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In this reply to Acklin (this issue) and Ritzler (this issue) we endeavor to clarify some of the points made in our original article. Most importantly, we do not see the idiographic-nomothetic and content-perceptual axes of Rorschach interpretation a s dichotomies. We do believe that the idiographic and content ends of the continua should receive increased attention. Our content-idiographic approach to the test should be used in combination with the currently emphasized perceptual-nomothetic approach. Further, we argue that our most inferential interpretations can be put on firm scientific footing though the requisite studies have not yet been performed.

The relationship between coping strategies and anxiety and depression was investigated in 29 women patients with acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection, at a psychiatric AIDS clinic. The women were divided on the basis of risk factor, intravenous drug use (IVDU), and nonintravenous drug use (non-IVDU), and coping strategies were compared. Based on a battery of psychological tests, the coping strategies of self-blaming denial, wish-fulfilling fantasy, emotional expression, and threat minimization were significantly related to greater anxiety and depression. There was no difference in coping strategies between the IVDUs and non-IVDUs, and none of the coping strategies employed appeared to be associated with less anxiety or depression. This may have been due to the psychiatric AIDS clinic sample, possibly representing the more distressed group of HIV/AIDS patients, for whom coping strategies were overwhelmed.

The influences of coping strategies and of perceived social support from family and friends on the psychological adjustment of intravenous drug users (IVDUs) with Acquired Immunodeficiency Syndrome (AIDS) were investigated. Twenty-seven male AIDS patients with a history of intravenous drug use completed a demographic questionnaire, Trails-B, the Ways of Coping Questionnaire, Perceived Social Support from Family, Perceived Social Support from Friends, and the Mental Health Inventory. Unexpected results were obtained: The only coping strategy to correlate significantly with psychological adjustment was "Seeking Social Support," and perceived social support from family correlated positively with psychological adjustment, but perceived social support from friends did not. Interpretations and implications of these findings are presented.

The present investigation compared cognitive and projective methods of assessing “differentiation,” Witkin's Embedded Figures Test (EFT) and Blatt's Concept of the Object Scale (COS), and reexamined expectations concerning the relationship between level of differentiation and capacity for empathy. Whether lesser or greater differentiation would promote empathy was of specific interest. Two forms of empathy were investigated, an “affective” form assessed by the Mehrabian Empathy Scale and a “cognitive” form assessed by the Hogan Empathy Scale. Expected sex differences in differentiation and empathy were also investigated. Results demonstrated consonance between COS and EFT measures of differentiation within the male sample only (p

Dependent measures used to assess anxiety and cooperation in children during a routine visit to the dentist included heart rate, the State–Trait Anxiety Inventory for Children (STAIC; Spielberger 1973), the Melamed Behavior Profile Rating Scale (MBPRS; Melamed, Weinstein, Hawes, & Katin-Borland, 1975), the Fear Thermometer (Cuthbert & Melamed, 1982) and the Frankl Scale (Frankl, Shiere, & Fogels, 1962). Results of univariate analyses of variance on these measures showed that in the “mother present” condition child monitors were more disruptive than child blunters on the MBPRS. A main effect of mothers' presence was also found. Children in the “mother present” condition were found to be less disruptive than children in the “mother absent” condition on the MBPRS. Results from this study suggest that mothers' presence appears to have a small beneficial influence on some children's anxiety and cooperative behavior in the dental operatory.

Two hundred fifty male, alcoholic VA inpatients were administered the Millon Clinical Multiaxial Inventory (MCMI) and the Alcohol Use Inventory (AUI). A cluster analysis, based on the scales of the MCMI, yielded three clusters: Cluster 1 was the smallest and was described by the least overall psychopathology. Cluster 2 had significant elevations on Antisocial, Narcissistic, Paranoid, Drug and Alcohol Abuse scales. Cluster 3 was the largest and had significant elevations on Avoidant, Schizoid, Dependent, Passive-Aggressive, Anxiety, Dysthymia, and Alcohol Abuse scales.

The use of the bootstrap sampling technique is applied to the type of data found in clinical research. Confidence intervals are computed for simulated values by use of SAS. By applying this approach, clinical researchers are free to explore topics that do not meet the requirements of traditional statistical analytic methods.

Previous studies of White, middle-class children with learning disabilities have shown that these youngsters tend to obtain form level ratings on the Rorschach that are significantly lower than would be expected based on Exner's (1974, 1993) normative data. In the current study, these findings were replicated and extended with a slightly older, urban, primarily minority population. The form level ratings of the youngsters tested in the current study were similar to those obtained in the past and suggest that a youngster's age, ethnicity, and lower socioeconomic status do not play major roles in bringing about the lower form level ratings of children with learning disabilities. The clinical implications of these findings are discussed, as are suggestions for future research.

This study is an examination of the relationship of religiosity and perceived social support to depression and self-esteem in nursing home residents. Answers to questionnaires administered to 83 nursing home residents indicated that perceived social support from family, public religious activity, and length of stay in the home were related to self-esteem and to depression. Past occupational status was also associated with self-esteem. Health status and having a choice in selecting the nursing home were negatively related to depression. Intrinsic religiosity and the resident's perceived social support from friends were not significantly related to depression or self-esteem.

Various approaches to the Rorschach Technique are described in terms of the idiographic-nomothetic axis and the perceptual-content axis. It is suggested that it is most productive to view the Rorschach as a projective tool, with perceptual scoring a secondary factor. Current efforts at objectification of the Rorschach are not seen as useful as efforts to enhance its projective qualities. Some possible ways are discussed in which the projective value of the instrument can be maximized.

The purposes of the study were: a) to examine whether risk for suicide and risk for violence were positively or negatively correlated; and b) to investigate potential predictors/mediators of suicide risk alone, violence risk alone, and risk for both suicide and violence. Suicide risk and violence risk were considered outcome variables. The predictor/mediator variables were eight ego defense mechanisms and 13 dysfunctional personality styles (both have been linked to aggressive risk). Seventy-four male alcoholics were administered questionnaire measures of suicide risk and violence risk, defenses, and disordered personality functioning. Results indicated that suicide and violence risk were significantly positively correlated. Three sets of predictor/mediator variables were identified: those predicting violence risk alone, those predicting suicide risk alone, and those predicting combined aggressive risk (risk for both suicide and violence). Connections obtained between predictor/mediator variables and outcome variables were explained in the context of existent clinical theory.

We tested the theory of intergenerational transmission, which suggests that the Holocaust trauma, combined with circumstances in the survivors' lives (early loss of a parent, was a child survivor, had a hiding experience) and circumstances in their children's lives (having a father who survived, being the first-born or only child, and not participating in a children of survivors group) would result in poorer interpersonal adjustment and coping and greater narcissism than in children of survivors without these circumstances and children of parents who imigrated from Europe before World War II. Three hundred fifty children (241 children of Holocaust survivors and 109 children o escaped European-born partners) completed four scales of the California Psychological Inventory (Gough, 1988), the O'Brien Multiphasic Narcissism Inventory (O'Brien, 1987), and the Hardiness scale (KobasaPuccetti, 1983). The results failed to support the attribution of adjustment and personality differences in children of survivors to survivor status.

The differences between hostility scores on projective and objective tests as a function of listening to aggressive or nonaggressive rock music were studied. While taking the Thematic Apperception Test (Cards 1, 3BM, 4, 9BM, and 10) and the Buss-Durkee (1957) Hostility Scale, subjects (N = 90) randomly assigned to one of three groups listened to a rock song with (a) nonaggressive music and non-aggressive lyrics, (b) aggressive music and nonaggressive lyrics, or (c) aggressive music and aggressive lyrics. TAT stories were scored for aggressive content according to Hafner and Kaplan's (1960) hostility rating scale. Hostility scores did not differ between groups. The findings are congruent with other investigators' reports that subjects do not pay attention to rock lyrics. Previous findings that music affects the emotional quality of TAT stories and hostility scores on the Buss-Durkee scale were not supported.

Increasing attention is being given to treating the psychosocial as well as the physical needs of mastectomy patients. The present study investigated and endeavored to quantify the psychological, sexual, and social adjustment reactions to a mastectomy, the possible interaction of these reactions, and the role of environmental support in mediating these responses. Forty married and 37 unmarried mastectomy patients completed a battery of tests, including the Body-Cathexis/Self-Cathexis Scale, SCL-90, Derogatis Sexual Functioning Inventory, Social Adjustment Scale-Self-Report, Perceived Social Support Scale, and a Support Questionnaire. Overall findings indicated that a mastectomy has the potential for affecting psychological, sexual, and social adjustment for at least a limited time post-operatively. Specifically, significant correlations were found between psychological, sexual, and social adjustment. Significant differences were also demonstrated in the married/nonmarried comparison. Additionally, results emphasized the importance of environmental support for postoperative adjustment.

Premenstrual Assessment Form (PAF) data are presented on the prevalence of premenstrual syndrome subtypes in self-referred women (N = 60) who were requesting an evaluation for premenstrual difficulties. These data are compared to the normative data of Halbreich and Endicott (1982). The PAF offers the advantages of comprehensive symptom coverage and criteria for non-mutually exclusive subtypes of premenstrual disorder. Although the PAF relies on retrospective accounts of premenstrual difficulty, it allows the exploration of the relationships between perception of premenstrual symptoms and sample selection criteria. The present data suggest that sample characteristics such as their manner of selection for study will influence significantly the prevalence of PAF subtypes.

A cross-sectional study of 60 multiple sclerosis outpatients assessed neuropsychological variables in relation to age, duration of disease, and degree of disability. The test battery included subtests of the WAIS (Vocabulary, Similarities, and Digit Span);the Raven matrices; and memory tests (Wechsler Paired Associates, Benton Visual Retention). Results showed that cognitive functioning of MS patients varies considerably. There is a general mild decline that affects abstract reasoning and memory as the disease progresses. These deficits are usually not sufficient to impair occupational or social functioning. In addition, there is spotty deterioration in certain cognitive functions for some patients (17%). Only a small subsample (6.7%), however, showed global deterioration significant enough to be highlighted by an Index of Dementia that was developed for this investigation.

Identified systematically those spouses of male VA hemodialysis patients who are at risk for experiencing difficulties in adapting to their husband's chronic kidney failure and hemodialysis treatment. To this end, an exploration was made of personality variables that might enhance a spouse's ability to cope with the unique stress of living with chronic illness. Fifty-six wives of VA dialysis patients were administered the Rotter Internal-External Locus of Control Scale (I-E), the Multidimensional Locus of Control Scale (MLC), the Multidimensional Health Locus of Control Scale (MHLC), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Significant relationships were found between I-E scores and all measures of emotional adjustment (state anxiety, trait anxiety, and depression) for the entire sample of spouses in general, and also for a subgroup of home dialysis spouses who were analyzed separately. Results were discussed in terms of the role that locus of control orientation plays in mediating the stress of living with chronic illness, as well as the failure to find relationships between adjustment and the MLC or the area-specific MHLC.

Two groups of 16 high school senior girls, achievers and underachievers, were compared on the following variables: educational and career goals, conception of woman's role, and fear of success (FOS). Chi-square analyses showed significant differences between groups with regard to their goals. Achievers aspired significantly higher than underachievers in their educational goals. In addition, they were significantly more contemporary in their career goals and more committed to these goals than the underachievers. In contrast to underachievers, achievers also had a more contemporary view of the roles women should assume in society and, on the other hand, showed more FOS in fantasies about women succeeding in contemporary roles, but these differences did not reach statistical significance.

Twenty women who underwent conservative surgical treatment of their breast cancer were compared with 20 women who underwent modified radical mastectomies on several indices of body image and psychological adjustment. The women were matched by pairs in terms of age and time postsurgery, and were group matched with respect to marital status. Women who underwent conservative surgical procedures showed significantly greater intactness of their external body boundaries, and significantly less change and weighted change in overall body satisfaction than women in the modified radical group. There were no significant differences between the groups with respect to body anxiety, general psychological adjustment, or marital satisfaction. The results with respect to body boundary and body satisfaction were interpreted to be the result of the less intrusive surgical procedures used to treat the breast cancer. Since body anxiety did not appear to be affected differentially by the two procedures, it may be that women in both groups were highly concerned about their bodies as a result of having had cancer. It was suggested that there was no difference in the psychological adjustment of the two groups because the women in the modified radical group were representative of that population which adjusts well to surgery. Finally, it was concluded that marital satisfaction is stable regardless of the surgical procedure undergone to treat the breast cancer.

Summary.-The present study investigated strength gains and change in selfconcept and locus of control related to participation in a weight-training program. 37 coUege football players were administered Rotter's Internal-External Locus of Control Scale and Gough and Heilbrun's Adjective Check List prior to and immediately following their participation in a 14-wk. weight-training program. While participants who scored high on the Femininity scale and high on externality on the I-E scale achieved greater gains on some of the strength measures, for the most part I-E and Adjective Check List scores d Greist, Klein, Eischens, Faris, Gurman, & Morgan, 1979; McCann & Holmes, 1984) and deviating anxiety (Morgan, 1979). While studies of the beneficial psychological effects of exercise have often been conducted with clinical populations, there is evidence to indicate that exercise can be effective in producing enhanced mood, greater feelings of relaxation, increased self-esteem, and a general over-all increase in feelings of psychological well-being in nonclinical populations as well (Hayes & Ross, 1986; Lichtman & Poser, 1983; Tucker, 1982, 1983a, 1987). The majority of such studies have utilized aerobic forms of exercise, most often running or walking. As Tucker (1987) points out, however, few forms of exercise are as effective as weight-training, an anerobic activity, in providing the participant with regular feedback on the results of the exercise. Regular weight-training has been shown to produce increases in strength and muscle size (Mathews & Fox, 1976). This change in physical appearance and increase in the weight lifted can easily be observed by the individual and can serve as sources of regular positive reinforcement.

Fifty-one psychotic women who were admitted to the psychiatric facility of a general hospital were studied to determine whether there was any difference in reported premenstrual/ menstrual symptomatology (as recorded on the Moos Menstrual Distress Questionnaire) between these women and the normal population studied by Moos. This comparison did yield data suggestive of an additive effect of psychotic symptoms with the normal cyclic fluctuations in symptoms associated with menstrual distress. Additionally, a comparison of responses to the Moos Questionnaire was made between psychotic women who had been admitted pre-menstrually and those admitted during the remainder of the cycle. No significant differences were found, suggesting the absence of a relationship between premenstrual syndrome and admission during this phase.

Thirty naltrexone and 30 methadone patients in outpatient opiate addiction treatment were compared on pretreatment somatization, stress, and family support. Also, the relationship between these pretreatment variables and outcome in terms of drug abuse and retention was examined. In the methadone group, drug abuse was correlated significantly with somatization, stress, and family support. In the naltrexone group, retention was correlated significantly with somatization and stress. Treatment and research considerations were discussed.

The perennial dispute between clinicians and researchers as to the validity of the Rorschach is discussed. It is suggested both groups are correct in that the Rorschach provides both poor psychometric data as seen by the researcher and rich idiographic data as seen by the clinician. The freedom of the Rorschach response process is viewed as largely responsible for both these situations. Some possible new directions for Rorschach usage and research are discussed which may improve on the quality of the idiographic information provided by the Rorschach test.

This study investigated the roles of spousal support and coping strategies in mediating the reaction of psychological distress to lung cancer. A battery of tests was administered to 60 lung cancer patients and their spouses one month after diagnosis and to 44 of the couples four months after diagnosis. Three models of analysis were used to test the hypotheses. Results showed that support was significantly related not only to psychological distress per se but to change in distress as well. The coping strategies of wish-fulfilling fantasy, self-blaming denial, and emotional expression were significantly related to greater distress. Moreover, wish-fulfilling fantasy was significantly related to change in distress. Thc results support the interpretations that the spouse's support serves a beneficial function for lung cancer patients in ameliorating psychological distress and that wish-fulfilling fantasy is an especially detrimental strategy for coping with psychological distress.

Forty‐two boys aged 7–0 through 12–11 and their parents took a Therapy Survey measuring expectations about treatment at a children's psychiatric clinic about a week before their first therapy and counseling sessions. Their scores on the Survey taken at this time were compared with their scores on the Survey taken after the sixth session. Number of appointments cancelled or failed and number of dropouts were recorded through the first six sessions. Appropriateness of expectations was not found to be related to social class, age, or source of referral, but number of correct expectations held by the children was related to the number held by the parents. Expectations were corrected over the course of the first six sessions, but within treatment families the corrections were made independently of one another. Social class was not related to appointment keeping or to dropout. Inappropriateness of expectations, while also unrelated to appointment keeping, was related to dropout. Results suggest that inappropria...

Degree of depression found in 120 spinal multiple sclerosis (MS) outpatients was related significantly to selected illness, demographic, and social variables. The more depressed individuals tended to be more disabled, older, and, in particular, perceived their families and friends as providing less social support than those who were less depressed. Those who had experienced at least one remission were less depressed than those who never had had a remission. Contrary to hypothesized expectations, the results also suggested that the longer a patient has MS, the more depressed he will be. Such results raise implications for psychotherapeutic intervention in this population, as well as suggest the need for future investigations of the MS patients's body image, self-concept, and perception of disability.

Descriptions of the creative individual or the individual who can regress in the service of the ego seem to parallel Fisher and Cleveland's (1968) description of the high barrier individual: well-integrated; self-sufficient, but often outgoing and communicative; and able to experience a full range of sensation and emotions without neurotic anxiety. The relationships between Barrier and five measures associated with creativity were investigated, using 100 paid male college student volunteers. The results support the notion that creativity is not a functional unity. Barrier was found to be related to aristic, expressive creativity which seems to be related to interest in human interactions, but unrelated to creativity associated with scientific endeavors and unrelated to creative receptivity (i.e., purest adaptive regression).

A computer program of MMPI interpretations originally developed for general practitioners working in a clinic setting was modified to some extent for use with a psychiatric inpatient population. This particular program, designed for a 1401 computer, is composed of 60 statements referring to specific MMPI scales, and a number of "modifier" statements combining information from two or more scales in configural fashion. Each of the statements referring to one particular scale reflects a low, normal, mild, moderate or marked "degree of elevation" of that scale. The computer program prints the MMPI profile as well as the interpretive statements. The computer interpretive statements were contrasted with findings from batteries of projective tests administered to the same patients. The psychologists administering and interpreting the projective instruments rated each of the computer statements appearing in a patient's MMPI record on a 6-point agreement-disagreement continuum. The psychologists judged the compute...

The demographic characteristics of the patients of one psychiatric outpatient clinic were studied and compared to the local population to determine how representative the Clinic sample is of the surrounding community. Comparisons also were made between presenting symptoms and demographic characteristics. The significance of such studies is discussed.

Summary A survey of book reviews pertinent to the Rorschach Test published in the Mental Measurements Yearbook series reflects the changing attitudes which can explain the Test's declining popularity and indicate what the future holds. A major shift from optimism to pessimism was seen; authors were criticized for not reacting to the research literature or altering their systems, for their overemphasis on scoring, for their ignoring of rival Rorschach schools, and for their lack of links with theoretical psychology. Considerable controversy surrounds the issue of content analysis. Also indicated is a growing methodological sophistication and increased attention to non-projective determiners of the response. It is concluded that regarding the Test as a standardized interview may presage the future utilization of the Rorschach.

Long-term hemodialysis patients have an alarmingly high suicide rate. Deaths that result from the patient's lack of adherence to the treatment regimen have in the past been viewed from a suicidal framework. The authors suggest that such behavior may be more fruitfully regarded as an attempt by the patient to reduce the anxiety resulting from the recognition of his tremendous responsibility in the treatment program.

The study undertook to evaluate the kinds of family utilizing the services of the Children's Clinic of the Institute of Living. In line with the previous investigation of Roach, Gurrslin and Hunt, 5 demographic factors were examined in 239 clinic patients. These were (a) sex of child, (b) family size, (c) occupation of major wage earner, (d) race and (e) religion. In addition, an effort was made to categorize presenting symptoms. The distribution of each of these descriptive characteristics in the clinic population was compared with census figures for the general population of the Greater Hartford area. The pattern of presenting symptoms found in the Hartford Clinic was contrasted with the results of the previous study. An effort was also made to determine whether these factors and the various kinds of presenting complaints were related in any way. It was found that the Hartford Clinic group did not always conform to general population expectation, particularly with respect to composition by sex, and numb...

Summary The present study employed a sample of 76 sets of twins who were distributed over six groups classified by zygosity and smoking status to investigate personality variables relating to smoking behavior. Results based on an analysis of intraclass correlation coefficients and intra-pair differences on MMPI scales showed that while monozygotic twin pairs were more similar than same-sexed dizygotic twins, differences were generally unrelated to smoking behavior. A possible exception was the finding of a statistically significant relationship between smoking and scores of the Pd scale, but this finding was in direct contrast to results from previous research. The hypothesis that twin pairs discordant for smoking might also be less alike in personality than sets in which concordance for smoking behavior exists was not supported.