Projective Measures in Psychology

Projective Measures

• Based on the psychoanalytic idea that people project their negative attributes about themselves onto ambiguous external stimuli
• Recent evidence suggests that responses are about the person's experience and personality, not projection per se
• Rorschach Inkblot Test: records subjects' perceptions of inkblots and analyzes them using psychological interpretation, complex algorithms, or both
• Thematic Apperception Test (TAT): participant tells a story about what they see in the picture, yielding data on needs, emotions, interpersonal relations, and conflicts within individual

Integrating Assessment Data

• Descriptive account of the client's level of functioning, considering their social and interpersonal environment
• Often, different assessments/tests provide conflicting results
• Case formulation: a clear hypothesis about how a problem developed and how it is maintained, offering a framework for developing the most suitable treatment approach

Case Formulation

• Aims to describe a person's presenting problems and use theory to make explanatory inferences about causes and maintaining factors
• Consists of:
  • Description of the presenting issues
  • Factors that create vulnerability or precipitate the problems
  • Factors that maintain the problems
  • Factors that can help the person cope or act as resources
• Benefits of case formulation:
  • Provides connection between various problems
  • Provides guidance on the type of treatment
  • Predicts the patient's functioning with and without treatment
  • Provides options if difficulties are encountered in treatment
  • Indicates options outside of psychological services

Components of Case Formulation

• Description of problems and symptoms
• Events or stressors that led to the symptoms or problems
• Predisposing life events/vulnerabilities
• Hypothesized mechanisms that link the problems to the person's current functioning

Steps of Case Formulation

• Develop a comprehensive problem list
• Determine the origin, precipitants, and consequences of the problems
• Identify patterns among the problems
• Develop working hypotheses to explain the problems
• Evaluate and refine the hypotheses
• Reconsider, re-evaluate, and revise the hypotheses in treatment

Client and Clinician Factors

• Client factors:
  • May try to under-pathologize themselves
  • Difficulty recalling problem behaviors or memories from their past (retrospective recall)
  • Can't assume clients are accurately perceiving/portraying reality
• Clinician factors:
  • Self-serving attributional bias
  • Overuse of heuristics (mental short cuts)
  • Biases (gender, ethnic, socioeconomic)
  • Decision-making biases

Improving the Accuracy of Clinical Judgment

• No specific points mentioned in the text