Rorschach Assessment of Complex Trauma in Youth

Abstract

Abstract. A history of complex trauma or exposure to multiple traumatic events of an interpersonal nature, such as abuse, neglect, and/or major attachment disruptions, is unfortunately common in youth referred for psychological assessment. The way these adolescents approach the Rorschach task and thematic contents they provide often reflect how such experiences have deeply affected their personality development. This article proposes a shift in perspective in the interpretation of protocols of adolescents who suffered complex trauma with reference to two aspects: (a) the diagnostic relevance of avoidant or emotionally constricted Rorschach protocols that may otherwise appear of little use, and (b) the importance of danger-related thematic contents reflecting the youth’s sense of threat, harm, and vulnerability. Regarding this last aspect, the article reintroduces the Preoccupation with Danger Index ( DI). Two cases are presented to illustrate the approach.

The Rorschach and Trauma – An Update

“…The Trauma Content Index in the CSI sample did not reach significance, likely as a result of the avoidant style. Ephraim (2020), presents clinical findings of youths with complex PTSD. He notes that severely and repetitively traumatized youths commonly give constricted or defensive protocols, those that are form-based, with high Lambdas.…”

“…He notes that the Rorschach protocols of these youths with complex PTSD often included danger-related themes that were directly or indirectly associated with specific trauma memories and/or reflected their strong negative expectations about the world. Ephraim revisits the Preoccupation with Danger Index (Ephraim & Kaser-Boyd, 2003), which was culled from response categories of two trauma groups: victims of torture/state violence, and severely battered women. A thematic content index, the DI contains four categories: Fear, Threat, Harm, and Violent Confrontation.…”

“…Ephraim (2020), presents clinical findings of youths with complex PTSD. He notes that severely and repetitively traumatized youths commonly give constricted or defensive protocols, those that are form-based, with high Lambdas.…”