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Nonsexually offending psychopaths (N = 32) were compared to sexual homicide perpetrators (N = 38) and nonviolent pedophiles (N = 39) on select Comprehensive System Rorschach variables (Exner et al., 1993). Results indicate similarities among the groups in pathological narcissism, formal thought disorder, and borderline level reality testing. Nonsexually offending psychopaths are distinguished by their lack of interest in and attachment to others and their seemingly conflict-free internal world. While both sexually deviant groups evidenced interest in others and appear to experience a very dysphoric internal world, the sexual homicide perpetrators are distinguished by high levels of obsessional thought and an inability to disengage from environmental stimuli. Pedophiles show significantly more characterological anger, which may stem from their general inadequacy, cognitive rigidness, less alloplastic (acting out) style, and their introversive inability to gratify their needs. Rorschach differences add to our understanding of sexual deviation and violence among these three groups.

A sample of incarcerated sexual homicide perpetrators (n = 18) were compared to a sample of non-sexually offending but violent male psychopaths (n = 23) on select Rorschach variables using the Comprehensive System (Exner, 1991). Results suggest that sexual homicide perpetrators are similar to psychopaths in their attachment abnormality, characterological anger, pathological narcissism, moderate and pervasive formal thought disorder, and borderline reality testing. They are distinguished, however, by a more frequent affectional hunger, a tendency to engage in more dysphoric rumination, and abnormal elevations of nonvolitional ideation (obsessional thoughts) due to unmet instinctual need states. They also show a greater interest in others as whole, real, and meaningful objects. Five psychodynamic factors, supported by the empirical findings, are proposed to partially explain the intrapsychic mechanisms involved in an act of sexual homicide.

The published Rorschach (Kaiser, 1970) of Sirhan Sirhan, the man who assassinated presidential aspirant Robert F. Kennedy in 1968, was studied. Psychostructural and psychodynamic analyses were conducted using reliable and valid methodology that was unavailable at the time of examination. In contrast to the defense experts at trial who diagnosed paranoid schizophrenia, the data suggest a depressed and suicidal individual organized at a borderline level of personality. Character pathology is hysterical, paranoid, and dependent. When the Rorschach findings are compared to the development history of Sirhan and the behavior around the time of the assassination, the data are somewhat consistent with the theme of psychic trauma, are very consistent with the theme of recurrent loss and pathological mourning, and validate a characterological distrust and hatred of, yet hysterical dependence on, the object world. Rorschach indices of predatory violence (Meloy, 1988a) in relation to the planned and purposeful assassination are also discussed.

This study utilized the Rorschach as a psychometric measure for understanding Antisocial Personality Disorder (American Psychiatric Association, 1987). Comprehensive System (Exner, 1986) Rorschach data for a sample of 60 ADP subjects and Rorschach object relations and defensive operations for 22 psychopathic APD (P-APD) and 21 nonpsychopathic APD (NP-APD) subjects are presented and discussed. The data support the absence of anxiety and attachment and the presence of pathological narcissism and borderline personality organization in P-APDs. The Rorschach's ability to differentiate antisocial groups based on level of psychopathy (Hare, 1980, 1985) strongly supports the need to use psychopathy as an independent measure when one is studying APD.

We investigated the constructs of attachment and anxiety in inpatient conduct-disordered and dysthymic adolescents. Texture, diffuse shading, and pure human content (Exner, 1986) Rorschach indices were compared between 48 subjects who met the criteria for conduct disorder and 30 subjects who met the criteria for dysthymia, according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987). We also compared mild, moderate, and severe conduct-disorder groups on the three selected Rorschach variables and investigated certain family characteristics for the two groups. We found a lower frequency of texture and pure human content responses in conduct-disordered subjects and a greater frequency of diffuse shading responses in the dysthymic subjects. The conduct-disordered subjects also came from homes in which the mother figure was significantly less present. Our psychometric findings of lessened attachment and diminished anxiety in the conduct-disordered adolescents are similar to adult psychopaths. We urge that an attachment or socialization disturbance criterion be reintroduced into the forthcoming DSM-IV conduct-disorder diagnosis.

We propose the addition of four aggressive indices for Rorschach scoring: aggressive content, aggressive potential, aggressive past, and sado-masochism scores. Interrater agreement is presented and ranges from 92-100%. Nomothetic comparisons are made between groups with higher base rates for violence with mixed results, although the sado-masochism frequency was significantly higher in severe psychopaths than in moderate psychopaths. Idiographic use of the aggression indices is emphasized, with a particular focus upon inferring the quality, intensity, and directionality of intrapsychic aggression in relation to self and object representations.

We investigated the constructs of anxiety and attachment in a group of 42 offenders who met the DSM-III-R criteria for antisocial personality disorder. Each antisocial subject's level of psychopathy was assessed with the Hare Psychopathy Checklist (PCL). Three Rorschach variables related to attachment, anxiety, and coping were compared between subjects scoring greater than or equal to 30 (N = 21) on the PCL and subjects scoring less than 30 (N = 21). Comparison Rorschach variables are also presented from a sample of 60 antisocial personality-disordered offenders. Moderate psychopaths (PCL score, less than 30) produced texture and diffuse shading responses at a significantly greater frequency than severe, or primary, psychopaths (PCL score, greater than or equal to 30). There was no significant difference in the two groups' propensity for producing vista responses. Although there were no significant differences between the coping index scores, the trend suggests less conflictual functioning in the severe psychopaths. A virtual absence of texture responses in the severe psychopaths, and a significantly greater frequency of diffuse shading responses in the moderate psychopaths, add construct validity to the lack of attachment in psychopaths and the role of anxiety in differentiating secondary from primary psychopathy. We view the presence of vista responses in this population as a measure of a failed grandiose self-structure, and note that it often occurs in the records of moderate psychopaths who also present achromatic color responses.

We analyzed the contemporary empirical and theoretical literature concerning the two predominant approaches for scoring formal thought disorder on the Rorschach, the Comprehensive System special scores, and the methodology of Rapaport, Gill, and Schafer (1946/1968). The psychoanalytic research related to selected special scores is reviewed, and some linkages to psychoanalytic developmental theory and psychopathology are made. Recommendations are presented to bridge the gap between these two important avenues of Rorschach research, with an emphasis on empirical rigor and intrapsychic contextual meaning.

We investigated Rorschach responses associated with narcissism and hysteria in a group of antisocial personality disordered offenders. The Rorschach protocols of 42 subjects who met the criteria from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) for antisocial personality disorder were analyzed using Exner's (1986) criteria for pairs, reflections, and personal responses, and Gacono's (1988) criteria for the impressionistic response. Severe, or primary psychopaths (n = 21), scoring greater than or equal to 30 on the Hare (1980) Psychopathy Checklist (PCL), were compared to moderate, or secondary pscyhopaths (n = 21), scoring less than 30 on the PCL. The mean number of pair and impressionistic responses did not significantly differ for the two antisocial groups. The highly psychopathic group, however, did exhibit a significantly greater mean number of reflection and personal responses. We discuss pair and reflection responses and their relationship to narcissism in psychopathic disturbance. We recommend interpreting the personal response within the context of the psychopathic character and view personal responses as expressions of narcissism and omnipotence in highly psychopathic subjects. We also hypothesize that the impressionistic responses are indicative of primitive dissociative processes and hysteria in psychopathic subjects, and that their presence provides construct validity for the work of Guze (1976) and others who suggested an underlying histrionic dimension to psychopathy.