This is a chapter excerpt from Guilford Publications.

Using the Rorschach Performance Assessment System® (R-PAS®).

Edited by Joni L. Mihura and Gregory J. Meyer. Copyright © 2018.
Purchase this book now: www.guilford.com/p/mihura

CHAPTER 1

Introduction to R‑PAS

s
Joni L. Mihura

es
Gregory J. Meyer

Pr
rd
lfo
ui
G
T he purpose of this book is to illustrate how to use and interpret the Rorschach
e

Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erd-
Th

berg, 2011) in a wide variety of situations. Through a presentation of illustrative

cases, the book focuses on the ways in which the Rorschach is often used and can
18

be helpful—­thus, the title Using the Rorschach Performance Assessment System®

(R-PAS ®). We designed the chapters to serve as exemplars for students and psycholo-
gists working in particular settings or situations (e.g., child custody, violence risk
20

assessments, criminal responsibility evaluations), with certain populations (e.g., cou-

ples, female psychopaths, inpatients with a recent suicide attempt), and answering
©

certain referral questions (e.g., detecting psychosis).

This volume should be considered essential for everyone who uses R-PAS, includ-
ht

ing practitioners, instructors, supervisors, and students. Its individual chapters, each
ig

of which has been thoroughly reviewed and vetted by the editors for administration,
coding, and interpretation, can also be used as exemplars for students or psycholo-
yr

gists who are using, or are considering using, R-PAS in any of these situations. There
op

are many other audiences for this book as well. Psychologists whose expertise is
not the Rorschach but who work in settings in which the Rorschach is used can
C

read examples of its potential application. Judges or attorneys can use the book as a
resource for relevant information on the Rorschach and the ways it is being used (or
can or should be used) in legal settings.

What Is R‑PAS?

R-PAS (Meyer et al., 2011) is a Rorschach system that vastly improves upon the
most commonly used previous system, the Comprehensive System (CS; Exner,

3
4 THE BASICS OF R-PAS

2003), by addressing its major criticisms (Meyer, Viglione, & Mihura, 2017;
Mihura, Meyer, Bombel, & Dumitrascu, 2015; Mihura, Meyer, Dumitrascu, &
Bombel, 2013; Wood, Garb, Nezworski, Lilienfeld, & Duke, 2015). R-PAS was
designed as a replacement for the CS by members of Exner’s Rorschach Research
Council (Gregory J. Meyer, Donald J. Viglione, Joni L. Mihura, and Philip Erdberg)
and a prominent forensic psychologist (Robert E. Erard). The council viewed this
replacement as a necessary step following Exner’s death in 2006 and the decision
by his heirs, about 2 years later, not to further develop the CS. The CS itself was
first published in 1974 (Exner, 1974), designed as a replacement for five previ-
ous competing Rorschach systems that were popular in the United States at the

s
time (i.e., Beck, Beck, Levitt, & Molish, 1961; Hertz, 1970; Klopfer & Davidson,

es
1967; Piotrowski, 1957; Rapaport, Gill, & Schafer, 1968), which themselves were
designed as extensions of and replacements for Hermann Rorschach’s original test

Pr
approach (Rorschach, 1921/1942).

rd
What Are the Essential Components of R‑PAS?

lfo
An R-PAS assessment starts with a standardized administration of the test stimuli
ui
(i.e., the 10 inkblots) by an examiner, who asks the respondent to look at each card
G
and answer the question “What might this be?” and then records the respondent’s
responses verbatim along with any relevant nonverbal expressions (Meyer et al., 2011).
e

All Rorschach systems use the same 10 inkblots,1 which were originally designed by
Th

Hermann Rorschach (1921/1942) after pilot-­testing various iterations of the inkblots

and refining them to improve their evocative features. After administering the test,
18

the examiner codes the responses according to R-PAS guidelines and enters these
codes into the online scoring and interpretation program (www.r-pas.org). This
secure online program calculates the scores to be interpreted and plots them on a
20

graph using standardized scores—­similar to those used by other popular tests, such
as intelligence tests—to compare the examinee’s scores to norms. Next, the examiner
©

interprets the test results using the R-PAS interpretive guidelines provided in the test
manual or the editable case-based interpretive guidelines that are available from the
ht

online program. The R-PAS results are interpreted in the context of other assessment
ig

data, taking into account the method by which all of the information was obtained
(e.g., clients’ performance behavior on the Rorschach vs. self-­report of their personal-
yr

ity on questionnaires).
op

Table 1.1, “Brief Guide to Variables on the R-PAS Profile Pages,” provides the
names and a brief description of each scale and its basic interpretation. Figure 1.1
C

provides an image of the R-PAS Page 1 Profile to illustrate the results printout.2 These
resources are provided for readers who are encountering R-PAS for the first time, in
order to give them a basic idea of its components. The table and figure are not suf-
ficient for using and interpreting the system, however. Instead, the full manual is
needed.
1 Other inkblot tests have been developed, but they are rarely used.
2 The R-PAS variables and results pages are updated with the emerging research.
Introduction to R-PAS 5

TABLE 1.1.  Brief Guide to Variables on the R-PAS Profile Pages

Term Description
Page 1
Administration Behaviors and Observations
Pr Prompt; used to encourage the respondent to give an additional response when only one
is given to a card. Giving only one response is a concrete instance of underproductive
behavior that does not meet the situational demands of the environment.

Pu Pull; when four responses are given to a card, the examiner asks for the card back and
reminds the participant of the desired number of responses. Giving four responses is a
concrete instance of overproductive behavior that does not meet environmentally set

s
demands.

es
CT Card Turns; total number of responses in which the card was turned, regardless of final

Pr
orientation for the response. Depending on how it is contextually expressed, card turn-
ing may be linked to intellectual curiosity, flexibility, compulsivity, hostility or defiance,
anxiety, authoritarianism, or suspiciousness.

rd
Engagement and Cognitive Processing

lfo
Complexity A composite variable that quantifies the amount of differentiation and integration
involved in a protocol based on Location, Space, and Object Qualities; Contents; and

ui
Determinants summed across all responses. G
R Number of Responses; R is associated with both ability and motivation, and the latter
may be due to intrinsic factors or situational factors.
e

F% Form Percent, computed as F/R (replaces the CS score Lambda). F is Form without
Th

other determinants, also referred to as Pure F, “the shape of a head.” Determinants are
perceptual dimensions that “determine” a response. They are coded for the characteris-
tics of the inkblot or characteristics attributed to the inkblot, including movement, color
18

(either chromatic or achromatic), shading, dimensionality, symmetrical reflection, and

the form, shape, or outline of a blot region. F% is inversely related to noticing, reacting
to, and articulating subtleties and nuances in the inkblot environment, which suggests
20

similar processes when the person is attending to his or her inner life and external
world.
©

Blend Blend response; a response with two or more determinants other than F; the deter-
minants are separated by a comma (e.g., Mp,FC). See F% for a description of F and
determinants. Blend is like the inverse of F%, but related more specifically to the ability
ht

to identify and articulate multiple features of one’s experiential environment.

ig

Sy A Synthesis response; two objects meaningfully related, “two birds sitting on branch”
(equal to the CS codes DQ+ and DQv/+). Sy is a measure of complex and sophisticated
yr

processing and coping, which involve integrative cognitive activity or relational think-
ing.
op

MC Sum of M and WSumC. (Replaces the CS term EA.) M is the Human Movement
C

determinant, “people dancing.” WSumC is the Weighted Sum of Color determinants:

(C×1.5)+CF+(FC×0.5). C is the Color determinant without form, also referred to as
Pure C, “this blue stuff is water.” CF is the Color-Dominated determinant with form
secondary, “pink cotton candy; sort of curved.” FC is the Form-Dominated Color
determinant, “an airplane with a red wing.” MC is a measure of psychological activ-
ity and processing that is considered an index of psychological resources and adaptive
capacity, based on the ability and propensity to populate, animate, and color one’s
experiential world.

(continued)
6 THE BASICS OF R-PAS

TABLE 1.1. (continued)
Term Description
MC –PPD The MC to PPD Difference Score; subtract PPD from MC (replaces the CS D-score
and in CS terms is equivalent to EA – es). MC is as defined above. PPD refers to the
Potentially Problematic Determinants, which are the sum of FM+m+Y+T+V+C′ (replaces
the CS acronym, es, for Experienced Stimulation). FM is the Animal Movement deter-
minant, “a bear eating a fish.” The variables m, Y, T, V, and C′ are described below.
MC – PPD is obtained by contrasting codes that suggest resources (MC) associated
with ideational elaboration (Human Movement) and lively responsiveness to the world
(chromatic color) to codes that suggest potential liabilities (PPD).

s
M Human Movement determinant, “people dancing.” Movement is not an actual attribute
of the inkblot; it is a mental embellishment that requires some capacity to envision or

es
imagine. M reflects the ability to use one’s imagination to elaborate human experiences
or activities; it represents a type of mentalization process that contributes to the capac-

Pr
ity for empathy, a sense of active personal agency, a capacity to reflect on events and
experiences, and a degree of developmental maturity.

rd
M/MC Human Movement Proportion, M divided by the sum of M and WSumC (replaces the
CS EB ratio or M:WSumC). M is as defined above. WSumC is defined above with MC.

lfo
M/MC assesses the degree to which decisions and actions are influenced by thoughtful
deliberation and mentalization (M) versus spontaneous reactivity, vitality, and emo-
tional expressiveness (WSumC).

(CF+C)/
ui
The CF+C Proportion or Color Dominance Proportion, CF+C divided by SumC
G
SumC (replaces the FC:CF+C ratio in the CS). FC, CF, and C are described under MC. SumC
is the sum of all the Color determinants, FC+CF+C. The CF+C Proportion is a rough
e
measure of the relative absence, or relaxation, of cognitive control and modulation in
one’s reactions to the environment, especially when there is emotional provocation.
Th

Perception and Thinking Problems

18

EII-3 Ego Impairment Index—3rd version; a broadband, composite measure of thinking dis-
turbance and severity of psychopathology. Its components include poor reality testing
(FQ–), thought disturbance (WSumCog), crude and disturbing thought content (Critical
20

Contents), and measures of interpersonal misunderstanding and disturbance (M–, PHR

vs. GHR). As it increases, there is greater likelihood of difficulty accomplishing day-to-
day tasks effectively.
©

TP-Comp Thought and Perception Composite; assesses reality testing (via FQ variables) and thought
disorganization (via Cognitive Codes), making it a broadband composite measure of psy-
ht

chopathology severity. (TP-Comp is a fully dimensional replacement for the CS PTI.)

ig

WSumCog Weighted Sum of Cognitive Codes; a measure of disturbed and disordered thought. Two
groups of Cognitive Codes may characterize a person’s responses: those that are visual
yr

and involve illogical or implausible relationships in the inkblot stimuli (i.e., INC, FAB,
CON) and those that are linguistic and involve illogical reasoning or difficulties with
op

effective communication (e.g., DV, DR, PEC). INC, FAB, DV, and DR are weighted for
severity (Level 1 or 2).
C

SevCog Sum of Severe Cognitive Codes, that is, DV2+INC2+DR2+FAB2+PEC+CON. SevCog

captures significant or severe disruptions in thought processes. At least among adults
and adolescents, these kinds of disruptions are typically most indicative of psychotic-
level lapses in conceptualization, reasoning, communication, or thought organization.

FQ–% “FQ Minus Percent”; percentage of all responses that are distorted—that is, FQ–/R
(equal to X–% in the CS). FQ–% is a measure of distortion, misinterpretation, or
mistaken perception, often leading to poor judgments, odd behavior, or poor adapta-
tion. Internal imagery and concerns may interfere with the person’s ability to process
and interpret external reality, and the person may see and describe things in a mistaken,
distorted, personalized way that others will not see or understand.
(continued)
Introduction to R-PAS 7

TABLE 1.1. (continued)
Term Description
WD–% “WD Minus Percent,” computed as WD–/WD. WD–% is similar to FQ–%, but it more
specifically indicates whether distortions occur even in perceptual situations that are
more common and conventional and tied to familiarly identified objects. Distortions in
this context may be considered more atypical and problematic.

FQo% “F-Q-O Percent”; percentage of all responses that are common, easy to see, and accu-
rate—that is, FQo/R (equal to X+% in the CS). FQo% is a measure of conventional
judgment, good reality testing, and seeing the world the way most other people do.
Like FQ–, FQo is a product of developmental maturation, such that FQo% increases

s
progressively from childhood to adolescence to young adulthood to adulthood (and FQ–
decreases).

es
P Popular response, “a bat” (Card I). Popular objects are relatively obvious perceptions that

Pr
are seen by a large proportion of people taking the test. Thus, P is a measure of highly
conventional interpretations of the environment and sensitivity to obvious external cues.

rd
Stress and Distress
YTVC′ “Y-T-V-C-Prime,” or Sum of Shading and Achromatic Color; Total number of shad-

lfo
ing (Y, T, V) and achromatic color (C′) determinants (equal to SumShading in the
CS). YTVC′ is a rough measure of being drawn to inconsistencies, uncertainties, and

ui
nuances in the environment, which extends to real and imagined interactions with oth-
ers. In terms of response process, incorporating these features into response descriptions
G
adds inconsistencies and nuances to the task, while also distracting the respondent from
focusing on the shape of the inkblot to answer the question of what it might be.
e

m and Y m = Inanimate Movement determinant, sometimes referred to as “little m,” “a falling

Th

rock.” Y = Diffuse Shading determinant, “the shading makes it look camouflaged”

(equal to the CS score SumY). Both m and Y have shown a relationship to moderate
to severe stressors. The m code involves mechanical or nonsentient activity that lacks
18

volitional control and is typically characterized by external forces acting on an object.

Y indicates sensitivity to nuance, minor gradations, and inconsistencies in the inkblot,
as well as an effort to make sense of, or account for, these features. Y is thought to
20

indicate a helpless feeling in the face of the stressors, whereas m is related to an anxious
kind of ideation that is outside of one’s control or possibly impinging on oneself from
external forces.
©

MOR Morbid Content Thematic Code; a response incorporating a damaged, dead, or depres-
sive quality, “a broken branch,” or a “sad person crying.” MOR responses indicate
ht

morbid, pessimistic, injured, damaged, or sad ideational themes.

ig

SC-Comp Suicide Concern Composite (a fully dimensional replacement for the CS S-CON). SC-
Comp is an implicit measure of risk for suicide or serious self-destructive behavior with
yr

many false-positives (elevated score but person does not engage in actual self-harm).
op

Self and Other Representation

C

ODL% Oral Dependent Language, “Fried shrimp on a plate,” divided by R. (ODL was for-
merly abbreviated ROD for Rorschach Oral Dependency; Food content [Fd] in the CS is
included in ODL.) ODL codes the words that suggest or images that convey themes of
nurturance, needed support or help, oral activity, food and eating, or birth and fragil-
ity. Elevations identify respondents who are implicitly motivated by dependent needs,
related to an underlying dependent trait or a state.

SR Space Reversal; the object seen resides within and is defined by the white space contours
so that the typical perspective of seeing ink on a white background is perceptually
reversed. The response may or may not include inked areas, “A (white) lamp in the cen-
ter” (the CS had combined Space Integration, described below, and SR into one code,
S). SR is an implicit behavioral measure of independence strivings, inventive or creative
perspective taking, and oppositionality.
(continued)
8 THE BASICS OF R-PAS

TABLE 1.1. (continued)
Term Description
MAP/ The Mutuality of Autonomy Pathology Proportion, MAP divided by MAHP. MAP is
MAHP the Mutuality of Autonomy–Pathology Thematic Code, “some sort of organism swal-
lowing up that bird.” MAHP is the total number of Mutuality of Autonomy Health
(MAH) and MAP codes. MAH is defined below. MAP/MAHP assesses the extent to
which relationships are viewed as destructive or harmful.

PHR/ The Poor Human Representation Proportion; the sum of Poor Human Representa-
GPHR tion (PHR) codes divided by the sum of Good and Poor Human Representation codes
(GPHR; replaces the GHR:PHR ratio from the CS and their difference score, the HRV).

s
GHR suggests an ability to envision the self and relationships with others in an adaptive
or positive way. PHR suggests a propensity to misunderstand others, relationships, and/

es
or the self, or to imbue relationships with themes of damage or aggression.

Pr
M– “M Minus”; Human Movement determinant with FQ–. M– is a rough measure of
significant misunderstanding or misperceptions of people that can result in disturbed
interpersonal relations.

rd
AGC Aggressive Content, “a weapon.” Regularly seeing aggressive, powerful, dangerous,

lfo
predatory, or threatening images is a behavioral indication that these themes are on the
person’s mind.

ui
H Whole Human content, “a person,” also referred to as Pure H. Reporting images of
whole human beings is associated with the ability to envision people in complete, intact,
G
multifaceted, and integrated ways.
e
COP Cooperative Movement; cooperative, positive, or pleasant interactions between objects,
“two people dancing.” COP reflects a generally positive template for envisioning rela-
Th

tionships.

MAH Mutuality of Autonomy–Health, “two women leaning in on a table between them,

18

talking.” Like COP but more restricted, MAH suggests the potential for mature and
healthy interpersonal relationships.
20

Page 2
Engagement and Cognitive Processing
©

W% Whole Percent, W/R. W% reflects a capacity for generalization and abstraction—sub-

suming various facts under a larger concept, the big picture.
ht

Dd% Unusual Detail Percent; Dd/R. Dd% reflects a tendency to focus on rare, small, or idio-
ig

syncratic details in the experiential environment.

yr

SI Space Integration; background space is used in a response along with an inked blot
area, “A dark face, the white is eyes” (the CS combined SI and SR into one code, S). SI
op

is typically indicative of cognitive effort, motivation, complex integration, and possibly

creative thinking.
C

IntCont Intellectualized Content, (2×ABS)+Art+Ay. ABS is Abstract Representation, “the swirl-

ing represents fear” (AB in the CS). Art is Art content, “a painting.” Ay is Anthropol-
ogy content; content with particular cultural, historical, or ethnographic significance,
“a Greek temple.” IntCont reflects an abstract or symbolic, intellectualized style of
information processing.

Vg% Vague percent; Vg/R. Vg is Vagueness, “some haze” (corresponds to the CS codes DQv
and DQv/+). Vg% reflects a vague, impressionistic, and relatively ineffective processing
style.
(continued)
Introduction to R-PAS 9

TABLE 1.1. (continued)
Term Description
V Vista determinant, where shading creates a sense of dimensionality, “a deep cave, it’s
darker in the back” (equal to the CS score SumV). V reflects using nuance and subtleties
as a basis for taking perspective, gaining distance, or seeing through things. It can be a
cognitive resource.

FD Form Dimension determinant, for dimensional responses based on form, “a road; the
end looks far off the way it gets narrower at the top.” FD suggests a general evaluative
perspective or capacity for taking a distancing perspective.

s
R8910% “R-8-9-10 Percent,” R8910/R (replaces the Afr from the CS). R8910 is the total number
of responses on Cards VIII, IX, and X. R8910% taps a general responsiveness to com-

es
pelling or vibrant stimuli, which may include emotional situations with other people.

Pr
WSumC Weighted Sum of Color determinants; (C×1.5)+CF+(FC×0.5). C, CF, and FC are
described under MC, above. WSumC is related to an interest in and awareness of
stimulating, compelling features of the environment, which may include one’s emotional

rd
reactions to them.

lfo
C Color determinant without form, also referred to as Pure C, “this blue stuff is water.”
C suggests a cognitively passive or even helpless receptivity to activating or compelling
experiences.

Mp/
ui
The Passive Human Movement Proportion, Mp/(Ma+Mp) (replaces the CS Ma:Mp
G
(Ma+Mp) ratio). Mp is the sum of Passive Human Movement determinants, “a woman look-
ing down,” and Ma is the sum of Active Human Movement determinants, “two men
e
wrestling.” Mp/(Ma+Mp) indicates a propensity for passive (versus active) fantasy and
ideation.
Th

Perception and Thinking Problems

18

FQu% “F-Q-U Percent”; percentage of all responses that are relatively uncommon but reason-
ably accurate, FQu/R (equal to Xu% in the CS). FQu responses are midrange in terms
of frequency and accuracy between FQo and FQ–. FQu% is associated with unconven-
20

tional and individualistic ways of interpreting experiences.

Stress and Distress

©

PPD Potentially Problematic Determinants; FM+m+Y+T+V+C′ (replaces the CS acronym, es,

for Experienced Stimulation). PPD is related to an environmental sensitivity or attun-
ht

ement because it reflects the capacity to animate percepts, to envision static objects in
motion, and to use and describe the saturation of ink or its achromatic colors when
ig

generating images. However, this kind of sensitivity or attunement can be a liability

because these codes also can be indicative of stressors that are outside one’s control in
yr

terms of impulses, needs, or feelings that are stimulating, irritating, upsetting, or press-
ing.
op

CBlend Color Blend, in which a color (FC, CF, C) determinant is blended with a shading (Y, T,
C

V) or achromatic color (C′) determinant in one response; for example, CF,T (equal to
Col-Shd in the CS). CBlend suggests emotional or environmental sensitivity in which
emotionally spontaneous reactions (Color) can be compromised by concerns with
inconsistencies, indefiniteness, and nuances (Shading) or gloomy darkness and deaden-
ing numbness (C′), thus suggesting that one is vulnerable to mixed affective experiences.

C′ Any achromatic color determinant using black, gray, or white, “a black coat” (equal to
the CS score SumC′). C′ suggests being drawn to dreary, dark, and gloomy stimuli.

(continued)
10 THE BASICS OF R-PAS

TABLE 1.1. (continued)
Term Description

V Vista determinant, as defined above. V involves perspective taking or an evaluative

attitude and may be associated with some discomfort or dissatisfaction when directed
against the self or others.

CritCont% Critical Contents divided by R. Critical Contents is an EII-3 subcomponent, equal

to An+Bl+Ex+Fi+Sx+AGM+MOR. Bl is Blood content. Ex is Explosion content, “an
atomic bomb going off.” Fi is Fire or smoke content, “a candle flame.” Sx is Sexual
content, “a nude guy.” MOR is described above; An and AGM are described below.

s
CritCont% may be elevated from traumatic experiences, primitive thinking, or exag-
geration and malingering.

es
Self and Other Representation

Pr
SumH Sum of all Human content codes, H+(H)+Hd+(Hd). SumH reflects an awareness of, or
interest in, other people.

rd
NPH/ The Non-Pure Human Proportion, NPH/SumH (replaces the CS H:(H)+Hd+(Hd) ratio).
SumH NPH is the sum of Non-Pure Human content, that is, the total number of human-like

lfo
or human detail contents, (H)+Hd+(Hd). NPH/SumH indicates the tendency to men-
tally represent human objects in incomplete, unrealistic, or fanciful ways.

V-Comp
ui
Vigilance Composite (a fully dimensional replacement for the CS HVI). V-Comp
G
assesses guardedness, effortful and focused cognition, sensitivity to cues of danger,
tense affective constriction, interpersonal wariness, and distancing.
e

r Reflection determinant, “a parrot looking in the mirror” (equal to the CS variable

Th

Fr+rF). r may reflect a need for mirroring support, experiencing oneself as reflected in
the world in a self-centered way, and/or a propensity to use the self as a frame of refer-
ence when processing information.
18

p/(a+p) The Passive Movement Proportion, p/(a+p) (replaces the a:p ratio from the CS). p is the
sum of Passive Movement determinants, “sitting.” p/(p+a) is a rough measure of passive
20

versus active inclinations in a person’s behaviors or attitudes.

AGM Aggressive Movement, “men fighting” (AG in the CS). AGM indicates that the person
©

has imagined, and, at some level, probably identified with, aggressive activity, but it
does not indicate the person’s attitude toward this aggressive activity.
ht

T Texture determinant, where shading designates a tactile sensation, “the coloration

makes it seem furry” (equal to the CS score SumT). T suggests that the person is
ig

attuned to touch and to tactile experiences in his or her environment, which may reflect
an implicit desire for interpersonal closeness.
yr

PER Personal Knowledge Justification, the use of personal experience to justify a response,
op

“it’s a fancy bicycle; I’ve seen one just like that.” PER suggests a tendency to justify
one’s views and positions based on private, personal knowledge or authority.
C

An Anatomy content, “a heart,” which includes medical imaging content, “an X-ray of a
chest” (equal to the CS An+Xy). An suggests that a person is concerned about bodily,
physical, or medical issues.
Introduction to R-PAS 11

sss
rees
PPr
rrdd
lfo
ui
G
e
Th
18
20
tt ©
ghh
rriig
pyy
oop
CC

FIGURE 1.1.  R-PAS results: Page 1 Profile. Reproduced from the Rorschach Performance Assess-
ment System® (R-PAS®) Scoring Program (© 2010–2016) and excerpted from the Rorschach Per-
formance Assessment System: Administration, Coding, Interpretation, and Technical Manual
(© 2011) with copyrights by Rorschach Performance Assessment System, LLC. All rights reserved.
Used by permission of Rorschach Performance Assessment System, LLC. Further reproduction is
prohibited without written permission from R-PAS.
12 THE BASICS OF R-PAS

How Is R‑PAS an Improvement Over the CS?

R-PAS addresses many problems with the CS that have been expressed by differ-
ent constituents: the self-­proclaimed “Rorschach critics” (Wood, Nezworski, Garb,
& Lilienfeld, 2006), psychologists who research and use the Rorschach in practice
(Meyer & Archer, 2001; Meyer, Hsiao, Viglione, Mihura, & Abraham, 2013), and
students learning to use the task for the first time (Viglione, Meyer, Resende, &
Pignolo, 2017). The following sections briefly summarize these improvements. See
Meyer et al. (2017) for more detail.

s
es
Validity Meta‑Analyses for Individual Scores
Although many narrative reviews of the Rorschach validity literature exist, including

Pr
Exner’s research reviews in the CS test manuals (Exner, 2003), meta-­analyses based
on systematic reviews of the literature have become the expected norm in psychology

rd
to summarize the existing research on a topic. Because the Rorschach has always
been somewhat controversial, by 2001, three independent meta-­analyses had been

lfo
conducted on the general validity of the Rorschach (Atkinson, 1986; Hiller, Rosen-
thal, Bornstein, Berry, & Brunell-­Neuleib, 1999; Parker, Hanson, & Hunsley, 1988).
ui
In each case, the authors compared the general validity of Rorschach to the general
G
validity of the Minnesota Multiphasic Personality Inventory (MMPI). Meyer and
Archer (2001) greatly expanded one of those meta-­analyses (Parker et al.) and then
e

statistically summarized the results across all three meta-­analyses. They showed that,
Th

on average, Rorschach scores were as valid as MMPI scores, both when considering
all hypothesized effects (r = .32 for both, using 523 effect sizes for the Rorschach and
18

533 effect sizes for the MMPI) and when considering all studies examining hetero-
method validity (r = .29 for both, using 73 studies for the Rorschach with N = 6,520,
and 85 studies for the MMPI with N = 15,985).
20

However, much less systematic work had been done on the validity of individual
Rorschach variables. Until 2011, validity meta-­analyses for six Rorschach scores had
©

been published. Four of these were not CS scores, and validity support was found for
all four scores (Bornstein, 1999; Diener, Hilsenroth, Shaffer, & Sexton, 2011; Meyer
ht

& Handler, 1997; Romney, 1990). For the two CS scores, support was found for the
ig

Schizophrenia Index but not the Depression Index (Jørgensen, Andersen, & Dam,
2000, 2001).3 However, over 60 Rorschach variables are interpreted in the CS, leav-
yr

ing the great majority of variables unaccounted for by meta-­analyses.

op

In 2012, the online version of Mihura and colleagues’ (2013) systematic meta-­
analytic reviews of 65 CS variables was published in the top scientific review journal
C

in psychology (Psychological Bulletin). This extensive project was started in 2005 in

response to the critics’ call for meta-­analyses on all CS scales, and eventually took
over 6 years and thousands of hours to complete. Although this project was originally
planned as a contribution to the CS, after Exner’s death, the prepublication versions
of the meta-­analyses eventually formed the backbone of the revised system, R-PAS.

3 Threeof the five Rorschach scores with meta-­analytic validity support are now included in R-PAS (the
Schizophrenia Index, which has been renamed the Thought and Perception Composite, the Ego Impairment
Index–3, and the Oral Dependent Language Scale).
Introduction to R-PAS 13

In a momentous event, in response to these meta-­analyses, the most vocal critics of

the Rorschach lifted their call for a global moratorium on the use of the Rorschach in
clinical and forensic settings (see Wood et al., 2015; and our response, Mihura et al.,
2015). Because the CS is frozen in time without the possibility of updating, it cannot
incorporate any of these meta-­analytic findings.
In addition to their importance for the Rorschach, Mihura and colleagues’
(2013) large-scale meta-­analyses were notable for any multiscale psychological test.
As of this writing, compared to the Rorschach, no other psychological tests have so
many published meta-­analyses addressing the construct validity of their individual
scales. Mihura et al. systematically reviewed the published validity literature for

s
65 Rorschach scales; enough data existed to perform meta-­analyses on 53 of these

es
scales.4 R-PAS included seven other non-CS variables that have published validity
meta-­analyses (Bornstein, 1999; Diener et al., 2011; Graceffo, Mihura, & Meyer,

Pr
2014), systematic reviews (Mihura, Dumitrascu, Roy, & Meyer, 2017), and meta-­
analyses in progress (Kiss, Mihura, & Meyer, 2017). In contrast, meta-­analyses on

rd
the popular MMPI-2 have mainly been conducted on the scales designed to detect
faking (e.g., Rogers, Sewell, Martin, & Vitacco, 2003). The MMPI-2 has published

lfo
validity meta-­analyses for only 2 of its 112 clinical and treatment scales, support-
ing the relationship between two depression scales and the diagnosis of depression
(Gross, Keyes, & Greene, 2000).
ui
G
e
More Accurate Norms Than the CS
Th

The CS norms have been an area of contention. Wood and his colleagues published
research suggesting that many of the CS normative values were inaccurate, in the
18

direction of overpathologizing clients (Wood, Nezworski, Garb, & Lilienfeld, 2001a,

2001b). At first, Exner and members of his Rorschach Research Council thought this
criticism was largely in error (Exner, 2001; Meyer, 2001), but research they conducted
20

on their own showed that the CS norms were substantially different for many impor-
tant scores (e.g., those assessing psychosis; Meyer, Erdberg, & Shaffer, 2007; Viglione
©

& Giromini, 2016). Subsequently, new international norms were published the year
after Exner’s death (Meyer et al., 2007), which R-PAS adopted with some modifica-
ht

tions (see Chapter 16, “Generating Normative Reference Data,” in the R-PAS manual;
ig

Meyer et al., 2011, pp. 469–484; Meyer, Shaffer, Erdberg, & Horn, 2015; Viglione &
Giromini, 2016). The R-PAS developers are currently collecting new norms.
yr
op

Less Variable Number of Responses Than the CS

C

The Rorschach in general (Cronbach, 1949) and the CS in particular (Meyer, 1992,
1993) have been criticized for using a method of administration that results in a
widely varying number of responses, depending on the respondent and the examiner.
Practically, this varying number of responses also makes it difficult for examiners to
allot time for an administration. In addition, examiners using the CS are often faced
with the need to readminister the task due to an insufficient number of responses,

4 R-PAS relies on CS research as part of its evidence base. Throughout the history of the CS, it also relied on
research from previous ways of scoring and administering the Rorschach.
14 THE BASICS OF R-PAS

resulting in frustration for the respondent and in confusion and scheduling complica-
tions for the examiner. Therefore, R-PAS instituted new administration guidelines
that were first reviewed, vetted, and tested in an early form by the Research Council
before Exner’s death (Dean, 2005; Dean, Viglione, Perry, & Meyer, 2007, 2008).
These guidelines were revised several times until they resulted in significantly reduced
variability in the number of responses and virtually eliminated the need to readmin-
ister the task (Hosseininasab et al., in press; Reese, Viglione, & Giromini, 2014;
Viglione et al., 2015). The latter is an improvement that is especially important in
forensic settings where the client might be resistant to engage in an assessment.

s
es
Reduces Examiner Differences Compared to the CS
Different examiner styles can significantly affect important Rorschach variables

Pr
when using CS administration and coding guidelines—­particularly the complexity
of a person’s responses and the degree to which the objects he or she sees fit the blot

rd
contours, which is used as a measure of reality testing (see Exner, 2007, Table 1). To
address this problem, R-PAS made numerous improvements to reduce ambiguities in

lfo
administration and coding and to ensure that both steps are undertaken with more
consistency and reliability across examiners (Meyer et al., 2011, 2017). R-PAS also
ui
provides many online resources to help clinicians and students practice and calibrate
G
to R-PAS standards for administration and coding (www.r-pas.org). These resources
include administration videos; practice protocols for role-­playing the examiner and
e

respondent, along with one for a “coach”; administration checklists; and several
Th

R-PAS cases coded by its developers.

18

Interpretation Is More Efficient and Credible Than in the CS

Two changes from the CS to R-PAS—(1) using standardized scores instead of raw
20

scores and (2) basing interpretations on the response process—­make interpretation

notably more efficient and credible. These improvements are especially important
©

for students who are learning the test for the first time, although making Rorschach
interpretation more credible and plausible is important for many constituents: the
ht

general public; psychologists who doubt the Rorschach simply based on its associa-
ig

tion with psychoanalytic theory; and judges, attorneys, and juries.

yr

Standardized Score Printout
op

The R-PAS scoring program provides test results that compare the client’s data to
C

norms using standardized scores like those used on self-­report tests (e.g., MMPI-2,
MMPI-2-RF, and Personality Assessment Inventory [PAI]) and intelligence tests (e.g.,
Wechsler Adult Intelligence Scale—­Fourth Edition [WAIS-IV]). In contrast, the CS
uses raw score results, requiring users to memorize or look up the normative values
for over 60 scores each time they interpret the test. CS interpretation presents an
overwhelming situation for students who are first learning the test. To illustrate the
difference, compare the R-PAS Page 1 results presented in Figure 1.1 to the bottom
third of the CS Structural Summary, which contains the main CS results, presented
in Figure 1.2. Instructors switching from CS to R-PAS say that the standardized
Introduction to R-PAS 15

RATIOS, PERCENTAGES, AND DERIVATIONS

AFFECT INTERPERSONAL
R = 16 L = 0.33 FC:CF+C = 0:4 COP = 1 AG = 3
-------------------------------------------------------------- GHR:PHR = 1:6
Pure C = 2
EB = 6 : 5.0 EA = 11.0 EBPer = N/A a:p = 5:3
SumC’ : WSumC = 1 : 5.0 Food = 1
eb = 2 : 2 es = 4 D = +2
Adj es = 4 Adj D = +2 Afr = 0.33 SumT = 0
-------------------------------------------------------------- S = 2 Human Content = 7
Pure H = 3
FM = 1 SumC’ = 1 SumT = 0 Blends:R = 4 : 16
PER = 4
m = 1 SumV = 1 SumY = 0
CP = 0 Isolation Index = 0.19

s
IDEATION MEDIATION PROCESSING SELF-PERCEPTION

es
a:p = 5 :3 Sum6 = 10 XA% = 0.56 Zf =9 3r+(2)/R = 0.25
Ma:Mp = 4 :2 Lvl-2 =3 WDA% = 0.54 W:D:Dd = 8:5:3 Fr+rF =0

Pr
2AB+(Art+Ay) = 2 WSum6 = 34 X-% = 0.31 W:M =8:6 SumV =1
MOR = 2 M- =3 S- =1 Zd = +4.5 FD =2
P =2 PSV =0 An+Xy =1

rd
M none = 0
X+% = 0.38 DQ+ =6 MOR =2
Xu% = 0.19 DQv =2 H:(H)+Hd+(Hd) =3:4

lfo
PTI = 5 DEPI = 4 CDI = 2
ui
S-CON = 7 HVI = Yes OBS = No
G
© 1999, 2001 by Psychological Assessment Resources, Inc. All rights reserved. Version: 5.00.137
e
FIGURE 1.2.  Rorschach Comprehensive System (CS) Structural Summary: Main results section.
Th

Reproduced by special permission of the Publisher, Psychological Assessment Resource, Inc.

(PAR), 16204 North Florida Avenue, Lutz, Florida 33549, from the Rorschach Interpretation
Assistance Program: Version 5 by John E. Exner, Jr., PhD, Irving B. Weiner, PhD, and PAR Staff.
18

Copyright 1976, 1985, 1990, 1994, 1995, 1999, 2001, 2003 by PAR. Further reproduction is
prohibited without permission of PAR.
20

score results and response process foundation for interpretation significantly improve
©

students’ learning experiences. R-PAS users report that being able to view all of the
main results at a glance is helpful, and they are less likely to lose track of important
ht

results. The main R-PAS results pages are described further in Chapters 2 and 3 and
ig

are illustrated in every case chapter (Chapters 4–19).

yr

Response Process‑Based Interpretations
op

The response process refers to the psychological operations that occur in the process
C

of generating a response to a task. As described further in Chapter 2, basing Ror-

schach interpretations on the response process is similar to interpreting cognitive
performance tasks like those on the WAIS-IV. For example, on the WAIS-IV Block
Design subtest, clinicians do not interpret the person’s ability to put together blocks
in everyday life; they generalize the psychological operations that occur in the pro-
cess of generating a response (e.g., visual analysis and synthesis in the case of Block
Design) to similar operations in everyday life. For CS interpretations, the lack of a
clear link between the respondent’s Rorschach response and the clinician’s interpre-
tation of that response has resulted in a sense of hiddenness and mystery around the
16 THE BASICS OF R-PAS

Rorschach that has surely led to an inherent doubting and discounting of the test.
Therefore, R-PAS highlights the link between the coded behavior and its interpreta-
tion, and removes the mystery.
As a broader context, for many years, the Rorschach was associated with psy-
choanalytic theory (even though Hermann Rorschach did not describe it that way;
Rorschach, 1921/1942; Searls, 2017). When psychoanalysis came under attack
(Crews, 1996), the Rorschach did too. Exner (1974) tried to remove the stigma from
the Rorschach by presenting his system as atheoretical and empirical, but for the vast
majority of variables, he did not explain the link between the coding of the response
and the resultant interpretation. In contrast, similar to Schachtel’s (1966) phenom-

s
enological approach to understanding the Rorschach, R-PAS focuses strongly on the

es
response process when interpreting the test results (see also Mihura et al., 2017).
Response process-­based interpretation makes Rorschach interpretation more cred-

Pr
ible, understandable, and easier for students to learn. We also expect that this strong
link between response process and interpretation will lead clinicians to more accu-

rd
rately see examples of the associated attitudes and behaviors in their client’s everyday
life.

lfo
Culture and Gender
ui
G
The last improvement over the CS that we mention is R-PAS’s nongendered interna-
tional norms. In addition to being more accurate than Exner’s CS norms (as previ-
e

ously noted), the R-PAS normative sample includes protocols from non-­A merican
Th

countries (i.e., Argentina, Belgium, Brazil, Denmark, Finland, France, Greece, Israel,
Italy, Portugal, Romania, and Spain), whereas Exner’s (2003) norms, collected in the
18

1970s and early 1980s (Exner, 1986; Exner & Weiner, 1982), were entirely from the
United States. There is no reliable evidence to date that the basic cognitive and per-
ceptual task of the Rorschach results in cultural and gender differences (e.g., Meyer
20

et al., 2007; Meyer, Giromini, Viglione, Reese, & Mihura, 2015; Meyer, Shaffer,
et al., 2015). The main differences across countries occur with some salient cul-
©

tural images—­such as the “Christmas elves” in Scandinavian countries reported in

response to Card II and totem poles in the U.S. Southwest reported in response to
ht

Card VI—but not, for example, how well the image fits the blot, the perceptual fea-
ig

tures that are described, or the base rates of thought disturbance. Six of the 16 case
chapters in this book focus on cases from countries other than the United States (i.e.,
yr

Finland, Israel, Italy, the Netherlands, and Norway).

op
C

What Are Key Strengths and Applications of R‑PAS?

More Construct Validity Meta‑Analyses Than Any Other Test
As previously noted, a significant strength of the Rorschach is that it has, by far, the
most published construct validity meta-­analyses for its clinical scales than any other
psychological test—over 50 Rorschach scales compared to only two MMPI-2 clinical
scales (Bornstein, 1999; Diener et al., 2011; Graceffo et al., 2014; Gross et al., 2000;
Meyer, 2000; Mihura et al., 2013). The development of R-PAS was guided by these
meta-­analyses—­which is not the case for any other existing Rorschach system.
Introduction to R-PAS 17

Incremental Validity Over Self‑Report Measures

In clinical and forensic practice, the Rorschach offers a different method of assess-
ment that provides incremental validity over self-­report measures (for a discussion,
see Meyer, 1996, 1997; Mihura, 2012; Mihura et al., 2013). There is strong sup-
port in the literature for valid Rorschach scores to add incremental validity over
self-­report measures, including Mihura et al.’s (2013) meta-­analyses and a number
of other studies (Blasczyk-­Schiep, Kazén, Kuhl, & Grygielski, 2011; Dao, Prevatt,
& Horne, 2008; Fowler, Piers, Hilsenroth, Holdwick, & Padawer, 2001; Hartmann
& Grønnerød, 2009; Hartmann, Sunde, Kristensen, & Martinussen, 2003; Meyer,

s
2000; Ritsher, 2004; Viglione & Hilsenroth, 2001). This finding is not surprising,

es
given that a substantial body of literature shows only small to moderate relation-
ships between what people say about themselves and what they do (e.g., Mihura &

Pr
Graceffo, 2014; Wilson & Dunn, 2004).

rd
The Best Normed Measure to Assess Psychosis

lfo
Especially strong and robust evidence exists regarding the Rorschach’s ability to detect
psychosis and psychotic symptoms (Jørgensen et al., 2000, 2001; Mihura et al., 2013,

ui
Table 4), something that even the Rorschach’s staunchest critics do not contest (Garb,
G
Wood, Lilienfeld, & Nezworski, 2005). Our recent, but as yet unpublished, system-
atic review of the literature on the ability of all versions of the MMPI to detect psy-
e
chosis in clinical and forensic settings suggests that it is a less valid measure for this
Th

purpose than the Rorschach (Mihura, Ales, et al., 2017). This finding is consistent
with published studies showing that the Rorschach provides incremental validity over
self-­report measures in detecting psychosis but not the other way around (e.g., Dao et
18

al., 2008). In Chapters 4, 5, 6, 10, 11, 12, and 16, we provide case examples of using
R-PAS when the referral question targets psychosis, as well as when the diagnosis of
20

psychosis emerges as a possibility only after R-PAS is administered.

©

Valid, Normed Behavioral Assessment of Psychological Characteristics

Not Available on Other Tests
ht
ig

In addition to the general ability to detect psychosis, R-PAS also offers valid, normed
behavioral assessment of psychological characteristics that are not available through
yr

other tests (for more discussion of this topic, see Mihura, 2012; Mihura & Graceffo,
op

2014). For example, reality testing and thought disturbance are components of psy-
chosis, but they are also characteristics of other disorders and of personality in gen-
C

eral. They run along a continuum that is not limited to psychosis or schizophre-
nia. Reality testing problems result in misinterpretations of the environment that
can make successful treatment and healthy adaptation very challenging, even among
patients who do not have psychotic-­spectrum difficulties (e.g., Opaas, Hartmann,
Wentzel-­Larsen, & Varvin, 2016). R-PAS also provides a typical performance mea-
sure of cognitive complexity, in contrast to the maximal performance measures of
cognitive complexity that are obtained by cognitive ability tests (e.g., intelligence,
memory). There is empirical evidence that a client who scores low on these Rorschach
measures of cognitive complexity is significantly more likely to report symptoms of
18 THE BASICS OF R-PAS

alexithymia (the inability to notice and describe one’s emotions; Porcelli & Mihura,
2010) and to have problems engaging in and benefiting from psychotherapy (Mihura
et al., 2013; see the “Strongly Supported Variables” section in the Discussion).
The Rorschach also is the only performance test with norms to assess mental
imagery—­norms that can provide helpful information about preoccupations in gen-
eral, as well as for disorders in which intrusive imagery is a symptom, such as PTSD
(with traumatic images) and OCD (with obsessive images). Finally, relevant for all cli-
nicians but especially those who integrate relational or psychodynamic components
in their case conceptualizations, R-PAS provides (1) valid, normed measures of self
and other representations and (2) coded behaviors with the examiner to compare to

s
norms (e.g., Card Turning; evidence of not “following the rules,” as in high number

es
of Prompts and Pulls) that can be generalized to everyday life and to interpersonal
dynamics that can be expected with the client’s therapist.

Pr
rd
Orientation to This Book

lfo
This book contains three introductory chapters written by R-PAS developers: (1) the
present introductory chapter by Mihura and Meyer; (2) a basic chapter on interpreta-
ui
tion, by Mihura and Meyer (Chapter 2), that summarizes and extends the interpretive
G
guidelines found in the R-PAS manual; and (3) a chapter on norms, by Meyer and
Erdberg (Chapter 3), with a particular focus on using R-PAS with children and ado-
e

lescents. For readers unfamiliar with R-PAS, Table 1.1 lists the variable names and a
Th

concise description of how they are coded and interpreted. The subsequent chapters
(Chapters 4–19) illustrate R-PAS cases from various settings—­clinical and foren-
18

sic as well as also medical, pre-­employment, neuropsychological, and educational.

The chapter topics were chosen to represent referral questions that R-PAS can help
answer. In all cases, client names and identifying information have been carefully
20

altered to protect their anonymity. The chapters are written by international assess-
ment experts; about two-­thirds are United States authors, and the others represent
©

the countries of Finland, Israel, Italy, the Netherlands, and Norway.

By design, the chapters have similar sections: (1) a brief introduction to the case,
ht

(2) the referral question(s), (3) a summary of other assessment data, (4) relevant
ig

research or legal matters, (5) reasons why R-PAS was chosen to help address the
referral questions, (6) the experience of the R-PAS administration, (7) the deidenti-
yr

fied Results (Responses, Code Sequence, and Profile Pages 1 and 2), and (8) a dis-
op

cussion of the results as applied to the case(s). The chapters are concise and tightly
packed with information. To assist the chapter authors with their case interpreta-
C

tion, an early version of the R-PAS Case-Based Interpretive Guide was prepared for
each of their cases. Depending on the particular assessment setting and situation, the
chapters conclude with a summary about the impact that the R-PAS experience had
on the person being assessed and/or the importance of the R-PAS data for under-
standing the person and answering the referral questions.
Introduction to R-PAS 19

REFERENCES

Atkinson, L. (1986). The comparative validities of the Rorschach and MMPI: A meta-­analysis.
Canadian Psychology, 27, 238–247.
Beck, S. J., Beck, A. G., Levitt, E. E., & Molish, H. B. (1961). Rorschach’s test: Vol. I. Basic pro-
cesses (3rd ed.). Oxford, UK: Grune & Stratton.
Blasczyk-­S chiep, S., Kazén, M., Kuhl, J., & Grygielski, M. (2011). Appraisal of suicide risk among
adolescents and young adults through the Rorschach test. Journal of Personality Assessment,
93, 518–526.
Bornstein, R. F. (1999). Criterion validity of objective and projective dependency tests: A meta-­
analytic assessment of behavioral prediction. Psychological Assessment, 11, 48–57.

s
Crews, F. (1996). The verdict on Freud. Psychological Science, 7, 63–67.

es
Cronbach, L. J. (1949). Statistical methods applied to Rorschach scores: A review. Psychological
Bulletin, 46, 393–429.

Pr
Dao, T. K., Prevatt, F., & Horne, H. L. (2008). Differentiating psychotic patients from nonpsy-
chotic patients with the MMPI-2 and Rorschach. Journal of Personality Assessment, 90,
93–101.

rd
Dean, K. L. (2005). A method to increase Rorschach response productivity while maintaining
comprehensive system validity. Dissertation Abstracts International, 65, 4280.

lfo
Dean, K. L., Viglione, D. J., Perry, W., & Meyer, G. J. (2007). A method to optimize the response
range while maintaining Rorschach comprehensive system validity. Journal of Personality
Assessment, 89, 149–161.
ui
G
Dean, K. L., Viglione, D. J., Perry, W., & Meyer, G. J. (2008). Correction to: “A method to opti-
mize the response range while maintaining Rorschach comprehensive system validity.” Jour-
nal of Personality Assessment, 90, 204.
e

Diener, M. J., Hilsenroth, M. J., Shaffer, S. A., & Sexton, J. E. (2011). A meta-­analysis of the
Th

relationship between the Rorschach Ego Impairment Index (EII) and psychiatric severity.
Clinical Psychology & Psychotherapy, 18, 464–485.
Exner, J. E. (1974). The Rorschach: A comprehensive system. New York: Wiley.
18

Exner, J. E. (1986). The Rorschach: A comprehensive system. Vol. 1: Basic foundations (2nd ed.).
New York: Wiley.
20

Exner, J. E. (2001). A comment on “The misperception of psychopathology: Problems with norms

of the Comprehensive System for the Rorschach.” Clinical Psychology: Science and Practice,
8, 386–396.
©

Exner, J. E. (2003). The Rorschach: A comprehensive system (4th ed.). New York Wiley.
Exner, J. E. (2007). A new U.S. adult nonpatient sample. Journal of Personality Assessment,
ht

89(Suppl.), S154–S158.
Exner, J. E., & Weiner, I. B. (1982). The Rorschach: A comprehensive system: Vol. 3. Assessment
ig

of children and adolescents. New York: Wiley.

yr

Fowler, J. C., Piers, C., Hilsenroth, M. J., Holdwick, D. J., & Padawer, J. R. (2001). The Ror-
schach Suicide Constellation: Assessing various degrees of lethality. Journal of Personality
op

Assessment, 76, 333–351.

Garb, H. N., Wood, J. M., Lilienfeld, S. O., & Nezworski, M. T. (2005). Roots of the Rorschach
C

controversy. Clinical Psychology Review, 25, 97–118.

Graceffo, R. A., Mihura, J. L, & Meyer, G. J. (2014). A meta-­analysis of an implicit measure of
personality functioning: The Mutuality of Autonomy Scale. Journal of Personality Assess-
ment, 96, 581–595.
Gross, K., Keyes, M. D., & Greene, R. L. (2000). Assessing depression with the MMPI and MMPI-
2. Journal of Personality Assessment, 75, 464–477.
Hartmann, E., & Grønnerød, C. (2009). Rorschach variables and Big Five scales as predictors of
military training completion: A replication study of the selection of candidates to the Naval
Special Forces in Norway. Journal of Personality Assessment, 91, 254–264.
20 THE BASICS OF R-PAS

Hartmann, E., Sunde, T., Kristensen, W., & Martinussen, M. (2003). Psychological measures as
predictors of military training performance. Journal of Personality Assessment, 80, 87–98.
Hertz, M. R. (1970). Frequency tables for scoring Rorschach responses (5th ed.). Cleveland, OH:
Case Western Reserve University.
Hiller, J. B., Rosenthal, R., Bornstein, R. F., Berry, D. T. R., & Brunell-­Neuleib, S. (1999). A
comparative meta-­analysis of Rorschach and MMPI validity. Psychological Assessment, 11,
278–296.
Hosseininasab, A., Meyer, G. J., Viglione, D. J., Mihura, J. L., Berant, E., Resende, A. C., . . .
Mohammadi, M. R. (in press). The effect of receiving CS administration or an R-­optimized
alternative on R-PAS variables: A meta-­analysis of findings from six studies. Journal of Per-
sonality Assessment.

s
Jørgensen, K., Andersen, T. J., & Dam, H. (2000). The diagnostic efficiency of the Rorschach

es
Depression Index and the Schizophrenia Index: A review. Assessment, 7, 259–280.
Jørgensen, K., Andersen, T. J., & Dam, H. (2001). “The diagnostic efficiency of the Rorschach

Pr
Depression Index and the Schizophrenia Index: A review”: Erratum. Assessment, 8, 355.
Kiss, A. B., Mihura, J. L., & Meyer, G. J. (2017). A meta-­analytic review of the AGC score and
its relationship to real life violence. Manuscript in preparation.

rd
Klopfer, B., & Davidson, H. H. (1967). The Rorschach procedure: An introduction. New York:
Harcourt, Brace & World.

lfo
Meyer, G. J. (1992). Response frequency problems in the Rorschach: Clinical and research impli-
cations with suggestions for the future. Journal of Personality Assessment, 58, 231–244.

ui
Meyer, G. J. (1993). The impact of response frequency on Rorschach constellation indices and on
their validity with diagnostic and MMPI-2 criteria. Journal of Personality Assessment, 60,
G
153–180.
Meyer, G. J. (1996). The Rorschach and MMPI: Toward a more scientifically differentiated under-
e

standing of cross-­method assessment. Journal of Personality Assessment, 67, 558–578.

Th

Meyer, G. J. (1997). On the integration of personality assessment methods: The Rorschach and
MMPI. Journal of Personality Assessment, 68, 297–330.
Meyer, G. J. (2000). The incremental validity of the Rorschach Prognostic Rating Scale over the
18

MMPI Ego Strength Scale and IQ. Journal of Personality Assessment, 74, 356–370.
Meyer, G. J. (2001). Evidence to correct misperceptions about Rorschach norms. Clinical Psychol-
20

ogy: Science and Practice, 8, 389–396.

Meyer, G. J., & Archer, R. P. (2001). The hard science of Rorschach research: What do we know
and where do we go? Psychological Assessment, 13, 486–502.
©

Meyer, G. J., Erdberg, P., & Shaffer, T. W. (2007). Toward international normative reference data
for the Comprehensive System. Journal of Personality Assessment, 89(Suppl.), S201–S216.
ht

Meyer, G. J., Giromini, L., Viglione, D. J., Reese, J. B., & Mihura, J. L. (2015). The association of
gender, ethnicity, age, and education with Rorschach scores. Assessment, 22, 46–64.
ig

Meyer, G. J., & Handler, L. (1997). The ability of the Rorschach to predict subsequent outcome: A
yr

meta-­analysis of the Rorschach Prognostic Rating Scale. Journal of Personality Assessment,

69, 1–38.
op

Meyer, G. J., Hsiao, W.-C., Viglione, D. J., Mihura, J. L., & Abraham, L. M. (2013). Rorschach
scores in applied clinical practice: A survey of perceived validity by experienced clinicians.
C

Journal of Personality Assessment, 95, 351–365.

Meyer, G. J., Shaffer, T. W., Erdberg, P., & Horn, S. L. (2015). Addressing issues in the devel-
opment and use of the Composite International Reference Values as Rorschach norms for
adults. Journal of Personality Assessment, 97, 330–347.
Meyer, G. J., Viglione, D. J., & Mihura, J. L. (2017). Psychometric foundations of the Rorschach
Performance Assessment System (R-PAS). In R. E. Erard & F. B. Evans (Eds.), The Rorschach
in multimethod forensic practice (pp. 23–91). New York: Routledge.
Meyer, G. J., Viglione, D. J., Mihura, J. L., Erard, R. E., & Erdberg, P. (2011). Rorschach Perfor-
mance Assessment System: Administration, coding, interpretation, and technical manual.
Toledo, OH: Rorschach Performance Assessment System.
Introduction to R-PAS 21

Mihura, J. L. (2012). The necessity of multiple test methods in conducting assessments: The role of
the Rorschach and self-­report. Psychological Injury and Law, 5, 97–106.
Mihura, J. L., Dumitrascu, N., Roy, M., & Meyer, G. J. (2017). The centrality of the response
process in construct validity: An illustration via the Rorschach space response. Journal of
Personality Assessment. [Epub ahead of print]
Mihura, J. L., & Graceffo, R. A. (2014). Multimethod assessment and treatment planning. In C.
J. Hopwood & R. F. Bornstein (Eds.), Multimethod clinical assessment (pp. 285–318). New
York: Guilford Press.
Mihura, J. L., Meyer, G. J., Bombel, G., & Dumitrascu, N. (2015). Standards, accuracy, and ques-
tions of bias in Rorschach meta-­analyses: Reply to Wood, Garb, Nezworski, Lilienfeld, and
Duke (2015). Psychological Bulletin, 141, 250–260.

s
Mihura, J. L., Meyer, G. J., Dumitrascu, N., & Bombel, G. (2013). The validity of individual

es
Rorschach variables: Systematic reviews and meta-­analyses of the comprehensive system. Psy-
chological Bulletin, 139, 548–605.

Pr
Mihura, J. L., Ales, F., Meyer, G. J., Meadows, E. A., Roy, M., & Dumitrascu, N. (2017). A
meta-­analytic review of the MMPI’s (all versions) ability to detect psychosis in clinical and
forensic settings. Manuscript in progress.

rd
Opaas, M., Hartmann, E., Wentzel-­Larsen, T., & Varvin, S. (2016). Relationship of pretreatment
Rorschach factors to symptoms, quality of life, and real-life functioning in a 3-year follow-­up

lfo
of traumatized refugee patients. Journal of Personality Assessment, 98, 247–260.
Parker, K. C., Hanson, R. K., & Hunsley, J. (1988). MMPI, Rorschach, and WAIS: A meta-­analytic

ui
comparison of reliability, stability, and validity. Psychological Bulletin, 103, 367–373.
Piotrowski, Z. A. (1957). Perceptanalysis. New York: Macmillan.
G
Porcelli, P., & Mihura, J. L. (2010). Assessment of alexithymia with the Rorschach Comprehensive
System: The Rorschach Alexithymia Scale (RAS). Journal of Personality Assessment, 92,
e

128–136.
Th

Rapaport, D., Gill, M. M., & Schafer, R. (1968). Diagnostic psychological testing (rev. ed., R.
Holt, Ed.). New York: International Universities Press.
Reese, J. B., Viglione, D. J., & Giromini, L. (2014). A comparison between Comprehensive System
18

and an early version of the Rorschach Performance Assessment System administration with
outpatient children and adolescents. Journal of Personality Assessment, 96, 515–522.
20

Ritsher, J. B. (2004). Association of Rorschach and MMPI psychosis indicators and schizophrenia
spectrum diagnoses in a Russian clinical sample. Journal of Personality Assessment, 83,
46–63.
©

Rogers, R., Sewell, K. W., Martin, M. A., & Vitacco, M. J. (2003). Detection of feigned mental
disorders: A meta-­analysis of the MMPI-2 and malingering. Assessment, 10, 160–177.
ht

Romney, D. M. (1990). Thought disorder in the relatives of schizophrenics: A meta-­analytic review

of selected published studies. Journal of Nervous and Mental Disease, 178, 481–486.
ig

Rorschach, H. (1942). Psychodiagnostik [Psychodiagnostics]. Bern, Switzerland: Bircher. (Origi-

yr

nal work published 1921)

Schachtel, E. G. (1966). Experiential foundations of Rorschach’s test. Hillsdale, NJ: Analytic
op

Press.
Searls, D. (2017). The inkblots: Hermann Rorschach, his iconic test, and the power of seeing. New
C

York: Crown.
Viglione, D. J., & Giromini, L. (2016). The effects of using the international versus Comprehensive
System Rorschach norms for children, adolescents, and adults. Journal of Personality Assess-
ment, 98, 391–397.
Viglione, D. J., & Hilsenroth, M. J. (2001). The Rorschach: Facts, fictions, and future. Psychologi-
cal Assessment, 13, 452–471.
Viglione, D. J., Meyer, G. J., Jordan, R. J., Converse, G. L., Evans, J., MacDermott, D., & Moore,
R. C. (2015). Developing an alternative Rorschach administration method to optimize the
number of responses and enhance clinical inferences. Clinical Psychology & Psychotherapy,
22, 546–558.
22 THE BASICS OF R-PAS

Viglione, D. J., Meyer, G. J., Resende, A. C., & Pignolo, C. (2017). A survey of challenges expe-
rienced by new learners coding the Rorschach. Journal of Personality Assessment, 99, 315–
323.
Wilson, T. D., & Dunn, E. W. (2004). Self-­knowledge: Its limits, value, and potential for improve-
ment. Annual Review of Psychology, 55, 493–518.
Wood, J. M., Garb, H. N., Nezworski, M. T., Lilienfeld, S. O., & Duke, M. C. (2015). A second
look at the validity of widely used Rorschach indices: Comment on Mihura, Meyer, Dumi-
trascu, and Bombel (2013). Psychological Bulletin, 141, 236–249.
Wood, J. M., Nezworski, M. T., Garb, H. N., & Lilienfeld, S. O. (2001a). Problems with the
norms of the Comprehensive System for the Rorschach: Methodological and conceptual con-
siderations. Clinical Psychology: Science and Practice, 8, 397–402.

s
Wood, J. M., Nezworski, M. T., Garb, H. N., & Lilienfeld, S. O. (2001b). The misperception of

es
psychopathology: Problems with norms of the Comprehensive System for the Rorschach.
Clinical Psychology: Science and Practice, 8, 350–373.

Pr
Wood, J. M., Nezworski, M. T., Garb, H. N., & Lilienfeld, S. O. (2006). The controversy over
Exner’s Comprehensive System for the Rorschach: The critics speak. Independent Practitio-
ner, 26, 73–82.

rd
lfo
ui
G
e
Th
18
20
©
ht
ig
yr
op
C

Copyright © 2018 The Guilford Press. Guilford Publications

No part of this text may be reproduced, translated, stored in a retrieval 370 Seventh Avenue, Suite 1200
system, or transmitted in any form or by any means, electronic, mechanical, New York, NY 10001
photocopying, microfilming, recording, or otherwise, without written 212-431-9800
permission from the publisher. 800-365-7006
Purchase this book now: www.guilford.com/p/mihura www.guilford.com