VOL. 12, NO. 3, 1986 Scoring Manual for the Thought Disorder Index 483 Original version by Mary Hollis Johnston and Philip S. Holzman 1 Revised version by Margie R. Solovay, Martha E. Shenton, Christine Gasperettl, Michael Coleman, Ellyn Kestnbaum, J. Tyler Carpenter, and Philip S. Holzman The Thought Disorder Index (TDI) tags, classifies, and measures instances of disordered thinking. It is especially useful because it permits a trained judge, even when without knowledge of other behaviors, to derive a qualitative and quantitative assessment of cognitive slippage. Whatever source the verbal material comes from, it is important that it be transcribed verbatim and contain a thorough inquiry of the thought slippage. The verbatim transcript is necessary to ensure that the complete verbal sample is recorded and available for assessment; the thorough inquiry is necessary to ensure that the subject has an opportunity to clarify the response and that the rater has the full information needed to classify the response. In a scored protocol, each instance of thought slippage is characterized both quantitatively and qualitatively, and contains the following information: • Total TDI score (which is the sum of each instance of thought disorder weighted by its severity level, corrected for response produc- tivity, expressed as a percentage). • Number of instances of thought disorder scored at each level. • Number of instances of thought disorder scored for each category. From this information, one may obtain an assessment of the severity of the subject's thought disorder and to what qualities of thinking this severity may be attributed. A high TDI score may result from a few instances of severe thought slippage, or many instances of mild slippage. Similarly, one subject's thought disorder may be characterized by problems with disorganization, whereas another's may be charac- terized by incongruous combinatory thinking. Although raters should not know the diagnoses of the subjects, raters should be aware of the education, social class, and ethnic background of the subjects, since certain expres- sions may be evidence of disorderd thought in some circles but may be acceptable usage in others. When a record is being assessed for thought disorder, a score is given each time thought disorder is exhibited. The question often arises as to whether a response may be given more than one thought disorder score. The rule of thumb is as follows: In general, the score given is that which best captures the process evident in the response. For example, a subject may give a Confabulation response that carries within it a Fabulized Combination. If the Fabulized Combination is part of the confabulatory process, and not a separate instance of slippage, the response is given a single score of confabulation. On the other hand, if during the course of giving a Confab- ulation response, a subject produces a Peculiar Verbalization as well, the subject would be given a score for Confabulation and a score for Peculiar Verbalization because the Peculiar Verbalization is not part of the confabulatory process. Several of the categories are broken down into more specific subcategories: Inappropriate Distance, Peculiar Verbalization and Responses, Incongruous Combi- nations, Idiosyncratic Symbolism, Queer Responses, and Confab- ulations. For the most part, subcate- gories are given as heuristic guides to scoring the categories and are provided solely to clarify various instances of use for that category. They are not meant to be scored in their own right. In fact, certain 'Johnson and Holzman (1979). at Ernst Mayr Library of the Museum Comp Zoology, Harvard University on May 12, 2014 http://schizophreniabulletin.oxfordjournals.org/ Downloaded from
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VOL. 12, NO. 3, 1986 Scoring Manual for theThought Disorder Index
483
Original version by MaryHollis Johnston and Philip S.Holzman1
Revised version by Margie R.Solovay, Martha E. Shenton,Christine Gasperettl, MichaelColeman, Ellyn Kestnbaum, J.Tyler Carpenter, and Philip S.Holzman
The Thought Disorder Index (TDI)tags, classifies, and measuresinstances of disordered thinking. It isespecially useful because it permits atrained judge, even when withoutknowledge of other behaviors, toderive a qualitative and quantitativeassessment of cognitive slippage.
Whatever source the verbalmaterial comes from, it is importantthat it be transcribed verbatim andcontain a thorough inquiry of thethought slippage. The verbatimtranscript is necessary to ensure thatthe complete verbal sample isrecorded and available forassessment; the thorough inquiry isnecessary to ensure that the subjecthas an opportunity to clarify theresponse and that the rater has thefull information needed to classifythe response.
In a scored protocol, each instanceof thought slippage is characterizedboth quantitatively and qualitatively,and contains the followinginformation:
• Total TDI score (which is thesum of each instance of thoughtdisorder weighted by its severitylevel, corrected for response produc-tivity, expressed as a percentage).
• Number of instances of thoughtdisorder scored at each level.
• Number of instances of thoughtdisorder scored for each category.
From this information, one mayobtain an assessment of the severityof the subject's thought disorder andto what qualities of thinking thisseverity may be attributed. A highTDI score may result from a fewinstances of severe thought slippage,or many instances of mild slippage.Similarly, one subject's thoughtdisorder may be characterized byproblems with disorganization,whereas another's may be charac-terized by incongruous combinatorythinking.
Although raters should not knowthe diagnoses of the subjects, ratersshould be aware of the education,social class, and ethnic backgroundof the subjects, since certain expres-sions may be evidence of disorderdthought in some circles but may beacceptable usage in others.
When a record is being assessedfor thought disorder, a score is giveneach time thought disorder isexhibited. The question often arisesas to whether a response may begiven more than one thoughtdisorder score. The rule of thumb isas follows:
In general, the score given is thatwhich best captures the processevident in the response. For example,a subject may give a Confabulationresponse that carries within it aFabulized Combination. If theFabulized Combination is part of theconfabulatory process, and not aseparate instance of slippage, theresponse is given a single score ofconfabulation. On the other hand, ifduring the course of giving a Confab-ulation response, a subject producesa Peculiar Verbalization as well, thesubject would be given a score forConfabulation and a score forPeculiar Verbalization because thePeculiar Verbalization is not part ofthe confabulatory process.
Several of the categories arebroken down into more specificsubcategories: InappropriateDistance, Peculiar Verbalization andResponses, Incongruous Combi-nations, Idiosyncratic Symbolism,Queer Responses, and Confab-ulations. For the most part, subcate-gories are given as heuristic guides toscoring the categories and areprovided solely to clarify variousinstances of use for that category.They are not meant to be scored intheir own right. In fact, certain
categories such as Peculiar Verbal-izations contain subcategories thatare difficult to distinguish reliably.
Subjects occasionally produceinstances of thought disorder thatcan be characterized by a particularcategory, although the slippage is notquite so severe as that categorywarrants. In such instances, one canscore a "Tendency" to the particularcategory, which means that the scoreis weighted by the immediately lowerlevel of severity. For example, aTendency to Confabulation would bescored at the 0.5 level instead of the0.75 level given to full Confab-ulations. Obviously, one can onlyscore a tendency for categories at the0.5, 0.75, or 1.0 levels. Although atendency may be scored for any ofthe categories, the need arises moreoften for certain of these categoriesthan others. These are: Confusion,Looseness, Fluidity, Autistic Logic,Confabulation, Incoherence, andContamination.
It is important that the examinernot deviate from the task, andgenerally not inquire about thesubject's personal associations thatdo not relate to the task ofresponding to the test questions.
In the administration of theWechsler Adult Intelligence Scale(WAIS), any odd verbalizationsshould be inquired into by theexaminer.
The TDI is usually derived fromverbatim responses to the RorschachTest and at times from the verbalsubscales of the WAIS. In admin-istering the WAIS and the Rorschach,it is most important that theexaminer inquire into all deviantverbalizations, percepts, slips, andreasoning.
The examiner should adopt a naivestance toward the test adminis-tration, and should not hesitate toinquire in order to clarify a point.
The examiner should not assume thats/he can figure out what a subjectmeant, deviant verbalizations,strange percepts, and ambiguous orelliptical responses should always beclarified through inquiry. Often asimple restatement of the subject'sown words (e.g., "nose of a spider?")will be enough of a prompt to elicitan explanation from the subject.Otherwise, questions such as, "Canyou say a little more about that?" or"I don't quite understand what youmean by ," should suffice. It isbetter to err on the side of overin-quiring than undennquiring.
List of TDI Categories(Revised)
0.25 Level
1. Inappropriate distancea. Loss or increase of distanceb. Excessive qualificationc. Concretenessd. Overspecificitye. Syncretistic response
2. Flippant response3. Vagueness4. Peculiar verbalizations and
This level is characterized by minoridiosyncracies that would only rarelybe noticed in ordinary conversation,although an accumulation of themwould result in a lack of clarity.These are the most subtle signs ofthought disorder that may bedifficult for an untrained observer todetect. One may have the feeling thatthe speaker is not quite "with" thetask, that there is some slightintrusion of an idiosyncratic set, orthat the respondent has at least somedifficulty in maintaining a clearunambiguous focus. Category
descriptions are given to help thescorer record "minor idiosyncracies,"and the definitions include some rulesto help make the judgments of thescorer easier. A common reaction ofbeginning scorers is to assume thatsince most people occasionally makecomments that could be scored at the0.25 level, these comments shouldnot be considered instances ofdisordered thinking. Although thecategories subsumed under the 0.25level are displayed even by thehealthiest of individuals, mostfrequently during periods of anxietyor fatigue, they are still episodes ofmild cognitive slippage and areviewed as such in this scoringsystem.
1. Inappropriate Distance
Inappropriate Distance refers to thepsychological distance that thesubject places between him/herselfand a task such as the RorschachTest. If the subject displays anIncrease of Distance, his/herresponses will show little regard forthe task or will be overelaboratedassociatively. The point is that theresponses seem to be dictated insuffi-ciently by the task at hand; rather,they are heavily influenced bypersonal associations. A Loss ofDistance is apparent when the subjectresponds to the task as being too realor interprets the task too literally. Inother words, the subject does notmaintain the appropriate perspective,and the result might be an overlyconcrete or emotionally chargedresponse to the blot. There are fivesubcategories subsumed underInappropriate Distance.
a. Loss or Increase of Distance.Responses falling under this subcat-egory are often but not alwayscharacterized by emotionally chargedaffective elaboration. A personalizedresponse is considered a Loss of
Distance when the task itself is takenas being too real or too personal.
Example: (IV) I'm afraid of whatelse it could be . . . it scares me tothink of what else it couldbe . . . overpowering.
A personalized response isconsidered an Increase of Distancewhen the affective elaboration resultsfrom a personal association to thetask rather than from the task itself.
Example: (III) It looks like abutterfly . . . it has twowings . . . sometimes they're alikeand . . . I like butterflies. I lovebutterflies. Butterflies are beautiful.
The distinction made aboveregarding the Loss or Increase ofDistance of these responses is notnecessary to make when scoringpersonalized responses. Thedistinction that must be made is thepoint at which such utterances shouldbe scored as thought disorder. At the0.25 level of scoring Loss or Increaseof Distance, the affective intrusiondoes not prevent the subject fromperforming adequately, but thepersonal associations tend to inter-mingle with adequate communi-cation. Sometimes this interminglingcauses an originally good response tobe spoiled or contradicted. In scoringpersonally elaborated responses, thescorer must keep in mind how appro-priate the final answer is to the taskat hand. If there is no attempt torelate the personalizing to the task,this indicates Inappropriate Distance.
Example from the WAIS (similaritybetween praise and punishment):Praise—like praising the Lord. Andpunishment when you didsomething wrong and you getpunished for it and then you prayfor the Lord to forgive you. Forforgiveness. And you say, "God, Ihave sinned. Will you pleaseforgive me?"
Examples from the Rorschach: Thislooks like a baby's head. . . .
There are two of them really. Idon't know what they're doing. Ijust really don't like to look at thisthing.(And you saw an island?) Uh-huh.I'm kind of against all this. I don'tlike . . . you know, letting myimagination flow unless it's withsomebody I love.A bug. Oh God. I hate bugs. Ihate bugs. I want to kill every oneI see.These two here, I don't know. I'mhungry right now so they look likefood.These look like crabs. . . . I lovecrabs, did you ever eat crab?It looks like a vagina because itreminds me of the way my ownvagina feels.Ooh! That's too horrible, take itaway, I can't stand to look at it.
In order to be scored as a Loss orIncrease of Distance, an associationmust disrupt the task. Sometimessubjects will ask questions about thetask itself or make personalcomments that are still very muchfocused on completing the task. Thefollowing are instances whenpersonal comments should not bescored: (a) comments about havingtaken the test before; (b) remem-bering prior responses; (c) asking atthe end of a response what inkblottests really mean; (d) socialcomments that do not occur in themiddle of a response, thereby notdisrupting or spoiling it;(e) comments about actual "extratest"events (e.g., a loud noise).
Examples of responses notscored: (Why does it look like avampire?) Because it looked justlike those vampires my kids watchon "Creature Features." When Iwas a kid, 1 used to be scared todeath of those things.(If you were lost in the forest . . .)That happened to us once, wefound a stream and followed it.
b. Excessive Qualification. In anexcessively qualified response, the
subject has trouble giving a responsebecause the inkblot is not a perfectlikeness of whatever percept thesubject considers. A subject mayoffer modifications that the perceptmust have before it merits a givenresponse or a subject may not giveany response at all because theinkblot does not conform to his/herexpectations of what it should looklike. Rigid perfectionism appears tobe interfering with a spontaneousresponse.
Example: (1) S'like a . . . leaf.Doesn't really look like aleaf . . . 1 dunno. Well, actually, itcouldn't be a leaf because of itscolor, right? 1 mean you don't findblack leaves . . . too often, doyou, unless they get older. Off'nsome trees you would, but theyusually turn to brown and ]ustdisintegrate. . . .
Example: (VI) . . . Looked kindafeathery. Suggested Indians, atotem pole, or somethin'. (Whatmade it look feathery?)Wh . . actually it wasn't feathery. Idon't know. I don't even knowwhy I said that. It doesn't reallylook feathery. If it were feathery,there would be more shading.
Example: (V) Looks pretty muchlike a bat but got a body thatlooks a little bit like amouse . . . a little bit more like aninsect though, you know. (Thebat?) . . . At the end of their wingsthey usually have claws orsomething, you know? The clawswould probably be off in this area,but, uh, but they're misplaced youknow. (Body like a mouse7) Well,I didn't really say a mouse, either,kinda like an insect again . . . can'treally fit any of the three.
c. Concreteness. The responseprocess of Concreteness suggests aloss of perspective in which the tasktakes on an apparent reality. Thesubject does not give a sufficientlyabstract response to the task.
Examples from the WAIS- (Whatdirection would you go if you weregoing from Chicago to Panama?) If
you went by airplane, I imagineyou would go south.
(Similarity between north-west)They're both opposite south andeast.
(How far is it from New York toParis?) Oh, I don't know. Eight-hour flight.
Examples from the Rorschach •(VIII) . . . an insect that's grownhuge—oversized. (Okay, whatmade it look like an overgrowninsect7) I could see the outline ofan insect, but it was too big to bea normal insect so it had to beovergrown.
(VII) Some kind of fancy militaryjet flying up the card.
d. Overspecificity. The overspe-cific response is similar to the exces-sively qualified response in that anobsessive disposition has becomeexaggerated in both cases. However,in an overspecific response, thescorer should look for arbitrary,irrelevant specifications that spoil aresponse and give it an ovendea-tional quality. The subject isattempting to be precise, but failsbecause of excessive obsessionality orcompulsivity, and thus tends towardabsurdity or bizarreness.
Examples from the WAIS: (Whatis the theme of the book ofGenesis?) It's, uh a fairytale . . . tryin' to describe tothe . . . proletariat masseshow . . . life began . . . for humanbeings.
(What is similar about a coat anda dress?) They both hang . . . an'they're opening at the bottom,mmm . . . they could havebuttons, both of them, or zippers.An' they're both worn as clothing.
Examples from the Rorschach:(III) A four-legged lamb.
(Ill) A bone of a bear.
e. Syncretistic Response. Erring inthe opposite direction of Overspeci-ficity, the subject is here too generaland abstract, instead of restricting aconceptual class, s/he includes too
much in it. The Syncretistic Responseis seen most often on items in theSimilarities subtest of the WAIS.
Examples from the WAIS: (Whatis similar about a fly-tree?) Theyboth live in the air.
(What is similar about an orange-banana?) They both containatoms.
2. Flippant Response
A Flippant Response also reflects aproblem with distance in that thesubject adopts a stance toward thetesting situation that betrays anabsence of seriousness or a tendencyto dismiss the test-taking withwisecracks. Flippant Responses areoften humorous, and may be veryengaging in informal conversation;however, when such remarks aredisruptive and inappropriate to thetesting situation, they are scored. Adifficulty that arises in scoring theseresponses is that their inappropriate-ness is due to the situation in whichthey occur, instead of to the malig-nancy of the response itself. Whereasthere might be no indication ofslippage when one makes a flippantresponse in ordinary conversation, itbecomes a problem if one fails toinhibit these responses in the testingsituation.
Example: (IX) I see anothervagina, I guess I'm a sexmaniac. . . . Oh, that's gettingwritten down? Uh-oh, they'll tellthe police about me
Example: (IX) If I had known 1was taking this test today, I wouldhave boned up on this section.
3. Vagueness
The vague response conveys no clearmeaning. However, Vagueness issometimes used to mask an absenceof information. When this is thecase, it may not have the samepathological weight as it does when
used in a context of confusion andautistic thinking. Because it isdifficult to distinguish between thetwo causes of Vagueness, it is scoredat a low level, 0.25. In theseresponses, the subject appears to beattempting to avoid giving inappro-priate responses (in which s/hesucceeds); nevertheless, s/he does notsucceed in giving any realinformation. More serious difficultymight result if the subject failed toinhibit the irrelevant material; suchfailure would be Confusion,Incoherence, or Absurdity, which arescored at higher levels.
Vagueness can include both long,meandering speeches as well asexcessively short, cryptic statementsthat carry hardly any specificinformation.
Example: (How are a poem andstatue alike?) Could be history.Example: (What does "sentence"mean?) It's something very short inthe way of speech reading.Example: (What is the Vatican?)It's in Rome, Pope. (Explain more.)That's all connected together. TheCatholic religion.
Example: (Why does the staterequire a license in order to getmarried?) Legal, legalities. That's astate issue why it's necessary,legality is involved.
On the Rorschach, the subjectappears unable to elaborate any clearpercept:
Example: Nothing but two figureson each side. (What made themlook like that?) I don't know whatkind of figures. They just lookedlike two smears.
The subject may give a responsewithout communicating clearly whats/he is seeing:
Example: Picture of like depth andstuff, like of distance . . . whereyour eye level would be.Example: Sort of strange andunclear . . . definition of . . .
unclear . . . totally confusing . . .grotesque.Example: . . . they all could beanimals, I - I, it's too much ingeneral. I don't know . . . .
4. Peculiar Verbalizations andResponses
Three kinds of Peculiar Responsesare included under this category:
• Peculiar Expressions• Stilted, Inappropriate
Expressions• Idiosyncratic Word Usage
As stated earlier, distinctionsamong these three subtypes(especially between the first two) arenot firmly established, but they arepresented as heuristic guides toscoring the general class of verbal-izations as Peculiar.
Peculiar Verbalizations includequaint, indiosyncratic, private termsor expressions in which the meaningmay be clear, but the expressionitself is unusual. There may be anunusual combination of wordsresulting in strange expressions, orincongruous modifiers. Generally,the scorer must be alert for stilted,strained, illogical, and unusualexpressions that are not part of theconventional modes of response tothe various test stimuli. Some preten-tious or stilted expressions that arepart of a cultural or ethnic mode ofresponding are not scored. Theseexceptions are noted in the examples.
a. Peculiar Expression. Oddcombinations of words, perhaps withreiteration or contradiction within aphrase, result in incongruity or apeculiar, inappropriate, or anthropo-morphic image.
Examples from the WAIS: (Whatis the definition of breakfast7)Morning dinner.(Why are dark-colored clotheswarmer than light-colored clothes7)
Because the sun warms up tothem . . . they retain the heat ofthe sun.
Examples from the Rorschach: Areverse reflectionEars looking forwardBearskin rug . . . you know howthey scatter out on each side.
b. Stilted, InappropriateExpression. These are awkwardlyphrased and stilted sounding expres-sions.
Examples from the WAIS: (Whatis similar about a table and achair?) Both room settings.(What is a sanctuary?) A placewhere a meeting can commence ofa religious origin.(What does slice mean?) Tosubdivide a piece of meat or a loafof bread into slices of thinnerpieces. It could also mean a slice ofbread or a slice of meat—a distri-bution of a larger whole.
Examples from the Rorschach: (IV)It's a piece of animation.(VI) I was, my mind was, or myattention was being put on thecenter line.(IX) (What made it lookpoisonous7 Most jellyfish that arepoisonous . . . give off a lot ofdifferent colors. Nature put it thatway, for a warning.(IV) (What made it look like ananimal7) Its head features.(II) And this is a set of lungs.(III) . . . No, you can't seeanymore unless you're looking at itfrom a perspective.(IV) What suggested it? Just itsoverall picture.
c. Idiosyncratic Word Usage. Oneexample of Idiosyncratic Word Usageis inappropriate metonymy, in whichone word is substituted for anotherof which the former may be anattribute.
Examples from the Rorschach: He'sall clowned up in some kind ofsuit.
The entire shape, the perimeter,the exterior shape.It looks like an inhuman form,something that's not natural,something that's unnatural.Could be a land.
Another example of idiosyncraticword usage is when words or ideasthat tend generally to occur togetherare equated and substituted for eachother. In this respect, the educationaland sociocultural background of thesubject should be considered whenscoring, because lower-class subjectsand those with low levels ofeducation frequently interchangecountries, cities, and continents aswell as body parts. Therefore, thiskind of interchange of words shouldbe scored only if the subject givesevidence of being confused, ofblocking on the correct word, or ofbeing aware that s/he should haveknown the correct word. Thus, if asubject calls antennae antlers at onetime and antennae at another, the useof antlers is scored as peculiar. Ifantlers is the subject's usual term forantennae, as inferred from the educa-tional and social class background, itshould not be scored.
Some examples of common wordinterchange occurring in normalsubjects of low social class or loweducation follow. Do not score unlessthe subject has at least a high schooleducation and indicates confusionabout correct terms:
(Where is Egypt?) In Jerusalem.(What is the capital of Italy?) Iwas going to say Spain, but Spainis in Portugal.Hands = paws = armsFeelers = tentacles = antennae= appendages = antlers
Similarly, do not score word inter-change resulting from the subject'ssubcultural dialect such as BlackEnglish:
Blood = person
Fang = feeler
Frequently "word play" sufficientlyalters words so that they are nolonger real words but arenevertheless still easily understood.The scorer should keep in mind theeducation and social class of thesubject, as well as whether themeaning is clear. "Word play" thatapproximates a correct word amongsubjects who do not know the correctword is not considered a scorableresponse. When scoring verbali-zations of lower-class subjects, it issometimes impossible to knowwhether a word has been producedfrom culturally acceptable "wordplay" or from fluidity in thinking. Insuch cases, the subject should begiven the benefit of the doubt andthe expression should not be scored.However, idiosyncratic use of wordsthat are clangs and appear to resultfrom an attempt to impress theexaminer with pretentious-soundingwords or that result from blockingshould be scored.2
Scorable examples from theWAIS: (How are the eye and earalike?) They're both necessity.(What does "repair" mean?) Getsomething wrong with itright . . . rightened.(Why are dark-colored clotheswarmer than light color clothes?)They exorb the sun.(What does "domestic" mean?)From some mahen source.film (rather than filament)
Scorable examples from theRorschach: It looks like a bearrug . . . because of the outstretch.Two charged elephants.Two imprint figures of elephants.
"See Queer Responses i l l ! for guidelines
on distinguishing Peculiar (IdiosyncraticiVord Usage), Queer {Queer WordUsage), and Xeologisttis
I have self-determine. That's whatyou need in this world.That's the way I impressioned it.Fetuses . . . it looked like therewas a tightly bunched organ.
5. Word-Finding Difficulty
The search for a word that thesubject appears to know but onwhich s/he is blocking is scored as(.25) Word-Finding Difficulty. It isimportant to distinguish this problemof blocking from a simple lack ofknowledge of the proper word. Inorder to score (.25) Word-FindingDifficulty, the subject must eithergive at least two wrong alternativesin her/his search for a word (even ifthe correct word is then found) orexpress clearly that s/he knows theword but cannot produce it.
Examples: (Name three types ofblood vessels) Capillaries, arteries,and it begins with a v [first try], Iwon't say ventricle [secondtry] . . . veins.What do you call those hard-shelled bugs? Beetle? No, that's notit . . . I'll say beetle, I think that'sthe name of a bug.(What made it look like a seaanimal?) It had the shape ofa . . . I can't think of the name ofthat animal, it's an exact repro-duction. I can't think of the namebut it's, umm . . . it's verycommon.If a (0.25) Peculiar Response is
given while the subject is seeking tofind the right word, both may t>escored as in the following example
There again it seems to be thesame picture on the other side, asit is on the other, only reverted, orwhatever you want to call it. Ican't say reverted.
Do not score when the subject doesnot know a word and simplyindicates so:
It has those, I don't know whatyou call them, things up there[points].
In the case of blocking on findingthe appropriate word, there must bemore than a temporary inefficiency.Do not score if the subject fumblesonly once and then immediately findsthe word s/he is looking for:
That looks like, uh, what do youcall it, oh yeah, antenna.
6. Clangs
Clanging is scored if the response islimited to a single, clear-cut usage ofrhyming or alliteration. The subject'sverbalization is determined by thesound rather than by the meaning ofthe word(s).
Examples from the WA1S: (Whatdoes travesty mean?) I think of thetreasure and the dynasty.(What is the population of theU.S.?) . . . millions. Billions andzillions. I don't knowabout . . . 500 million zillions.
Examples from the Rorschach:(IX) . . . And this mist here kind ofsuggests that they live in amystical world. Even their formwould suggest something like that,because they have more solid formhere, and then a more misty formhere, implying that they would bea more mystical mythical type ofanimal.
(VII) I said frog, I didn't say log[laughs] . . . just a dab. A seadab, crab. . . .
7. Perseveration
Perseveration may occur on both theWAIS and the Rorschach. It isrevealed by a lingering, unsup-pressed, compulsively repeated ideathat is forced inappropriately andarbitrarily into a response.
On the Rorschach, Perseveration isscored if a response that is repeatedat least three times does not havegood form—that is, when the inkblotdoes not justify the percept:
(One subject saw a space ship on
six Rorschach cards. On card X, hehad to strain to justify hisresponse) A part of a ship, youcan't see all of it.
Repetitions of either commonresponses (such as "butterfly"), whichconform to the inkblot, or of vagueresponses (such as "leaf"), which fitalmost any inkblot, are not persever-ations. To be scored, the responsemust be arbitrary; the subject mayhave difficulty justifying it or maystrain to fit the idea to the inkblot.
Examples from the Rorschach: Justyour roots inside your body (thirdreference to "roots inside yourbody").I keep seein' fur coats. Looks likefur to me (third reference to furcoats).
8. Incongruous Combinations
Incongruous Combination is scoredprincipally on the Rorschach, wherecontiguous details of the inkblot orsuggested images are merged into asingle incongruous percept. Incon-gruous combination is scored if theactivity described is unrealistic andincludes only one area of the blot.Weiner (1966) described theseresponses as reflecting inappropriatedistance from the Rorschach cards,taking the relationships betweenimages as real, and embellishingthem unjustifiably. He described fourtypes: composite, arbitrary form-color, inappropriate activity, andexternal-internal responses.
a. Composite Response. AComposite Response combines partsof two separate percepts into a"hybrid" creature. Both parts of thepercept are accurately perceived butare combined incongruously into aninappropriate unit:
The thing on top is a person with,for some reason, two pairs of armsoutstretched.
A bear with a duck's face.It looks like a cross between a catand a jet.I see a couple of horns on the bird.It looks like a mastedon wearingshoes.
Do not score images that are justifiedin art or mythology (for example, acentaur) or simple descriptions ofparts of the blot in which the subjectnotices the incongruity but does notattempt to link the incongruousparts:
Don't know what this is. It has ahead like a rat and a body like ahorse. But there isn't any suchanimal.
It is sometimes difficult to distinguisha Composite Response (8a) from aPeculiar Verbalization (3c). Forexample, if a subject says, "antlerson a butterfly," is the word antlerbeing substituted for antennae (i.e., aPeculiar Verbalization), or does thesubject actually see antlers on abutterfly (i.e., a Composite)! Inambiguous cases such as these, it isimportant that the examiner inquireto clarify this distinction.
b. Arbitrary Form-Color Response(FCarb). The FCarb Response (seeRapaport, Gill, and Schafer 1968,pp. 369-370) involves an excessivelyconcrete, a priori decision thatbecause the object perceived is aparticular color on the card, then itmust actually be that color (forexample, a pink polar bear). Theinkblot is more real than what thesubject knows as reality distinct fromthe inkblot. Composite Responsesinvolve combining the form qualitiesof the blot, while FCarb Responsesare condensations of two modalities,form and color. The object seen isinconsistent with the color attributedto it. Inquiry can establish whetherthe subject intended the arbitrarydescription humorously, had some
specific art or literary figure in mind,or can account for it in a strainedbut realistic manner. FCarb is scoredonly if the subject does not showawareness of the inappropnateness ofthe combination.
Examples from the Rorschach: Thisis a little girl right here She's onfire, too, green fire.An orange pelvic bone. Or a smallguy with two orange arms.Two crabs with green appendages.
c. Inappropriate ActivityResponse. This response involves theattribution of an inappropriateactivity to an object, usually ahuman or animal figure. If theresulting image is impossible anddistorts reality, it should be scored.
Examples from the Rorschach: Liketwo animals having their nose tiedtogether.A beetle crying.A man shedding his skin.Caterpillars shaking hands.
d. External-Internal Response (tobe scored at the 0.5 level). Thisresponse occurs when both theexternal and the internal parts of anob]ect are seen at the same time, in arealistically impossible manner.
Examples from the Rorschach- Thisis a woman and down here is herovaries.Ah . . . this kinda looks like, likea person. You know? Like thiswould be the nostrils, and thiswould be the mouth. And theperson's wearing the hat. And theperson's hair is down like this. An'the person's collar. Person'strachea. Let's see . . . that's all.
Although External-Internal Responsesfit conceptually into the IncongruousCombination category (i.e., twoaspects of a percept are combinedincongruously), the severity level ofthis subcategory is more appro-priately classified as 0.5 than as 0.25For this reason, we have chosen to
categorize it as an IncongruousCombination, but to score it at the0.5 level.
0.5 Level
Many 0.25 level responses areencountered with moderate frequencyin everyday discourse, but theyrarely convey the impression that thesubject has lost contact with reality.Rather, they suggest that the subjectmay have trouble dealing appropri-ately with some tasks or mayrespond idiosyncratically, but notbizarrely, to some situations. Such aperson may be "on the fringe" butis still in tune with her/hissurroundings. People who areseverely anxious, fatigued, or undersome temporary systemic distressmay give several .25 responses. Incontrast, an accumulation of .5responses conveys an impression ofloss of mooring, shaky realitycontact, emotional overreaction, anddistinct oddness.
9. Relationship Verbalization
Relationship Verbalization is scoredwhen the subject either repeats aresponse previously given or offers anew response, but relates the presentresponse to the former one. Thesubject makes connections betweenresponses
(A patient related each card to thepreceding one in a kind of storysequence, carrying the story a bitfurther with each card.) You havethe same thing here, except for thepig's being slaughtered. . . . Nowthe devil has destroyed the animaland the butterfly.There again you have thatexpansive thing . . . I find it to beprevalent in quite a few of yourpictures.An allusion back to an earlier one,that being the mandibles in thevery first picture.
It's in pieces. That's the other partof that [points to previous card], Ibelieve.
10. Idiosyncratic Symbolism
Two types of symbolic Rorschachresponses can be distinguished(Weiner 1966; Rapaport, Gill, andSchafer 1968); one involves interpre-tation of the meaning of the color orshading, and the other makes use ofconcrete images to represent abstractideas. We have divided IdiosyncraticSymbolism into two subcategories:
• Color Symbolism• Image Symbolism
It is important to note that symbolicresponses do not always representdisordered thinking and should bescored only when they take idiosyn-cratic rather than conventionalforms.
a. Color Symbolism. Holt andHavel (1960) gave examples ofconventional color symbolism thatinclude black as evil, red as anger,green as envy, blue as coldness, andyellow as warmth. Such responsesare not scored, nor are simple colorresponses (where color is used as aprimary, secondary, or sole deter-minant of the response) scored assymbolism. For example, "This is aplant because it's green." Symboliccolor or shading responses are scoredonly when the interpretation isidiosyncratic.
Examples: . . . and, of course, theorange is symbolic of hell. The redshows action.And the fading of this dead worldindicates the coming of the newworld, which is highly green,symbol of a new world
b. Image Symbolism. The use ofconcrete images to represent abstractideas is scored when such symbolismis idiosyncratic and is given with an
air of reality (rather than as playfullyimaginative).
Examples: Two men beating thedrums . . . like Siamese twins.Their hearts would beat at thesame time. This would be symbolicof their hearts beating together.Two objects right here might seemto be horns of the devil. Hornsmight represent evilness.This picture has a lot of meaning.It means love, peace, andhappiness.
At times, highly imaginativepeople who are not psychotic maygive symbolic responses, but they doso with an awareness of the imagin-ative or fantasy nature of theresponse. Idiosyncratic Symbolism isscored only when this awareness isabsent and is replaced by a certaintyabout the symbolic representation.
11. Queer Responses. The QueerResponses lie on a continuumof a particular kind of bizarreexpression: Peculiar at 0.25; Queerat 0.5; Absurd at 0.75; andNeologism at 1.0. Whereas PeculiarResponses, although deviant, couldpass as unremarkable in ordinaryconversation, Queer Responses carryan obvious ring of pathology thatreflects disorganization. We haveclassified Queer Responses into threecategories:
• Queer Expressions• Queer Imagery• Queer Word Misusage
a. Queer Expressions. These arepeculiar responses carried to anextreme. The subject utters the queerexpression with an air of certainty,but the listener has little idea of whatis meant.
Examples of Queer Expressions:Inward type of a photograph of aflower's reproductive cells.
The outside lookers, the onlookersof the outside.Their feet are going togetherunitedly.Like the outcenter.
b. Queer Imagery. Queer Imageryis more than an idiosyncratic use ofwords; it is also a particularly distantor unrelated response to a taskpresented by the examiner. There isan ambiguity that exceeds vagueness.The listener has the feeling that thecommunication is of some privateimagery, outside the realm ofcommon discourse:
Idealized fire. (What do youmean7) It didn't have any blue init, so it looked like something thathad been burning for a long time,or fire that wasn't lit with a match.
c. Queer Word Misusage. Wordmisusage which is more severe thanthat described for Idiosyncratic WordUsage (4c), and which does notappear to be the result of lack ofeducation, is also scored as (0.50)Queer.
(How are a fly and a tree alike7) Afly has branches like a tree.
The use of pretentious, clangingwords by subjects of lower educa-tional levels has been discussedearlier. Many such words are scored(0.25) peculiar. However, some ofthese words may involve more thanpretentiousness, when enough fluidityin thinking occurs so that two wordswith separate meanings combine, andthe resultant word has no clearmeaning. Such words might bescored as Neologisms (1.0), but webelieve that many may be more aresult of social class and educationthan of a neologistic process. Unlessthe examiner inquires about thewords, it is difficult to know whatprocess has determined the formationof the word. Because of this diffi-culty, we have made a compromiserule: score such words as (0.5)
Queer, because they seem worse thanpeculiar, but are perhaps not neolo-gistic.
To clarify the distinctions amongIdiosyncratic Word Usage (4c),Queer Word Misusage (10c), andNeologism (20), we have providedthe following rules of thumb:
Peculiar (4c): These are real wordsused incorrectly or awkwardly (orreal words with an incorrect prefixor suffix added), although themeaning is very clear.Queer (lie): These may be realwords used incorrectly where themeaning is not clear or they maybe words which are not real, butwhose meaning is clear. (Eitherthey are very close to a real wordor they are a clear combination ofreal words.)Neologisms (23): These are alwaysinvented words whose meaning orderivation is not at all clear to thelistener.
Example of Queer WordUsage-. Pestals on a flower [combi-nation of petals, pistil].
Examples of Neologisms:Tarangula [perhaps a combinationof tarantula and orangutan, fromthe context].Domestic inquility [although thismay be a simple peculiar distortionof tranquility, it may also haveidiosyncratic meaning].
A moliqamous society.
12. Confusion
The subject does not appear to besure what s/he is saying, thinking, orperceiving. Confusion is also scoredwhen the subject appears to bedisoriented about time, place, orperson.
Examples of confusion: This lookslike some kind of insect, youknow, like under the sea, sometype of, not under the sea, sometype of crab, yeah, under the sea.Or a milkweed butterfly, youknow how those milkweed worms
used to look, in the backyard. Oh,you weren't in my backyard.Somebody could have cut the skinoff it and pulled it open andwatched it, or looked at it, orsomething, or stripped it out orsomething, or pulled it out orsomething, or had it out straightfor a minute.. . . some people smoking matchesand burning cigarettes.
Sometimes a word or expressionappears to be the result of a slip. Ifthe slip is limited to a single instance,it is scored as Tendency to Confusion(0.25) instead of Confusion (0.5). Donot score a slip if the subject correctsher/himself without prompting fromthe examiner.
An example of Tendency toConfusion: (Why are child laborlaws needed?) So that they canprotect the incident. (Q7) I-nocent,innocent.
13. Looseness
Looseness represents a dramatic lossof cognitive focus. The subjectresponds to a question or a perceptwith ideas that seem either unrelatedor arbitrarily or tangentially related.Associations are embellished in anidiosyncratic manner and may flowrapidly with no focus of conver-sation. The original point is lost; thesubject produces free-flowing associ-ations that sometimes may involveserial clanging. If the subject limitsher/his looseness to one associationas in loose humor, or to a singleclang, then it is scored at the 0.25level {Loss of Distance, Tendency toLooseness, or Clang). Free-flowing,uncontrolled looseness is more patho-logical, although a short responseshould not deter one from scoringLooseness. We distinguish betweenlooseness in language and conceptualactivity and looseness in perceptualorganization, which we call Fluidity(0.75).
Examples from the WAIS: (Whyshould people pay taxes?)Taxation, we have represen-tation . . . taxation withoutrepresentation is treason . . . .It's frightening what Nixon hasdone now.
(What does tranquil mean?) Peace,pleasant, something pleasant tolisten to or do, or smell. A smile ispleasant.You're a pleasant dummy to bearound.
Examples from theRorscnach: Because it's black,dark, darkness, lovemakingIt could be a bow for your hair, ifyou've got any. Most people dohave a lot of hair, it grows, sothey should know how to take careof it.(What made it look like a crab?)Cuz I'm Cancer the Crab maybe.My sign is cancer. My horoscope.And I'm thinking a lot aboutcancer too. God forbid if anybodyis dying of cancer . . . I wish itwas me . . . .Two fetuses. I love my baby. 1really do. I want to go home soonso I can tell her I love her myself.You know, maybe she can comeout today. Do you think I passedanything off to her, like a lot ofnerves?
A Tendency to Looseness (0.25) isscored when the subject's looseresponse is limited and controlled.
An example of Tendency toLooseness: These look liketrousers. Trousers look better onmen than women
14. Fabulized Combinations, Impos-sible or Bizarre
Combinatory thinking makes use ofthe primary process mechanism ofcondensation, in which perceptionsand ideas are inappropriatelycondensed and thus violate realisticconsiderations. Combinatorythinking can be seen in the language,thought, and perceptual realms
Unrealistic relationships are inferredamong images, blot qualities, objects,ideas, or activities attributed toobjects and result in IncongruousCombinations at the 0.25 level,Fabulized Combinations at the 0.5level, some Confabulations at the0.75 level, and Contaminations at the1 0 level.
Many subjects produce FabulizedCombinations that do not distortreality constraints (for example, oncard II, "two women holding bowlingballs"). These fabulized combinationsare not scored because they resultfrom the combination of twoaccurately perceived images into arealistically possible whole. FabulizedCombination is scored when thesubject forces into an unrealisticrelationship two or more separateand discrete percepts that arecontiguous. The form quality of theseparate percepts may be good, butthe spatial relationship between themis taken as immutably real, and thefinal combined image is realisticallyimpossible. Impossible combinationsdistort reality by:
• Involving impossible sizediscrepancies between objects or blotdetails;
• Combining objects that do notoccur together in nature;
• Mixing natural and supernaturalframes of reference.
Examples from the Rorschach:Two crows with Afros and they'repushing two hearts together
Two potatoes with eyes and amouth trying to climb up somekind of pipe or pole
Two women . . . a neck with achest cavity . . and looks like thetwo women are resting on thechest
This looks like two hippos that areclimbing up some structure andstepping on a baby
At times, raters may have diffi-culty distinguishing among Incon-gruous Combination/CompositeResponse (7a), Fabulized Combi-nation (14), and Contamination (21).The following guidelines aresuggested:
Incongruous Combination (7a). Acomposite response is scored when ahybrid creature (i.e., a creaturecomprising incongruous components)is seen in one area of the inkblot(e.g., a mouse in a coat).
Fabulized Combination (14). Afabulized combination is scored whentwo or more areas of the blot arecombined or related inappropriately(e.g., a man being held by seahorses).
Contamination (21). A contam-ination is scored when two or morepercepts are seen in the same area, oroverlapping areas, of the blot andare merged together so that theidentity of each is spoiled (e.g., ananimal plant).
15. Playful Confabulation
A Playful Confabulation is related tothe group of Confabulation responses(19). The subject's original percept isrelated to the inkblot, but theresponse is then overly elaboratedbeyond the stimulus qualities of thecard. It is distinguished from a fullConfabulation because it is not somalignant. In general, the fabulizingtendency is not so extreme, and moreimportantly, there is a playfulness orhumorous quality to the response.There may be overelaboration of thefanciful activity, where the subjectseems to be playing with the perceptsand images, usually injecting somehumor into the response. Because aPlayful Confabulation does notindicate the severe slippage that afull Confabulation does, it is scoredat the 0.5 level. A Playful Confabu-lation may sometimes be difficult to
distinguish from a fabulized combi-nation (0.5) because it may alsoinclude an inappropriate combinationof percepts; however, a PlayfulConfabulation is a more fullyelaborated response that conveysmore of a story.
Examples from the Rorschach: (IX)A witch on a broom stick. And itlooked like an electric broom stickor something . . . gas poweredbecause she had a cloud of smoke.(IX) The middle part looks like anevil witch doing a squaredance . . . . She had her dress likethis and she was doe-see-doeing.
16. Fragmentation
Fragmentation is characterized by aninability to organize and integrateinformation appropriately. Twokinds of fragmentation are scored:
1. Fragmentation is scored when asubject is unable spontaneously toverbalize an integration of severalaspects of a percept into a singlecoherent response. Additionally,there are times when a subjectimplies a relationship betweenpercepts or blot areas, but articulatesthis relationship in an unclear,choppy, or disjointed manner.
This response represents a deficitin the capacity to synthesizeindividual percepts into an integratedresponse. The fragmentation responseshould be differentiated fromresponses that are organized percep-tually in a clear, understandable waybut are communicated in a disor-ganized manner. These latterresponses, which are marked bydisorganized presentation, are moreappropriately scored Confusion, or,in very severe cases, Incoherent.
Examples: A masquerade partycostume. Cha cha. Clap hands.Let's dance. (Inquiry) Partly thecolor . . . partly the contour ofthe . . . that's a dance. And . . .and you stump . . . stump . . . you
stump your feet (score stumppeculiar] . . . clap yourhands . . . together . . . with yourpartner.They . . . act . . . just like justfriends. Act like friends, children.(Inquiry) Their feet. That would betwo feet. That's when they areclose together . . . because theyseem so playful.. . . because of the closeness oftheir parts. Looks like . . . acentipede. (Inquiry) He's puttogether right there. Two differentparts. This part . . . and this part.
2. Fragmentation is also scoredwhen a subject verbalizes a part of alarger percept or discrete responsewithout regard to the larger percept,although it may be inferred that thesubject intends to verbalize the largerobject. This process is usuallydiscerned either on inquiry or insubsequent verbalizations. Theseresponses, too, are marked by aninability to integrate or synthesizeinformation, and should be distin-guished from those responses charac-terized by constriction or poverty ofcontent. The impoverished responsesare generally scored Vagueness.
Examples: I can't see much onthis. I can see that it'sdark . . . that looks like a handle.That's about all I can figure out ofthis picture. (Inquiry) Well, itlooked like a handle. That's all Ican say . . . . Well, I don'tknow . . . just looked like . . . .
Couldn't make much out of this. Ithink these two on the sides . . .are picking at . . . they'repicking at . . . at this. (Inquiry)Two claws . . . gives you anindication they might be crabs.The two claws . . . . I can't makeanything else out of that.
These little things . . . are likewhiskers. 1 don't know what thiscan be. They certainly don't looklike wings. And still that's thebody. They must be wings.(Inquiry) I don't like this forwings. But I don't know what elseto call them. Well . . . from what
I've seen of butterflies . . . thebody . . . and the big flying wings.
This type of Fragmentationresponse was described by Rorschachas a "Do" or "oligophrenic" response.It is applied when the subjectidentifies an area that is usually seenas a component of a larger area,either the whole card or a largedetail. For example, a subject maysee the antennae of a bufferfly onCard V, but not see the butterfly.
The disorder to be inferred when aFragmentation response is given isthat some process is interfering withthe capacity to integrate the separateparts of the blot into a wholeresponse. The process may reflectdifficulties in perceptual organizationor in the associative integration ofpercepts with their ideationalreferents. At times, the subject willverbalize several parts of theresponse (e.g., "wings, antennae,legs"), but will be unable, even oninquiry, to combine them into aunitary response.
0.75 Level
Responses scored at the 0.75 levelrepresent clear thought disturbancesthat clinicians have associated withpsychotic disruption. Instability ofthinking and perceiving, absurdity,and unrestrained combinatoryideation are typical.
17. Fluidity
In Fluidity, the impression is that thesubject perceives the world in ahighly unstable way; somethingperceived as one thing at one instantis seen differently at the next instant.The constancy of the object is gone:things do not exist for very long.Fluidity is scored when:
• The subject states that onepercept appears to be changing intoanother.
• The subject is unable to assignan explicit identity to a percept, sothat the examiner remains uncertainabout what has been described.
• The subject is unable to locate orremember a previously describedpercept because it appears that thepercept is so unstable that it cannotbe found again.
Examples: Two people . . oneminute this appears like their eyesand the next this appears like theirentire body holding on This lookslike a picture of, hmmm. Oh, atfirst it looked like a picture of, butI lost that one, so it doesn't looklike that anymore.The head of a rocket or the headof a . . . bear or the head of abird, but . . that . . . tome . . . it looked like the topdidn't go with the bottom.(Umhmm) Looked like somethingwas becoming something else
When the subject wavers betweentwo percepts, unable to decide onone or the other—thus evidencing acertain fluidity, though not as clearlyas in the preceding examples — (0.5)Tendency to Fluidity is scored.
Examples: The two poodles andthe two ladies are the same place,and I couldn't tell if they werepoodles or ladies.When I first looked at it, it lookedlike a bat flying away, then Ilooked at it again, it looked like abat coming toward me.
Do not score responses that are givenas differentiated, explicit alternatives-
It could be a bird or an insect.
It is sometimes difficult todistinguish Fluidity from verbalLooseness, where the sub]ect'sthoughts race and s/he is unable tostick to one focus. To score Fluidity,it is important that the subject clarifythat one percept appears to bechanging into another rather thanjust following quickly upon aprevious, discrete percept This may
be especially difficult in disturbedsubjects who speak very rapidly anddart from one percept to another.
18. Absurd Responses
When the examiner or scorer canform no idea about the source of aresponse, it is scored (0.75) AbsurdResponse. It may have meaning inrelation to internal events of thesubject but not in relation to thequestion asked or task set for thesubject; therefore, it is almost whollyarbitrary.
Example from the WAIS: (What isthe "Apocrypha"7) Is that theemancipation and the procla-mation?
On the Rorschach, an AbsurdResponse is one that has no objectivesupport in the inkblot itself. Thescorer should distinguish betweenAbsurd Responses and Perseverationand Vague percepts.
Examples from the Rorschach: Aspider. (Do you see anything else?)No. (What suggested the spider?)The legs. (Was there anything elseabout it that made it look like aspider?) The nose.It looks like . . I don't know. Ican't see much in that exceptmaybe bits and pieces ofThailand . . . shapes . all kindsof . . .This is sticking out there.Remember that's the, uh, curethere. It's our cure, it's called . . .I don't know what that is. (Whydon't you look at it for a fewminutes?) The only thing I can sayis I haven't got a spinal tail Inever saw tail. I never sawanything outside of my ownanatomy which is different fromother anatomies. That's what Ithink
And this white space . . . lookslike part of a pentagon
related to the inkblot or testmaterial, and if s/he had stoppedthere, all would be well. Instead, thesubject interprets the rest of the blotor material as though it had tobelong and fit in with the originalpercept. Confabulation results fromexcessive distance from the inkblot ortask. There are two kinds ofConfabulation:
• Overgeneralizationsfrom small to largerRorschach blot areas.
• Extreme associative elabo-ration and interpretationof a percept or a question.
a. Details in One Area Generalizedto a Larger Area. This type ofconfabulation occurs only on theRorschach Test. The subject respondsto a small area on the blot andovergeneralizes from that area to alarger one in a way that violates theshape of the larger area, although itmay be justified for the smaller area.
Example: The player, thebasketball player. (What makes itlook like a basketball player?)Here's the ball, then, it's not clearwhere the basketball player is, butI can see the ball, it must besomewhere in there.
b. Extreme Elaboration. ExtremeElaboration results from a fabulizingideational tendency that goes too farby autisticaUy extending the interpre-tation of the blot beyond the realmof reality constraints.
Examples from the Rorschach: Thelight bulb is—I think it'smanmade. And the pink is downhere and it gives energy for thelight bulb. And the light bulb andthe vapors from the pink give, urn,cause the green and orange to, uh,to be there. It was—it was—it hadits own energy, but the pinkcoming up into the light bulb gaveit more energy.
I now see kind of an evil wizardholding two things up. And I guessthey have great powers. He's gotthis fierce mane of hair . . .
hanging down over his shoulders.Some kind of Nordic magic leaderof a tribe. Oh, the two things he'sholding up could be twoanimals . . . kind of climbing upthe side of his body and hisshoulders. He must have themtrained somehow. They seem veryominous—it's like he was holdingthem up and they gave him somekind of power . . . .
It looks like the meeting of two,um . . . dragons who arecomparing swords . . . or who areeach so self-absorbed in themselvesthey're ignoring each other anddoing a hell-like, hellish . . .demonic . . . dance of the under-world . . . or they're just staring ateach other on rollers or standingon clouds, kind of pink clouds.
20. Autistic Logic
To score Autistic Logic requires anexplicit statement of faulty thinkingor reasoning. This may occur when asubject attempts to justify a responsewith an explanation that includes a"because" phrase, but what followsappears illogical or based on privateautistic reasoning rather than oncommonly acknowledged logicalsequences.
Examples: WAIS (PictureCompletion): I don't see any sailson this ship, so I would say wedon't have anyone operating thisship. I see something rather like anappendix. (What made it look likean appendix?) Looked to metotally useless, then I thought ofthe appendix.(Gold bullion?) Everything waspointing up to that gold bullionand so I said it was the mostprecious metal I could think of.
Sometimes a response that appearsto conform well to the details of theblot is explained autisticaUy in theinquiry. It is difficult to knowwhether it is this idiosyncraticreasoning that has produced theresponse, whether the subject is alsoaware of the form but did notverbalize this awareness, or whether
the language of description is itself sopeculiar that the scorer cannot besure how the subject arrived at thepercept. In these cases, we score aTendency to Autistic Logic (0.5).
Examples: (What suggested arock?) It looked like a hard, a non-hammer surface {Peculiar). Itlooked like a rock. It didn't looklike a human.(Response given to detail on CardIV, which is commonly called atree) Giant tree, a dead tree, adead tree, its leaves falling off.(What made it look likethat?) . . . looked like somethingthat was dead. So something thattowers over you and is dead to mefollows it would be a dead tree.
1.0 Level
At the 1.0 (most disordered) level,reality contact appears to havebroken down completely.
21. Contamination
In the Contamination response onthe Rorschach, two separate andincompatible percepts merge intoone. This is the extreme of combi-natory activity, in which neitherpercept retains its original identity.Two overlapping images, usuallyof the same area of the inkblot, arefused in a single percept.
Examples: A butterfly holding theworld together. (What makes itlook like that?) Because I see onboth sides patterns of a map.That's an Indian god . . . jumpinginto the meadow. A Joe Smithdrug meadow. (What is a JoeSmith drug meadow?) He workshere at night and every time hehands out medication I see green infront of his eyes like a meadow inIreland.This is definitely a man . . . a manbutterfly. A butterfly with a man'sface . . . could be a dark cloudthat's dark because it swallows upall . . . uh . . . the dark particles.
Man butterfly . . . it could be acloud-like man butterfly.
22. Incoherence
An Incoherent response is not onlyunrelated to the task but iscompletely impossible for theexaminer or scorer to understand inany context.
Examples: (What makes it looklike a duck7) Their disar-rangement. They follow outtogether, they follow one another.The two toes together, meeting oneanother. They jacked up in back,like spinal cord being broken.It's all in front. It's all free handwork. Freehand. Rememberfreehand? Once in a while we hadto freehand. So I did that 'til Iended up here for down the rest.You get crabby. And it's morethan aging gracefully. For strongpeople.(What made it look like muscles?)It looked like the hairs. (What?)The hairs (What?) The hairs. Theshoulders. (Did you say it lookedlike the hairs?) Yeah. (What madeit look like hair?) No, not hair. Itlooked like, kind of . . . that's all Icould think of.
23. Neologisms
Neologisms are invented words,perhaps as a result of verbal conden-
sation, perhaps out of a privatelanguage. Sometimes a Neologismresembles a verbal contamination inthat two words are combined and athird one emerges from the combi-nation but still carries the meaning ofboth words. The subject seemsunaware of any unusualness in theword uttered. It appears to havemeaning to her/him. But the listenermay be confused, either because theinvented word carries two conflictingmeanings, or because it is incompre-hensible. See Queer (11) for guide-lines to distinguish Peculiar (4),Queer (11), and Neologism (23).
Examples: That's tavro orneoglyphics.It looks like a firmabone. (Afirmabone?) That's right, afirmabone.
TDw = the sum of the TDI scores onthe WAIS
TDR = the sum of the TDI scores onthe Rorschach, divided bythe number of Rorschachresponses, multiplied by 100
TDw = .25(A) + .50(B) + .75(C) +1.00(D)
.25(a) + .50(B) + .75(C) +1.00(D)
TDR = X 100R
where:A = number of responses scored at
level .25B = number of responses scored at
level .50C = number of responses scored at
level .75D = number of responses scored at
level 1.00R = total number of Rorschach
responses
References
Holt, R.R., and Havel, J. A methodfor assessing primary and secondaryprocess in the Rorschach.In: Rickers-Ovsiankina, M.A., ed.Rorschach Psychology. NewYork: John Wiley & Sons, 1960.pp. 263-315.Johnston, M.H., and Holzman. P.S.Assessing Schizophrenic Thinking.San Francisco: Jossey-Bass, 1979.
Rapaport, D.; Gill, M.M.; andSchafer, R. Diagnostic PsychologicalTesting. Edited by R. Holt. NewYork: International UniversitiesPress, 1968.
Weiner, I.B. Psychodiagnosis inSchizophrenia. New York: JohnWiley & Sons, 1966.
