1st Edition
Rorschach Assessment of Senior Adults
This guide is a much-needed reference for clinicians on how to use the Rorschach Inkblot Test with senior adults, an essential tool for assessing personality functioning to better identify psychological interventions. The book integrates historical developments, current research, conceptual considerations, and therapeutic and diagnostic applications.
Chapters review basic guidelines for the understanding and interpretation of Rorschach variables, including protocol validity; interpretation of structural variables, thematic imagery, and cross-cultural normative data; sequence analysis; and more. The authors then provide 10 case illustrations of how the Rorschach indices of cognitive functioning, emotional experience, interpersonal relatedness, and self-perception can facilitate differential diagnosis and treatment planning in clinical work with older people. These case illustrations are rooted in previously non-existent Rorschach reference data based on an international sample of more than 250 senior adults and a second sample of more than 200 patients with Alzheimer’s disease.
Clinicians will come away with a solid empirical basis for distinguishing between normal-range personality functioning and manifestations of psychological disorder in the elderly and for providing beneficial interventions to senior adult patients.
Preface
Acknowledgments
About the Authors
Part I Introduction
Chapter 1: Current Research and Perspectives on Aging
Neuropsychological Research on Aging
Psychodynamic Perspectives on Aging
Conclusion
References
Chapter 2: Historical Developments in the Rorschach Assessment of Senior Adults
Early History
Standardized Data for Senior Adults
Historical Developments in Applying the Rorschach as a Neuropsychological Tool
Conclusion
References
Part II. Conceptual Considerations
Chapter 3: Effective Utilization of the Rorschach Task in Clinical Gerontopsychology
The Nature of the Rorschach Task
Interpretive Significance of Test Behaviors
Comments
Expressive Style
Interpersonal Style
Conclusion
References
Chapter 4: Parameters of Rorschach Interpretation
Protocol Validity
Interpretation of Structural Variables
Cognitive Functioning
Affective Experience
Interpersonal Relatedness
Self-Perception
Interpretation of Thematic Imagery
Identifying Responses Rich in Thematic Imagery
Formulating Interpretive Hypotheses
Judging the Plausibility of Thematic Interpretations
Sequence Analysis
Conclusion
References
Part III. Normative Rorschach Data for Senior Adults
Introduction to Normative Rorschach Data for Senior Adults
References
Chapter 5: International Normative Data for Nonpatients
Interpreting Rorschach Cross-Cultural Normative Data
Normative Data for Senior Adults in the Twenty-First Century
Implications of the Normative Data
Conclusion
References
Chapter 6: Developmental Issues
Basic Developmental Concepts in Aging
Applying the Rorschach for Assessing Developmental Personality Changes
Rorschach Assessment of Younger and Older Senior Adults
Cognitive Functioning
Affective Experience
Interpersonal Relatedness
Self-Perception
Conclusion
References
Chapter 7: Patients with Alzheimer’s Disease
Cognitive and Emotional Symptoms in Alzheimer’s Disease
Rorschach Assessment of Patients with Alzheimer’s Disease
Cognitive Functioning
Affective Experience
Interpersonal Relatedness
Self-Perception
Conclusion
References
Part IV. Applying Rorschach Assessment of Senior Adults: Case Illustrations
Introduction to Case Illustrations
Chapter 8: Dementia: "Old miners" or "Happy clowns?"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 9: Bipolar Disorder: "A broken heart, ruptured in some way"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 10: Korsakoff’s Syndrome: "Reminds me of my life"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 11: Therapeutic Assessment of Acute Depressive Reaction: "Disgusting creatures"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 12: Traumatic Stress Condition: "Two people helping each other, but it’s hopeless"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 13: Manic Defenses: "Could be a conflict but it’s nice to me"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 14: Medical Condition and Somatization: "A slight indication of a butterfly"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 15. The Aprés Coup Effect: "Like a butterfly that is folded"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 16: Fibromyalgia and Alexithymia: "It’s better not to think about it than to suffer"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Chapter 17: Obsessive-Compulsive Personality: "I’m looking for a symbolic response"
Background Information
Interpretation of Rorschach Data
Conclusion
References
Part V. Conclusion
Chapter 18: Concluding Remarks+
References
Index
Biography
Irving B. Weiner, PhD, ABPP, is a retired professor of psychiatry and behavioral neurosciences at the University of South Florida. He is a past president of APA Division 12 (Clinical Psychology), APA Division 5 (Quantitative and Qualitative Methods), the Society for Personality Assessment, and the International Rorschach Society. His published books include Psychodiagnosis in Schizophrenia (1966), Principles of Rorschach Assessment (2nd ed., 2003), Principles of Psychotherapy (3rd ed., 2009), the Handbook of Personality Assessment (2nd ed., 2017), and, with Shira Tibon-Czopp, Rorschach Assessment of Adolescents (2016).
Liat Appel, PhD, is a clinical psychologist who is currently involved in an international research project on senior adults at Goldsmiths, University of London. Dr. Appel lectures in various clinical programs in Israel and practices clinical psychology in Tel- Aviv. She is a coauthor of the Rorschach Reality–Fantasy Scale (RFS-2, 2016). Her recent publications include an article on adolescents with psychosomatic disorders in Rorschachiana (2011); a coauthored article on national trauma in Psychology (2011); and a coauthored article on Shedler–Westen assessment in Psychoanalytic Psychology (2012). She was the 2016 recipient of the Society for Personality Assessment Exner Scholar award.
Shira Tibon-Czopp, PhD, ABAP, is a clinical psychologist and visiting research fellow at Goldsmiths, University of London, where she co-conducts an international project on personality and attitudes in senior adults. She has been lecturing in various clinical programs in Israel and has worked in inpatient and outpatient public clinics. Some of her recent publications include an essay on the Rorschach Inkblot Method in the Encyclopedia of Adolescence (2012); a coauthored book with Irving B. Weiner entitled Rorschach Assessment of Adolescents (2016); and coauthored articles on the Rorschach Reality–Fantasy Scale and Rorschach psychometric validity in the Journal of Personality Assessment (2016).
"Written by three of today’s leading Rorschach scholars, Rorschach Assessment of Senior Adults fills a crucial gap in the literature, presenting a comprehensive, clinician-friendly framework for using the Rorschach Inkblot Method to assess psychological functioning in older adults. Blending empirical evidence with clinical wisdom and richly elaborated case material, the authors provide a step-by-step guide to this important assessment tool that will be useful to graduate students and early career psychologists as well as experienced clinicians and clinical researchers. This compelling and thought-provoking book provides a unique perspective on the opportunities and challenges in personality assessment of senior adults; it should be on every clinician’s bookshelf."
Robert F. Bornstein, PhD, Professor of Psychology, Adelphi University, and Past President of the Society for Personality Assessment
"As our population for senior adults grows with advances in health care, all too often an in-depth psychological understanding of these individuals lags behind. This is especially true for projective/performance-based assessment methods. Weiner, Appel & Tibon-Czopp’s new book impressively steps into this knowledge gap. Blending cutting edge conceptualization and research along with persuasive and lucid clinical application, Rorschach Assessment of Senior Adults is a tour de force! "
F. Barton Evans, PhD, Clinical Professor of Psychiatry and Behavioral Sciences, East Tennessee State University.
"This is a wonderful and long-overdue addition to the assessment literature! With clinical sophistication, along with empirical and theoretical rigor, Weiner, Appel, and Tibon-Czopp have produced a book that offers the clinician and researcher important guidance on how think about and assess personality and psychopathology in older people. In a society where the conceptualization of age is necessarily being reformulated, this book belongs on every assessment clinician’s shelf."
Steven K. Huprich, PhD, University of Detroit Mercy, and Past Editor of the Journal of Personality Assessment
"Weiner, Appel and Tibon-Czopp provide the first comprehensive, international book addressing older adults and the Rorschach. As Weiner has done before, these three authors weave conceptual approaches with research findings into a stimulating and accessible narrative. They introduce reference data for healthy seniors, seniors with Alzheimer’s dementia, and younger and older senior adults. Clinicians will benefit from the Rorschach case interpretations in the latter chapters. This impressive contribution should stimulate needed clinical work and research with this deserving population."
Donald J. Viglione, PhD, Professor of Psychology, Alliant International University
