To address the utility of the Rorschach, the author synthesized a large sample (N = 138) of empirical, quantitative research published in the past 20 years. Longitudinal and behavioral criteria and ecological incremental validity beyond self-report and interview were emphasized because of their relationship with test applications. Methodological issues (temporal consistency, diversity, clinician judgment), applications (treatment outcome, schizophrenia, thought disorder, depression and suicide risk), and selected Rorschach variables are addressed. The evidence reveals that many Rorschach variables are efficient tools for clinical, forensic, and educational applications. The test is particularly useful in (a) individualizing case conceptualizations and interventions and (b) predicting and evaluating outcomes. These conclusions are consistent with using the Rorschach as a behavioral problem-solving test that illuminates the interaction among psychological, biological, and environmental factors.I thank my good friends and colleagues,

The standard model of assessing ego impairment relies on patients' accurate self-report and description of their behavior. This study offers an alternative approach to assessing ego impairment in a population of major depression, melancholic type outpatients treated with tricyclic antidepressants. A new index called the Ego Impairment Index (EII) was developed. The index is derived from the Rorschach test and offers a single composite score of ego impairment. It was hypothesized that those melancholic, biologically depressed individuals who were lacking in ego resources were less likely to benefit from tricyclic antidepressant treatment. Thus, the EII could predict overall outcome while on antidepressants. The results support that the level of ego impairment, as assessed by the EII, could predict depression outcome averaged over 9 weeks of tricyclic antidepressant treatment.

A large body of empirical evidence supports the reliability, validity, and utility of the Rorschach. This same evidence reveals that the recent criticisms of the Rorschach are largely without merit. This article systematically addresses several significant Rorschach components: interrater and temporal consistency reliability, normative data and diversity, methodological issues, specific applications in the evaluation of thought disorder and suicide, meta-analyses, incremental validity, clinician judgment, patterns of use, and clinical utility. Strengths and weaknesses of the test are addressed, and research recommendations are made. This information should give the reader both an appreciation for the substantial, but often overlooked, research basis for the Rorschach and an appreciation of the challenges that lie ahead.

This article describes the development of the Inventory of Problems-29 (IOP-29), a new, short, paper-and-pencil, self-administered measure of feigned mental and cognitive disorders.Four clinical comparison, simulation studies were conducted. Study 1 (n = 451) selected the items and produced an index of potential feigning. Study 2 (n = 331) scaled such index to produce a probability score, and examined its psychometric properties. Study 3 tested the generalizability of Study 2's findings with two additional samples (ns = 128 and 90). Results supported the utility of the IOP-29 for discriminating bona fide from feigned psychiatric and cognitive complaints. Validity was demonstrated with mild traumatic brain injury, psychosis, PTSD, and depression. Within the independent samples of studies 2 and 3, the brief IOP-29 performed similarly to the MMPI-2 and PAI, and perhaps better than the TOMM.Classifications within these samples with base rates of .5 produced sensitivity, specificity, positive predictive power, and negative predictive power statistics of about .80. Further research is needed testing the IOP-29 in ecologically valid field studies.

This study is an extension of our work on a new scale, the Ego Impairment Index (EII; Perry & Viglione, 1991). The index is theoretically based on Beres's (1956) model of ego assessment and was empirically developed on a sample of melancholic, depressed outpatients, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980). The EII is derived from the Rorschach Inkblot Test and offers a single composite score of ego impairment. This study validates the use of the EII with a heterogeneous sample of schizophrenic patients. In support of the trait-like characteristics of the scale, the EII continues to be expressed as a single factor, with a correlation of .98 when comparing the original factor derived from a melancholic population with this sample of schizophrenic patients. Significant correlations were also found between the EII and other clinical indices, including the Magical Ideation Scale, the Schizophrenia Index, and the Minnesota Multiphasic Personality Inventory (MMPI). Finally, the EII was found to differentiate between a paranoid subgroup and a mixed undifferentiated/disorganized subgroup who theoretically have more ego impairment. These results offer support for the use of the EII as an empirical means of quantitatively and qualitatively assessing thought disorder within a theoretical framework. Further research is needed to understand the application of the EII across different diagnostic groups and its relationship to other indices of psychological disturbance.