseness of early research
stemmed from the fact that there was little
agreement as to which of the five similar but
competing systems the Rorschach should
be evaluated on, as well as a more general
resistance to research in some psychoan-
alytic circles. In the 1970s, John E. Exner
(1928–2006) introduced the Comprehensive
System (CS; Exner, 2003), which sought to
integrate the five systems, as well as approach
interpretation of responses from an athe-
oretical, actuarial standpoint. This system
eschewed reliance on clinicians’ subjective
impressions of what responses meant, and
instead attempted to base interpretations on
systematic differences between variables in
clinical and nonclinical samples. Although
this more data-driven approach to Rorschach
assessment was laudable, the CS suffered from
two primary limitations that have led it to
become a source of significant controversy in
clinical psychology. First, for many years the CS
relied on problematic normative data (Garb,
Wood, Lilienfeld, & Nezworski, 2005) that has
only recently been improved with a large inter-
national normative sample (Meyer, Erdberg,
& Shaffer, 2007). Second, in the process of
integrating prior systems, the CS added dozens
of interpretive variables and ratios, many of
which had little empirical support (Lilienfeld,
Wood, & Garb, 2000). A recent meta-analysis
found that of the 65 main variables in the CS,
13 variables had excellent support, 17 had good
support, 10 had modest support, 13 had little
to no support, and 12 have never been stud-
ied (Mihura, Meyer, Dumitrascu, & Bombel,
2013). Based on these findings, there have been
recent efforts to develop a consolidated system
for evaluating the Rorschach that retains only
those variables with empirical support, known
as the Rorschach Performance Assessment
System (R-PAS; Meyer & Eblin, 2012).
4 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY
Although coding systems should continue to
evolve to best capture current empirical knowl-
edge, supporters and critics of the Rorschach
agree that as a tool it has demonstrated value
in evaluating disordered thought processes
and dependency needs, and in predicting
treatment outcome (Garb et al., 2005; Weiner
& Greene, 2007). Further, non-CS scales such
as the Mutuality of Autonomy (MOA) scale
and the Ego Impairment Index (EII) have
shown strong empirical support in evaluating
interpersonal and psychological impairment,
respectively (Bombel et al., 2009; Diener,
Hilsenroth, Shaffer, & Sexton, 2011). Lastly,
it should be noted that the core variables that
have been integral throughout the history
of the Rorschach (i.e., form, human move-
ment, color, shading, accuracy, distortions)
have received good to excellent support in
the research literature (Mihura et al., 2013).
However, further data on the reliability and
validity of Rorschach systems will be necessary
to address its controversial status (Lilienfeld
et al., 2000).
The Thematic Apperception Test
There is a human propensity for story-telling
as a means of imposing meaning. Indeed,
humans communicated by story-telling for at
least 100,000 years before literacy turned nar-
ratives into written forms. Telling stories may
thus by now be hard-wired into the human
condition. To ask respondents to tell a story,
therefore, is to ask them to perform a fun-
damentally human task. To ask respondents
to perform this task when the pictures that
serve as their inspiration are ambiguous at
best and downright morbid at worst, therefore,
challenges this basic human capacity to the
fullest.
The TAT asks the respondent to do some-
thing that is required on a daily basis: tell a
series of stories that make sense out of a given
situation. On average 10 TAT cards are admin-
istered, each depicting ambiguous scenes of
one to three people in what appear to be emo-
tionally charged interpersonal moments. The
respondent is asked to tell a story to each of
the cards that includes: (1) what is going on
in the picture, (2) what led up to the scene,
(3) what will happen in the future, (4) what
the characters are feeling, and (5) what they
are thinking. In doing so, the respondent is
challenged to organize the figure(s) into a
gestalt that both contains a coherent narrative
and integrates the perceived emotionality of
the scene. The TAT is thought to have a real-life
analog in its asking the respondent to scan the
facial features and body language of people,
assess the settings where and emotions with
which such postures occur, and integrate these
data into a story-form, all under the eyes of a
watchful examiner. For example, consider the
person who enters a meeting with a prospec-
tive employer. How well does the person
“read” the situation, successfully conveying
his or her strengths without putting off this
prospective boss? This process is thought to
have immediate application to many aspects of
everyday life.
Furthermore, when prompted with “What
led up to this story?” the respondent is chal-
lenged to make the thoughts and feelings of the
“present” coherently linked to the “past.” Once
again, the analogs to the real world are telling.
Think of the respondent who goes into a meet-
ing and reads the faces of his or her colleagues
as friendly even though he or she has been held
accountable for a blunder in prior meetings.
The need for both accuracy (“What’s going on
in the picture?”) and coherence (“What led up
to it?”) in nearly every social setting is essential.
The TAT evaluates the capacity to link past and
present with future ramifications by also asking
“What will happen in the future”? Once again,
the analogs to the “real world” are germane.
If the child in the playground has accurately
read her past and present reputation among
her peers, she is far more likely to predict
accurately what a given behavior might do to
her future standing. The TAT thus provides
the clinician with information to assess how
comfortable and competent the respondent is
in accurately reading a difficult situation, in
linking the present to the antecedents that may
 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY
have caused it, and in coming up with a con-
vincing future approach that either validates
the present course of action or warrants a new
and better approach.
The final two TAT probes, moreover, are
thought to evaluate emotional problem solv-
ing. The respondent is not simply asked to
create a narrative; he or she is also asked to
state what the characters are each thinking and
feeling. This is thought to reflect the respon-
dent’s level of complex emotional reasoning:
Are characters capable of having different feel-
ings for different reasons? Can they both think
and feel, or is one simply an extension of the
other? Asking what a character in a TAT scene
is thinking and feeling is thought to provide a
window into the respondent’s ability to assess
the mental states of others, especially in the
context of an often negatively toned setting.
If characters in a story can not only cohere
their thinking with their actions, but also can
be described as having affects commensurate
with their experience, the implications for
similarly advanced reflective capacities in
their everyday lives can be posited. Failures
in linking a character’s line of reasoning to a
given story line, conversely, impel the clini-
cian to think about the disjunction between
thought, affect, and behavior. Thus the TAT is
a narrative-making task whose instructions,
though seemingly simple, are thought to push
the testee to respond in a manner consistent
with the social and emotional demands of
“real life.”
Despite also flourishing in clinical practice
through the twentieth century, research sup-
port for the TAT has also lagged behind. This
is most centrally related to the fact that there is
no comprehensive system for evaluating TAT
responses; instead most clinicians evaluate
respondent’s cognitive, affective, and inter-
personal processes through the idiographic
process previously described. However, there
have been three systems developed to evaluate
more specific aspects of TAT data that have
received strong empirical support (Weiner &
Greene, 2007). The TAT has demonstrated util-
ity in assessing defense mechanisms (DMM;
5
Cramer, 2000), social cognition and object rela-
tions (SCORS; Stein, Slavin-Mulford, Sinclair,
Siefert, & Blais, 2012), and the need for achieve-
ment (n-Ach; see Weiner and Greene, 2007).
However, concerns have been raised about
the reliability and validity of these systems
(Lilienfeld, Wood, & Garb, 2000); though some
argue that more recent data may allay some
of these concerns (Stein et al., 2012). Further-
more, although a growing evidence base for
such measures suggests that TAT stories can
be evaluated with reliability and validity, there
are many other aspects of TAT narratives that
are regarded as clinically useful but have yet to
be evaluated empirically. Again, further data
on the reliability and validity of TAT systems
will be necessary to address aspects of its
controversial status (Lilienfeld et al., 2000).
The Sentence Completion Task
The sentence completion task (SCT) provides
the respondent with a much less stressful psy-
chological milieu: simply complete a sentence
stem with whatever comes to mind. Because
this task is less taxing and less likely to reveal
pathological features than the RIM and TAT,
it may provide balance in an assessment by
highlighting adaptive resources. Though there
are many versions of the SCT, respondents
are general told that they will receive a series
of beginnings of a sentence and are asked to
complete each in whatever way they would
like. This may be given on paper, and subjects
are asked to write sentences. Alternatively, the
sentence stems are presented aurally in a brisk
succession. This is done with the hope that
the respondent develops a rhythm such that a
response is the “first” thing that comes to mind,
rather than an attempt to provide a socially
appropriate response. Naturally, respondents
will exhibit a range in their capacity to develop
such a “free associative” response rhythm.
Indeed, one way to assess a respondent’s per-
formance on this task is to note how much
time is taken to respond to a given sentence
stem. Inordinately long pauses, either prior to
the start of a response or during the response
6 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY
itself, suggest a disruption in the flow of their
associations to the stem. These disruptions
give a window into the processes stirred up
by a particular stem, which when added to
the interpretation of the content of the tes-
tee’s responses, allow the sentence completion
method to be used to its fullest.
The interpretation of an SCT follows the
same general framework as the RIM and TAT.
Disruptions in cognitive and affective process-
ing are assessed through lapses in syntax and
unusual pauses in the response process, sug-
gesting a defense-based disruption in the usual
flow of a respondent’s speech and response
patterns. Respondents tend to also perseverate
upon a theme evoked by a stem, resulting in
3–5 consecutive responses that converge upon
a salient issue for the respondent. Respon-
dents also tend to depict a theme and then its
opposite in successive or nearby stems. In a
typical sentence completion performance, the
respondent tends to evoke 4–6 fundamental
issues with which they struggle. These core
issues are then often found in different forms
on the other projective methods used, creating
a coherent “fingerprint” of the respondent’s
experience. Each sentence stem becomes a
springboard for the generation of one or more
hypotheses as to its meaning. These hypotheses
can then be tightened, expanded, revised, or
discarded with each and every other sentence
stem reviewed. The more specific and succinct
each hypothesis, the easier it can be refined,
confirmed, or rejected as one progresses to
other sentence stems.
Although many different versions of the SCT
have been adopted by clinicians, the Rotter
Incomplete Sentences Blank (RISB; Rotter
& Rafferty, 1950) and the Washington Uni-
versity Sentence Completion Test (WUSCT;
Loevinger 1985) have been the most widely
used (Holaday, Smith, & Sherry, 2000). The
RISB, although popular with clinicians, has a
very limited empirical foundation. In contrast
the WUSCT, though more commonly used
as a research tool, has demonstrated strong
reliability and validity as a measure of ego
development (Weiner & Greene, 2007).
Figure Drawing Tasks
Drawings and other artistic representations
often reflect aspects of the personality of their
creator. Along these lines, psychologists have
long noted that a testee’s figural representations
often mirror his or her internal representations
of self and others. When controlling for the
testee’s age, fine motor skills, and artistic ability,
attributes that are under- or overemphasized in
figures are thought to reflect underlying needs
or concerns.
The most commonly administered figure
drawing task is the house–tree–person (HTP)
task, in which the testee is simply asked to
draw a house, followed by a tree, followed by
a person. Respondents are often then asked
to describe each figure in order to evoke key
themes associated with the imagery. Also
commonly administered is the draw-a-person
(DAP) task, in which the testee is asked to draw
a person, then a second person of the opposite
sex (from the initial figure), followed by a short
story accompanying each figure, as well as
a drawing of oneself, followed by a descrip-
tion of oneself as a person. Last, the kinetic
family drawing (KFD) task asks for drawings
of the members of one’s family engaged in
some kind of activity, followed by the name
and description of each person as well as
what the family is like and how they tend to
get along.
In terms of how these drawings are evaluated,
a consideration of the developmental progres-
sion of drawings in children provides a context
for how and why this projective measure could
gainfully be used to assess personality. The
capacity for representing imagery pictorially
progresses through development as a result of
an interaction between perceptual/fine motor
capacities and representational development,
as articulated in the stages of cognitive devel-
opment described by Jean Piaget (1952) as well
as Heinz Werner and Bernard Kaplan (1963).
Sensorimotor level representations, and
associated pictorial imagery, are embedded
within the child’s immediate sensory experi-
ence. Objects are not yet represented as objects,
 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY
but rather organized around sensations such
as how they feel to rub, bite, and squeeze.
At this level, imagery is organized according
to how it “feels to me” rather than features
or categories that can be objectively agreed
on (such as a drawing by a 3-year-old of
“dinosaurs wrestling,” which consisted of
two intensely colored spiky blurs with no
discernible features).
Preoperational level representations, and
associated pictorial imagery, begin to have
discernible features that others can appreciate,
and yet the imagery is somewhat egocentric in
its close tie to the child’s subjective experience.
This is reflected in drawings in which objective
features are more clearly depicted but highly
influenced by how it “feels to me” (such as a
drawing by a 5-year-old of “me and mom,”
each depicted as heads with protruding limbs,
with the mom exponentially larger—despite
the mother’s petite stature in reality).
Conceptual (or concrete operations)-level
representations, and associated pictorial
imagery, are primarily logical and have coher-
ent features and categories. This is reflected
in drawings that are much more technically
accurate, though this is usually accomplished
through suppressing the more dynamic and
affective influence on earlier drawings (such
as a drawing by a 9-year-old of a soldier,
which was structurally accurate but obsessively
detailed).
Werner and Kaplan (1963) noted that
although there is a move towards higher
conceptual level representations through
development, we do not abandon more prim-
itive ways of representing our experience.
Therefore at the highest levels of representa-
tional development (or formal operations),
the individual is able to recruit subjective
affective/sensory experience in the service
of abstractly elaborating what is otherwise
accurate and reality-based imagery with fan-
tasy and creativity (such as a drawing by a
12-year-old of her family, with accurately
formed figures that were each shaded with a
primary color representing an aspect of each
member’s personality).
7
This developmental progression mirrors the
continuum along which figure drawings may be
assessed. Ego strength may be indicated by the
degree to which the testee can integrate realism
and technical accuracy with more dynamic
and sensory aspects of his or her experience to
bring creativity to the drawing. On the other
hand, distortions may be conceptualized as
the emergence of a “preoperational process”
in which logical accuracy has been subsumed
by the testee’s subjective experience and need
states. Distortions in figures, or in parts of
figures, are thought to reflect attitudes and
schematic distortions towards oneself or others
(such as the 10-year-old boy who concretized
his feeling of lacking agency by drawing a
tiny picture of himself with no legs). When
such distortions go beyond what could be
explained by age, fine motor skills, or artistic
ability, the respondent’s straying from logical
accuracy are thought to reflect underlying
needs or concerns associated with the figure
represented.
Figure drawing tasks are difficult to standard-
ize, as there are no test stimuli per se, leading to
very little data on the psychometric properties
of these tasks. As with the TAT, there is no
comprehensive system for evaluating figure
drawings; instead most clinicians evaluate
respondent’s drawings through an idiographic
process. This raises the concern of overzealous
interpretations of drawings that may be highly
speculative and yet based on little data (Lilien-
feld et al., 2000). Nonetheless, drawing tasks
remain quite popular due to their perceived
clinical utility and ease of administration (as
there is no “equipment” required other than
a pencil and paper). Proper use of such tasks
involves staying close to the data and using
findings to generate hypotheses to be borne out
in other empirically supported testing data as
part of a multimodal assessment; conclusions
should never rest on drawings alone.
SEE ALSO: Human Figure Drawings; Incomplete
Sentences Blank; Personality Assessment Inven-
tory (PAI); Rorschach Inkblot Test; Self-Report
Questionnaires; Thematic Apperception Test
 8 PROJECTIVE MEASURES OF PERSONALITY/PSYCHOPATHOLOGY

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