Abnormal Psychology. William J. Ray

test takers’ scores to a large international reference sample, using a graphic array of percentiles and standard score equivalents.

      3 Providing a simplified, uniform, and logical system of terminology, symbols, calculations, and data presentation in order to reduce redundancy and increase parsimony.

      4 Describing the empirical basis and psychological rationale for each score that is to be interpreted.

      5 Providing a statistical procedure to adjust for the overall complexity of the record and a graphical illustration of its impact on each variable.

      6 Optimizing the number of responses given to the task in order to ensure an interpretable and meaningful protocol, while drastically reducing both the number of times the task needs to be readministered because of too few responses and the likelihood of inordinately long and taxing administrations because of too many responses.

      7 Developing new and revised indices by applying contemporary statistical and computational approaches.

      8 Offering access to a scoring program on a secure, encrypted web platform from any device that can interface with the Internet (e.g., PC, laptop, smartphone, tablet).

      The R-PAS system was developed around 2006 and continues to be tested worldwide. An initial review and meta-analysis article was published in Psychological Bulletin, which described Rorschach variables with research support and those with little or no support (Mihura, Meyer, Dumitrascu, & Bombel, 2013).

      Figure 4.4 What Is Happening in This Picture?

      Source: Explorations in personality: A clinical and experimental study of fifty men of college age by Murray et al. (1938), “TAT drawing” p. 622. By permission of Oxford University Press, USA.

      Other researchers have begun to use neuroscience techniques such as brain imaging and electrophysiology to understand physiological processes underlying Rorschach responses. For example, Giromini and his colleagues (Giromini, Porcelli, Viglione, Parolin, & Pineda, 2010) examined movement responses on the Rorschach and how these were reflected in the EEG.

      Thematic Apperception Test (TAT)

      The Thematic Apperception Test (TAT) is composed of 30 black-and-white drawings of various scenes and people (see Figure 4.4 for an example). The instrument was developed by Christiana Morgan and Henry Murray in the 1930s. Typically, an individual is shown 20 of the cards, one at a time, and asked to create a story about what is being depicted on the card. The basic idea is that by noting the content and emotionality of the individual’s responses, it is possible to gain insight into his or her thoughts, emotions, and motivations including areas of conflict. For example, if an individual described many of the cards in terms of someone leaving another person, the clinician might ask if abandonment was an important issue for the person. Although the TAT technique may be useful to gain additional information concerning a person such as suicidal thoughts, it lacks scientific evidence to make it useful in obtaining a formal diagnosis. Similar problems of reliability and validity exist with the TAT as with the Rorschach.

      Thematic Apperception Test (TAT): a projective testing instrument composed of black-and-white drawings of various scenes and people; by evaluating the individual’s interpretive responses to the ambiguous drawings, it is possible to gain insight into his or her thoughts, emotions, and motivations including areas of conflict

      Overall, projective techniques have been the subject of great debate and controversy. P. Frick, Barry, and Kamphaus (2010) presented some of the major pros and cons concerning the use of projective techniques (see Table 4.1). Some professionals see their value not in terms of giving exact diagnoses but in their ability to allow a professional to see how an individual responds to ambiguous stimuli—especially in terms of suicidal ideation as well as disorganized thought processes. This may lead to further discussions of areas that a professional would not normally discuss. The major disadvantage of projective techniques centers on questions of validity in terms of both the test’s ability to identify specific disorders and the reliance of the test interpretation on a specific population such as children.

      Neuropsychological Testing

      Neuropsychological tests have been developed to help mental health professionals assess a person’s general level of cognitive functioning. Intelligence tests, for example, are able to compare a given individual with his or her peers to determine level of functioning. The common intelligence tests, such as the Wechsler Adult Intelligence Scale (WAIS), have a number of subscales designed to measure verbal and performance tasks. The verbal tasks include measurements of acquired knowledge, verbal reasoning, and comprehension of verbal information. The performance tasks include nonverbal reasoning, spatial processing skills, attention to detail, and visuomotor integration.

      Wechsler Adult Intelligence Scale (WAIS): a common intelligence test with a number of subscales designed to measure verbal and performance tasks

       Table 4.1

      Source: Frick et al. (2010), with kind permission from Springer Science+Business Media B.V.

      Other neuropsychological tests have been designed to assess specific types of brain functioning as well as brain damage. These include memory, attention, reasoning, emotional processing, and motor processes including inhibition of action. One advantage of traditional neuropsychological tests is that they have been given to a large number of people so that norms could be established. Thus, it is possible to know whether a 70-year-old individual is showing a normal memory decline in certain areas or if there might be the beginning of a neurocognitive disorder, such as Alzheimer’s disease.

      Although neuropsychological testing was initially developed to assess brain damage resulting from accidents, strokes, or war, it is now finding a use in delineating deficits in those with mental illness. Today, there is a coming together of neuropsychological tests, measures of cognitive processes in normal individuals, and brain imaging techniques. For example, the Wisconsin Card Sorting Test (WCST) requires that an individual sort cards into four piles. Each card has a specific shape on it, such as a circle or square, and a specific number of these shapes. Each card is also printed in a specific color. Thus, you could sort the cards by shape, by number, or by color. The person administering the test makes note of whether the individual is sorting each card correctly or not. After a number of sorts, the administrator changes the correct sort category. Individuals with frontal lobe damage have difficulty responding to changing demands. Individuals with schizophrenia also have difficulty responding to changing task requirements.

      Wisconsin Card Sorting Test (WCST): an assessment instrument that requires an individual to sort cards into four piles; each card has a specific shape on it and a specific number of these shapes, and each card is printed in a specific color; thus, the cards could be sorted by shape, number, or color. The sort criteria are changed throughout the test. The purpose of the test is to measure the person’s ability to adjust to changes in sorting criteria

      Continuous Performance Test (CPT): a test that measures attentional characteristics

      These sisters were identical quadruplets who all developed schizophrenia by age 24. When they became subjects of study because of their shared disorder, they were given the pseudonym of the “Genain” quadruplets to protect their identity. The word genain, from Greek, translates to “bad gene.”

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      Another test that is commonly used in psychopathology research is the Continuous Performance Test (CPT), which measures attentional characteristics. In one version of the test, participants are shown a series of letters and must respond whenever a