This article was downloaded by: [Central Michigan University] On: 14 January 2015, At: 07:12 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Personality Assessment Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjpa20
Rorschach Structure of a Hospitalized Sample of Vietnam Veterans With PTSD Wayne L. Hartman , Michael E. Clark , Mary K. Morgan , Victoria K. Dunn , Allan D. Fine , Glenn G. Perry Jr. & David L. Winsch Published online: 22 Jun 2011.
To cite this article: Wayne L. Hartman , Michael E. Clark , Mary K. Morgan , Victoria K. Dunn , Allan D. Fine , Glenn G. Perry Jr. & David L. Winsch (1990) Rorschach Structure of a Hospitalized Sample of Vietnam Veterans With PTSD, Journal of Personality Assessment, 54:1-2, 149-159 To link to this article: http://dx.doi.org/10.1080/00223891.1990.9673982
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
JOURNAL OF PERSONALFTY 4SSESSMEhT 19% %(. & 2) 149-159 Copvnght c 1992, Lawence Erlbaum .4ssocxates Inc.
Downloaded by [Central Michigan University] at 07:12 14 January 2015
Rorschach Structure of a Hospitalized Sample of Vietnam Veterans With PTSD Wavne L. Hartman, IMichaeli E. Clark, K. Morgan, Victoria K. Dunn, Aflan B. Fine, Glenn 6;. Pernib fr., and David L. Wirrsch \'A A4edical Center
Bay Pines, Norfda
Rorschach structurai summary d a m are presented for a g r m p oi 4 I pmttraama:jc stress disorder i?TSIS) patients a h c were being treated Ir. a speaaiirei inpatient E S D treatnen: program. Results suggest that pzaenrs suffering from FTSD exhibir impaired realky-:esting abilities and tend tc utliize :neitecave coping ,r
strategies. T h e group's szructural summary factors are presezxed as itlcipien: norrna:ive data for the Exner Conprehensive Svs:ern or; patirn:~ with FTSD. implications that thew protocols silggest a more severe and pervasive level sf ,. psychoparhoiogv :han w o ~ l dbe expected from t h e o r e t d descriptions oi :he
disorder are discussed.
The contr~burmnof tradmonal psychoiogical test ~rocedwestc the diagnostic assessmen: of patlens exh:bmng svmptons oi posttraumatic stress d:sorder (PTSD)has Seen almost as controversd as rhe d1agnos:s itself. A: a resdr, ancl m part hecase :he d~agnoslsof PTSD 1s often made cimcalh on the Sass of a patient's hlstoy and or seli-report of svmptoms. t t e E S D 11rera:ure c o n t a m ric ot' the dlsorder re1at:velv iew ciescrlptmns of the p ~ ~ ~ h o m e rch;iracter:st~cs and an almost complete lack of sol16 normatxe test daca aga:ns: ahich ro compare :nd~vlduaIclrnlcal :esr prohies. Editor's Note: This a~ticleand :he one chat follows reporr smiiar srudies of Rorschach hadings in postrraurnatlc szress disorder. This similaricy it coin;:den:ai I:; :hat the reseaxi: wa: conduc:ed independently and the amcles were submitred and re1,iewed separatek Hence, rhe :wc. s e x oi findmgs serve. at ieasr ;n ?a::. ro cross-vairdate each other.
iYFSD firsr appeared as a formal psychiatric diagnosis with the release of the
Downloaded by [Central Michigan University] at 07:12 14 January 2015
Diugnostic arid Statistical M a m i o? Mentai Disorders (3rd ed. [DSM-EI;, Arnerican Psychiatric Association, 1980). Although revised slightly in DSM-IEI-R (American Psychiatric Association, 1983, the diagnosis conticues to be based essentially on fox- broad features: (a) the presence of a recognizable traumatic even?, (b) persisreni reexperiencing of the even:, (ci avoidance of stimuli zssociaced with the trauma or numbing of responsiveness, and id) persistent symptoms of increased arousal. A major obstacie inherent in this cicfinition, and one that makes reliabke diagnosis of PTSD diScult: is its relatively low reliance o n observable and qsantifiable behavior. As a result, with the exception of measuring symptoms of increased arousal (the most loosel~organized and least predictive symptom group), the deveiopment of a roie for :he use of standardized psychdogical test instruments in detecting PTSD has had Little theoretical basis. Therefore, clinical interpretation of traditicnai tests has depended largely on .;he measuremerrt oi intervening variables or traits through :he disccverp of common profiies 3i patterns of test results. Not surprisingly? what little iniorrna~ionthat has accumulated over rhe past severai years has focrased prinrarily or: the Minnesota h4uitip'nasic Personaliry Invenrory (MMPI!. Beginning in i977 with rhe first report of a rommcnly found 8-2 profile among disturbed combat veterans (Merbaurn, 19??), several sxdies reported on the MMPI profiles of veterans with PTSD and systematically refined its use in discriminating P T D patients from other groups (Fairbank, Keane, & Ma:lloy, 1983; Fairbank: McGafirev, & Keane, 1985; Fov, Siprelie, Rueger, & CarroZi, 198':; Penk er al., iS81; Roberts et a!., 1952).In fact, Keane, MalBoy, and ?al. c &.
>
--!
A , ,
Downloaded by [Central Michigan University] at 07:12 14 January 2015
2.35
..
! 7:
A
1 26
. .. 1.;;
c.95
;.;I c3,74 2.G i.37 2,16 Z.23 6.34
. -;>"
,-, \
.*.,
7
-. -:7 ' i *, , ., -. -.
.
2.~2
More fa.arably, h o w e ~ w means , for the six special siorec 2:e cn!;. ~ i i p h : ! ~ abo7-e normal, suggestmp that a l t h o q h rhese s:rkjt.cts ma\- kzve signiiica~t diFkuirv in perceiving their eni::ronmeni along convercional Iines. chev d~ nor , . exhibit significa:dy strzined hgic or Zrr.paireci thotight processes. Aithough the mean Sch~zophreniclnde?: (SCZII at 2.37 :s reiativeI17 high an6 is :r; the range repcrced for borde:line or sctiizotvpai popuiations, ir is weii bcioa the means report& far schizophrecics (Euner, 19862, 198hb:. Sirn:larly, the mecn b! levei of 17.54,aithongh considerablu higher than :ha: h r nonFatients, is hwer thm the m e m observed k m Exner's schizophre~:ic grou? and is more In line ivrth his findings for borderlines iEsner, 19A61.I. Another interesting finding is that, as shown in Tabie 2 . rherc 1s a rela:ivel-f ., . large groap (!% subjecrsi that fair inro the ambitengve Lategar\- ir. terms of their r o p i q style. O r akernatii.eiv, from withir: :he Exner inter~reti~ye 5amewcrrL. i: . could be a q p e d char these !8 sublects are iacking a detinitive coring srde and that they vacii!ate In their approach rc decision-mzking hetweer. delay and idearior,, on the o x hand, and a trial-and-error. a5ect:velv 1n5uenced. ~nr.iiri~-e approach, on the other. L3i the remai~.ing23 sub!ecrs, airnost c w c e as macy exhibit an inrroverske rather chan an esrraremve cnying stvie Six:larh:.. . ,-
156
PEARTMAN FT AL. TABLE 2
Frequencies and Percentages Concerning D~ectlonalityfor 18 Structural Variables for 41 PTSD Padents
Downloaded by [Central Michigan University] at 07:12 14 January 2015
i'criabie
ER S q i e M - VC'SUMG' 2 2 (introversive) M - WSUhdC = -f i.5 ro - 1.5 (Arnb!iens~ve) WST,!MC -- M 2 2 (Ex::atensive! EA --es differences: Overioad D Score < 0 Adj D Score < 2 %d Score > X P (Gverincorporator) 2a Score < -3.0 (Llnderincor?orator)
F q
96
15
36.6 4.3.9
18 8
.,
~3.5
24
34.1
9
&-.b
0
2.2
-
,
,
I ( . IT
+
7
-,
Pi
F o m cuafiiy deviations
X 4 96 < o:. F + % < .7C X - ?c > .is S-Conste!latior, 2 E. Schizophrems Index S ~ Z= I 5 SCZI = 4 Depressim index DEf'] = 5
- 7
i)
HO.5
.7 6.,
65.4
2" 6
T?
i
!L.!
44 :7 A".-
DEE = 4 hGsceilaneous variabiec. FM m
Journal of Personality Assessment Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjpa20
Rorschach Structure of a Hospitalized Sample of Vietnam Veterans With PTSD Wayne L. Hartman , Michael E. Clark , Mary K. Morgan , Victoria K. Dunn , Allan D. Fine , Glenn G. Perry Jr. & David L. Winsch Published online: 22 Jun 2011.
To cite this article: Wayne L. Hartman , Michael E. Clark , Mary K. Morgan , Victoria K. Dunn , Allan D. Fine , Glenn G. Perry Jr. & David L. Winsch (1990) Rorschach Structure of a Hospitalized Sample of Vietnam Veterans With PTSD, Journal of Personality Assessment, 54:1-2, 149-159 To link to this article: http://dx.doi.org/10.1080/00223891.1990.9673982
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
JOURNAL OF PERSONALFTY 4SSESSMEhT 19% %(. & 2) 149-159 Copvnght c 1992, Lawence Erlbaum .4ssocxates Inc.
Downloaded by [Central Michigan University] at 07:12 14 January 2015
Rorschach Structure of a Hospitalized Sample of Vietnam Veterans With PTSD Wavne L. Hartman, IMichaeli E. Clark, K. Morgan, Victoria K. Dunn, Aflan B. Fine, Glenn 6;. Pernib fr., and David L. Wirrsch \'A A4edical Center
Bay Pines, Norfda
Rorschach structurai summary d a m are presented for a g r m p oi 4 I pmttraama:jc stress disorder i?TSIS) patients a h c were being treated Ir. a speaaiirei inpatient E S D treatnen: program. Results suggest that pzaenrs suffering from FTSD exhibir impaired realky-:esting abilities and tend tc utliize :neitecave coping ,r
strategies. T h e group's szructural summary factors are presezxed as itlcipien: norrna:ive data for the Exner Conprehensive Svs:ern or; patirn:~ with FTSD. implications that thew protocols silggest a more severe and pervasive level sf ,. psychoparhoiogv :han w o ~ l dbe expected from t h e o r e t d descriptions oi :he
disorder are discussed.
The contr~burmnof tradmonal psychoiogical test ~rocedwestc the diagnostic assessmen: of patlens exh:bmng svmptons oi posttraumatic stress d:sorder (PTSD)has Seen almost as controversd as rhe d1agnos:s itself. A: a resdr, ancl m part hecase :he d~agnoslsof PTSD 1s often made cimcalh on the Sass of a patient's hlstoy and or seli-report of svmptoms. t t e E S D 11rera:ure c o n t a m ric ot' the dlsorder re1at:velv iew ciescrlptmns of the p ~ ~ ~ h o m e rch;iracter:st~cs and an almost complete lack of sol16 normatxe test daca aga:ns: ahich ro compare :nd~vlduaIclrnlcal :esr prohies. Editor's Note: This a~ticleand :he one chat follows reporr smiiar srudies of Rorschach hadings in postrraurnatlc szress disorder. This similaricy it coin;:den:ai I:; :hat the reseaxi: wa: conduc:ed independently and the amcles were submitred and re1,iewed separatek Hence, rhe :wc. s e x oi findmgs serve. at ieasr ;n ?a::. ro cross-vairdate each other.
iYFSD firsr appeared as a formal psychiatric diagnosis with the release of the
Downloaded by [Central Michigan University] at 07:12 14 January 2015
Diugnostic arid Statistical M a m i o? Mentai Disorders (3rd ed. [DSM-EI;, Arnerican Psychiatric Association, 1980). Although revised slightly in DSM-IEI-R (American Psychiatric Association, 1983, the diagnosis conticues to be based essentially on fox- broad features: (a) the presence of a recognizable traumatic even?, (b) persisreni reexperiencing of the even:, (ci avoidance of stimuli zssociaced with the trauma or numbing of responsiveness, and id) persistent symptoms of increased arousal. A major obstacie inherent in this cicfinition, and one that makes reliabke diagnosis of PTSD diScult: is its relatively low reliance o n observable and qsantifiable behavior. As a result, with the exception of measuring symptoms of increased arousal (the most loosel~organized and least predictive symptom group), the deveiopment of a roie for :he use of standardized psychdogical test instruments in detecting PTSD has had Little theoretical basis. Therefore, clinical interpretation of traditicnai tests has depended largely on .;he measuremerrt oi intervening variables or traits through :he disccverp of common profiies 3i patterns of test results. Not surprisingly? what little iniorrna~ionthat has accumulated over rhe past severai years has focrased prinrarily or: the Minnesota h4uitip'nasic Personaliry Invenrory (MMPI!. Beginning in i977 with rhe first report of a rommcnly found 8-2 profile among disturbed combat veterans (Merbaurn, 19??), several sxdies reported on the MMPI profiles of veterans with PTSD and systematically refined its use in discriminating P T D patients from other groups (Fairbank, Keane, & Ma:lloy, 1983; Fairbank: McGafirev, & Keane, 1985; Fov, Siprelie, Rueger, & CarroZi, 198':; Penk er al., iS81; Roberts et a!., 1952).In fact, Keane, MalBoy, and ?al. c &.
>
--!
A , ,
Downloaded by [Central Michigan University] at 07:12 14 January 2015
2.35
..
! 7:
A
1 26
. .. 1.;;
c.95
;.;I c3,74 2.G i.37 2,16 Z.23 6.34
. -;>"
,-, \
.*.,
7
-. -:7 ' i *, , ., -. -.
.
2.~2
More fa.arably, h o w e ~ w means , for the six special siorec 2:e cn!;. ~ i i p h : ! ~ abo7-e normal, suggestmp that a l t h o q h rhese s:rkjt.cts ma\- kzve signiiica~t diFkuirv in perceiving their eni::ronmeni along convercional Iines. chev d~ nor , . exhibit significa:dy strzined hgic or Zrr.paireci thotight processes. Aithough the mean Sch~zophreniclnde?: (SCZII at 2.37 :s reiativeI17 high an6 is :r; the range repcrced for borde:line or sctiizotvpai popuiations, ir is weii bcioa the means report& far schizophrecics (Euner, 19862, 198hb:. Sirn:larly, the mecn b! levei of 17.54,aithongh considerablu higher than :ha: h r nonFatients, is hwer thm the m e m observed k m Exner's schizophre~:ic grou? and is more In line ivrth his findings for borderlines iEsner, 19A61.I. Another interesting finding is that, as shown in Tabie 2 . rherc 1s a rela:ivel-f ., . large groap (!% subjecrsi that fair inro the ambitengve Lategar\- ir. terms of their r o p i q style. O r akernatii.eiv, from withir: :he Exner inter~reti~ye 5amewcrrL. i: . could be a q p e d char these !8 sublects are iacking a detinitive coring srde and that they vacii!ate In their approach rc decision-mzking hetweer. delay and idearior,, on the o x hand, and a trial-and-error. a5ect:velv 1n5uenced. ~nr.iiri~-e approach, on the other. L3i the remai~.ing23 sub!ecrs, airnost c w c e as macy exhibit an inrroverske rather chan an esrraremve cnying stvie Six:larh:.. . ,-
156
PEARTMAN FT AL. TABLE 2
Frequencies and Percentages Concerning D~ectlonalityfor 18 Structural Variables for 41 PTSD Padents
Downloaded by [Central Michigan University] at 07:12 14 January 2015
i'criabie
ER S q i e M - VC'SUMG' 2 2 (introversive) M - WSUhdC = -f i.5 ro - 1.5 (Arnb!iens~ve) WST,!MC -- M 2 2 (Ex::atensive! EA --es differences: Overioad D Score < 0 Adj D Score < 2 %d Score > X P (Gverincorporator) 2a Score < -3.0 (Llnderincor?orator)
F q
96
15
36.6 4.3.9
18 8
.,
~3.5
24
34.1
9
&-.b
0
2.2
-
,
,
I ( . IT
+
7
-,
Pi
F o m cuafiiy deviations
X 4 96 < o:. F + % < .7C X - ?c > .is S-Conste!latior, 2 E. Schizophrems Index S ~ Z= I 5 SCZI = 4 Depressim index DEf'] = 5
- 7
i)
HO.5
.7 6.,
65.4
2" 6
T?
i
!L.!
44 :7 A".-
DEE = 4 hGsceilaneous variabiec. FM m
