A Comparative Analysis of MMPI and Rorschach Findings Assessing Combat-Related PTSD in Vietnam Veterans—Analysis of MMPI and Rorschach Findings Assessing PTSD

Ioanna Katsounari, Jordan Jacobowitz

.

DOI: 10.4236/psych.2011.24053                

Abstract

There has been a proliferation of assessment research on Post-traumatic Stress Disorder (PTSD) over the past twenty years. In spite of recent advances in the PTSD assessment research, there continues to be a controversy as to whether the MMPI or Rorschach is more useful in determining the presence of PTSD. The present comparative analysis of the research literature will carefully evaluate controlled empirical studies, which utilized psychometric measures such as the MMPI/2 and Rorschach to identify PTSD in Vietnam Veterans. This analysis is guided by the paucity of comparative data for standardized objective and projective instruments to assess combat-related PTSD. The analysis indicated that the MMPI as an assessment instrument focuses on symptom recognition of PTSD while the Rorschach seems to be more likely to identify chronic adaptations to trauma. The significance of pre-combat factors, such as preexisting personality, and their impact on the way individuals make meaning and express traumatic experiences needs to be further addressed in future research. The need for reliable and valid measures to assess combat-related PTSD is urgent as an increasing number of soldiers return from war zones.

Keywords

PTSD, Combat Trauma, PTSD Assessment, Rorschach, MMPI

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Albrecht, N. N., Talbert, F. S., Boudewyns, P. A, Touze, J., Albrecht, J. W., Hyer, L. A., & Lemmon, C. R. (1994). A comparison of MMPI and MMPI-2 in PTSD assessment. Journal of Clinical Psychology, 50, 578-585. doi:10.1002/1097-4679(199407)50:4<578::AID-JCLP2270500413>3.0.CO;2-X
[2]	Baldrachi, R., Hilsenroth, M., Arsenault, L., Sloan, P., & Walter, C. (1999). MMPI-2 assessment of varying levels of posttraumatic stress in Vietnam combat veterans. Journal of Psychopathology and Behavioral Assessment, 21, 109-116. doi:10.1023/A:1022104405161
[3]	Burke, H. R., & Mayer, S. (1984). The MMPI and the post-traumatic stress syndrome in Vietnam era veterans. Journal of Clinical Psychology, 41, 152-156. doi:10.1002/1097-4679(198503)41:2<152::AID-JCLP2270410204>3.0.CO;2-3
[4]	Cannon, D. S., Bell, W. E., Andrews, R. H., & Filkenstein, A. S. (1987). Correspondence between MMPI posttraumatic measures and clinical diagnosis. Journal of Personality Assessment, 51, 517-521. doi:10.1207/s15327752jpa5104_3
[5]	DeAngelis, T. (2008). PTSD Treatments grow in evidence, effectiveness. Monitor, 39, 40.
[6]	Ephraim, D. (2002). Rorschach trauma assessment of survivors of torture and state violence. Rorschachiana, 25, 58-76.
[7]	Elhai, J. D., Frueh, B. C, Gold, P. B., Hammer, M. B., & Gold, S. N. (2003). Posttraumatic stress, depression and dissociation as predictors of MMPI-2 scale 8 scores in combat veterans with PTSD. Journal of Trauma and Dissociation, 4, 51-64. doi:10.1300/J229v04n01_04
[8]	Fairbank, J. A., Keane, T. M., & Malloy, P. F. (1983). Some preliminary data on the psychological characteristics of Vietnam veterans with Posttraumatic Stress Disorders. Journal of Consulting and Clinical Psychology, 51, 912-919. doi:10.1037/0022-006X.51.6.912
[9]	Gayton, W. F., Burchstead, G. N., & Matthews, G. R. (1986). An investigation of the utility of an MMPI Posttraumatic Stress Disorder subscale. Journal of Clinical Psychology, 42, 916-918. doi:10.1002/1097-4679(198611)42:6<916::AID-JCLP2270420616>3.0.CO;2-6
[10]	Glenn, M. D., Beckham, J. C., Sampson, W. S., Feldman, M. E., Hertzberg, M. A., &Moore, S. D. (2002). MMPI-2 profiles of Gulf and Vietnam veterans with chronic Posttraumatic Stress Disorder. Journal of Clinical Psychology, 58, 371-381. doi:10.1002/jclp.1149
[11]	Goldfinger, D. A., Amdur, R. L., & Liberzon, I. (1998). Rorschach patterns of response in Vietnam veterans with Posttraumatic Stress Disorder versus combat and normal controls. Depression and Anxiety, 8, 104-111. doi:10.1002/(SICI)1520-6394(1998)8:3<104::AID-DA2>3.0.CO;2-Y
[12]	Hartman, W. L., Clark, M. E., Morgan, M. K., Dunn, V. K., Fine, A. D., Perry, G. G., & Winsch, D. L. (1990). Rorschach structure of a hospitalized sample of Vietnam veterans with PTSD. Journal of Personality Assessment, 54, 149-159. doi:10.1207/s15327752jpa5401&2_15
[13]	Herman, J. (1997). Trauma and recovery. New York: Basic Books.
[14]	Hyer, L., Boudewyns, P. A., & O’Leary, W. C. (1987). Key determinants of the MMPI- PTSD subscale: Treatment considerations. Journal of Clinical Psychology, 43, 337-340. doi:10.1002/1097-4679(198705)43:3<337::AID-JCLP2270430306>3.0.CO;2-U
[15]	Hyer, L., Fallon, J. H., Harrison, W. R., & Boudewyns, P. A. (1987). MMPI overreporting by Vietnam combat veterans. Journal of Clinical Psychology, 43, 79-83. doi:10.1002/1097-4679(198701)43:1<79::AID-JCLP2270430110>3.0.CO;2-P
[16]	Hyer, L., O’ Leary, W. C., Saucer, R. T., Blount, J., Harrison, W. R., & Boudewyns, P. A. (1986). Inpatient diagnosis of Posttraumatic Stress Disorder. Journal of Consulting and Clinical Psychology, 54, 698-702. doi:10.1037/0022-006X.54.5.698
[17]	Keane, T. M., & Fairbank, T. K. (1983). Survey analysis of combat-related stress disorders in Vietnam veterans. American Journal of Psychiatry, 140, 348-350.
[18]	Keane, T. M., Malloy, P. F., & Fairbank (1984). Empirical development of an MMPI subscale for the assessment of combat-related Posttraumatic Stress Disorder. Journal of Consulting and Clinical Psychology, 52, 888-891. doi:10.1037/0022-006X.52.5.888
[19]	Meyer, G. J. (1996). The Rorschach and MMPI: Toward a more scientifically differentiated understanding of cross-method assessment, Journal of Personality Assessment, 67, 558-578. doi:10.1207/s15327752jpa6703_11
[20]	Munley, P. H., Bains, D. S., Bloem, W. D., & Busby, R. M. (1995). Posttraumatic stress and the MMPI-2. Journal of Traumatic Stress, 8, 171-179. doi:10.1002/jts.2490080113
[21]	Salley, R. D., & Teiling, P. A. (1984). Dissociated rage attacks in a Vietnam veteran: A Rorschach study. Journal of Personality Assessment, 48, 98-104. doi:10.1207/s15327752jpa4801_17
[22]	Shatan, C. F. (1973). The grief of soldiers: Vietnam combat veterans’ self-help movement. American Journal of Orthopsychiatry, 43, 460-652.
[23]	Sloan, P., Arsenault, L., & Hilsenroth, M. (2002). Use of the Rorschach in the assessment of war-related stress in military personnel. Rorschachiana, 25, 86-122.
[24]	Souffront, E. M. (1987). The use of the Rorschach in the assessment of Posttraumatic Stress Disorder among Vietnam combat veterans. Doctoral Dissertation, Philadelphia, Pennsylvania: Temple University.
[25]	Swanson, G. S, Blount, J., & Bruno, R. (1990). Comprehensive system Rorschach data on Vietnam veterans. Journal of Personality Assessment, 54, 160-169. doi:10.1207/s15327752jpa5401&2_16
[26]	Tolin, D. F., Maltby, N., Weathers, F. W., Litz, B. T., Knight, J., & Keane, T. M. (2004). The use of the MMPI-2 Infrequency-Psychopathology scale in the assessment of Posttraumatic Stress Disorder in male veterans. Journal of Psychopathology and Behavioral Assessment, 26, 23-29. doi:10.1023/B:JOBA.0000007453.24885.39
[27]	Van der Kolk, B. A., & Ducey, C. P. (1989). The psychological processing of traumatic experience: Rorschach patterns in PTSD. Journal of Traumatic Stress, 2, 259-275. doi:10.1002/jts.2490020303
[28]	Watson, C. G., Kucala, T., & Manifold, V. (1986). A cross validation of the Keane and Penk MMPI scales as measures of Posttraumatic Stress Disorder. Journal of Clinical Psychology, 42, 727-732. doi:10.1002/1097-4679(198609)42:5<727::AID-JCLP2270420508>3.0.CO;2-4
[29]	Weyermann, A. G., Norris, F. H., & Hyer, L. A (1996). Examining comorbidity and Posttraumatic Stress Disorder in a Vietnam veteran population using the MMPI-2. Journal of Traumatic Stress, 9, 353-360. doi:10.1002/jts.2490090216
[30]	Wilson, J. P., & Walker, A. J. (1990). Toward an MMPI trauma profile. Journal of Traumatic Stress, 3, 151-168. doi:10.1002/jts.2490030111