McAnulty College and Graduate School of Liberal Arts
aphasia, perception, Rorschach
This study explored the use of the Rorschach with eight individuals diagnosed with mild to moderate fluent or non-fluent types of aphasia to consider the extent to which the Rorschach captured aspects of language impairment not otherwise probed by traditional neurolinguistic measures. A ninth participant, with Wernicke’s aphasia, produced non-scorable responses and was therefore left out of all analyses. Of primary interest was whether the Rorschach, historically understood as a projective psychological instrument, would allow individuals living with language impairment to recognize, retrieve and coherently express words that reflected their thoughts. At the same time, this study sought to explore how the ambiguous nature of Rorschach inkblots could be leveraged together with traditional neuropsychological and linguistic measures, to provide insight into the relationship between perception, thought, psychological process and language - a multimethod assessment approach to describe the complex phenomena surrounding aphasia.
This study demonstrated that individuals with reduced language function were able to provide responses to inkblots presented in a Rorschach assessment that were sufficient in number and quality to allow scoring and interpretation. Spearman’s rank-order correlation coefficients were calculated for WAB-R AQ score, CLQT Language Functions Domain Scores, the Rorschach cognitive processing simplicity, complexity scores and, the thought and perception EII and severe cognitive scores. Correlations among neurolinguistic and Rorschach cognitive processing and thought and perception variables, indicate a clear and intuitive relationship between these different measures.
Finally, participants were administered a confrontation naming task in which a series of 10 black and white line drawings representing images of the most popular responses for each of the 10 Rorschach cards were presented. Results from that task confirmed that study participants could accurately retrieve the word for the most common responses, suggesting that object naming is not a limitation in the population of individuals with mild to moderate aphasia.
Although differences between small groups of individuals with fluent and non-fluent aphasia could not be validated with significance testing, descriptive analyses showed some differences in means and standard deviations of Rorschach variable scores between the two groups. Specifically, individuals in the non-fluent aphasia group, who had more impairment in language ability, provided more vague responses, were typically only able to provide one defining characteristic of the blot (i.e., blends), and produced more communicative distortions (as measured by the thought and perception variables) than compared to individuals in the fluent aphasia group. The participant group, as a whole, produced a high degree of vague responses, was found to produce more simplistic descriptions of the blot, and typically only produced one defining characteristic of the blot (i.e., blends) - as compared to the neurotypical population.
This study shows that the Rorschach can be administered to a population of individuals with mild to moderate fluent or non-fluent aphasia to generate scoreable results, with named objects comparable to those in norms derived from a neurotypical population. Limited amount and quality of supporting description of those named objects provided by the participants, however, limits the utility of the Rorschach from a psychological assessment perspective. In light of the dependence of this instrument on verbal ability, future studies might consider modified application of the Rorschach with administration that allows non-verbal responses (e.g., drawing, picture taking) as a means of supplementing participant verbal responses – to develop a richer understanding of the individual’s perception, and insight into their psychological state.
Collin Dilmore, V. (2016). Perception and Language: Using the Rorschach with People with Aphasia (Doctoral dissertation, Duquesne University). Retrieved from http://ddc.duq.edu/etd/93