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Using Quantitative and Qualitative Rorschach Data within a Multi-Method, Forensic Assessment of Dissociative Posttraumatic Stress Disorder

Abstract

This case study demonstrates the procedures and the complementary function and contribution of the Rorschach within a multi-method forensic mental health evaluation. This particular case addressed the state of mind of a perpetrator and related traumatic reactions and the possibility of Posttraumatic Stress Disorder (PTSD) associated with violent attacks involving rape. The verbatim Rorschach record contained repeated and troubled images of splitting and ripping, and of transitions from cooperative and pleasing to darkness and evil representations, that likely reflected the individual’s distressed perception of his own dissociation. A previous review of the research of the Rorschach and post-traumatic reactions (Viglione et al., 2012) provided the main structure for applying the Rorschach in this case. The resultant Rorschach interpretations were consistent with the outcome of self-report assessments including measures of mental status and trauma reactions, as well as with additional familial declarations and forensic and clinical interviews. The full battery of tests provided the image of a criminal suffering from chronic, complex PTSD with dissociative symptoms reflecting opposing affiliative and aggressive traits; his fluctuating aggressive behavior was consistent with features of antisocial personality disorder.

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Notes

  1. The respondent is referred to as Mr. TA to stand for trauma assessment. This and other changes and omissions of information have been made to preserve anonymity. Information that might have the smallest chance to identify this individual has been changed or omitted in a way that would likely not change the understanding of the important points of the article. Thus, he cannot be identified with the current information. Moreover, omission of some of the specific description of these characteristics is not deemed crucial to the aims of the paper, so that some identifying information that is typically provided is not included.

  2. Simple cognitive problem to solve.

  3. He did not use the term “depersonalization,” but rather just asserted that such experiences happen frequently.

  4. T-scores use M = 50, SD = 10 with male community college normative sample.

  5. The IOP score is a probability of feigning score with a cutoff of .50. It corresponds to a 0.94 negative predictive power assuming a base rate of 0.30.

  6. Complexity Adjusted Scores as a correction for the effect of simple versus complex on other scores are only recommended when Complexity is ≥ 115. Accordingly, they are not included in the R-PAS output in the Appendices.

  7. Applying Brand et al. (2009) results to Mr. TA’s Rorschach would lead to speculation about Borderline Personality Disorder (BPD). However, his history, behavior, and symptoms are not consistent with BPD.

  8. The TSI-2 includes scales relevant to DID. Additional tests including DID assessment are included under the limitation section.

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Acknowledgements

We thank Dallas Boyce, M.A. and Alaina Paterson for their careful reading and editing of the manuscript.

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Donald J. Viglione has a direct financial interest in the Rorschach Performance System and Inventory of Problems-29. He is a member of the two LLC’s that own the rights to these tests.

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Morales, T.I., Viglione, D.J. Using Quantitative and Qualitative Rorschach Data within a Multi-Method, Forensic Assessment of Dissociative Posttraumatic Stress Disorder. Psychol. Inj. and Law (2022). https://doi.org/10.1007/s12207-022-09453-1

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Keywords

  • Rorschach
  • PTSD
  • Dissociation
  • Multi-method
  • Forensic mental health assessment
  • Case study