
There are a variety of options used by psychologists, psychiatrists, and counselors to identify the symptoms of mental health issues and psychiatric disorders among patients. In turn, the Rorschach test is considered one of the most popular and developed assessment systems utilized in different parts of the world. This test has got a vast spread throughout the media, which is why the majority of the worldwide population is aware of this test due to movies, TV-shows, and fictional stories. On the one hand, such considerable popularity of this assessment tool can be explained by its effectiveness in the process of detecting numerous psychiatric issues. On the other hand, this test has been criticized by scientists and healthcare providers for several decades in a row.
Nowadays, this test is represented as a procedure when the examiner demonstrates the other person each of 10 cards and asks to describe them. In turn, the examinee expresses personal thoughts and ideas regarding the images, thereby, offering a psychiatrist the opportunity to determine some deviations associated with the psychological health of a patient. These cards are mainly black-and-white, although some inkblots are colored. In terms of interpretation and assessment of the results, scientists have been debating since the middle of the past century. As a result, there are numerous evaluation tools which can be applied to the answers of patients. The Rorschach Performance Assessment System (RPAS) and Exner’s Comprehensive System (CS) are regarded as the most reliable and valid assessment tools which can be used for the Rorschach test. Thus, in spite of the fact that the suggested psychiatric test has been critiqued many times, it is still one of the most well-grounded methods to identify psychiatric issues, such as schizophrenia.
History
Even though Rorschach is frequently perceived as the first scientist to assess the psychological well-being of individuals on the basis of ambiguous scenes, this belief is not accurate. In fact, this person was inspired by numerous other influencers aiming at detecting the earliest stages of psychiatric issues. Initially, the boy developed an interest in this area due to the game called Blotto , a form of Klecksography (Teles, 2020). The majority of kids were playing this game at the beginning of the 19th century. However, the production of art and charade-based pictures out of inkblot has become Rorschach’s main point of interest in adulthood as well.
Once the health issue called schizophrenia became a globally recognizable problem, Rorschach began studying the artwork of mental patients. In 1920, the scientist managed to develop 15 inkblot cards which were intended to test the psychological health of patients (Teles, 2020). First, the effectiveness of using these cards was tested with the help of 400 patients, including 117 individuals previously diagnosed with various types of mental health issues. Once the effectiveness of this method of psychiatric assessment was confirmed, Rorschach took appropriate measures to spread this information throughout the whole world. In 1921, the book called Psychodiagnostik was published by the House of Bircher (“The Status of the Rorschach”, 2005). However, the Swedish scientist died one year later due to complications of physical health issues. In turn, the contribution of this individual to the field of psychology and psychiatry was acknowledged only after his death.
Uses
To assess and interpret the responses of patients accurately, it is important to understand how the Rorschach test should be used. First, each respondent should be provided with 10 cards, one by one (Weiner & Greene, 2008). In turn, the examinee is allowed to analyze pictures from different positions. Therefore, test-takers are able to hold the cards upside down or sideways. Moreover, these individuals can provide answers related to their associations with the picture in any form they want; it can be done with one word or several phrases. Second, the examiner is allowed to ask additional questions or stop the process of a patient responding if the given explanation is not subject to future interpretation.
Rorschach and Assessment Practices
Usually, the assessment of received results is based on 2 important steps, such as simultaneous analysis and further interpretation. In the context of the first stage of assessment, examiners pay attention to a variety of different factors. They include the way respondents describe the image, the length of response, extra comments, and the uniqueness of responses. For instance, the majority of individuals have a similar view on the inkblot cards, which is why the responses of mentally stable individuals are usually the same. Therefore, once the individuals provide a unique view of ambiguous scenes, it can be a sign of disturbances in thought patterns. Furthermore, examiners take into consideration the amount of time the respondent takes to give the answer. In fact, if the waiting time for responses taken more than 10 seconds, the person is suspected to be shocked.
As of the assessment practices, there is a variety of versions which can be used to assess the result of the test. In the past century, the most commonly used assessment practices were the Beck system, the Klopfer system, the Hertz system, the Piotrowski system, and the Rapaport-Schafer system (Mihura & Graceffo, 2014). At the same time, the effectiveness of these systems emerged to be dubious when other scoring systems were discovered. Exner’s CS has been considered the most reliable way to interpret the results of the test for several decades, although the Rorschach Performance Assessment System (R-PAS) became its improved version.
Criticisms of Exner’s CS and Comparisons to the R-PAS Administration
As one of the most widely used interpretation approaches to the Rorschach test, Exner’s CS has been used by psychiatrists and psychologists since the 1960s. This scoring system can be considered a tremendously difficult approach, as it includes numerous variables that should be measured with the help of different tools. However, a high level of validity is the main benefit of this scoring system.
In terms of criticism, Exner’s CS has been discussed in relation to over-diagnosing psychotic disorders and subjectiveness. The presence of errors was the main cause of the poor reliability of this scoring system. In order to facilitate the process of results interpretation, scientists kept working on the development of an innovative scoring system even when Exner’s CS was introduced to the world. As a result, R-PAS took into account the disadvantages of previous systems and improved them (Meyer & Eblin, 2012). For example, some of the variables were eliminated, whereas the others were analyzed from different perspectives.
Nowadays, complexity, space integration, and space reversal are considered the most important variables of this assessment system, even though there are many other variables taken into consideration. At the same time, it has been confirmed that responses to the Rorschach test vary depending on the country. Therefore, R-PAS is based on a total of 15 adult samples, which makes this scoring system even more reliable (Mihura et al., 2013). In spite of the fact that the latest scoring system still requires improvement, it is regarded as the most valid method to interpret the results of the Rorschach test in modern society.
Coding
Coding Rorschach responses is one of the most significant stages in the process of results interpretation. In fact, the accurate coding of responses is expected to give psychologists and psychiatrists a brief understanding of the patients’ internal world and their mental health. At the same time, inaccurate coding of responses can lead to the prescription of ineffective treatment (Kimoto et al., 2016). Hence, scientists and psychiatrists usually code responses on the basis of 2 steps.
The first step of coding requires examiners to take the information transcribed during the test administration (qualitative material), whereas the second step of coding is based on interpreting it into numeric scores (quantitative information). In turn, gained scores are used for the interpretation and discussion of health issues that can be associated with each respondent. Such a comprehensive approach to coding makes the Rorschach test one of the most popular tools used in the psychiatric area.
Interpretation
The responses of test-takers can be interpreted in different ways, although there are common rules that are followed during this process by examiners. First, it is important to pay attention to sexual responses. If the individual interprets at least 4 cards in a sexual manner, it is predicted that the examinee faces schizophrenia or sexual frustration (Dimsdale, 2015). Second, all the cards are symmetrical, which was purposefully planned by Rorschach. In fact, if the respondent interprets at least 3 cards as something reflected in the water, it can be a sign of a self-reflective and thoughtful personality (Dimsdale, 2015). Third, examiners should pay a vast amount of attention to food responses. In case a person interprets at least 1 picture as an example of food, this individual can be engaged in a more addictive behavior than psychologically stable people.
Simultaneously, this test offers the opportunity to identify positive qualities as well. For instance, if the respondent analyzed the picture from a general perceptive, it can be a sign that they have well-developed leadership skills and considerable ambitions for life. It can be explained by the fact that the majority of successful and goal-oriented individuals analyze problems in general rather than its little components. Accordingly, the accurate interpretation of responses can help psychiatrists, psychologists, and counselors determine the health status of different population groups.

Rorschach test is one of the most widely used assessment tools in the area of psychology. Despite the fact that it was developed almost 1 century ago, it still has vast relevance. Such considerable popularity can be explained by a high level of validity and reliability. At the same time, scientists still take appropriate measures to improve the quality of this test. In fact, taking into consideration that the discussed test results in spontaneous outcomes, some interpretations can be considered inaccurate. Furthermore, it depends upon non-verbal communication and its specific features. Motivational barriers are also included in the list of disadvantages associated with the Rorschach test.
However, the accurate interpretation of responses is beneficial for the identification of particular psychiatric illnesses. It is the reason why this evaluation tool has been used for numerous decades in different parts of the world. In the future, scientists should improve the scoring system in order to offer examiners the opportunity to improve the reliability and validity of the received results. Thus, the Rorschach test can be regarded as an integral part of the process of psychological assessment, as it helps detect mental health issues and psychiatric disorders.