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Interrater agreement and reliability for the Rorschach have recently come under increasing scrutiny. This is the second report examining methods of Comprehensive System reliability using principles derived from observational methodology and applied behavioral analysis. This study examined a previous nonpatient sample of 20 protocols (N = 412 responses) and also examined a new clinical sample of 20 protocols (N = 374 responses) diagnosed with Research Diagnostic Criteria. Reliability was analyzed at multiple levels of Comprehensive System data, including response-level individual codes and coding decisions and ratios, percentages, and derivations from the Structural Summary. With a number of exceptions, most Comprehensive System codes, coding decisions, and summary scores yield acceptable, and in many instances excellent, levels of reliability. Limitations arising from the nature of Rorschach data and Comprehensive System coding criteria are discussed.

Although the Rorschach test has demonstrated significant refinements in reliability, validity, and statistical power as a result of the procedural standardization and scoring innovations introduced by Exner's Comprehensive System, the issue of Rorschach interrater reliability remains unexplored. This article examines the psychometric foundations of Rorschach interrater reliability and applies notions from applied behavioral analysis to the treatment of Rorschach data. We empirically compare 3 methods of quantifying interrater agreement, their accuracy in estimating interrater agreement, and efficiency in reducing error in Rorschach research. Results indicate that the magnitude of differences between methods of quantifying interrater agreement and the associated reductions of error are significant. We propose a standard method for quantifying interrater agreement in Rorschach research.

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The relationship between depression and chronic low back pain (LBP) is controversial. Theorists differ in the emphasis they place on predisposing versus reactive factors in LBP disability and depression. Alexithymia has been suggested as a predisposing factor in psychosomatic disorders, including chronic LBP. This study addresses the association between depression, alexithymia, and LBP using the Rorschach comprehensive system. LBP patients were hypothesized to be distinguishable from Research Diagnostic Criteria-diagnosed inpatient depressives, to exhibit features of alexithymia, and to resemble a group of DSM-III personality disorders. Subjects were 33 chronic LBP patients. Results supported the hypotheses. On depression measures, LBP patients differed significantly from depressives (p less than .001). LBP patients exhibited Rorschach features consistent with alexithymia. They also exhibited a number of similarities to the personality disorders group. The role of alexithymia as a cognitive-mediating factor in coping and adaptation is discussed.