Directions of development in projective techniques; the projective approach in relation to diagnosis and psychotherapy.
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Projective techniques, by bypassing the conscious resistance of anxiety and defenses, elicits information about the hidden side of perception and thoughts processes, personality, emotions, and psychodynamic processes. They thus enable an assessment of ego strength and the patient's ability to face unconscious content. The aims of psychotherapy similarly disclose the psychodynamics of symptoms formation and conflicts and help the patient to face them. In some respects the test administration procedure is analogous to the psychotherapeutic process. This makes test administration useful not only for diagnosis, but also as a therapeutic tool, especially in brief psychotherapy and when sharing the results with the patient. The therapist, by translating the results, stimulates the gradual gaining of insight and self-awareness at the patient's own pace. Sharing results may allay paranoid suspicions and fears concerning the test administration and the patient-therapist relationship. The meeting with one's own deep feelings acts as a catalyst in the therapeutic process and saves valuable time. Projective results are especially useful when the interpretations are juxtaposed with content arising in the therapeutic session.
Using a projective technique among child and adolescent psychiatric inpatients, we tested several hypotheses derived from Coyne's (1976b) interpersonal theory of depression. First, we predicted that depression would be associated with rejection, even controlling for the effects of aggression. Depression and rejection were associated only when aggression effects were covaried. Second, we hypothesized that the depression-rejection relation would display symptom specificity. Consistent with this hypothesis, we found that depression, but not anxiety, was related to rejection. Third, we assessed whether an index of interpersonal style--reliance on others--moderated the depression-rejection relation. Results suggested that depression and overreliance were both associated with high rejection scores, whereas the combination of low depression and low reliance on others was associated with low rejection scores. We found that results held across age groups. The implications of our findings for the interpersonal theory of depression in youngsters are discussed.
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Using a battery of three projective techniques (Rorschach, Hand Test, Bender-Gestalt) only slight discrimination was found between low IQ subjects classified according to the presence or absence of brain trauma (exogenous vs endogenous), while substantial discrimination was obtained between the same subjects categorized in terms of "lower" (60-74) and "higher" (75-89) FS WAIS IQ. All four groups used in this study had been first equated on sex and age. Results were interpreted as supporting the position that some sort of brain impairment underlies most or all retardation. Question was raised concerning the efficacy of projective techniques for diagnosing organicity in subjects of average or better intelligence.
Evaluators and researchers often have to deal with situations in which conventional research tools are impossible to use, either because of the characteristics of a population or unclear research variables. This paper presents a technique that succeeds in overcoming this kind of problem--a projective technique, but one that differs from the usual approach to projective techniques. The approach presented here is a hermeneutic one that assumes an interpretive process. By means of an example, this paper presents the process of working with projective techniques and concludes with a discussion of this approach.
The purpose of this study was to review and analyze the use of projective techniques in published nursing studies in which children were the subjects. A search of the pediatric nursing research literature revealed 27 studies that were published between 1984 and 1993 in which projective techniques were used to investigate children's responses. The research purposes, characteristics of subjects, projective techniques employed and their validity and reliability, data analysis strategies, and major findings of the studies reviewed are analyzed and summarized. Recommendations for the use of projective techniques in research and clinical practice with children are offered.
OBJECTIVE: This study was undertaken to compare the in vitro and clinical value of two-dimensional multislice breath-hold MR cholangiopancreatography (MRCP) with a single-shot projection technique using a half-Fourier acquisition single-shot turbo spin-echo sequence. SUBJECTS AND METHODS: We examined 108 patients with pancreaticobiliary diseases, using breath-hold MRCP and a half-Fourier acquisition single-shot turbo spin-echo sequence on a 1.5-T MR unit with a body phased-array coil. Two data acquisition techniques were employed: multislice acquisition postprocessed by maximum intensity projection (MIP) (multislice technique) and single-shot projection with a thick slice (projection technique). In the multislice technique, nine contiguous slices were obtained with a thickness of 5 mm (acquisition time. 18 sec). In the projection technique, a single slice was obtained with a thickness of 30, 50, or 70 mm (acquisition time. 2 sec). Contrast-to-noise ratio (CNR) between the common bile duct and the liver as well as detectability of normal structures and diseases were compared for these two acquisition techniques. In the multislice technique, source images were also evaluated. ERCP or percutaneous transhepatic cholangiography images were used as the gold standard. RESULTS: Most of the pancreatic duct and common bile duct was revealed on 54% and 100% of the projection images, respectively, and on 35% and 98% of the MIP images, respectively, CNR was significantly higher with the multislice technique than with the projection technique (p < .01). With the projection technique, CNR decreased as slice thickness increased. Dilatation and occlusion of the pancreaticobiliary tree were equally well revealed by the two imaging techniques. However, abnormalities in the periampullary region and anomalies in the pancreaticobiliary tree were more clearly seen on projection images than on MIP images (p < .05). Stones in the common bile duct, gallbladder, or intrahepatic bile duct were best seen on source images acquired by the multislice technique (83% sensitivity). CONCLUSION: Because of the absence of misregistration and the speed of image acquisition, breath-hold single-shot MRCP using the projection technique with a slice thickness of 30 or 50 mm consistently revealed the pancreaticobiliary tree and periampullary region with an acceptable CNR. Stones in the bile duct were best seen on the source images acquired by the MIP technique.
Projective techniques (e.g., the Rorschach, Human Figure Drawings) are sometimes used to detect child sexual abuse. West recently conducted a meta-analysis on this topic, but she systematically excluded nonsignificant results. In this article, a reanalysis of her data is presented. The authors conclude that projective techniques should not be used to detect child sexual abuse. Many of the studies purportedly demonstrating validity are flawed, and none of the projective test scores have been well replicated.
Numerous surveys have alternately demonstrated either a decline or continued vitality of diagnostic assessment and projective techniques in clinical psychology. This paper examines some of the factors which have contributed to the ambivalent attitudes about projective procedures. The first part of the paper considers questions about the limitations and potential contributions of projective techniques in research. The second portion of the paper examines some of the issues which limit the contributions of diagnostic assessment and projective techniques in clinical practice. A proposal is made for conceptualizing diagnostic assessment as a more integral part of the therapeutic process.
A new pattern projection technique for measuring three-dimensional topography is presented, called the optimal intensity-modulation projection technique. The proposed technique dramatically shortens the measurement time and improves stripe detection accuracy compared with previous methods. Furthermore, the method deals reliably with discontinuous patterns and multiple objects.
Analyzed predicted decline of projective techniques in usefulness and emphasis when viewed from several different perspectives: the academic community; members of APA Division 12; internship centers; the applied clinical setting; and private practitioners. An extensive review of empirical, survey, and position studies over the past two decades supports the utility of projective techniques, with the exception of the clinical academic setting. The apparent loss in status of projective assessment is attributed, in part, to changing roles and functions of clinical psychologists. Implications for graduate training are discussed.
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