L&B5 - Indirect methods

indirect methods

- attempt to retrieve information that can neither be obtained through self-reporting nor through direct behavioural observation

- Indirect methods do not primarily focus on psychiatric diagnoses, but on personality processes;

> If these personality processes contribute to the acknowledgment of psychiatric diagnoses, indirect methods can contribute to diagnostics

> Scoring systems that focus on structural personality traits offer new possibilities in this area, because they are not based on self-report questionnaires

characteristics of indirect methods

- subject is offered a relatively unstructured task, to which he must assign an interpretation or a structure of his own choosing;

> The manner in which someone approaches these materials will be quite personal and consequently reflect something about the subject’s characteristics

> From a psychodynamic perspective, it is argued that the unstructured materials function as a screen, onto which the subject projects his conflicts and motives:

> The ‘projective hypothesis’ is nowadays not the primary approach to indirect methods

outcome of indirect methods testing

- The outcomes of the tests are the result of the interplay between perception and the personal interpretation of meaning, rather than projection of a defence mechanism;

> Many responses to the tests contain no projective elements at all

> The respondent constructs his response on the basis of an interaction between the characteristics of the materials, and his internal world

scoring system of indirect methods

- For certain indirect methods, the scoring systems are at a nominal level of measurement:

> In the Rorschach test, the total number of answers within substantively different categories can be used, or ordinal scales exist for examining the outcomes of this test

> For the TAT, several scoring systems for evaluating the development quality of representations of self and others was developed

> BUT (!) indirect methods in clinical practice are often not scored and therefore interpreted intuitively

pros of using indirect methods

- People may self-report on certain feelings, thoughts and may also have insight into certain psychological phenomena, but this insight is limited;

> Experts who have undergone research training and have the necessary practical experience often have more insight

- Indirect techniques are less sensitive to the tendency of consciously or unconsciously presenting oneself as different;

> Does not mean that indirect methods cannot be manipulated

- Indirect techniques also allow for so-called ‘functional’ diagnostics, that examine how people react or behave at the present time

- Many psychological processes not only occur outside of consciousness, but they are simply not accessible for self-reporting;

> Indirect methods aim to describe these implicit latent processes

- The use of multiple methods increases the validity of diagnostics

five categories of indirect methods

1. Association methods, in which the subject must respond to a stimulus using the first word or first perception that comes to mind

2. Construction methods, in which the subject is given the task of producing something, usually a story, in a stimulus situation

3. Completion methods, in which an incomplete task, that must be completed by the subject

4. Choice or ordering methods, in which the subject makes his own choice from a number of options, or ranks a number of stimuli

5. Expressive methods, in which the subject is asked to draw a picture, such as a tree, a house, or a person

the Rorschach test

- The subject is initially offered ten plates with inkblots and is subsequently instructed to state what the inkblots represent;

> Half of the plates are achromatic, while the other half contain colours

> The answers are recorded as literally as possible, the subject is then further questioned for the purpose of scoring the answers

two leading scoring systems for the Rorschach Test

- Exner's Comprehensive System (CS)

- Rorschach Performance Assessment System (R-PAS)

Exner's Comprehensive System (CS)

- Requires standardized administration of the test, coding of the answers in accordance with detailed scoring principles, and a systematic interpretation strategy

- Criticism: the validity of various scoring variables in the CS proved to be inadequate, occasionally containing conflicting or negative evidence

Rorschach Performance Assessment System (R-PAS)

- R-PAS is both an improvement and an extension of the CS, because it includes new scoring scales

- Standardization for adults and children is not yet fully completed due to the fact that an insufficient number of protocols have been collected

- Distinguishes between variables that have been properly validated, versus variables for which there is less or little validity evidence;

> It is recommended that these variables are used with caution and that they are not used in forensic questions

- The profile sheet with the summary of scores provides a picture of the strengths and weaknesses of the subject’s personality at a single glance

- A four-day training course is required and it is advised that the skills are maintained through regular participation in intervision groups;

> A qualitative or substantive analysis of the answers is carried out in a second phase after the coding of the test answers:

> This will rarely yield relevant information when the subject has failed to provide comprehensive answers

> This qualitative approach has not been properly validated, and so its implementation involves a certain level of uncertainty

> The English-language approaches make use of the above-mentioned psychoanalytic scoring systems

- One interesting approach is the subject’s involvement in the interpretation of the Rorschach test;

> During the discussion of the psychodiagnostic examination, the subject can respond to the psychologist's interpretations, or interpret certain answers himself, which can be a meaningful experience

the Thematic Apperception Test (TAT)

- subject is offered images and is instructed to tell a story, usually involving the subject being instructed to tell a story about:

> What is happening at that point in time

> What preceded the event and how it ends

> What the characters are thinking and feeling

- 31 images are printed in black and white with most of the images depicting either one or more people in a variety of situations that vary considerably in their ambiguity;

> Nowadays a shortened series of eight to twelve images is usually used, with the test being administered in one session

- During administration of the test, the tester records the story literally and asks the subject for more information if one of the instruction elements is missing from the story;

> In clinical practice the TAT is usually interpreted in a qualitative way, which involves little to no scoring:

> In Bellak’s clinical system the stories are analysed on a dozen different dimensions and the interpretation follows a clear systematic approach, but the analysis of the stories involves a great deal of interpretation

> The Social Cognition and Object Relations Scales (SCORS) is based on an integration of social cognition theories and object relations theories:

> It measures six dimensions of interpersonal functioning

> The reliability and validity of the subscales is excellent

The Sentence Completion Test (ZAT)

- The subject is given the opening words or sentence stems which must then be completed to make a sentence;

> There are many versions of the ZAT, varying in length from 20 to 100 sentences

- Various scoring systems exist for the ZAT but they do not tend to be used in actual practice, partly because of their complexity and subjectivity;

> Interpretation often occurs in an impressionistic manner: the completions are first divided into two categories, e.g., meaningful and meaningless

> Using a general content analysis, the meaningful completions are subsequently subdivided into a number of sections:

> It is then possible to obtain an impression of a number of positive aspects, such as positive feelings toward other people and a number of more negative aspects, such as conflicts

- Some clinical psychologists occasionally use the meaningful completions as a starting point for their interview with the client;

> The psychologist should bear in mind that this instrument is quite susceptible to social desirability elects

- The Sentence Completion Test Curium (ZALC) makes it possible to determine the stage of ego development in persons between eight and 25 years of age;

> The stage of ego development reflects the personal frame of reference from which social-emotional reality is interpreted:

> For diagnostics, it is important to know whether the stage of ego development corresponds to the expected level of development for age and gender

drawings

- The subject is given a sheet of drawing paper and is asked to draw something;

> The topics of the drawings that the subject must make are often people or trees and the instructions vary considerably

- There is a variety of scoring systems for drawings which are, incidentally, not used very systematically

two basic rules for a structured interpretation

- There is a simultaneous dialectic between the element that is to be explained/interpreted and the context of the element

- There is convergence of meanings and a lack of divergence of meanings

implication for the interpretation of indirect methods

- The psychologist must familiarize himself with the theory or theories that have been used in the development of the indirect method

- The materials should never be examined in isolation but within the context of the entire interpretation process and should be combined with other qualitative and quantitative data

-> A complete examination should include the findings from the substantive interpretation of the indirect methods, the information from the quantitative data and the interview data

evaluating and using indirect methods

- Indirect methods do require standardized administration and systematic coding on the basis of reliable and validated instruments;

> Too frequently, people rely on a range of unfounded assumptions and there is a lack of fixed rules or clearly defined principles when interpreting

> An empirically validated scoring system such as the R-PAS for the Rorschach test is a good example of a well-validated approach:

> Application of such methods implies a standardized administration, a stringent coding with guidelines, and a systematic interpretation

> The 'field reliability' of the Rorschach test is often lower than the figures in published research because coding the answers is not simple, even for trained psychologists

- Further research still needs to be carried out to eliminate as much as possible the shortcomings of indirect methods;

> The lack of standardization in the administration conditions remains a problem, particularly in the case of the TAT:

> This problem can be solved when the Rorschach test is used in accordance with the R-PAS, or when quantitative scoring systems are used for the interpretation of the TAT

- Further research is still needed, especially for the R-PAS variables with weak validity evidence

- For the TAT, it certainly makes sense to verify which quantitative scoring systems may be valuable:

> Cramer's Defense Mechanism Manualfor coding defense mechanisms

> A scoring system for evaluating problem-solving skills

> A scoring system for autism spectrum disorders (ASD):

> The TAT may be a valuable tool for examining theory of mind problems ASD sufferers, because it exposes them to the ambiguous social scenes

- A great deal of research is needed to determine which psychometric requirements apply to a number of the indirect methods;

> In the case of the TAT, the predictive validity and construct