ArticlePDF AvailableLiterature Review

Rorschach Oral Dependency in psychopaths, sexual homicide perpetrators, and nonviolent pedophiles

  • Consultant/author/artist

Abstract and Figures

Rorschach Oral Dependency scores (Masling, Rabie, & Blondheim, 1967) were compared among nonsexually offending psychopaths (NSOPs, n = 32), sexual homicide perpetrators (SHPs, n = 38), and non-violent pedophiles (NVPs, n = 39) as initially reported by Gacono, Meloy, and Bridges (2000). The aggressive special scores of Gacono and Meloy (1994; Gacono, unpublished doctoral dissertation, 1998) were also scored and compared with ROD scores. Consistent with theory and predictions, NVPs were found to have significantly higher levels of oral dependency scores than NSOPs or SHPs. Additionally, there was a high degree of association between oral dependency and aggression in the SHP and NSOP groups. These Rorschach differences support the validity of the ROD as an implicit measure of dependency and add to the understanding of the dynamics that fuel sexually deviant violence.
Content may be subject to copyright.
Behavioral Sciences and the Law
Behav. Sci. Law 22: 345–356 (2004)
Published online in Wiley InterScience ( DOI: 10.1002/bsl.585
Rorschach Oral Dependency in
Psychopaths, Sexual Homicide
Perpetrators, and Nonviolent
Steven K. Huprich, Ph.D.,*
Carl B. Gacono,
Robert B. Schneider, M.S.
and Michael
R. Bridges, Ph.D.
Rorschach Oral Dependency scores (Masling, Rabie, &
Blondheim, 1967) were compared among nonsexually
offending psychopaths (NSOPs, n¼32), sexual homicide
perpetrators (SHPs, n¼38), and non-violent pedophiles
(NVPs, n¼39) as initially reported by Gacono, Meloy, and
Bridges (2000). The aggressive special scores of Gacono
and Meloy (1994; Gacono, unpublished doctoral disserta-
tion, 1998) were also scored and compared with ROD
scores. Consistent with theory and predictions, NVPs
were found to have significantly higher levels of oral de-
pendency scores than NSOPs or SHPs. Additionally, there
was a high degree of association between oral dependency
and aggression in the SHP and NSOP groups. These
Rorschach differences support the validity of the ROD as
an implicit measure of dependency and add to the under-
standing of the dynamics that fuel sexually deviant vio-
lence. Copyright #2004 John Wiley & Sons, Ltd.
The Rorschach Oral Dependency Scale (ROD; Masling et al., 1967) assesses
elements of interpersonal dependency. For example, Shilkret and Masling (1981)
found that ROD scores predict help-seeking behavior of participants in a research
project. ROD scores are also positively and significantly correlated with cooperation
and compliance with authority figures (Bornstein & Masling, 1985; Masling,
O’Neill, & Jayne, 1981), self-reported levels of insecure attachment (Duberstein
& Talbot, 1993), eating disorders (Bornstein & Greenberg, 1991), and behavioral
difficulties in terminating inpatient psychiatric treatment (Greenberg & Bornstein,
1989). Summarizing 28 years of research with the ROD, Bornstein (1996) con-
cluded that the ROD has construct validity and is a good measure of overt
dependent behavior.
Copyright #2004 John Wiley & Sons, Ltd.
*Correspondence to: Steven K. Huprich, Ph.D., Department of Psychology and Neuroscience, Baylor
University, P.O. Box 97334, Waco, TX 76798-7334, U.S.A. E-mail:
Baylor University.
Clinical and Forensic Psychologist Austin, TX.
Temple University.
The ROD is scored from the content of Rorschach material that is administered
either in standard or group format (Bornstein, 1996). Each response is read and
inspected for oral dependency content. Content may fall into one of 16 categories:
food and drinks, food sources, food objects, food providers, passive food receivers,
begging and praying, food organs, oral instruments, nurturers, gifts and gift-givers,
good luck objects, oral activity, passivity and helplessness, pregnancy and repro-
ductive organs, ‘‘baby talk’’ responses, and negations of oral dependent percepts.
One point is assigned for each oral dependent response, and a percentage score is
obtained by taking the number of oral dependent responses divided by the total
number of responses provided. Although the ROD is not used to assign a diagnosis
of dependent personality disorder, it has been found to correlate highly with other
projective measures of dependency (Fowler, Hilsenroth, & Handler, 1996) and
moderately with self-report measures of dependency (Bornstein, 1996, 1999;
Bornstein, Rossner, Hill, & Stepanian, 1994; Hirschfeld et al., 1977). ROD studies
have demonstrated its robust psychometric properties (Bornstein, 1994, 1996,
1999) including adequate interrater reliability and test–retest consistency
(Bornstein, Hilsenroth, Padawer, & Fowler, 2000; Bornstein, Rossner, & Hill,
1994; Juni & Semel, 1982). Given the nature of the Rorschach’s ability to partially
bypass volitional controls (Meloy, 1992; Gacono & Meloy, 1994), the ROD is
ideally suited to assess interpersonal dependency in samples where self-presentation
bias may be a concern, such as in a forensic population (Bannatyne, Gacono, &
Greene, 1999; Gacono, Evans, & Viglione, 2002).
Although this measure has been used to assess non-pathological aspects of
dependency (Bornstein, Riggs, Hill, & Calabrese, 1996; Bornstein, 1998a,
1998b) and the relationship of dependency to Axis I disorders (Bornstein &
Greenberg, 1991; Greenberg & Bornstein, 1989; O’Neill & Bornstein, 1990,
1991), little research has been conducted with the ROD scale and Axis II disorders.
Blais, Hilsenroth, Fowler, and Conboy (1999) found that DSM-IV (APA, 1994)
dimensional ratings for borderline personality disorder significantly correlated with
ROD ratings (r¼0.43). Comparing inpatient and outpatient borderlines, psychotic
inpatients, and dependent, avoidant, narcissistic, and antisocial outpatients,
Bornstein et al. (2000) found that inpatient borderlines had the highest ROD scores
(mean ¼0.265), followed by dependent and avoidant outpatients (mean ¼0.204)
and narcissistic outpatients (mean ¼0.202). Antisocial outpatients (mean ¼0.117)
and borderline outpatients (mean ¼0.109) produced lower mean scores than the all
of these groups, including university-student nonclinical controls (mean ¼0.162).
In the present study, we selected a forensic population to study ROD scores.
Specifically, we compared the ROD scores of nonsexually offending psychopaths
(NSOPs), sexual homicide perpetrators (SHPs), and nonviolent pedophiles (NVPs)
who were incarcerated or in a forensic psychiatric hospital. Previously, Gacono,
Meloy, and Bridges (2000) had evaluated the Rorschachs of such individuals with
Comprehensive System variables (Exner, 1993) and found that psychopaths were
distinguished by their lack of interest and attachment to others (NSOPs, 100%,
T¼0; mean for human content ¼4.00; mean COP ¼0.56) compared with SHPs
and NVPs (SHPs, 39%, T51; mean for all human content ¼6.39; COP ¼1.37;
NVPs, 49%, T51; mean for all human content ¼8.05; COP ¼1.18). However,
they did not evaluate these protocols for ROD and the extended aggression scores
(Gacono, unpublished doctoral dissertation, 1998; Gacono & Meloy, 1994).
346 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Although dependency and aggression were not directly assessed by Gacono et al.
(2000), their results suggested that psychopaths are the least likely of the three
groups to experience dependency needs.
We evaluated the aforementioned groups for four reasons. First, to our knowl-
edge, no published study has examined Rorschach Oral Dependency in pedophiles,
sexual homicide perpetrators, or psychopaths, despite the importance of this
construct to the theoretical underpinnings of each group. Second, we were inter-
ested in extending the growing body of research related to the ROD’s validity as a
measure of dependency. Third, these groups were ideal for examining the manner in
which dependency needs and aggression drive derivatives are expressed (Gacono &
Meloy, 1994; Gacono et al., 2000), given the links between interpersonal depen-
dency and aggression in violent sexual behavior. Based upon a confluence of
psychodynamic principles and previous research with these populations (Bridges,
Wilson, & Gacono, 1998; Gacono & Meloy, 1994; Gacono et al., 2000), we
predicted that that the sexual homicide perpetrators would have significantly higher
ROD scores than pedophiles, and that the lowest levels of oral dependency would be
found among psychopaths (SHPs >NVPs >NSOPs). Finally, we were interested in
the manner in which dependency and aggression might be associated in Rorschachs
of these groups. SHPs and NVPs are believed to experience deep conflicts over their
dependency needs and how to express them in the context of aggression they feel
toward themselves (NVPs; Bridges et al., 1998) and others (SHPs; Gacono, 1997b;
Gacono & Meloy, 1994; Meloy, 1992). In contrast, psychopaths have been found to
have little need or interest in interpersonal relationships, while also expecting
interpersonal relationships to be fraught with conflict and aggression (Gacono &
Meloy, 1994; Gacono et al., 2000). In the present study, it was believed that, given
the predominance of dependency and aggression in the real world behaviors of such
individuals, aggression and dependency would be found together in sequence in
participants’ Rorschach protocols. We predicted that this mixture would be most
frequently found in the sexual homicide perpetrators (high aggression toward
others, high interpersonal dependency), followed by the pedophiles (moderate
levels of aggression toward others, high interpersonal dependency) and non-sexually
offending psychopaths (high aggression toward others, low interpersonal depen-
dency). That is, SHPs >NVPs >NSOPs.
Participants were comprised of three groups: NSOPs (n¼32), SHPs (n¼38), and
NVPs (n¼39). Rorschachs were administered by advanced doctoral level clinical
psychology interns or licensed clinical psychologists using Comprehensive
System guidelines (Exner, 1974, 1986, 1993). The inclusion criteria for each group
were as follows: (i) having a valid Rorschach protocol; (ii) for the NSOPs, a valid
PCL-R score (530; Hare, 1991); (iii) for the NVPs, a DSM-IV (American
Psychiatric Association, 1994) diagnosis of pedophilia; and (iv) for the SHPs,
having committed a sexual homicide. All other data, including demographic
information, were treated as dependent variables.
RODs of psychopaths 347
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
All individuals in this group were free of mental retardation, psychosis, or neuro-
logical impairment, and were incarcerated in medium- to maximum-security
correctional or forensic facilities when tested. Psychopathic Rorschachs were
obtained from a larger male antisocial personality disorder Rorschach sample
(n¼105; see Gacono & Meloy, 1994). Forty-six of the 105 were psychopathic,
with PCL-R scores530 (Hare, 1991). Of the 46, 30 individuals, although violent,
had no history of sexual violence or any sex offense. Two cases (violent but not
sexually violent) were randomly chosen from the Gacono and Meloy (1994) female
psychopathic antisocial personality disorder sample (n¼24) and added to the male
psychopaths. These cases were added to match the number of females present in the
SHP group. All individuals in this sample were administered the Rorschach between
1984 and 1996.
Sexual Homicide Perpetrators
Sexual homicide perpetrators were chosen from valid cases among the Gacono–
Meloy (1994) sexual homicide sample. The sample was entirely male except for two
individuals. All 38 Rorschachs were administered between 1986 and 1997 to
individuals convicted of sexual homicide and incarcerated in various prisons and
forensic hospitals in California, Florida, Illinois, Massachusetts, and the District of
Columbia. Evidence that a sexual homicide had been committed and the produc-
tion of a valid Rorschach protocol were the only inclusion criteria. Positive evidence
of a sexual homicide was verified by independent record reviews by Carl B. Gacono,
Ph.D., and J. Reid Meloy, Ph.D., and included an intentional killing and (i) physical
evidence of sexual assault; (ii) sexual activity in close proximity to the victim, such as
masturbation; or (iii) a legally admissible confession of sexual activity by the
perpetrator during the homicide. In order to accurately represent the heterogeneity
of this population, individuals were not excluded due to mental retardation, mental
illness, neurological impairment, or gender to accurately represent the probable
heterogeneity of this population. None, however, were mentally retarded (IQ <70)
or psychotic when tested and, although it was not formally assessed, organic
impairment was not suggested from record review or clinical interviewing. Two-
thirds of this sample met criteria for psychopathy, and most met criteria for
antisocial personality disorder. Two of the 38 subjects were female.
Nonviolent Pedophiles
Nonviolent pedophiles were obtained randomly by Michael R. Bridges, Ph.D., from
a larger sample that contained violent and nonviolent subjects (n¼60; see Bridges
et al., 1998). Rorschachs were administered between 1991 and 1996 to subjects
incarcerated in a correctional facility awaiting sex offender treatment. All individuals
were male and met the DSM-IV criteria (APA, 1994) for pedophilia, as determined
by agreement by two experienced clinicians (an advanced clinical psychology
graduate intern or licensed psychologist) from record review and interview. None
348 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
of the pedophiles were mentally retarded, psychotic, neurologically impaired, or
evidenced a history of interpersonal violence. While individual PCL-R scores were
not available for the 39 pedophiles, a review of their files indicated that no
individuals met the criteria for antisocial personality disorder, and none would be
psychopathic (i.e., PCL-R 530).
All protocols were those evaluated initially by Gacono et al. (2000). In this study, the
protocols were scored for ROD content (Masling et al., 1967) and the aggressive
content scores of Gacono and Meloy (1994; Gacono, unpublished doctoral
dissertation), neither of which were scored or reported by Gacono et al. Scoring
for ROD content is described above. In the present study, all ROD content was
scored by the first author. All aggressive content scores are scored from content
within both the Free Association and Inquiry and include (i) Aggressive Content
(AgC), (ii) Aggressive Potential (AgPot), (iii) Aggressive Past (AgPast), or (iv)
Sadomasochistic Aggression (SM). Examples of each category are as follows: (i) ‘‘A
blood-hungry bat’’ (AgC); (ii) ‘‘A tiger about to attack a goat’’ (AgPot); (iii) ‘‘A
missionary killed by an African tribesman’’ (AgPast); and (iv) ‘‘A bat who has been
beaten and tortured’’ (examinee laughs; SM). These scores increase the examiner’s
ability to assess and code aggressive drive derivatives in psychopathic and non-
psychopathic antisocial personality disordered individuals, beyond that of Exner’s
Aggression score (Gacono, 1997a). Each response is evaluated for all of the
aforementioned categories. A given response may be scored for more than just
one of these categories, and the results of each category are reported for each
individual. In the present study, all aggressive content scores were scored by the
second author.
Once ROD and aggression special scores had been computed, ROD scores were
evaluated for the presence of aggressive content in the response immediately prior
to, co-occurring with, or immediately after an oral dependent score. The total
number of oral dependent–aggressive sequences for each individual was computed
and evaluated across groups. Such computations were an empirical way by which to
represent a sequential analysis of the pairing of aggression and dependency.
Sequential analysis has long been understood as a mechanism by which to evaluate
the processes with which an individual copes with, defends against, and recovers
from conflicting psychological impulses, needs, and states (Peebles-Kleiger, 2002;
Weiner, 2003). Given the nature of our clinical samples, we expected that stimuli
from a given Rorschach card would generate dependent or aggressive impulses, and
that the generation of such impulses would more than likely be associated with the
other impulse. Utilizing sequence analysis guidelines, we anticipated that the two
impulses would be in close proximity to each other in Rorschach responses. As
stated earlier, we predicted that this mixture would be most frequently found in the
sexual homicide perpetrators (high aggression toward others, high interpersonal
dependency), followed by the pedophiles (moderate levels of aggression toward
others, high interpersonal dependency) and non-sexually offending psychopaths
(high aggression toward others, low interpersonal dependency). That is, SHPs >
RODs of psychopaths 349
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Demographic data are presented by Gacono et al. (2000). However, it should be
noted that Gacono et al. reported that pedophiles were both significantly older and
better educated than psychopaths or sexual homicide perpetrators. Psychopaths and
sexual homicide perpetrators contained male and female subjects, while pedophiles
were all male.
Interrater agreement for the PCL-R scores and Rorschach variables are reported
by Gacono et al. (2000). Interrater agreement was also computed for ROD and
Aggression special scores. Twenty individuals’ protocols were randomly selected for
reliability analysis, which was conducted by the third author. The two raters agreed
on 97% of the ROD scores. Kappa was computed to be 0.72. The interrater
reliabilities for the Aggression special scores were also good. The two raters agreed
on 97% of the Aggression Content scores (kappa ¼0.97), 99% of the Aggression
Potential scores (kappa ¼0.99), 99% of the Aggression Past scores (kappa ¼0.99),
and 99% of the Sadomasochism scores (kappa ¼0.99).
Means, standard deviations, and frequencies of the selected Rorschach variables are
presented in Tables 1 and 2 along with reports of effect sizes, as computed by the
methodology suggested by Rosnow, Rosenthal, and Rubin (2000). For the mea-
sures of oral dependency and oral dependency coupled with aggressive scores, the F
values reported are focused contrast Fvalues. It was hypothesized a priori that these
variables’ means would be ordered in the following direction: oral dependency,
SHPs >NVPs >NSOPs, and oral dependency–aggression, SHPs >NSOPs >
NVPs. There were significant main effects on one-way analyses of variance for the
mean number of ROD responses (F(1, 107) ¼5.14, p¼0.013, r¼0.19) and the
ROD score expressed as a percentage of R(F(1, 107) ¼4.00, p¼0.024, r¼0.18).
Tukey post hoc analyses indicated the following pattern of significant differences in
means: ROD mean (NVPs >NSOPs) and ROD score expressed as a percentage of
R(NVPs, SHPs >NSOPs). Significant main effects were also found for the mean
number of ROD responses that were asssociated with aggression special scores
(F(1, 107) ¼4.93, p¼0.015, r¼0.21) and ROD percentages that were associated
with aggression content special scores (F(1, 107) ¼7.09, p¼0.004, r¼0.25).
Tukey post hoc analyses were conducted and the following results were obtained:
mean number of RODs that included aggression special scores, SHPs >NVPs,
NSOPs, and ROD percentages that included aggression special scores,
SHPs >NVPs, NSOPs. These results are presented in Table 1.
The aforementioned variables were also analysed with non-parametric tests, as
these variables are low base rate variables that may violate the distribution assump-
tions implicit in parametric tests (i.e. ANOVA; see the work of Viglione (1995) for a
discussion of this issue). The following significant results were obtained: number of
RODs produced,
¼16.42, p<0.001, r¼0.24.
350 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Table 1. Means, standard deviations, and frequencies for oral dependency and oral dependency–
aggression variables
Psychopaths Pedophiles Sexual hom. perp. pr
Variable (n¼32) (n¼39) (n¼38)
ROD number 3.48 (2.84)
8.31 (6.94)
6.32 (4.35) 0.013 0.19
(0) 6% 5% 5% <0.001*0.24
(1) 23% 0% 8%
(2) 16% 5% 5%
(3) 19% 13% 8%
(4 þ) 36% 72% 73%
ROD % 0.17 (.13)
0.26 (0.15)
0.25 (0.16)
0.024 0.18
ROD number sequentially paired or co-occurring with Aggression special scores
1.63 (1.88)
1.82 (1.52)
3.13 (3.73)
0.015 0.21
(0) 34% 23% 29% 0.116*
(1) 25% 23% 8%
(2) 16% 23% 26%
(3 þ) 25% 31% 37%
ROD % sequentially paired or co-occurring with Aggression special scores
0.08 (0.09)
0.06 (0.05)
0.14 (0.19)
0.004 0.25
ROD sequentially paired or co-occurring with Aggression special scores/Total ROD
0.42 0.26
0.045 0.24
is the computation of effect size as suggested by Rosnow et al. (2000). Superscripts indicate that means
differ significantly at p<0.05 on the Tukey post hoc test. *indicates the pvalue when frequencies were
evaluated with a
Table 2. Means, standard deviations, and frequencies of aggression special scores
Psychopaths Pedophiles Sexual hom. perp. p
Variable (n¼32) (n¼39) (n¼38)
AgC 2.65 (1.92) 3.00 (2.08) 3.21 (2.41) 0.556
AgC % 0.137 (0.10) 0.116 (0.12) 0.128 (0.10) 0.679
(0) 6% 10% 5% 0.555
(1) 25% 5% 21%
(2) 29% 31% 24%
(3þ) 40% 54% 50%
AgPast 0.68 (1.05) 0.38 (0.67)
1.05 (1.49)
AgPast % 0.036 (0.06) 0.015 (0.03)
0.048 (0.06)
(0) 55% 72% 45% 0.042
(1) 35% 18% 32%
(2þ) 10% 10% 23%
AgPot 0.03 (0.18)
0.21 (0.47)
0.71 (1.14)
AgPot % 0.00 (0.01)
0.01 (0.02)
0.036 (0.07)
(0) 97% 82% 58% <0.001
(1) 3% 15% 26%
(2) 0% 3% 10%
(3) 0% 0% 6%
SM 0.19 (0.40) 0.03 (0.16)
0.45 (1.13)
SM % 0.011 (0.02) 0.00 (0.01)
0.01 (0.04)
(0) 81% 97% 76% 0.022
(1) 19% 3% 16%
(2þ)0% 0% 8%
RODs of psychopaths 351
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
All aggressive content scores were evaluated with an omnibus ANOVA. The
following significant effects were found: AgPast, F(2, 107) ¼3.43, p¼0.036; Ag-
Past as a percentage of R,F(2, 106) ¼4.18, p¼0.018; AgPot, F(2, 106) ¼8.38,
p¼0.001; AgPot as a percentage of R,F(2, 106) ¼6.42, p¼0.002; SM,
F(2, 106) ¼3.41, p¼0.037; and SM as a percentage of R,F(2, 106) ¼3.64,
p¼0.030. Tukey post hoc analyses were conducted, and the following results were
obtained: AgPast, SHPs >NVPs; AgPot, SHPs >NSOPs, NVPs; and SM,
SHPs >NVPs. A similar pattern of post hoc results was obtained when these analyses
were conducted on these variables while controlling for R. These results are
presented in Table 2. The aforementioned variables were also analysed with non-
parametric tests, as these variables are low base rate variables that may violate the
distribution assumptions implicit in parametric tests (i.e. ANOVA; see the work of
Viglione (1995) for a discussion of this issue). Furthermore, we were interested in
assessing the difference in frequencies among the three groups. The following
results were obtained: AgPast,
¼6.35, p¼0.042; AgPot,
¼16.22, p<0.001;
and SM,
¼7.63, p¼0.022.
To further explore the relationship between dependency and aggression in this
sample, Pearson correlations were computed between ROD scores and each of the
Gacono–Meloy (1994) aggression scores. The percentage of RODs produced
during Free Association was significantly and positively correlated with AgPot as
a percentage of R(r¼0.23, p¼0.02, two tailed) and SM as a percentage of R
(r¼0.19, p¼0.05, two tailed). The percentage of RODs produced in the entire
protocol was significantly and positively correlated with AgPot as a percentage of R
(r¼0.26, p<0.01) and SM as a percentage of R(r¼0.22, p¼0.02).
The results of our findings add to the growing body of literature supporting the
utility of the ROD in understanding dependency and aggression. Two of our groups
were sexually deviant (SHPs, NVPs), and two had histories of aggression (NSOPs,
SHPs). Consistent with the idea that dependency or interpersonal strivings fuel their
behavior, ROD scores were elevated in our sexually deviant groups (SHPs, NVPs).
The frequent pairing of dependency and aggression in SHPs (almost 50% of ROD
scores were accompanied by aggression) offers a Rorschach marker that differenti-
ates the real world behaviors of the SHP (sexually violent) and NVP (sexually
nonviolent). These findings will be discussed in greater detail.
Psychopaths appear to lack interpersonal relatedness. Given the low frequency of
ROD scores, the absence of Texture responses in their records, and the low
frequency of COP (Gacono et al., 2000), psychopaths have very little ‘‘need’’ for
others, except related to narcissistic enhancement (elevated reflections; Gacono
et al., 2000). Additionally, dependency, when infrequently expressed, was often
associated with aggression, a finding consistent with the high frequencies of
Kwawer’s (1980) violent symbiosis responses previously reported in psychopaths
(Gacono & Meloy, 1994). It appears that whatever levels of dependency remain in
the psychopath act as an irritant rather than a source of affectional relatedness (see
Gacono & Meloy, 1991, for a discussion of negated and spoiled T responses).
352 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
In contrast, pedophiles seem to have greater interest in interpersonal relatedness,
as they had the highest levels of oral dependency. As noted previously, pedophiles
tend to feel damaged and experience low self-esteem and dysphoria (Bridges et al.,
1998; Gacono et al., 2000). Their acting out may be triggered by such feelings and
fueled by the dependency identified by the ROD. Consistent with their history of
‘‘nonviolence,’’ our findings suggest that pedophiles’ dependency needs are the least
associated with aggressive impulses of the three groups.
Sexual homicide perpetrators were found to have relatively high levels of oral
dependency, which was consistent with their relatively high levels of Texture and
Food responses (Gacono et al., 2000). Yet, much of their dependency was
associated with aggressive content. Furthermore, SHPs had the highest levels of
the aggressive special scores of Gacono and Meloy (1994) on three of the four
categories (AgPast, AgPot, and SM), suggesting that they are highly preoccupied
with aggressive impulses, including the dangerous mix of sadomasochistic ideation.
Gacono et al. (2000) found that SHPs have high levels of dysphoria, interpersonal
yearning, cognitive distortion, and obsession, coupled with an inability to disengage
from the environment (low Lambdas). Thus, when complex ideation coupled with
sexual arousal meets a certain threshold, sexual homicide perpetrators act from their
internal fusion of sexual, dependent, and aggressive impulses collectively. Consis-
tent with the use of projective identification, SHPs project their oral needs into their
victims and then react with rage, disgust, and violence in attempt to eradicate these
needs (see Gacono & Meloy, 1988). This group’s high levels of thought disturbance
(X %¼26; X þ%¼0.47; WSUM6 ¼23.00; see Gacono et al., 2000) provides a
template for the cognitive and perceptual distortions that allow such behavior.
These findings are best reflected in one SHP’s Rorschach response, ‘‘a lonely bird of
prey out looking for a relationship.’’
The present findings have important implications in understanding and assessing
these groups of patients. First, our results demonstrate the utility of projective
assessment in detecting implicit needs and motives that may not otherwise be
acknowledged (McClelland, Koestner, & Weinberger, 1989). Bannatyne et al.
(1999) and Gacono et al. (2002) state that the Rorschach is especially helpful in
assessing forensic patients who tend to misrepresent themselves in traditional self-
report measures. Since dependency is often unacknowledged by SHPs, NVPs, and
NSOPs, and because dependent and aggressive impulses are often associated within
these individuals, it appears that the ROD is a meaningful tool by which to further
elucidate the psychopathology of these individuals beyond traditional self-report
Second, effects obtained in this study provide meaningful information about
individuals incarcerated for sexual and/or aggressive deviance. Although the present
effect sizes are generally considered to be small (Cohen, 1988), the practical and
clinical significance of these findings is notable. ‘‘Practical significance’’ indicates
not only the magnitude of the difference between group means, but also its meaning
for the question being asked (Kirk, 1996). ‘‘Clinical significance’’ refers to the
phenomenon of whether the method applied to a reference group has any positive or
real effect (Kazdin, 1999). From the perspective of practical significance, the
present study set out to determine whether there is a detectable difference in levels
of Rorschach oral dependency among the three groups. As this study may have been
the first of its kind, the findings suggest that, indeed, there is a detectable difference
RODs of psychopaths 353
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
in the levels of interpersonal dependency in these groups. From the perspective of
clinical significance, the present findings demonstrate that incarcerated individuals
with criminal histories can be meaningfully differentiated by their levels of depen-
dency and aggression. Such differences may affect the way that inmates interact with
each other, with forensic officials, and with mental health professionals who are
faced with the task of evaluating them. Thus, despite the positive correlations that
exist between oral dependency and aggressive potential and sadomasochistic con-
tent for the entire sample, analyses of group differences indicate that SHPs and
NSOPs are much more likely to associate dependency and aggressive impulses,
while NVPs are not.
In an exploratory set of analyses, aggressive content scores (Gacono & Meloy,
1994) were evaluated. Since no research has been conducted on this scoring system
with these groups, it was uncertain what differences might exist. All three groups
had aggressive content (AgC), past aggression (AgPast), and potential aggression
(AgPot) mean scores higher than has been reported in nonclinical samples (Gacono
& Meloy, 1994). Among the groups, SHPs had significantly higher means of
AgPast, AgPot, and SM than NVPs and significantly higher AgPot means than
NSOPs. Consistent with Gacono et al. (2002), it appears that SHPs are preoccupied
with aggression and its expression against others.
The present findings are limited in that they may only apply to NSOPs, NVPs,
and SHPs who are incarcerated. It may be that, when such individuals are not within
the restrictive environment of a prison, their levels of dependency and aggression
would differ. Likewise, it is uncertain whether the association of dependency and
aggression would be found in individuals who commit lesser crimes, or who have
other serious psychopathology (e.g., schizophrenia a severe personality disorders).
Nonetheless, given the similarities among members of each group with respect to
their crime, cognitive functioning, and state of incarceration, the present findings
meaningfully demonstrate how implicit assessment of dependency and aggression
allows clinicians and researchers to better understand the intrapsychic dynamics
that fuel their deviant behavior. Thus, the Rorschach Oral Dependency scale
continues to remain a meaningful tool for clinicians to better understand personality
dynamics and corresponding behavioral disorders.
Special thanks are extended to Ariel Graham for her assistance in data entry.
American Psychiatric Association (APA). (1994). Diagnostic and statistical manual of mental disorders (4th
ed.). Washington, DC: Author.
Bannatyne, L. A., Gacono, C. B., & Greene, R. (1999). Differential patterns of responding among three
groups of chronic psychotic forensic outpatients. Journal of Clinical Psychology, 55, 1553–1565.
Blais, M. A., Hilsenroth, M. J., Fowler, C., & Conboy, C. A. (1999). A Rorschach exploration of DSM-
IV borderline personality disorder. Journal of Clinical Psychology, 55, 1–10.
Bornstein, R. F. (1994). Face validity and fakability of objective and projective measures of dependency.
Journal of Personality Assessment, 63, 363–386.
354 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Bornstein, R. F. (1996). Construct validity of the Rorschach Oral Dependency Scale, 1967–1995.
Psychological Assessment, 8, 200–205.
Bornstein, R. F. (1998a). Implicit and self-attributed dependency needs: Differential relationships to
laboratory and field measures of help seeking. Journal of Personality and Social Psychology, 75, 778–787.
Bornstein, R. F. (1998b). Implicit and self-attributed dependency needs in dependent and histrionic
personality disorders. Journal of Personality Assessment, 71, 1–14.
Bornstein, R. F. (1999). Criterion validity of objective and projective dependency tests: A meta analytic
assessment of behavioral prediction. Psychological Assessment, 11, 48–57.
Bornstein, R. F., & Greenberg, R. P. (1991). Dependency and eating disorders in female psychiatric
inpatients. Journal of Nervous and Mental Disease, 179, 148–152.
Bornstein, R. F., Hilsenroth, M. J., Padawer, J. R., & Fowler, J. C. (2000). Interpersonal dependency and
personality pathology: Variations in Rorschach Oral Dependency scores across Axis II diagnoses.
Journal of Personality Assessment, 75, 478–492.
Bornstein, R. F., & Masling, J. M. (1985). Oral dependency and latency of volunteering to serve as
experimental subjects: A replication. Journal of Personality Assessment, 49, 306–310.
Bornstein, R. F., Riggs, J. M., Hill, E. L., & Calabrese, C. (1996). Activity, passivity, self denigration, and
self-promotion: Toward an interactionist model of interpersonal dependency. Journal of Personality, 64,
Bornstein, R. F., Rossner, S. C., & Hill, E. L. (1994a). Retest reliability of scores on objective and
projective measures of dependency: Relationship to life events and intertest interval. Journal of
Personality Assessment, 62, 398–415.
Bornstein, R. F., Rossner, S. C., Hill, E. R., & Stepanian, M. L. (1994b). Face validity and fakability of
objective and projective measures of dependency: Relationship of life events and interest interval.
Journal of Personality Assessment, 62, 398–415.
Bridges, M. R., Wilson, J. S., & Gacono, C. B. (1998). A Rorschach investigation of defensiveness, self-
perception, interpersonal relations and affective states in incarcerated pedophiles. Journal of Personality
Assessment, 70, 365–385.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Lawrence
Duberstein, P. R., & Talbot, N. L. (1993). Rorschach oral imagery, attachment style, and interpersonal
relatedness. Journal of Personality Assessment, 61, 294–310.
Exner, J. E. (1974). The Rorschach: A comprehensive system. Volume 1. New York: Wiley.
Exner, J. E. (1986). The Rorschach: A comprehensive system. Volume 1: Basic foundations (2nd ed.). New
York: Wiley.
Exner, J. E. (1993). The Rorschach: A comprehensive System. Volume 1: Basic foundations (3rd ed.). New
York: Wiley.
Fowler, C., Hilsenroth, M. J., & Handler, L. (1996). A multimethod approach to assessing dependency:
The Early Memory Dependency Probe. Journal of Personality Assessment, 67, 399–413.
Gacono, C. B. (1997a). Is the Rorschach Aggression Score enough? British Journal of Projective Psychology,
42, 5–11.
Gacono, C. B. (1997b). Borderline personality organization, psychopathology, and sexual homicide: The
case of Brinkley. In J. R. Meloy, M. W. Acklin, C. B. Gacono, J. F. Murray, & C. A. Peterson (Eds.),
Contemporary Rorschach interpretation (pp. 217–238). Mahwah, NJ: Erlbaum.
Gacono, C. B. (1998). A Rorschach analysis of object relations and defensive structure and their
relationship to narcissism and psychopathy in a group of antisocial offenders. Unpublished doctoral
dissertation. San Diego: United States International University.
Gacono, C. B., Evans, B., & Viglione, D. (2002). The Rorschach in forensic practice. Journal of Forensic
Psychology Practice, 2, 33–54.
Gacono, C. B., & Meloy, J. R. (1988). The relationship between cognitive style and defensive process in
the psychopath. Criminal Justice and Behavior, 15, 472–483.
Gacono, C. B., & Meloy, J. R. (1991). A Rorschach investigation of attachment and anxiety in antisocial
personality. Journal of Nervous and Mental Disease, 179, 546–552.
Gacono, C. B., & Meloy, J. R. (1994). The Rorschach assessment of aggressive and psychopathic personalities.
Mahwah, NJ: Erlbaum.
Gacono, C. B., Meloy, J. R., & Bridges, M. R. (2000). A Rorschach comparison of psychopaths, sexual
homicide perpetrators, and nonviolent pedophiles: Where angels fear to tread. Journal of Clinical
Psychology, 56, 757–777.
Gacono, C., Meloy, R., Speth, E., & Roske, A. (1997). Above the law: Escapes from a maximum security
forensic hospital and psychopathy. Bulletin of the American Academy of Psychiatry and the Law, 25, 547–
Greenberg, R. P., & Bornstein, R. F. (1989). Length of hospitalization and oral dependency. Journal of
Personality Disorders, 3, 199–204.
Hare, R. D. (1991). The Hare Psychopathy Checklist–Revised (PCL-R) manual. Toronto: Multi Health
RODs of psychopaths 355
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Hirschfeld, R. M. A., Klerman, G. L., Gough, H. G., Barrett, J., Korchin, S. J., & Chodoff, P. (1977).
A measure of interpersonal dependency. Journal of Personality Assessment, 41, 610–618.
Juni, S., & Semel, S. R. (1982). Person perception as a function of orality and anality. Journal of Social
Psychology, 118, 99–103.
Kazdin, A. E. (1999). The meanings and measurement of clinical significance. Journal of Consulting and
Clinical Psychology, 67, 332–339.
Kirk, R. E. (1996). Practical significance: A concept whose time has come. Educational and Psychological
Measurement, 56, 746–759.
Kwawer, J. (1980). Primitive interpersonal modes, borderline phenomena, and Rorschach content. In
J. Kwawer, H. Lerner, P. Lerner, & A. Sugarman (Eds.), Borderline phenomena and the Rorschach test
(pp. 89–106). New York: International Universities Press.
Masling, J. M., O’Neill, R. M., & Jayne, C. (1981). Orality and latency of volunteering to serve as
experimental subjects. Journal of Personality Assessment, 45, 20–22.
Masling, J. M., Rabie, L., & Blondheim, S. H. (1967). Obesity, level of aspiration, and the Rorschach and
TAT measures of oral dependence. Journal of Consulting Psychology, 31, 233–239.
McClelland, D. C., Koestner, R., & Weinberger, J. (1989). How do self-attributed and implicit motives
differ? Psychological Review, 96, 690–702.
Meloy, J. R. (1992). Violent attachments. Northvale, NJ: Aronson.
Meloy, J. R., & Gacono, C. B. (1992). The Aggression response and the Rorschach. Journal of Clinical
Psychology, 48, 104–114.
O’Neill, R. M., & Bornstein, R. F. (1990). Oral dependence and gender: Factors in help-seeking response
set and self-reported psychopathology in psychiatric inpatients. Journal of Personality Assessment, 55,
O’Neill, R. M., & Bornstein, R. F. (1991). Orality and depression in psychiatric inpatients. Journal of
Personality Disorders, 5, 1–7.
Peebles-Kleiger, M. J. (2002). Elaboration of same sequence analysis strategies: Examples and guidelines
for level of confidence. Journal of Personality Assessment, 79, 19–38.
Rosnow, R. L., Rosenthal, R., & Rubin, D. B. (2000). Contrasts and correlations in effect-size estimation.
Psychological Science, 11, 446–453.
Shilkret, C. J., & Masling, J. M. (1981). Oral dependence and dependent behavior. Journal of Personality
Assessment, 45, 125–129.
Viglione, D. J., Jr. (1995). Basic considerations regarding data analysis. In J. E. Exner, Jr. (Ed.), Issues and
methods in Rorschach research (pp. 195–226). Mahwah, NJ: Erlbaum.
Weiner, I. B. (1998). Principles of Rorschach interpretation. Mahwah, NJ: Erlbaum.
356 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
... A search of PsycINFO between 1989 (AgScores were introduced in Gacono, 1988) and 2003 using the keywords Rorschach and aggressive, aggression, AgC, AgPot, AgPast, sadomasochism, sado-masochism, Gacono, or Meloy, revealed eight published articles (Gacono, 1990;Baity & Hilsenroth, 1999;Baity & Hilsenroth, 2002;Kamphuis et al., 2000;Mihura & Nathan-Montano, 2001;Mihura et al., 2003) and 12 dissertations (additional dissertations came from other searches) that have included one or more of the Extended AgScores . A similar analysis between 2004 and 2022 produced 15 additional published articles (Domjan, 2018;Benjestorf et al., 2013;Huprich et al., 2004;Joubert & Webster, 2017;Kivisto & Swan, 2013;Kochinski et al., 2008;Liebman et al., 2005;Nørbech et al., 2016;Rosso et al., 2015;Rovinski et al., 2018;Schug, 2021;Smith et al., 2020Smith et al., , 2021bSmith et al., 2019;Weizmann-Henelius et al., 2006) and two dissertations (Dehass, 2014;Kiss, 2017). Table 1 summarizes the inter-rater reliability for the Gacono and Meloy Extended Aggression Scores from 25 sources. ...
... Four studies found elevated AgPast in male and female offender groups where an early history of victimization might be expected (Huprich et al., 2004;Smith et al., 2021b;Weizmann-Henelius et al., 2006;White, 1999). Pedophiles were twice more likely to have at least one AgPast than those without the diagnosis (White, 1999), sexual homicide perpetrators produced more AgPast than nonviolent pedophiles (Huprich et al., 2004), and violent male psychopaths produced more AgPast than nonpsychopathic males with a history of violence (Hartmann et al., 2006). ...
... Four studies found elevated AgPast in male and female offender groups where an early history of victimization might be expected (Huprich et al., 2004;Smith et al., 2021b;Weizmann-Henelius et al., 2006;White, 1999). Pedophiles were twice more likely to have at least one AgPast than those without the diagnosis (White, 1999), sexual homicide perpetrators produced more AgPast than nonviolent pedophiles (Huprich et al., 2004), and violent male psychopaths produced more AgPast than nonpsychopathic males with a history of violence (Hartmann et al., 2006). Female sex offenders produced significantly more AgPast than a sample of nonviolent male pedophiles (Smith & Gacono, 2021;Smith et al., 2019), while female psychopaths had significantly more AgPast than nonpsychopathic females (Smith et al., 2020(Smith et al., , 2021b. ...
Full-text available
Determining a patient's aggressivity is a function of assessing multiple factors, including personality vulnerabilities, past behaviors, and potential future circumstances. Evaluating the nature and predominance of aggressive drive, impulse control, affect lability, inhibitory mechanisms, cognitive deficits, and conscious and unconscious attitudes (e.g.
... Huprich and colleagues (2004) examined Rorschach Oral Dependency (ROD) scores and Gacono and Meloy's (1994) aggressive content scores, and their cooccurrence, in psychopathic violent offenders, sexual homicide perpetrators, and nonviolent sexual offenders against children (Huprich et al., 2004). ROD scores, expressed as a percentage of R, were significantly lower in psychopathic offenders compared with the other two offender groups. ...
... There were no meaningful differences between the three groups on AgC; however, sexual homicide perpetrators consistently gave the highest number of AgPast and AgPot scores of the three groups. The authors conclude that the ROD scale provides an implicit assessment of dependency needs that allows evaluators to better understand the underlying dynamics of offending behavior (Huprich et al., 2004). ...
Full-text available
Over the years, a significant number of Rorschach studies have been conducted with forensic adult and adolescent samples, partly motivated by the use of the test in forensic psychological evaluations. Could the Rorschach, as a performance-based personality assessment tool, provide unique information that is not as vulnerable to distortion on the part of the examinee as self-report measures are? This article provides a review of Rorschach studies on relevant Rorschach variables, including those with different forensic samples. Empirical findings are mixed; there is not a one-on-one relationship between certain Rorschach variables and forensically relevant traits, such as psychopathy or hostility. This does not mean the Rorschach cannot provide useful information in answering psychological questions before the court. A case illustration of a male college student, who committed a (first) violent offense, illustrates the unique contribution of the Rorschach for understanding the psychological dynamics behind a violent act that was seemingly out of character.
... Research indicates that the ROD scale has excellent psychometric qualities, including good retest reliability over 16, 28, and 60 weeks (Bornstein et al., 1994a) and good internal consistency and construct validity . The IRR of the ROD scale is excellent, with correlations between two independent raters' scores typically being 0.90 and higher (Bornstein et al., 1994b;Huprich et al., 2004). In both laboratory and clinical settings, the ROD scale has been found to predict the extent of overt dependent behavior exhibited by individuals, with the behaviorally referenced criterion validity of ROD scale scores being comparable with or greater than most self-report measures of interpersonal dependency. ...
Full-text available
There is lack of empirical findings on a direct link between suicidality and dependency in youth. This is particularly relevant for children and adolescents with a trauma history, since traumatization is a well-established risk factor for suicidality in this population. Research on dependency predominantly uses self-report assessments, which may be susceptible to biases. In this study, performance-based interpersonal dependency scores in inpatient children and adolescents with trauma history were compared with patients' suicidal behavior (suicidal ideation and suicidal attempts) as derived from chart records. The results showed a gender effect. High dependency scores were associated with higher suicidal ideation for girls and with lower suicidal attempts for boys. These findings demonstrate that a relationship between dependency and suicidality for hospitalized traumatized youth is impacted by gender.
... Whilst alternative methodologies have been utilised, for example polygraph (Buschman et al., 2010), phallometric (Seto & Lalumière, 2001), and Rorschach (Huprich et al., 2004) testing, the validity and reliability of these approaches is questionable (Ben-Shakhar, 2008;Lilienfeld et al., 2000;Marshall & Fernandez, 2000). In the case of suicide ideation/attempts, retrospective self-report accounts may be inaccurate due to poor recall or reporting bias, and where an attempt is successful, it is generally not possible to obtain the individual's perspective following the event. ...
Conference Paper
This thesis centres around the relationship between indecent images of children (IIOC) offending and suicide, and the impact of these issues on the partners of IIOC offenders. Part I is a conceptual introduction exploring IIOC offender suicide as a phenomenon and considering how several prominent theories of suicide may account for suicide in this population. Part II documents an empirical study investigating women’s experiences of their male partners being arrested for IIOC offences and subsequently developing suicidal ideation, or attempting or committing suicide. This utilised interpretative phenomenological analysis to analyse interview data from six participants, with three superordinate themes identified; A Living Nightmare, Something Needs to Change, and Adjustment & Adaptation. Part III of this thesis is a critical appraisal of the research process, focusing specifically on some key considerations when conducting research with partners of IIOC offenders.
... AgPot is coded for those responses where an aggressive act was about to occur (Gacono, 1988), related to sadism (Meloy & Gacono, 1992), and identification with predatory objects or a preoccupation with predation (Gacono & Meloy, 1994). The SM response is scored 6 when devalued, aggressive, or morbid content is accompanied by pleasurable effects and correlates with both psychopathy and sexual homicide behavior (Gacono & Meloy, 1994;Huprich et al., 2004). AgPast is coded for any response in which an aggressive act has occurred, or the object has been the target of aggression (Gacono, 1988(Gacono, , 1990). ...
Full-text available
Managing the incarcerated population is the primary task within correctional settings. Using psychological assessment to predict institutional behavior, the psychologist has a unique set of skills essential to the management of prisoners. PCL-R, PAI, and Rorschach data were compared with institutional infractions (total, physical, verbal, non-aggressive) among 126 incarcerated women. Multiple binary logistic regression analyses were used which found significant correlations between PCL-R total score, PAI scales (BOR, ANT, VPI), and Rorschach variables (ROD, EGOI, TCI, AgPot, AgPast, SumV, SumC’, MOR) with total, verbal, physical, and nonviolent incident reports. Each of these measures adds incrementally to the assessment and understanding of institutional misbehavior for incarcerated women. Clinical implications of the findings were presented.
... For over a half-century, the Rorschach task has been used in attempts to elucidate the psychological and personality functioning of homicide perpetrators. Rorschach case studies of single-victim and familial mass murderers (Gacono, 1992(Gacono, , 1997Lewis & Arsenian, 1982;McCully, 1978McCully, , 1980Meloy, 1992;Nørbech, 2020), descriptive Rorschach studies of samples of murderers (Kahn, 1965(Kahn, , 1967Perdue, 1964;Satten et al., 1960), and comparative Rorschach studies incorporating murderers (Greco & Cornell, 1992;Kaser-Boyd, 1993;Perdue & Lester, 1973) and sexual murderers (Gacono et al., 2000;Huprich et al., 2004;Meloy et al., 1994) have indicated disturbances in personality and psychological functioning, in domains of engagement and cognitive processing, perception and thinking problems, stress and distress, and self and other representation. Findings are not always consistent across studies, though this may be due in part to the heterogeneity of murderers as a population (i.e., psychological, motivational, and behavioral), or to the different methods and systems historically used for scoring the Rorschach. ...
Full-text available
The present paper utilized the case study of an incarcerated serial killer (“Keith”) to demonstrate how combining three assessment techniques (the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, the Rorschach task, and a comprehensive battery of neuropsychological measures) within a multilevel personality assessment framework might elucidate possible personality-based underpinnings of extreme and repetitive violence—representing a “next wave” of serial killer research while also highlighting the empirical and clinical value of an empirically-neglected multilevel assessment approach. Gacono and Meloy’s multimethod “levels” model was selected as a multilevel framework, and Leary’s recommended examination of inter-level consistency was utilized as an integrative strategy. Results indicated marked divergencies among Keith’s data levels in areas of executive abilities, psychotic symptoms, affective/emotional disconnectivity, and sexual disturbance that suggested areas for potential change (perhaps in therapy), while consistencies among levels in social cognition and object relations suggested more stable characteristics that may be resistant to modification. The application of multilevel personality assessment methods to extremely and repetitively violent persons represents an important clinical approach worthy of future study—potentially having implications for research, clinical and forensic assessment, and treatment, and advancing empirical and clinical understandings of the continuum of interpersonal violence.
... Assim, 77% dos estudos (n=7) observaram que os AVSs apresentavam algum prejuízo cognitivo leve, ou seja, insuficiente para caracterizar qualquer tipo de psicose ou deficiência mental (Dåderman & Jonson, 2008;Jiménez Etcheverría, 2009;Pasqualini-Casado et al., 2008;Scortegagna & Villemor-Amaral, 2013;Scortegagna & Amparo, 2013;Young et al., 2010Young et al., , 2012, evidenciado por quatro estudos de caso e três de comparação entre grupos. Com relação à autopercepção, todos os estudos pesquisados (n=9) apontaram para algum prejuízo nesse aspecto (Carabellese et al., 2011;Dåderman & Jonson, 2008;Huprich et al., 2004;Jiménez Etcheverría, 2009;Pasqualini-Casado et al., 2008;Scortegagna & Villemor-Amaral, 2013;Scortegagna & Amparo, 2013;Young et al., 2010Young et al., , 2012. Tais apontamentos indicam percepções errôneas e imaturas de si e do outro por parte dessas pessoas (Zúquete & Noronha, 2012). ...
O objetivo deste estudo foi realizar uma revisão da literatura de publicações que investigam a personalidade do autor de violência sexual por meio do teste de Rorschach. Realizou-se uma busca bibliográfica nas bases de dados PubMed, Psycnet, Web of Science, PePSIC e SciELO, com descritores: “Sex Offender”, “Pedophile”, “Sex Offenses”, “Sexual Molester”, “Sexual Violence” e “Rapist”, combinados com Rorschach. A busca foi limitada aos artigos publicados nos idiomas inglês, espanhol e português, dos últimos quinze anos, considerando os Sistemas Compreensivo e de Avaliação por Performance no Rorschach, com autores de violência do sexo masculino, e tendo como vítimas crianças e adolescentes. Ao total foram encontrados nove artigos, e a análise apontou que os AVSs podem ter comprometimento nos aspectos cognitivos, afetivos, na autopercepção e na tendência a responder de modo impulsivo. Tais achados podem colaborar na criação de estratégias de intervenção e tratamento para esse público. Futuros estudos, que considerem diferentes bases de dados e descritores, poderão comparar os resultados encontrados, enriquecendo o processo de investigação nesta área.
Despite the perception that women do not commit sexual offenses, female offenders engage in sexual homicide, sexually assault their students or their own children, and, at times, work with co-perpetrators to sexually aggress against their victims. Few studies have used psychological tests to psychometrically map the personality of female sexual offenders. In this chapter, we use the PCL-R, PAI, and Rorschach in studying a sample of female sexual offenders with offenses against minors (N = 39). These women evidenced (1) borderline reality testing, defenses, & thinking; (2) a damaged sense of self (entitlement & victim stance); (3) abnormal bonding and pseudo-dependency (maladaptive neediness); (4) affective instability; (5) impulsivity; and (6) chronic anger couched within a malignant hysterical style that masks an underlying paranoid position. Descriptive personality measure data and two case examples are presented to highlight the dynamics of their offending behavior.
In this chapter, we provide a theoretical and empirically based understanding of antisocial and psychopathic women. We begin by clarifying the differences between psychopathy, sociopathy, and ASPD, and then provide a historical perspective of hysteria. While the underlying personality of the female psychopath is paranoid, malignant hysteria is their predominant personality style (Gacono & Meloy, 1994). Overviews of the Hare Psychopathy Checklist-Revised (PCL-R), Personality Assessment Inventory (PAI), and Rorschach are offered as a refresher for those experienced clinicians and as a resource for those that are not. Finally, we present group PAI and Rorschach data (also Trauma Symptom Inventory-2 [TSI-2]) for 337 female offenders including subsets of psychopathic (N = 124) and non-psychopathic (N = 57) females. We make note of the differences between female and male psychopaths.
Full-text available
In this study, the Psychopathy Checklist-Revised (PCL-R), the Rorschach, and the Personality Assessment Inventory (PAI) were used to elucidate the personality functioning of incarcerated females with sex offenses against minors (FSOAM; N = 31). There was significant convergence among the PCL-R, PAI, and Rorschach data. Both the PAI and Rorschach suggested: 1) borderline/psychotic reality testing and idiosyncratic thinking; 2) damaged sense of self, entitlement, and victim stance; 3) abnormal bonding and dependency; 4) affective instability; 5) impulsivity; and 6) chronic anger. Our comparison with a sample of male pedophiles (N = 36) highlighted gender specific issues with the women. Specifically, the women had more emotional deficits, ego-syntonic aggression, idiosyncratic thinking, and inappropriate attachments. A case study and our findings suggest a conceptual model for understanding the dynamics that result in female sexual offending behavior.
Full-text available
D. C. McClelland, R. Koestner, and J. Weinberger (1989) argued that self-report tests assess self-attributed needs (i.e., motives that are openly acknowledged by the actor), whereas projective tests assess implicit needs (i.e., motives that affect behavior without conscious awareness on the actor's part). The present studies examined the effects of implicit and self-attributed dependency strivings on laboratory and field measures of help seeking. In Study 1, college students were prescreened with widely used objective and projective dependency tests, then underwent an information manipulation designed to influence their attention to dependency-related issues. As expected, dependency status and information condition interacted to predict help-seeking behavior. Study 2 used experience-sampling procedures to demonstrate that implicit and self-attributed dependency needs differentially predict direct and indirect help seeking in vivo.
Full-text available
The previous articles in this special section make the case for the importance of evaluating the clinical significance of therapeutic change, present key measures and innovative ways in which they are applied. and more generally provide important guidelines for evaluating therapeutic change. Fundamental issues raised by the concept of clinical significance and the methods discussed in the previous articles serve as the basis of the present comments. Salient among these issues are ambiguities regarding the meaning of current measures of clinical significance, the importance of relating assessment of clinical significance to the goals of therapy, and evaluation of the construct(s) that clinical significance reflects. Research directions that are discussed include developing a typology of therapy goals, evaluating cutoff scores and thresholds for clinical significance, and attending to social as well as clinical impact of treatment.
Elements of response style were examined among three groups of chronic, psychotic, forensic patients: paranoid schizophrenics(N = 89); undifferentiated-disorganized schizophrenics ( N = 38), and schizoaffective patients(N = 53). Forensic patients with elevated MMPI-2 L Scales produced increased percentages of Pure Form (F%) on the Rorschach. A similar relationship occurred when the Rorschach was used as the independent measure. Schizoaffective patients reported more psychotic symptoms on the MMPI-2 and lower F% (Rorschach) than both schizophrenic groups. Although undifferentiated schizophrenics evidenced the most psychopathology on the Rorschach (impaired reality testing and perceptual accuracy disturbance), all three groups produced lower than expected frequencies for Rorschach variables commonly associated with thought disorder and poor reality testing (Exner, 1995b). The clinical importance of using the MMPI-2 and Rorschach in tandem with forensic psychiatric patients is discussed. Our empirical findings suggest the need for forensic evaluators to consider the important relationship between psychiatric diagnosis and response style (defensiveness, denial, illness chronicity, medications, and concurrent Axis II psychopathology) when interpreting often constricted psychological testing protocols in chronic forensic patient populations. (C) 1999 John Wiley & Sons, Inc.
This study examined whether oral dependent characteristics (as measured on the Rorschach) predispose patients to longer psychiatric hospitalizations. Results obtained on 75 voluntary psychiatric patients revealed that level of dependency predicted length of hospitalization for women but not for men. Reasons for the sex difference are discussed. Contrary to some speculation in the literature, findings showed no evidence of sexism in the provision of psychological services. Men and women had equivalent lengths of stay in the hospital, and treatment duration - no matter what the sex of the patient - did not vary as a function of sex of the primary therapist.
This second edition of Irving Weiner's classic comprehensive, clinician-friendly guide to utilizing the Rorschach for personality description has been revised to reflect both recent modifications in the Rorschach Comprehensive System and new evidence concerning the soundness and utility of Rorschach assessment. It integrates the basic ingredients of structural, thematic, behavioral, and sequence analysis strategies into systematic guidelines for describing personality functioning. It is divided into three parts. Part I concerns basic considerations in Rorschach testing and deals with conceptual and empirical foundations of the inkblot method and with critical issues in formulating and justifying Rorschach inferences. Part II is concerned with elements of interpretation that contribute to thorough utilization of data in a Rorschach protocol: the Comprehensive System search strategy; the complementary roles of projection and card pull in determining response characteristics; and the interpretive significance of structural variables, content themes, test behaviors, and the sequence in which various response characteristics occur. Each of the chapters presents and illustrates detailed guidelines for translating Rorschach findings into descriptions of structural and dynamic aspects of personality functioning. The discussion throughout emphasizes the implications of Rorschach data for personality assets and liabilities, with specific respect to adaptive and maladaptive features of the manner in which people attend to their experience, use ideation, modulate affect, manage stress, view themselves, and relate to others. Part III presents 10 case illustrations of how the interpretive principles delineated in Part II can be used to identify assets and liabilities in personality functioning and apply this information in clinical practice. These cases represent persons from diverse demographic backgrounds and demonstrate a broad range of personality styles and clinical issues. Discussion of these cases touches on numerous critical concerns in arriving at different diagnoses, formulating treatment plans, and elucidating structural and dynamic determinants of behavior. © 2003 by Lawrence Erlbaum Associates, Inc. All rights reserved.
Psychoanalytic theory and previous research on oral dependence both suggest that an oral-dependent character style is associated with increased risk for depression. The present study examined the relationship of orality to three separate measures of depression in a sample of 40 psychiatric inpatients (20 males and 20 females). A significant, positive relationship was found between level of orality and depression scores for male patients but not for females. These findings are discussed in the context of traditional psychoanalytic theory, object relations theory, and previous research in these areas. Suggestions for future studies are offered.
The authors review Yochelson and Samenow's (1977) model of the criminal mind. They propose a levels hypothesis for understanding the relationship among object relations, defensive operations, and the conscious cognitive-behavioral style of the psychopath. They advocate the addition of an explicit psychodynamic dimension to Yochelson and Samenow's model. A hypothetical case is presented to illustrate the relationship between unconscious defense process and conscious cognitive-behavioral style of the psychopathic personality.
The psychoanalytic theory of preoedipal fixation predicts that person perception is affected by basic characterological variables. Specifically, perceptual accuracy of nurturing figures is expected to be a function of orality, while a tendency to perceive authority as very different from oneself is hypothesized to be a function of anality. Thirty-one men and 24 women were given person perception scales, and their fixation scores were determined by Rorschach content analysis. The oral hypothesis was confirmed for women only, while the anal was confirmed for men only.