SIS Journal of Projective Psychology & Mental Health

ISSN 0971-6610 SIS Journal of Projective Psychology & Mental Health

Volume: 24 Number: 01 January 2017 Editorial Wilfred A Cassell 1-2 Thematic Apperception Techniques (TAT, CAT) in Assessment: A Summary Review of 67 Survey-based Studies of Training and Professional Settings Chris Piotrowski 3-17 Blood Pressure Variations and Emotional Dampening: Preliminary Evidence for the Curvilinear Relationship Dharmendra Jain, Meenakshi Shukla and Rakesh Pandey 18-25 Integrative Assessment of Interpersonal Dependency: Contrasting Sex Differences in Response Patterns on Self- Attributed and Implicit Measures Adam P. Natoli and Robert F. Bornstein 26-33 Rorschach Research through the Lens of Bibliometric Analysis: Mapping Investigatory Domain Chris Piotrowski 34-38 Fairy tales: The Emotional Processors of Childhood Conflicts in Dynamic Interpretative Lens Nilanjana Sanyal and Manisha Dasgupta 39-47 Efficacy of Cognitive Drill Therapy in Treatment of Specific Phobia Bhavana Arya, Sandhya Verma and Rakesh Kumar 48-51 Response to the Blank Card of Thematic Apperception Test (TAT) and its Correlation with Personality Factors Anand Manjhi and Sunita Purty 52-56 Mindfulness, Emotion Regulation, and Subjective Well-Being: Exploring the Link Satchit P. Mandal, Yogesh K. Arya and Rakesh Pandey 57-63 Recovery-Focused Behavior Therapy (RFBT): A Case Study Rakesh Kumar and Raj Kumar Sahu 64-68 SIS Society Honors Early Adventures into Space and Others of Note Wilfred A. Cassell 69-70 Official Publication of the Somatic Inkblot Society www.somaticinkblots.com

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH is a refereed journal and published twice a year (January, July) by the SOMATIC INKBLOT SOCIETY and is devoted to the advancement of research in the areas of projective psychology, personality assessment, psychotherapy and mental health. The journal is broadly concerned with the development of inkblot tests and personality assessment in clinical, counseling, cross cultural, organizational and health psychology settings. It aims to reach clinical psychologists, psychotherapists, psychiatrists, social workers, medical professionals and professional managers interested in the understanding and modification of human behavior. The journal includes (a) research articles (b) book reviews (c) brief reports (d) news about conferences and letters to the editor. MANUSCRIPTS PREPARATION: Manuscripts should be prepared in accordance with the format of the Journal of Personality Assessment/ SIS Journal of Projective Psychology and Mental Health. The manuscript should be prepared only in MS Word. No other formats are acceptable. An MS Word Template for preparing manuscript can be downloaded from the SIS Website. MANUSCRIPTS SUBMISSION: The typewritten manuscript in MS Word should be submitted only through email to the Editor Emeritus or Editor-in-Chief. The print version of the manuscript is not considered. The manuscript should be emailed on following Email IDs. (1) Dr. Bankey L. Dubey, Ph. D. Editor Emeritus, SIS Journal, Email: bldubey@gmail.com (2) Dr. Naveen Gupta, Ph.D. Editor-in-Chief, SIS Journal, Email: dr_naveengupta@yahoo.com (3) Dr. Rakesh Kumar, Ph.D. Executive Editor, SIS Journal, Email: jain.imhh@gmail.com Note: The Editorial Board of SIS Journal of Projective Psychology and Mental Health have full rights to accept/reject or require a re-submission of submitted manuscripts. Minor additions/ deletions/ changes can also be made in the manuscript at the level of Editors. JOURNAL SUBSCRIPTION: The SIS Journal of Projective Psychology and Mental Health is delivered to the members of the Somatic Inkblot Society as a membership privilege according to the nature of the membership and opted preference for Print Version or Soft Copy. We encourage the individuals and Institutions to become member of the Somatic Inkblot Society on the prescribed Membership Application Form available in this issue of the Journal to receive a copy of the journal. Non-members may purchase any single issue in print version or soft copy on the prevailing rates which are quoted in the latest issue of the journal. Current Rates: Foreign: $45 and Indian Rs. 600/- per issue. (1) All online payments or direct cash deposit for the journal should be made to following bank account: Name of Account: SIS Journal of Projective Psychology and Mental Health Bank Name: State Bank of India Branch Address: Krishna View Plaza, Marble Market, Plot # 20, Sector 20, Dwarka, New Delhi-110075 Account No.32297525238 IFS Code:SBIN0011361 (2) All payments through Multi City Cheque (or Demand Draft payable at State Bank of India Delhi)in favor of “SIS Journal of Projective Psychology and Mental Health”be sent to the following address by Registered/Speed Post: Dr. Naveen Gupta, Ph.D., Director, Hindustan Institute of Management and Computer Studies, Farah, Mathura-281122 U.P. (INDIA) Email: dr_naveengupta@yahoo.com, Cell: 91-9627182913 CHANGE OF ADDRESS: Any changes in address should be submitted to us through email for updating our records and seamless receipt of the Journal and other communications. Email: bldubey@gmail.com Copyright ©1994. SIS Center, India/Anchorage SIS Website: http://www.somaticinkblots.com

Editorial In my Jan 2016 editorial I wrote about the time limited aspects of the human body and hence its occupant’s existence. Since then I have turned 82 years old and confess to readers that my psychological defense mechanisms are weakening which earlier in life enabled me to deny “Somatic Death”. Moreover this psychic blindness was dramatically weakened in April last year, when my dermatologist informed me that I had a skin tumor lesion which was a form of cancer that untreated could sometimes metastasize. Fortunately a plastic surgeon was able to effectively remove it. While this health related incident has led me to focus on issues related to aging, I frequently tend to avoid this existential issue at night prior to sleep by fantasizing. I imagine waking up in the morning living in a young man’s body with more time and energy to complete SIS studies. Caen Chaffee a movie producer symbolized this theme in a production “The Curious Case of Benjamin Button”. In his fantasy film an infant child born, with an aged body, eventually over time developed into a normal adult healthy man. Relative to this fantasy theme, there now are a number of pharmacological studies in experimental animals suggesting that it may eventually be possible in humans to slow aging or even reverse the process. For example, a study published in the journal “Cell Reports” led by Dr Jorge Ivan Castllo-Quan found that when fruit flies were given a low dose of Lithium, in adulthood or later in life, they lived an average of 16 to 18% longer than flies who received sodium chloride. This finding was regardless of the insect’s genetic makeup. Another example involves research led by HeikiTanile Professor of Molecular Biology at the A, I. Virtanen Institute of Eastern Finland. His group found that longterm dietary supplement with pyruvate increases the energy reserves in the brains of mice. Hopefully such studies eventually may be repeated in human subjects that would have more relevance to younger members of our SIS Society than myself. In my relatively limited time left living on our planet earth, I hope to move my life focus. I plan on investigating the relationship between the acting out of aggressive impulses and imagery denoting aggression. I hope to conduct studies to correlate how specific SIS stimuli viewed prior to sleep might stimulate clinically relevant dreams - especially those of a posttraumatic nature. The proposed research subjects will be both perpetrators of aggression, as well as their victims. Human history is too replete with aggression and warfare. At times there appears to be a strong evidence for relating acts of violence to sexuality. In animals this relationship is witnessed every fall in Alaska. Then the previously quiet male moose’s testosterone surges thereby attracting him to females as well as motivating him to fight off competitors. For humans social norms in world cultures prevent such overt acting out yet, for some men the connection may have some theoretical relevance. Sometimes sexual potency in men has been linked to social power and their having access to the “BOMB”. Historically, in World War II nuclear scientists in America built atomic bombs which were used to destroy Japanese cities effectively ending the conflict. Yet they failed to develop international safeguards for the future! Now in 2016 military leaders of little world power can brag about access to such weapons of mass destruction. They are fully aware that citizens worldwide are anxious about this dangerous state of affairs This “Nuclear Anxiety” may exist either in full conscious awareness consciously or out of it. I observed this in the early 1960s when I first conducted field tests with college students in the normal population. As outlined in my book BODY SYMBOLISM, my intention was to develop projective test color-form configurations with embedded structure

partially suggestive of the human heart. It was hoped that these would facilitate psychophysiological studies of medical patients suffering from either real or imagined cardiac pathology. Eventually with much research this was found to be a useful projective aide for standard interviewing. However in addition there was a totally unexpected but highly interesting finding as follows in regard to Figure 1:

Many students viewed this as “An atomic Bomb explosion”. Since then I have learned that the projection of such explosive imagery may symbolize deep seated fears of ultimately dying from a future nuclear war. (Perhaps symbolically reflecting in the human brain’s neural “wiring” linking sex imagery with images of aggression, some subjects projected the sexual anatomical response “Female genitalia”.) This is a very complex psychophysiological area where there exist many more fundamental questions related to violent imagery than answers. I now invite members of our international SIS Society to contemplate considering such future fascinating, and in a nuclear age ESSENTIAL SIS RESEARCH! Wilfred A Cassell, M.D., FAPS, APC. Editor Emeritus, SIS J. of Proj. Psycho.& Mental Health Director, SIS Center, Anchorage (USA) Email: siswilfredacassell@yahoo.com

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH (An Official Publication of Somatic Inkblot Society) Published Regularly Twice a Year in January and July First Volume Published in 1994 All Volumes of the SIS Journal are also available in PDF Format Individuals/Institutions can become Member of Somatic Inkblot Society by Submitting Membership Application Form Given in the Journal and Receive Print Version/Soft Copy of the Journal Published After the Date of Membership Free of Cost

Bankey L. Dubey, Ph.D., DPM, DM&SP, Editor Emeritus, SIS Journal of Projective Psychology and Mental Health, E-mail : bldubey@gmail.com

Thematic Apperception Techniques (TAT, CAT) in Assessment: A Summary Review of 67 Survey-based Studies of Training and Professional Settings Chris Piotrowski A cursory review of the recent literature in the areas of testing and assessment tends to depict the impression that Thematic tests have been largely eschewed in professional practice over the past 2 decades. Indeed, this class of assessment instruments has been the target of extensive criticism based on incisive reviews of the literature (e.g., Lilienfeld et al., 2000). The intent of the current study is to determine whether this collective movement, evident in the scholarly literature since 1990, against Thematic assessment, has had a deleterious impact on the popularity of these tests in graduate training programs and professional usage worldwide. To that end, the author identified, through an extensive literature review, published survey research with regard to Thematic instruments that reported on assessment training and test usage patterns from 1989-2017. The 67 identified survey-based or records-based studies served as the data pool in the current review (Training=16; Practice=51 settings). The summary analysis indicated that 43 of the 67 studies (64%) reported that Thematic tests have been relied upon in assessment training or practice to at least a „moderate‟ degree. This trend was particularly evident in 9 of the 16 surveys (56%) of graduate-level and internship training. However, only 20% (n=10) of the practice-based studies reported a high level (top 10 ranking) of usage of Thematic techniques. Most of the 67 studies found infrequent use of children‟s Thematic tests (e.g., CAT). This review revealed that, over the years, Thematic techniques have been favored by clinical psychologists and professional counselors, but rather neglected in forensic and neuropsychological assessment. Also, a dramatic decline in usage of both the TAT and CAT was noted in most samples of school psychologists. Noteworthy, several studies found that coursework and training emphasis with the TAT was rather cursory and unstructured. On a cautionary note, this review observed a slight diminutive trend in Thematic methods in both training and practice since 2008. Thus, the future status of Thematic tests in the assessment armamentarium appears precarious, particularly as competing assessment approaches and novel testing instruments emerge in the field. Finally, there is a need for additional research regarding the scope of Thematic assessment in training programs in countries outside the USA (Piotrowski, 2015b), due to the dearth of studies of academic settings overseas. Over the past 75 years, Thematic methods, within the family of projective tests, have been popular assessment tools (Dana, 1996; Dupree &Prevatt, 2003; Frank, 1948; Handler & Hilsenroth, 1998; Handler & Smith, 2013; Keddy & Piotrowski, 1992; Klopfer & Taulbee, 1976; McGrath & Carroll, 2012; Murstein, 1965; Piotrowski, 2015a; Piotrowski & Keller, 1989, 1992; Wade & Baker, 1977). Despite their status in the testing community, projective tests have generated much scholarly criticism by clinicians and academicians over the years, even during the zenith of their popularity (e.g., Butcher, 2006; Fisher, 1967; Ivnik, 1977; Keiser & Prather, 1990; Retzlaff, 1992; Reynolds, 1979; Swensen, 1968; Vukovich, 1983). Since this onslaught of academic critique has been particularly contentious over the past 25 years (see Garb et al., 2002; Lilienfeld et al., 2015; Meyer et al., 2001; Wood et al., 2002), the aim of the current study is to review the extant literature, since 1989, on assessment usage of the most popular thematic tests (i.e., the TAT and CAT) in both academic training and applied practice settings. Other Thematic instruments, like the Roberts Apperception Test, Make-A-Picture-Story-Test, and the Children‟s Apperceptive Story-Telling Test (Schneider &Perney, 1990) have a limited research base and, thus, are not included in this analysis. Proponents of projective assessment contend that Thematic tests provide rich idiographic material not only clinically but also as a robust source of research data in scholarly investigations (e.g., Basu, 2014; Blatt, 1975). In support of this view, Dana (1996, p. 203) concluded “The TAT continues to be used in assessment practice because of the potential richness of the protocol data for personality study.” Moreover, Thematic approaches seem particularly amenable in the assessment of children (e.g., Chandler, 2003). More recently, Weiner and Greene (2008) Chris Piotrowski, Ph.D. University of West Florida (USA) Email: cpiotrowski@uwf.edu Keywords: TAT, CAT in Assessment.

argue that Thematic techniques can serve as a prodigious precursory tool in screening for psychological disturbance or maladjustment. Critics, like Ziskin (1995, pp. 866-870), counter that “The TAT is an extremely difficult technique to evaluate empirically.” Scholarly research on Thematic tests, particularly the TAT, has been rather robust over the years. A keyword search (March 2016) of the database PsycINFO produced 930 article references and 200 dissertations. In an analysis on the prevalence of projective techniques in published research reported in key journals from 1947-1965, Crenshaw et al. (1968) found the TAT to be ranked 2nd in terms of investigatory interest over time, and even surpassed the Rorschach in the 1960- 1964 period. Historical Context: Graduate-level Training Settings: From an historical perspective (i.e., prior to 1990), attitudes of mental health practitioners toward Thematic techniques remained quite positive; however, views of clinical faculty and internship directors toward some projective tests, while positive, have become more tepid over time (see Kolbe, 1985; Piotrowski 1999, 2015b for review; Rossini & Moretti, 1997). Early surveys, such as McCully (1965), reported rather positive attitudes of internship directors regarding the TAT, with 94% of respondents considering Thematic techniques as somewhat or very important. In a survey of academic clinical psychologists in APAapproved clinical training programs, Thelen et al. (1968) found that Thematic tests were considered the most important of the projective techniques to master, with 71 of respondents confirming that coverage of the TAT should be required coursework. About this time, Shemberg and Keeley (1970) detected a slight decrease in training in projective techniques in PhD clinical training programs. However, very positive attitudes toward diagnostic testing was reported by internship directors (Garfield & Kurtz, 1973); in fact, 93% of internship centers emphasized the TAT. During the 1980s, where attitudes of academic faculty and internship directors toward projective tests were somewhat tempered, the TAT was still endorsed as important by 74% of academic clinical psychologists (Pruitt et al., 1985). Moreover, the TAT continued to be emphasized during internship training (see Durand et al., 1988). These positive attitudes on the part of faculty toward Thematic assessment reflected the importance attributed to diagnostic training at clinical practicum sites (see Craig & Horowitz, 1990). In support of these findings, in a national survey of practicing clinical psychologists, Wade and Baker (1977) found that nearly 30% recommended that clinical students learn the TAT. It must be noted, however, that, during this time, the CAT was not emphasized in clinical training (e.g., Piotrowski & Keller, 1984). Mental Health Practice Settings: Early national surveys on clinical test usage in practice settings found the TAT ranked 4th and the CAT in 38thplace (Sundberg, 1961). Hinkle et al. (1968), on data from 247 psychotherapists, found the TAT to be amongst the top tests used in private practice. In a nationwide survey of clinical agencies, Lubin et al. (1971) reported that the TAT ranked 7th and the CAT 14th. Gendreau (1975), in a study on psychological test usage in corrections in Canada, reported the TAT ranked 9th. Surveys of mental health practitioners in the 1970s corroborated the popularity of Thematic instruments with the TAT and CAT amongst the top 10 and top 15 tests, respectfully (see Brown & McGuire, 1976; Piotrowski & Keller, 1978). Emphasis in practice with Thematic approaches continued into the 1980s (Fee, Elkins, & Boyd, 1982; Harrison et al., 1988; Haynes & Peltier, 1983; Lubin, Larsen, &Matarazzo, 1984; Sweeney, Clarkin, &Fitzgiggon, 1987; Tuma& Pratt, 1982; Watkins et al., 1988). In fact, one survey found that 91% and 23% of practitioners recommended competency in the TAT and CAT, respectfully (Piotrowski, 1985). Quite revealing, surveys of practicing school psychologists (i.e., Goh et al., 1981) reported that both the TAT and CAT were frequently

used in the assessment of personality. Even clinicians with an anathema to projective techniques, such as behavior therapists, have been reported to rely on the TAT (Piotrowski & Keller, 1984). Interestingly, this popularity of the TAT was also evident overseas. Evers and Zaal (1982) reported that the TAT ranked 4th in test usage in The Netherlands. Based on test usage data from 383 Australian psychologists, Sharpley and Pain (1988) found the TAT to be the 8th „most valued‟ test and highly recommended for inclusion in graduate-level training. Rationale for Current Study: Since the early 1990s, the assessment community has witnessed a steady stream of rather disparaging commentary directed largely on the lack of psychometric credibility of individual projective methods, including Thematic techniques (see Lilienfeld et al., 2000; Smith & Dumont, 1995; Ziskin, 1995). Thus, based on this dramatic shift (commencing around 25 years ago) to expunge projective techniques from both training emphasis and clinical practice, it would be of interest to a) summarize survey data regarding coursework and training emphasis in Thematic tests in professional/graduate training programs since 1989, and b) examine the extent of professional usage of Thematic techniques in applied practice settings during this time frame. Investigatory Design: In order to appreciate historical trends on the scope of emphasis and usage of Thematic techniques in graduate-level training and practice/professional settings, the author utilized bibliometric analyses of the extant literature to identify survey-based studies. To that end, a systematic search of the database PsycINFO (published by the American Psychological Association) was conducted, as this research repository is considered the leading scholarly file of research in the social and behavioral sciences worldwide. Table 1 summarizes survey findings of both academic and applied settings on emphasis and usage of Thematic tests since 1989. This analysis includes the 67 published studies on test usage that were identified in journal publications, based on academic/training and clinician/practitioner samples worldwide. Findings: First, response-rates of the reviewed studies varied widely; thus, the conclusions of the current analysis findings must be tempered by the unknown views of a sizeable percentage of non-responders from the samples under study. Thus, with a cautionary stance, the current analysis showed that, overall, based on data from both academic and practice settings over the past 25 years, the TAT has been emphasized or used to at least a „moderate‟ degree in 43 of the 67 (64%) studies in this review. This popularity was more apparent in training or internship settings, where the TAT was found to be highly valued in coverage in 9 of the 16 studies (56%) compared to only 11 of the 51 studies (22%) of practitioners. In fact, 21 of the 51 studies (41%) of practice settings indicated sparse usage of the TAT. However, „moderate‟ levels of TAT use were noted in 38% of the studies involving practitioners. With regard to the Children‟s Apperception Test (CAT), reliance on the CAT was rather absent across all academic and practice settings. Many studies that found the TAT to be popular also reported sparse usage or emphasis on the CAT. This disuse of the CAT was even evident in surveys of child practitioners and school psychologists. Moreover, only a couple studies found moderate use of the Roberts Apperception Test. Interestingly, scant discussion on the neglect of children‟s Thematic tests was proffered by investigators in the literature reported in the current analysis. In addition, this extensive review revealed that there has been a slight decline in enthusiasm for Thematic instruments by both graduate faculty and practitioners in recent years (see Peterson et al., 2014; Ready &Veague, 2014; Stedman et al., 2017). Moreover, the latest evidence (Mihura et al., 2016; Wright et al.,

2016) points to the fact that although there continues to be some reliance on performance-based testing, interest in Thematic tests appears to be waning (see Rabin et al., 2016; Ready et al., 2016). Several other trends in practice or applied settings were noted. Thematic tests have been popular with clinical psychologists and professional counselors (e.g., Clark, 1995), but less so with forensic psychologists (Neal &Grisso, 2014), and largely neglected by neuropsychologists (see Rabin et al., 2005; Smith, 2010). In fact, studies regarding forensic mental health assessment, including survey data from outside the USA (Martin et al., 2001), indicate that projective tests are not relied upon by practitioners in most legal settings (McLauglin&Kan, 2014; Ryba et al., 2003). Furthermore, Thematic tests have, historically, had a central role in the assessment practices of school psychologists (e.g., Hughes et al., 2010; Hutton, 1992; Kennedy et al., 1994); however, recent surveys in the school psychology field indicate a slight de-emphasis on reliance of these evaluation tools, with the CAT showing the most decline in usage (e.g., Hojnoski et al., 2006; Shapiro &Heick, 2004). Despite the popularity and emphasis with the TAT in academic training settings prior to 2008, empirically-based studies have found that TAT training in graduate education has been rather cursory and unstructured (Duffy, 1993). It must be noted that in the recent Mihura et al. (2016) study, survey objectives failed to elucidate the extent or depth of training in specific assessment approaches or tests. Moreover, academic coverage in clinical training with the TAT appears to be rather restricted to the seminal models proposed by Bellak and Murray (see Rossini & Moretti, 1997) and recent data point to a lack of instructional emphasis on TAT scoring protocols (see Mihura et al., 2016). The impact of this de-emphasis on future trends is uncertain. Hence, interested students may need to pursue educational opportunities with Thematic tests via nontraditional venues such as workshops and individualized instruction from mentors. Noteworthy, there is a dearth of data on the status of Thematic techniques in graduate-level educational or training programs in countries outside the USA (see Piotrowski, 2015b for review). Future research needs to examine didactic issues and identify trends regarding assessment training, over time, at universities in nations worldwide (see Elosua&Iliescul, 2012; Raez de Ramirez, 1999). Conclusion: These findings, based on extensive survey data over time, point to the reality that a sizeable minority of faculty and mental health professionals have relied on Thematic assessment and have done so based largely on several key attributes of these techniques discussed in the assessment literature: notably, that Thematic techniques tend to be conducive in diagnostic assessment (Dana, 1996; Woolford et al., 2015; Wright et al., 2016), particularly in understanding and addressing stressors, social-emotional needs, and interpersonal challenges. In this context, Thematic methods may offer an integrative function within the multi-method assessment model (Flanagan & Motta, 2007; Hopwood & Bornstein, 2014; Riccio& Rodriguez, 2007). However, based on recent evidence (since 2008), there appears to be a diminution of didactic and practicum offerings in academic and internship programs in projective techniques; hence, the future status of the TAT in the assessment armamentarium appears precarious. Historically, the current findings regarding Thematic tests attest to the popularity of and interest in projective assessment over the decades, as evidenced in coverage in scholarly books on psychological tests (e.g., Aronow, Weiss, &Reznikoff, 2013; Groth- Marnat, 2009; Harwood, Beutler, &Groth- Marnat, 2011; Murstein, 1965; Newmark, 1996; Rabin, 1986; Rapaport et al., 1968). This scholarship reflects the vast research landscape on projective techniques evident in the extant literature. However, future studies are needed to determine whether interest in

Thematic methods will expand beyond a narrow circle of enthusiasts, particularly as competing assessment approaches and testing instruments emerge in the field. Table 1: Emphasis or Use of Thematic Tests in Training/Practice Settings across 67 Studies (1989-2017) Study Country Sample Findings Piotrowski & Keller (1989) USA Test usage in 413 mental health facilities Amongst the top 30 tests used, the TAT ranked 9th; the CAT 14th. Tsoi&Sundber g (1989) Hong Kong Division of Clinical Psychology of the Hong Kong Psychological Society The TAT ranked 4th. Bubenzer et al. (1990) USA 743 members of the American Association for Counseling & Development, primarily practitioners The TAT ranked 7th in terms of usage but used only occasionally. *Watkins et al. (1990) USA Data based on 56 directors of counseling psychology training programs 45% of these programs emphasized the TAT in coursework/training. Archer et al. (1991) USA 165 respondents who were either APA Division 12 members, Society for Personality Assessment members, and/or practitioners with a research interest in adolescent assessment The TAT ranked very highly for inclusion in a „Standard‟ test battery, endorsed by 63% of respondents. Butler et al. (1991) USA 280 members of the International Neuropsychological Society 33% of respondents in neuropsychology use the TAT for „personality‟ assessment. Ogawa & Piotrowski (1992) Japan Japanese Clinical psychologists Although several projective tests were ranked highly, the TAT was not used frequently. Hutton (1992) USA 389 school psychologists (members of NASP); update on the Goh et al. (1981) study

For the area of personality assessment, the Roberts Apperception Test ranked #2; the CAT #3; the TAT 12th. *Piotrowski &Zalewski (1993) USA A replication of the Piotrowski & Keller (1984) study; 80 Directors of both PhD and PsyD APA clinical psychology programs in 1991 80% of the programs suggested competency in the TAT; this was on par (85%) with findings of the 1984 survey. Only 10% of programs endorsed the CAT. Pinkerman et al. (1993) USA Surveyed 126 psychologists in 37 juvenile/family courts on scope of testing practices of children under age 18 Projective tests were used frequently, including the TAT. Kennedy et al. (1994) USA Practicing school psychologists Overall, projective tests used frequently; TAT ranked #9; CAT #12. Stinnett et al. (1994) USA Data analysis based on 123 members of the National Association of School Psychologists (NASP) in 1993 In social-emotional assessment, 29% use the TAT (ranked 11th); 15% use the CAT (ranked 19th). Chan & Lee Hong Kong 50 practicing psychologists 56% noted the TAT, ranked 12th; 38%

(1995) in 1993 used the CAT, ranked 18th. Watkins et al. (1995) USA 412 APA members who were clinical psychologists TAT used by 82% of practicing psychologists & ranked 5th overall; the CAT was used by 42% (ranked 16th); 90% felt that clinical students should gain competency in the TAT; however, only 22% endorsed the CAT in training & only 6% recommended competency in the Roberts Apperception Test. Borum&Grisso (1995) USA 102 forensic psychologists/psychiatrists For psychologists, the TAT was relied upon by only 8% of respondents; for psychiatrists, 10%; CAT not mentioned. *Wilson &Reschly (1996) USA Data, obtained in 1992, on assessment practices from 251 members of the National Association of School Psychologists (NASP); and faculty in school psychology programs For the practitioner sample, Thematic tests were not amongst the top 10 instruments; for faculty, the TAT was covered by 35% in coursework and by 54% in supervised training. Lees-Haley et al. (1996) USA Forensic evaluation reports by 100 forensic neuropsychology experts Only 6% of „neuropsychology‟ reports included use of TAT (ranked #39 test); CAT not listed. *Rossini & Moretti (1997) USA 50 Directors of APAaccredited clinical psychology training programs shared their views on coursework/coverage of the TAT 30 of these programs provided coverage of the TAT in graduate-level courses; Interpretations of TAT protocols by students were infrequently required; only about 15 programs offered practicum experiences with the TAT; surprisingly, book chapters on the TAT and journal articles were rarely required readings; thus, instruction on the TAT was found to be unstructured. *Culross& Nelson (1997) USA Surveyed 63 instructors listed in NASP-approved graduate programs in school psychology on tests emphasized in personality assessment coursework The TAT and CAT were taught in 71% and 52% of personality assessment courses, respectively. Ackermann & Ackermann (1997) USA Practitioners in court-related custody evaluations In a re-analysis of the findings, Hagen &Castagna (2001) found that the TAT was used in 16% of assessment reports of parents; The CAT was used in 17% of evaluations of children, the Roberts Apperception Test in 7%. Frauenhoffer et al. (1998) USA Surveyed 487 mental health practitioners (psychologists, counselors, social workers) For psychologists, 50% used the TAT and 26% the CAT; however, thematic tests were not popular with either social workers nor professional counselors. Piotrowski et al. (1998) USA 137 practitioners in National Register of Health Service providers in Psychology Tests considered most important to practice: only 15% of psych. practitioners noted the TAT; CAT not recommended. Muniz et al. (1999) Spain, Portugal, & Latin Test use by practicing psychologists Overall, projective methods were quite popular; The TAT was ranked 10th, but more emphasized in Argentina than in

America Spain. Boccaccini& Brodsky (1999) USA Diagnostic test usage in personal injury cases by 80 practicing forensic psychologists Although only 9% used the TAT, 67% of respondents endorsed the TAT due to „acceptance within the field‟; 50% based on „research support‟. *Piotrowski & Belter (1999) USA Extent of graduate-level assessment curriculum was reported by training directors from 84 APA-approved internship settings 76% of these internship sites provided training on TAT; 23% on the Roberts Apperception Test; however, only 10% of these directors considered the TAT essential for practice. Camara et al. (2000) USA 179 practitioners, mostly clinical psychologists regarding test usage Neuropsychologists shunned thematic tests; but clinical psychologists valued the TAT (ranked 6th) and, to a lesser degree, the CAT (16th). Archer & Newsom (2000) USA 346 psychologists, working with adolescents The TAT (ranked #4) was used by 63% of respondents; Roberts Apperception Test used by 40% (ranked #19); Interestingly, CAT not listed amongst top 30 test. *Stedman et al. (2000) USA 324 internship directors across a variety of mental health settings Directors had favorable attitudes for the TAT and picture-story tests to be included in „integrated‟ assessment. Boothby & Clements (2000) USA Correctional (prison) psychologists Thematic tests were not amongst the top 20 assessment instruments. *Clemence& Handler (2001) USA Surveyed 382 internship settings on use and training of psychological tests Internship directors supported graduatelevel preparation in projective assessment; 56% recommended competency and inclusion for the TAT in „Testing battery‟. Muniz et al. (2001) European (Spain, UK, Holland, Slovenia, Croatia, Belgium) 3,455 professional psychologists use of psychological tests In 5 of the 6 countries, projective tests were not popular; in Belgium, the TAT and CAT were noted by 16%, and 10% of professionals. Luiselli et al. (2001) USA Assessment for autism reported by 100 practitioners in national service centers for developmental disabilities in 30 states 27% of service centers use the TAT in the treatment of autism. *Belter & Piotrowski (2001) USA Survey data on 82 directors of APA-approved doctoral clinical/professional psychology training programs on assessment curriculum Nearly 60% of the programs required a specific course on projective testing; The TAT was amongst the most emphasized (by 70% of directors). *Childs &Eyde (2002) USA Course syllabi data, from 84 APA clinical psychology programs, determined coverage of projective assessment techniques 71% of programs indicated that the TAT should be a key component in the assessment curriculum. Cashel (2002) USA 162 child & adolescent practitioners in outpatient, 56% of respondents use the TAT (ranked 19th) to some degree; 48% use

hospital and school settings the CAT; 34% use the Roberts Apperception Test. *Stedman et al. (2002) USA Based on survey data from 334 psychology interns, determined extent of preinternship assessment report writing experiences Results showed that clinical students met or exceeded most expectations of internship training directors by producing a median of 18 integrated testing reports; however, reports including the TAT were a few (M=1.5). Bow et al. (2002) USA 84 psychologists reported on assessment practices regarding sexual abuse in child custody cases The TAT was used in 15% of assessments of accusing parents and alleged perpetrators. Demaray et al. (2003) USA Surveyed over 316 school psychologists on assessment practices in ADHD Although 30% supported projective assessment, less than 5% noted the CAT, TAT, or Roberts test. Lally (2003) USA 64 Diplomate-status forensic psychologists, test use in court-related evaluations TAT was deemed „unacceptable‟ by 77% of sample across several forensic domains.

Ryba et al. (2003) USA Psychologists‟ test usage in juvenile competency to stand trial evaluations Projective tests were infrequently employed; only 12% reported using the TAT. Shapiro &Heick (2004) USA Determined assessment practices of 648 school psychologists (NASP members) The TAT was used occasionally across recent cases involving psychological assessment issues. Echemendia& Harris (2004) USA Test use practices of 911 neuropsychologists No Projective techniques were amongst top tests used. Anderson &Paulosky (2004) USA Diagnostic assessment practices of 95 „eating disorder‟ specialists Although 75% of the respondents rely on self-report measures, only 10% use any projective techniques. Rabin et al. (2005) USA/ Canada Assessment practices of 747 clinical neuropsychologists Only the Rorschach was amongst the top 40 tests in neuropsychological assessment. de Oliveira et al. (2005) Brazil 35 professional psychologists CAT-Human, used by 57%, ranked #1; TAT infrequently emphasized. Hojnoski et al. (2006) USA 170 school psychologists reported use of projective tests TAT used by 31% of respondents, mostly for diagnostic purposes & treatment planning; 16% use the CAT. Archer et al. (2006) USA 152 forensic psychologists‟ use of projective techniques in court-related assessments 54% of respondents (n=54) use the TAT at least „occasionally‟ in forensic evaluations of adults; The CAT was not popular in child forensic assessment. Koonce (2007) USA 246 NASP members were surveyed on selection of tests in ADHD assessment For direction for selection of ADHD test battery, none of the „thematic‟ tests were used. Herzberg &Mattar (2008) Brazil Clinical psychology faculty use of projective tests in practice, University of Sao Paulo TAT ranked #1, used by 73% of faculty; the CAT-Human figures by 15%. Madaus et al. (2009) USA Assessment practices reported by 164 „special Apparently, projective techniques are not used in the assessment of socialeducation‟ directors in school districts in 5 northeastern states emotional behavior in „special education‟ milieu. Ogawa et al. (2010) Japan 237 Japanese psychologists in practice TAT not listed in the top 20 tests used in Japan in 2010; in the prior 2004 survey, TAT used only by 8% of sample. Smith et al. (2010) USA 404 members of the International Neuropsychological Society or National Academy of Neuropsychology surveyed on personality assessment practices The TAT was occasionally used by about 30% of the sample in personality assessment, but not highly ranked. Donoso et al. (2010) USA 150 professionals who conduct vocational rehabilitation evaluations Overall, projective techniques were relied upon infrequently; TAT was used by 28% of respondents, ranked #18. Raez (2011) Peru University psychologists in Lima, and members of the Peru Society of Rorschach & Projective Methods 92% of the sample use projective techniques; 43% rely on TAT; 41% on CAT. Ackermann &Pritzl (2011) USA 213 forensic psychologists surveyed on tests used with parents in child custody evaluations 29% of the sample use the TAT in assessment of parents. Evers et al. (2012) European countries Study conducted in 2009; sample included 12,606 professional psychologists regarding testing practices; data analysis based on 400 respondents Projective tests were not ranked highly in 6 countries (Netherlands, Norway, Sweden, UK, Croatia, Germany). Turkey was the only European country with TAT usage, but rather infrequently, 7%. *Neukrug et al. (2013) USA Based on survey data from 210 counselor educators across the U.S., this study examined graduate-level coverage of assessment instruments by instructors 93% of instructors report teaching emphasis with the TAT, which was ranked 12th. Peterson et al. (2014) USA 926 counselors (clinical mental health, school, occupational) rated tests of all types regarding usage Amongst a copious set of testing instruments, the TAT seems to be used moderately (ranked 40th); the CAT occasionally (ranked 70th). Neal &Grisso (2014) International sample: USA (45%), Canada (7%), Europe (3%), Australia- New Zealand (4%) 434 forensic examiners of professional organizations Across a variety of forensic/legal domains, a myriad of testing instruments was used; however, the only projective test noted was the Rorschach. *Ready &Veague (2014) USA Compared training in psychological assessment across 3 training models (Clinical-Science, Scientist- Although the response-rate was rather low (33%), no projective tests ranked in the top 10; only practitioner-scholar programs offer limited coverage on

Practitioner, Practitioner- Scholar) in APA-Accredited programs projective techniques; younger faculty express little interest or competency in teaching specific projective techniques. Sotelo- Dynega& Dixon (2014) USA Cognitive assessment practices of 323 school psychologists A variety of IQ, achievement tests, and educational measures were popular; no projective tests were noted. Wechsler et al. (2014) Iberian/Latin -American countries Test development & usage in Portugal, Spain, Argentina, Venezuela, and Brazil Projective tests very popular in Venezuela; Rorschach somewhat popular in Brazil and Argentina; Spain and Portugal indicated low usage of projective tests. Thematic tests are not amongst the top tests used by practitioners in any of these countries. Rabin et al. (2016) USA & Canada Testing practices of 512 neuropsychologists; members of INS and NAN Among Top tests for „personality assessment‟; TAT ranked 14th, but used infrequently (1%). *Ready et al. (2016) USA & Canada Views of Directors of internship settings on preinternship preparation in assessment; Data based on 236 APPIC sites Overall, the majority of directors indicated that professional academic programs do not adequately prepare students for assessment activities on internship; 28% of sites offer training in the TAT. Wright et al. (2016) USA 279 members of APA in practice, with an interest in Assessment; Data based on low response rate (17%) 49% indicated use of projective techniques other than the Rorschach (TAT data not specifically reported); 54% use the Rorschach. *Mihura et al. (2016) USA Of 244 APA-accredited doctoral clinical psychology programs, 83 usable surveys were analyzed The survey, in a general fashion, inquired about „coverage‟ in assessment courses and practicum; authors concluded that instruction emphasized “breadth at the expense of depth”; TAT „covered‟ in 63% of programs; only 8 programs (15%) taught formal coding for the TAT. *Stedman et al. (2017) USA APPIC internship programs reported on „Assessment‟ training offered and on preinternship expectations of testing competency 72% of programs (adult focused) desire pre-internship training in assessment; in mixed-programs (adults/children), 35% offer training in „Story‟ techniques. Note. Studies (n=16) marked with asterisk (*) focused on graduate/internship training. References: Ackerman, M.J., & Ackerman, M.C. (1997). Custody evaluation practices: A survey of experienced professionals. Professional Psychology: Research and Practice, 28, 137-145. Ackerman, M.J., &Pritzl, T.B. (2011). Child custody evaluation practices: A 20-year follow-up. Family Court Review, 49(3), 618-628. Anderson, D.A., &Paulosky, C.A. (2004). A survey of the use of assessment instruments by eating disorder professionals in clinical practice. Eating & Weight Disorders, 9(3), 238-241. Anderson, T.K., Cancelli, A., &Kratochwill, T.R. (1984). Self-reported assessment practices of school psychologists: Implications for training and practice. Journal of School Psychology, 22, 17- 29. Archer, R.P., Buffington-Vollum, J.K., Stredny, R.V., & Handel, R.W. (2006). A survey of psychological test use patterns among forensic psychologists. Journal of Personality Assessment, 87, 84-94. Archer, R.P., Maruish, M., Imhof, E.A., & Piotrowski, C. (1991). Psychological test usage with adolescent

clients: 1990 survey findings. Professional Psychology: Research and Practice, 22, 247-252. Archer, R.P., & Newsom, C.R. (2000). Psychological test usage with adolescent clients: Survey update. Assessment, 7(3), 227-235. Aronow, E., Weiss, K.A., &Reznikoff, M. (2013). A practical guide to the Thematic Apperception Test: The TAT in clinical practice. New York: Bruner-Routledge. Bartram, D., & Coyne, I. (1998). Variations in national patterns of testing and test use: The ITC/EFPA international survey. European Journal of Psychological Assessment, 14(3), 249-260. Basu, J. (2014). Psychologists‟ ambivalence toward ambiguity: Relocating the projective test debate for multiple interpretative hypotheses. SIS Journal of Projective Psychology & Mental Health, 21, 25-36. Belter, R.W., & Piotrowski, C. (2001).Current status of doctoral-level training in psychological testing.Jour. of Clin. Psych., 57, 717-726. Belter, R.W., Piotrowski, C. (1999). Current status of master‟s-level training in psychological assessment. Journal of Psychological Practice, 5(1), 1-5. Beutler, L.E., Williams, R.E., Wakefield, P.J., &Entwistle, S.R. (1995).Bridging scientist and practitioner perspectives in clinical psychology. American Psychologist, 50, 984-994. Blatt, S.J. (1975). The validity of projective techniques and their research and clinical contribution. Journal of Personality Assessment, 39, 327-343. Boccaccini, M.T., & Brodsky, S.L. (1999).Diagnostic test usage by forensic psychologists in emotional injury cases. Professional Psychology: Research and Practice, 30, 253-259. Boothby, J.L., & Clements, C.B. (2000).A national survey of correctional psychologists. Criminal Justice and Behavior, 27, 716-732. Borum, R., &Grisso, T. (1995).Psychological test use in criminal forensic evaluations. Professional Psychology: Research and Practice, 26, 465-473. Bow, J.N., Quinnell, F.A., Zaroff, M., &Assemany, A. (2002).Assessment of sexual abuse allegations in child custody cases. Professional Psychology: Research and Practice, 33, 566-575. Brown, W.R., & McGuire, J.M. (1976). Current psychological assessment practices. Professional Psychology, 7, 475-484. Bubenzer, D.L., Zimpfer, D.G., &Mahrle, C.L. (1990).Standardized individual appraisal in agency and private practice: A survey. Journal of Mental Health Counseling, 12, 51-66. Butcher, J.N. (2006). Assessment in clinical psychology: A perspective on the past, present challenges, and future prospects. Clinical Psychology: Science and Practice, 13(3), 205-209. Butler, M., Retzlaff, P., &Vanderploeg, R. (1991).Neuropsychological test usage. Professional Psychology: Research and Practice, 22(6), 510-512. Camara, W.J., Nathan, J.S., & Puente, A.E. (2000). Psychological test usage: Implications in professional psychology. Professional Psychology: Research and Practice, 31, 141-154. Cashel, M.L. (2002). Child and adolescent psychological assessment: Current clinical practices and the impact of managed care. Professional Psychology: Research and Practice, 33(5), 446- 453. Chan, D.W., & Lee, H.B. (1995).Patterns of psychological test usage in Hong Kong in 1993. Professional Psychology: Research and Practice, 26, 292-297. Chandler, L.A. (2003). The projective hypothesis and the development of projective techniques for children. In C.R. Reynolds & R.W. Kamphaus (Eds.), Handbook of psychological and educational assessment of children: Personality, behavior, and context (2nd ed., pp. 51-65). New York: Guilford Press. Childs, R., &Eyde, L. (2002). Assessment training in clinical psychology doctoral programs: What should we teach? What do we teach? Journal of Personality Assessment, 78, 130-144. Clark, A.J. (1995). Projective techniques in the counseling process. Journal of Counseling and Development, 73(3), 311-316. Clemence, A., & Handler, L. (2001). Psychological assessment on internship: A survey of training directors and their expectations for students. Journal of Personality Assessment, 76, 18-47. Craig, R.J., & Horowitz, M. (1990).Current utilization of psychological tests at diagnostic practicum sites.The Clini.Psychst, 43, 29-36. Crenshaw, D.A., Bohn, S., Hoffman, M.R., Matheus, J.M., & Offenbach, S.G. (1968). The use of projective methods in research: 1947-1965. Journal of Projective Techniques & Personality Assessment, 32(1), 3-9. Culross, R.R., & Nelson, S. (1997). Training in personality assessment in specialist-level school psychology programs. Psychological Reports, 81, 119-124. Dana, R.H. (1996). The Thematic Apperception Test (TAT). In C.S. Newmark (Ed.), Major psychological assessment instruments (2nd ed., pp. 166-205). Boston, MA: Allyn and Bacon. Demaray, M.K., Schaefer, K., & Delong, L.K. (2003). Attention-deficit/hyperactivity disorder (ADHD): A national survey of training and current assessment practices in the schools. Psychology in the Schools, 40(6), 583-597. de Oliveira, K.L., Noronha, A.P., Dantas, M.A., & Santarem, E.M. (2005). The use of psychological techniques and instruments for behavioral psychologists.PsicologiaemEstido, Maringa, 10(1), 127-135. Donoso, O.A., Hernandez, B., &Horin, E.V. (2010).Use of psychological tests within vocational rehabilitation. Journal of Vocational Rehabilitation, 32, 191-200.

Duffy, J.N. (1993). Utility of the Thematic Apperception Test as an aid to personality assessment.Dissertation Abstracts International, 54, 1711. Dupree, J.L., &Prevatt, F. (2003).Projective storytelling techniques. In C.R. Reynolds & R.W. Kamphaus (Eds.), Handbook of psychological and educational assessment of children: Personality, behavior, and context (2nd ed., pp. 66-90). NY: Guilford Press. Durand, V., Blanchard, E., & Mindell, J. (1988). Training in projective testing: Survey of clinical training directors and internship directors. Professional Psychology: Research and Practice, 19, 236-238. Echemendia, R.J., & Harris, J.G. (2004). Neuropsychological test use with Hispanic/Latino populations in the U.S.: Part II of a national survey. Applied Neuropsychology, 11, 4-12. Elosua, P., & Iliescu, D. (2012). Tests in Europe: Where we are and where we should go. International Journal of Testing, 12, 157-175. Evers, A., Muniz, J., Bartram, D., et al. (2012). Testing practices in the 21st century: Developments and European psychologists‟ opinions. European Psychologist, 17(4), 300-319. Evers, A., &Zaal, J.N. (1982).Trends in test use in The Netherlands. International Review of Applied Psychology, 31, 35-53. Fee, A.F., Elkins, G.R., & Boyd, L. (1982). Testing and counseling psychologists: Current practices and implications for training. Journal of Personality Assessment, 46, 116-118. Fisher, S. (1967). Projective methodologies. Annual Review of Psychology, 18, 165-191. Flanagan, R., & Motta, R.W. (2007). Figure drawings: A popular method. Psychology in the Schools, 44(3), 257-270. Frank, L. (1948). Projective methods. Springfield, IL: C.C. Thomas. Frauenhoffer, D., Ross, M.J., Gfeller, J., Searight, H.R., & Piotrowski, C. (1998). Psychological test usage among licensed mental health practitioners: A multidisciplinary survey. Journal of Psychological Practice, 4, 28-33. Garb, H.N., Wood, J.M., Lilienfeld, S.O., &Nezworski, M.T. (2002). Effective use of projective techniques in clinical practice: Let the data help with selection and interpretation. Professional Psychology: Research and Practice, 33, 454-463. Garfield, S.L., & Kurtz, R.M. (1973). Attitudes toward training in diagnostic testing: A survey of directors of internship training. Journal of Consulting and Clinical Psychology, 40, 350-355. Gendreau, P. (1975). Psychological test usage in corrections. Canadian Journal of Criminology and Corrections, 17(3), 215-220. Goh, D.S., Teslow, C.J., & Fuller, G.B. (1981).The practice of psychological assessment among school psychologists. Professional Psychology, 12, 696-706. Groth-Marnat, G. (2009). Handbook of personality assessment (5thed.). Hoboken, NJ: Wiley. Hagen, M.A., &Castagna, N. (2001). The real numbers: Psychological testing in custody evaluations. Professional Psychology: Research and Practice, 32, 269-271. Handler, L., &Hilsenroth, M. (Eds.).(1998). Teaching and learning personality assessment. Mahwah, NJ: Erlbaum. Handler, L., & Smith, J.D. (2013). Education and training in psychology assessment. In J.R. Graham, J.A. Naglieri, & I.B. Weiner (Eds.), Handbook of psychology, Vol. 10: Assessment psychology (2nd ed., 211-238). Hoboken, NJ: Wiley. Harrison, P.L., Kaufman, A.S., Hickman, J.A., & Kaufman, N.L. (1988). A survey of tests used for adult assessment. Journal of Psychoeducational Assessment, 6, 188-198. Harwood, T.M., Beutler, L.E., &Groth-Marnat, G. (2011). Integrative assessment of adult personality (3rded.). New York: Guilford Press. Haynes, J.P., & Peltier, J. (1983). Psychological assessment practices in juvenile forensic settings. Psychological Reports, 52, 759-762. Herzberg, E., &Mattar, A. (2008). Clinical instruments used in the department of clinical psychology of USP: 10 years later. Boletim de Psicologia, 58, 1- 11. Hinkle, J.E., Nelson, S.E., & Miller, D. (1968).Psychological test usage by psychologist psychotherapists in private practice. Psychotherapy: Theory, Research, and Practice, 5(4), 210-213. Hopwood, C.J., & Bornstein, R.F. (Eds.).(2014). Multimethod clinical assessment. New York: Guilford Press. Hojnoski, R.L., Morrison, R., Brown, M., & Matthews, W.J. (2006). Projective test use among school psychologists: A survey and critique. Journal of Psychoeducational Assessment, 24, 145-159. Hughes, T.L., McGoey, K.E., & Owen, P. (2010).The importance of personality assessment in school psychology training programs. In E. Garcia- Vasquez, T.D. Crespi, & C.A. Riccio (Eds.), Handbook of education, training, and supervision of school psychologists in school and community, Vol. 1: Foundations of professional practice (pp. 185-211). New York: Routledge. Hutton, J.B., Dubes, R., Muir, S. (1992). Assessment practices of school psychologists: Ten years later. School Psychology Review, 21, 271-284. Ivnik, R.J. (1977). Uncertain status of psychological tests in clinical psychology. Professional Psychology, 8(2), 206-213. Keddy, P., & Piotrowski, C. (1992).Testing in psychotherapy practice: Literature review survey, and commentary. Journal of Training & Practice in Professional Psychology, 6(1), 30-39.

Keiser, R.E., & Prather, E.N. (1990). What is the TAT? A review of ten years of research. Jr. of Personality Assessment, 55, 800-803. Kennedy, M.L., Faust, D., Willis, W.G., & Piotrowski, C. (1994). Social-emotional assessment practices in school psychology. Journal of Psychoeducational Assessment, 12, 228-240. Klopfer, W.G., &Taulbee, E.S. (1976).Projective tests. Annual Review of Psychology, 27, 543-567. Kolbe, K., Shemberg, K., & Leventhal, D. (1985).University training in psychodiagnostics and psychotherapy.The Clini.Psyst, 38, 59-61. Koonce, D.A. (2007). Attention deficit hyperactivity disorder assessment practices by practicing school psychologists. Journal of Psychoeducational Assessment, 25(4), 319-333. Lally, S.J. (2003). What tests are acceptable for use in forensic evaluations? A survey of experts. Professional Psychology: Research and Practice, 34, 491-498. Lees-Haley, P.R., Smith, H., Williams, C.W., & Dunn, J.T. (1996). Forensic neuropsychological test usage: An empirical survey. Archives of Clinical Neuropsychology, 11(1), 45-51. Lilienfeld, S.O., Lynn, S.J., &Lohr, J.M. (2015). Science and pseudoscience in clinical psychology (2nded.). New York: Guilford Press. Lilienfeld, S.O., Wood, J.M., & Garb, H.N. (2000).The scientific status of projective techniques. Psychological Science in the Public Interest, 1(2), 27-66. Lubin, B., Larsen, R.M., &Matarazzo, J.D. (1984), Patterns of psychological test usage in the United States: 1935-1982. American Psychologist, 39, 451-454. Lubin, B., Wallace & Payne (1971). Patterns of psychological test use in the United States: 1935- 1969. Profesal. Psychology, 2, 70-74. Luiselli, J.K., Campbell, S., Cannon, B., et al. (2001). Assessment instruments used in the education and treatment of persons with autism: Brief report of a survey of national service centers. Research in Developmental Disabilities, 22, 389-398. Madaus, J., Rinaldi, C., Bigaj, S., &Chafouleas, S.M. (2009). An examination of current assessment practices in northeastern school districts. Assessment for Effective Intervention, 34(2), 86- 93. Martin, M., Allan, A., & Allan, M.M. (2001).The use of psychological tests by Australian psychologists who do assessments for the courts. Australian Journal of Psychology, 53(2), 77-82. McCully, R.S. (1965). Current attitudes about projective techniques in APA-approved internship training centers. Journal of Projective Techniques and Personality Assessment, 29(3), 271-280. McGrath, R.E., & Carroll, E.J. (2012).The current status of “projective tests”. In H. Cooper et al. (Eds.), APA handbook of research methods in psychology, Vol. 1: Foundations, planning, measures, and psychometrics (pp. 329-348). Washington, DC: American Psychological Association. McLaughlin, J.L., &Kan, L.Y. (2014). Test usage in four common types of forensic mental health assessment. Professional Psychology: Research and Practice, 45(2), 128-135. Meyer. G.J., Finn, S.E., Eyde, L.D, et al. (2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist, 56(2), 128-165. Mihura, J.L., Roy, M., &Graceffo, R.A. (2016).Psychological assessment training in clinical psychology doctoral programs. Journal of Personality Assessment, 98(6), 745-754. Miller, D.N., & Nickerson, A.B. (2007).Projective techniques and the school-based assessment of childhood internalizing disorders. SIS Journal of Projective Psychology & Mental Health, 14, 48- 58. Muniz, J., Bartram, D., Evers, A., et al. (2001). Testing practices in European countries. European J. of Psychological Assessment, 17(3), 201-211. Muniz, J., Prieto, G., Almeida, L., & Bartram, D. (1999). Test use in Spain, Portugal and Latin American countries. European Journal of Psychological Assessment, 15(2), 151-157. Murstein, B.I. (1965). Handbook of projective techniques. Oxford, UK: Basic Books. Neal, T., &Grisso, T. (2014). Assessment practices and expert judgment methods in forensic psychology and psychiatry: An international snapshot. Criminal Justice and Behavior, 41, 1406-1421. Neukrug, E., Peterson, C.H., Bonner, M., & Lomas, G. (2013).A national survey of assessment instruments taught by counselor educators. Counselor Education & Supervision, 52, 207-219. Newmark, C.S. (1996). Major psychological assessment instruments (2nded.). Boston, MA: Allyn and Bacon. Ogawa, T., et al. (2010). Psychological testing practices in Japan: Comparisons between 2010, 2004, and 1986. Paper presented at the Japanese Psychological Association meeting (for full report contact: ogawa.toshiki.ke@u.tsukuba.ac.jp). Ogawa, T., & Piotrowski, C. (1992). Clinical psychological test usage in Japan: A comparative study with a survey in the U.S.A. Tsukuba Psychological Research, 14, 151-158. Peterson, C.H., Lomas, G.I., Neukrug, E.S., & Bonner, M.W. (2014). Assessment use by counselors in the United States: Implications for policy and practice. Journal of Counseling & Development, 92, 90-99. Pinkerman, J.E., Haynes, J.P., & Keiser, T. (1993).Characteristics of psychological practice in juvenile court clinics. American Journal of Forensic Psychology, 11(2), 3-12. Piotrowski, C. (2016). Bender-Gestalt Test usage worldwide: A review of 30 practice-based studies.

SIS Journal of Projective Psychology & Mental Health, 23(2), 73-81. Piotrowski, C. (2015a). Projective techniques usage worldwide: A review of applied settings 1995- 2015. Journal of the Indian Academy of Applied Psychology, 41(3), 9-19. Piotrowski, C. (2015b). Clinical instruction on projective techniques in the USA: A review of academic training settings 1995-2014. Journal of Projective Psychology & Mental Health, 22(2), 83-92. Piotrowski, C. (2015c). On the decline of projective techniques in professional psychology training. North American Journal of Psychology, 17(2), 259-265. Piotrowski, C. (2007). Forensic psychological testing as a function of affiliation and organizational setting. Organization Development Journal, 25(1), 94-98. Piotrowski, C. (1999). Assessment practices in the era of managed care: Current status and future directions. Journal of Clinical Psychology, 55, 787-796. Piotrowski, C. (1985). Clinical assessment: Attitudes of the Society for Personality Assessment membership. Southern Psychologist, 2(4), 80-83. Piotrowski, C. (1984). The status of projective techniques. Journal of Clinical Psychology, 40, 1495-1502. Piotrowski, C., & Belter, R.W. (1999). Internship training in psychological assessment: Has managed care had an impact? Assessment, 6(4), 381-389. Piotrowski, C., Belter, R.W., & Keller, J.W. (1998). The impact of “Managed Care” on the practice of psychological testing: Preliminary findings. Journal of Personality Assessment, 70, 441-447. Piotrowski, C., & Keller, J.W. (1992). Psychological testing in applied settings: A literature review from 1982-1992. Journal of Training & Practice in Professional Psychology, 6(2), 74-82. Piotrowski, C., & Keller, J.W. (1989). Psychological testing in outpatient mental health facilities: A national survey. Professional Psychology: Research and Practice, 20, 423-425. Piotrowski, C., & Keller, J.W. (1989).Use of assessment in mental health clinics and services.Psychological Reports, 64, 1298. Piotrowski, C., & Keller, J.W. (1984).Psychodiagnostic testing in APA-approved clinical psychology programs. Professional Psychology: Research and Practice, 15, 450-456. Piotrowski, C., & Keller, J.W. (1984).Attitudes toward clinical assessment by members of the AABT. Psychological Reports, 55, 831-838. Piotrowski, C., & Keller, J.W. (1978).Psychological test usage in southeastern outpatient mental health facilities in 1975. Professional Psychology, 9, 63- 67. Piotrowski, C., Keller, J.W., & Ogawa, T. (1993). Projective techniques: An international perspective. Psychological Reports, 72, 179-182. Piotrowski, C., &Zalewski, C. (1993).Training in psychodiagnostic testing in APA-Approved PsyD and PhD clinical psychology programs. Journal of Personality Assessment, 61(2), 394-405. Pruitt, J.A., Smith, M., Thelen, M.H., &Lubin, B. (1985). Attitudes of academic clinical psychologists toward projective techniques: 1968-1983. Professional Psychology: Research and Practice, 16, 781-788. Rabin, L.A. (1986). Projective techniques for adolescents and children. New York: Springer. Rabin, L.A., Paolillo, E., & Barr, W.B. (2016). Stability in test-usage practices of clinical neuropsychologists in the U.S. and Canada over a 10-year period. Archives of Clinical Neuropsychology, 31, 206-230. Rabin, L., Barr, W.B., & Burton, M. (2005). Assessment practices of clinical neuropsychologists in the United States and Canada: A survey of INS, NAN, and APA Division 40 members. Archives of Clinical Neuropsychology, 20, 33-65. Raez de Ramirez, M. (2011).Latin-American perspectives on projective techniques, Rorschach diagnostics, and evaluation of personality. Data based on Symposium presented by the author: Lima, Peru. Raez de Ramirez, M. (1999).The present situation about the teaching of the Rorschach and other projective tests in Peru.Revista de Psicologia, 17(2), 147-167. Rapaport, D., Gill, M.M., & Schafer, R. (1968). Diagnostic psychological testing (rev. ed.). New York: International Universities Press. Ready, R.E., Santorelli, G.D., Lundquist, T.S., & Romano, F.M. (2016).Psychology internship directors‟ perceptions of pre-internship training preparation in assessment. North American Journal of Psychology, 18(2), 317-334. Ready, R.E., &Veague, H.B. (2014). Training in psychological assessment: Current practices of clinical psychology programs. Professional Psychology: Research and Practice, 45, 278-282. Retzlaff, P. (1992). Professional training in psychological testing: New teachers and new tests. Journal of Training & Practice in Professional Psychology, 6(1), 45-50. Reynolds, W.M. (1979). Psychological tests: Clinical usage versus psychometric quality. Professional Psychology, 10, 324-329. Riccio, C.A., & Rodriguez, O.L. (2007). Integration of psychological assessment approaches in school psychology. Psychology in the Schools, 44(3), 243-255. Rossini, E.D., & Moretti, R.J. (1997). Thematic Apperception Test (TAT) interpretation: Practice recommendations from a survey of clinical psychology doctoral programs accredited by the APA. Professional Psychology: Research and Practice, 28, 393-398. Ryba, N.L., Cooper, V.G., & Zapf, P.A. (2003). Juvenile competence to stand trial evaluations: A survey of current practices and test usage among psychologists. Professional Psychology: Research and Practice, 34(5), 499-507.

Schneider, M.F., &Perney, J. (1990).Development of the Children‟s Apperceptive Story-Telling Test. Psychcal Assent, 2(2), 179-185. Shapiro, E.S., &Heick, P.F. (2004). School psychologist assessment practices in the evaluation of students referred for social/behavioral/emotional problems. Psychology in the Schools, 41(5), 551- 561. Sharpley, C.F., & Pain, M.D. (1988).Psychological test usage in Australia. Australian Psychologist, 23(3), 361-369. Shemberg, K., & Keeley, S. (1970). Psychodiagnostic training in the academic setting: Past and present. Journal of Consulting and Clinical Psychology, 34, 205-211. Smith, D., & Dumont, F. (1995). A cautionary study: Unwarranted interpretations of the Draw-A- Person test. Professional Psychology: Research and Practice, 26, 298-303. Smith, S.R., Gorske, T., Wiggins, C., & Little, J.A. (2010).Personality assessment use by clinical neuropsychologists. International Journal of Testing, 10, 6-20. Sotelo-Dynega, M., & Dixon, S.G. (2014). Cognitive assessment practices: A survey of school psychologists. Psychology in the Schools, 51(10), 1031-1045. Stedman, J.M., et al. (2017). Availability of training in psychological assessment at internship sites.Journal of Training and Education in Professional Psychology, in press. Stedman, J.M., Hatch, J.P., &Schoenfeld, L.S. (2002). Pre-internship preparation of clinical and counseling students in psychological testing, psychotherapy, and supervision: Their readiness for medical school and non-medical school internships. Journal of Clinical Psychology in Medical Settings, 9, 267-271. Stedman, J.M., Hatch, J.P., &Schoenfeld, L.S. (2000). Pre-internship preparation in psychological testing and psychotherapy: What internship directors say they expect. Professional Psychology: Research and Practice, 31, 321-326. Stinnett, T.A., Havey, J.M., &Oehler-Stinnett, J. (1994). Current test usage by practicing school psychologists: A national survey. Journal of Psychoeducational Assessment, 12, 331-350. Sundberg, N. (1961). The practice of psychological testing in clinical services in the United States. American Psychologist, 16, 79-83. Sweeney, J.A., Clarkin, J.F., & Fitzgibbon, M.L. (1987).Current practice of psychological assessment. Professional Psychology: Research and Practice, 18, 377-380. Swensen, C. (1968). Empirical evaluations of human figure drawings: 1957-1966. Psychological Bulletin, 70, 20-44. Thelen, M.H., Varble, D.L., & Johnson, J. (1968).Attitudes of academic clinical psychologists toward projective techniques. American Psychologist, 23, 517-521. Tsoi, M.M., &Sundberg, N.D. (1989).Patterns of psychological test use in Hong Kong. Professional Psychology: Research and Practice, 20, 248-250. Tuma, J.M., & Pratt, J. (1982). Clinical child psychology practice and training: A survey. Journal of Clinical Child Psychology, 11, 27-34. Vukovich, D.H. (1983). The use of projective assessment by school psychologists. School Psychology Review, 12, 358-364. Wade, T.C., & Baker, T.B. (1977). Opinions and use of psychological tests: A survey of clinical psychologists. American Psychologist, 32, 874- 882. Watkins, C.E., Campbell, V.L., & Manus, M. (1990).Personality assessment training in counseling psychology programs. Journal of Personality Assessment, 55, 380-383. Watkins, C.E., Campbell, V.L., & McGregor, P. (1988). Counseling psychologists‟ use of and opinions about psychological tests: A contemporary perspective. The Counseling Psychologist, 16, 476-486. Watkins, C.E., Campbell, V.L., Nieberding, R., & Hallmark, R. (1995).Contemporary practice of psychological assessment by clinical psychologists. Professional Psychology: Research and Practice, 26, 54-60. Wechsler, S.M., Oakland, T., Leon, C., et al. (2014). Test development and use in five Iberian Latin American countries. International Journal of Psychology, 49(4), 233-239. Weiner, I.B., & Greene, R.L. (2008).Handbook of personality assessment. New York: Wiley. Wilson, M.S., &Reschly, D.J. (1996).Assessment in school psychology training and practice. School Psychology Review, 25(1), 9-23. Wood, J.M., Garb, H.N., Lilienfeld, S.O., &Nezworski, M.T. (2002).Clinical assessment. Annual Review of Psychology, 53, 519-543. Woolford, J., Patterson, T., Macleod, E., Hobbs, L., & Hayne, H. (2015). Drawing helps children to talk about their presenting problems during a mental health assessment. Clinical Child Psychology and Psychiatry, 20, 68-83. Wright, C.V., Beattie, S.G., Galper, D.I., et al. (2016). Assessment practices of professional psychologists: Results of a national survey. Professional Psychology: Research and Practice, 47, 236-249. Ziskin, J. (1995). Coping with psychiatric and psychological testimony, Vol. (5th ed., Challenging personality testing: The Rorschach & other projective methods, pp. 866-870). Los Angeles, CA: Law and Psychology Press.

Blood Pressure Variations and Emotional Dampening: Preliminary Evidence for the Curvilinear Relationship Dharmendra Jain, Meenakshi Shukla and Rakesh Pandey The present study attempts to validate and extend the earlier findings linking blood pressure (BP) and reduced emotion recognition ability i.e., emotional dampening (ED). Twenty normotensive participants had their BP readings taken via an automated BP monitor and were subsequently assessed on a task of Facial Emotion Recognition. Bivariate linear correlations revealed that both SBP and DBP were associated with poor emotion recognition (i.e., ED). Partial Least Square Modelling showed that ED was also linked with a single latent measure of BP and BP related emotional dampening occurs more for positive and negative non-aroused emotions as compared to negative aroused emotions. Further, when the link of ED and BP was tested under the assumption of non-linearity (quadratic), the correlation of emotion recognition accuracy with SBP and DBP not only increased substantially in magnitude but some of the previously non-significant correlations became significant. This observation provides support for a quadratic relationship between BP and ED and implies that ED occurs for both higher and lower levels of BP. Researchers have recognized for a long time that emotional factors, particularly negative emotional states and psychological stress, may lead to development of hypertension (Somova, et al., 1995; Everson,et al., 1998; Rutledge & Hogan, 2002; Player, et al., 2007). However, the observation that elevation in blood pressure (BP) and hypertension may lead to emotional impairment is relatively a recent one. During the beginning of the 21st century a number of researchers observed that individuals with hypertension showed a reduction in pain sensitivity and an increase in pain threshold (e.g., Bruehl& Chung, 2004) whereas individuals with low blood pressure showed an opposite pattern i.e., enhanced pain sensitivity (Duschek, et al., 2009; Duschek, et al., 2008). Similarly, some studies reported that patients with hypertension perceived their negative emotional states and/or psychological stress/distress as less aversive (Nyklíˇcek, et al., 1996, 1998, 1999). These observations suggest that hypertension is associated with reduced emotional responsivity (i.e., emotional dampening) for aversive and negative emotional states such as pain, stress, distress etc. (Bruehl& Chung, 2004; Duschek et al., 2008, 2009; Nyklíˇcek, et al., 1996, 1998, 1999). The studies linking hypertension with enhanced pain threshold and/or reduced aversiveness of negative emotional states, however, do not provide evidence for the possibility that hypertension and/or elevation in blood pressure may dampen the emotional responding for positive emotional valence too. Pury and colleagues (Pury, et al., 2004) empirically tested whether the emotional dampening in response to elevated blood pressure is generalized across emotional valence or not. They tested three predictive models of the emotional impact of elevated blood pressure viz., the ameliorative model, the positivity bias model, and the emotional dampening model. The ameliorative model assumes that elevations in BP result in less negative appraisal of negative emotional stimuli but the appraisal of positive stimuli will not be altered. However, the positivity bias model proposes that elevation in BP is associated with a less negative appraisal of negative stimuli and at the same time increased positive appraisal of positive emotional stimuli. The third model i.e., the emotional dampening model holds that appraisal of both negative and positive emotional stimuli is reduced in individuals with higher resting blood pressure (see Pury et al., 2004 for details). Pury and colleagues (2004) obtained support only for the emotional dampening model of hypertension suggesting that elevation in blood pressure impairs the appraisal of emotional stimuli irrespective of the emotional valence. Dharmendra Jain, D.M. Asst. Professor in Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Email: djaincard@gmail.com, Meenakshi Shukla, M.A.(Psy) Research Scholarand Rakesh Pandey, Ph.D., Professor & Head, (Corresponding author) Dept.of Psychology, Banaras Hindu University, Varanasi-221005 (India), Email: rpan.in@yahoo.com. Keywords: Emotional dampening, blood pressure, hypertension, facial emotion recognition

Subsequent researches supported the emotional dampening-elevated blood pressure relationship using a wide variety of emotion perception tasks (e.g., McCubbin,et al., 2011, 2013; Wilkinson & France, 2009). Further, emotional dampening has also been reported in aged individuals who were at high risk for developing hypertension (McCubbin, et al., 2011) as well as in individuals with parental history of hypertension (Wilkinson & France, 2009). The empirical evidence accumulated so far; thus, provide support for the relationship of blood pressure elevation with emotional dampening. However, the observed mild to moderate magnitude of relationship [correlations ranged from -0.19/-0.22 to -0.35/- 0.36 in some studies (Pury et al., 2004; McCubbin et al.,2011), while in others it ranged from -0.360 to -0.581 (McCubbin, et al, 2013)] suggest other possibilities and explanations. For instance, the obtained mild to moderate correlations suggest that the relationship of BP with emotional dampening is either inherently weak, or the said relationship may be strong but might not have been captured by the statistical methods used. Close examination of the said studies revealed that the correlation between BP and emotional dampening was computed using a statistical method that assumes the relationship between them to be linear. Thus, it is likely that the inherently strong but curvilinear relationship between BP and emotional dampening might have been underestimated. To the best of our knowledge, none of the studies conducted till date have empirically tested and compared the relationship between blood pressure elevation and emotional dampening under the assumption of linearity as well as non-linearity. Almost all the studies examining emotional dampening in relation to blood pressure have assumed the relationship to be a linear one. However, some indirect evidences do point towards the possibility that the emotional dampening – blood pressure relationship may be curvilinear in nature. For example, the observation that low blood pressure is strongly associated with decreased recognition of positive affect (Jorm, 2001) suggests the possibility that reduction in blood pressure may also be associated with emotional dampening. This finding coupled with the observation that emotional dampening occurs in response to elevation in blood pressure (Pury et al., 2004; McCubbin, et al., 2011, 2013) suggests the possibility that emotional dampening may occur at both lower and higher levels of the BP range and the emotional responsiveness may remain intact in between. The observation of ‘‘inverted U-shaped’’ relationship between BP and cognitive performance (e.g., Morris et al., 2002) suggest the possibility that such curvilinear relationship might hold true for performance involving affective domain. However, empirical test of the proposed ‘‘inverted U-shaped’’ relationship between BP and emotional dampening is a striking gap in the existing literature. Moreover, the aforesaid studies demonstrating association between emotional dampening and elevated blood pressure have not presented consistent findings in relation to elevation in Systolic Blood and Diastolic Blood Pressure (SBP & DBP, respectively). For instance, some studies noted a significant relationship of emotional dampening with SBP but not with DBP (e.g., Pury et al., 2004) while others observed the reverse pattern (e.g., McCubbin, et al., 2013). Still others noted that both SBP and DBP correlated significantly with emotional dampening (e.g., McCubbin, et al., 2011). The observed variation in findings questions the validity of conclusion that elevation in BP is associated with emotional dampening and suggests the need to reinvestigate this relationship. Further, the reported variations in findings in relation to SBP and DBP also necessitate exploration of emotional dampening in relation to a composite measure of BP. Given the difference in the biological mechanisms of the SBP and DBP, the sum or average of SBP and DBP would not be an appropriate composite index of BP. However, BP may be modelled as a latent reflective construct with SBP and DBP as indicators. Following this approach, the present study also attempts to

examine the relationship of emotional dampening with a single latent measure of BP reflected in SBP and DBP. Considering the said gaps, the present study attempts to examine the relationship between blood pressure and emotional dampening under the assumption of both linear and curvilinear (Quadratic) relationship. Further, attempt has also been made to test the relationship of various discrete emotion categories (viz., positive, negative aroused and negative non-aroused emotions) with the reflective latent construct of blood pressure using partial least square regression. The effort to examine the link of emotional dampening with a single index of blood pressure would not only help to reconcile the observed inconsistency in findings but also to generalize the findings of blood pressure related emotional dampening. Methods: Participants: Participants were 30 adults (15 male, 15 female) in the age range of 19-50 years (average= 28.31 ± 8.95 years). The ethnic background of all the participants was Asian and they belonged to middle class socio-economic status. To achieve comparability of the findings with previous studies (Pury et al., 2004; McCubbin, et al., 2011, 2013) those participants were excluded whose blood pressure was in the hypertensive range as per the criteria laid down by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7, 2003; Chobanian, et al., 2003). Thus, individuals with a Systolic Blood Pressure (SBP) ≥ 140mmHg and/or Diastolic Blood Pressure (DBP) ≥ 90mmHg were excluded from the present study. Further, individuals having BP in normotensive range but taking anti-hypertensive medication were also excluded. Since a single latent construct of BP (based on SBP and DBP) was to be created in the present study, individuals with atypical BP variations (e.g., high SBP and low DBP or vice-versa) were identified and excluded from the analysis. For this purpose, median split was performed on SBP and DBP measures to form high and low SBP and DBP groups. The participants falling in high SBP and low DBP group or vice-versa (N=8) were excluded from the analysis. Further, two participants (having higher age as compared to others) were also excluded as their inclusion led to unnecessary inflation of the age range. Thus, the final sample comprised of 20 participants (10 male, 10 female) in the age range of 21-44 years (average= 27.85 ± 7.55 years). Materials and Experimental Task: The Facial Emotion Recognition Task comprised of 18 black & white photographs of human faces expressing the six basic emotions of happiness, sadness, fear, anger, surprise, and disgust. The photographs were chosen from a standardized set of photographs displaying posed facial expressions of male and female Indian adult subjects (Mandal & Rai, 1987). These photographs were correctly recognized for the emotion expressed by 70% of the observers and rated on a 7-point scale for distinctiveness of the expressed facial emotion. The stimuli consisted of photographs each for the said emotion categories and an equal number of male and female faces were included. The task (designed in Super Lab 4.0) consisted of 18 trials (3 photographs x 6 basic emotions). In each trial, a facial emotion photograph was presented on the computer screen along with six five-point rating scales (one for each of the six basic emotions). Participants were required to indicate the presence of each of the six emotions in a given facial affect photograph on the five-point rating scale (ranging from ‘1-Not At All Present’ to ‘5-Completely Present’) by encircling an appropriate number of the scale. Procedure: The participants of the study had been asked to refrain from consuming caffeine, alcohol, or performing strenuous exercise for about 2 hours before the experiment. Immediately upon their arrival to the laboratory, participants were requested to sit on a comfortable chair and relax for about 10-15 minutes. Meanwhile, demographic information was collected from them. Following this, three BP (SBP and DBP) measurements were taken from the nondominant arm of the participants using OMRON SEM-1 Automated Blood Pressure Monitor, allowing 2 minutes gap between the readings. The readings were then averaged to determine the final blood pressure reading. Participants were then requested to sit in a chair facing the computer monitor to complete the facial emotion recognition task. Apart from giving verbal instructions about how to complete the task, instructions were also presented on-screen. After ensuring that participants have clarity about how to perform the task, they were given a small practice session with three trials. If any difficulty was noted in the practice session, it was resolved with another practice session. After practice session, the final task was administered. After completion of the task, the recognition accuracy score for each emotion photograph was calculated using the following formula: [(rating on the target emotion/ sum of ratings on all the remaining emotions) x100]. The recognition accuracy score for each discrete emotion was calculated by averaging the scores obtained on the three photographs of that emotion. Further, an average score of all the six emotions was also computed as an index of overall emotion recognition accuracy (irrespective of valence). Based on the empirical observation that for medium and high-intensity facial expressions, fear is consistently confused for surprise but not vice-versa (e.g., Guo, 2012), overall emotion recognition accuracy score excluding the emotions of fear and surprise (i.e. average score of happiness, sadness, anger, and disgust) was also calculated. Further, the emotion recognition accuracy was also scored in accordance with valence and arousal of the emotions. The average scores for ‘happy’ and ‘surprise’ was used as an index of recognition accuracy of Positive Emotions. Similarly, the average scores of ‘anger’ and ‘fear’ represented Negative Aroused Emotions while the average scores of ‘sadness’ and ‘disgust’ were clubbed as negative Non- Aroused Emotions. Results and Discussion: The average resting SBP of the participants ranged from 100-139 mmHg (M= 123.30 ± 9.56 mmHg), while the average resting DBP ranged from 63-88 mmHg (78.25 ± 7.30 mmHg) across the entire sample. The SBP of men ranged from 106-139 mmHg and that of women from 100-127 mmHg. The range of DBP of men was 64-88 mmHg and that of women was 66-88 mmHg. This finding suggests that all the participants were having their BP in the normotensive range and thus the findings of the study would have implications for the emotional correlates of resting state BP variations in the normal range. The link of the BP with emotional dampening (i.e. reduced emotion recognition accuracy) was first tested under the linearity assumption. Findings revealed that the resting SBP and DBP were negatively correlated with the recognition accuracy of various emotions supporting the notion of blood pressure related emotional dampening. However, correlation of none of the emotions with either SBP or DBP reached conventional level of statistical significance except happiness which correlated significantly with both SBP (r= - 0.468, p= 0.037) and DBP (r= - 0.452, p= 0.045). The observed negative correlation of overall emotion recognition accuracy was marginally significant with SBP (r= - 0.418, p= .067) but not with DBP (r= - 0.272, p= .245). The correlation of overall emotion accuracy, obtained for four emotions (i.e., happy, anger, sad, and disgust) after excluding the often confused emotions of fear and surprise, with SBP and DBP resulted in a slight increase in the magnitude of correlation. The pooled emotion recognition accuracy correlated significantly with SBP (r= - 0.454, p= 0.044) but not with DBP (r= - 0.318, p= 0.172). The said pattern of correlation between emotion recognition accuracy and BP clearly indicates that elevation of blood pressure even in the normotensive range is associated with dampened emotional responding as reflected by reduced accuracy in recognizing facial expressions of emotions. Further, these findings corroborate earlier findings that blood pressure related emotional dampening involves both positive and negative emotions and is not limited to any specific emotional

valence (Pury et al., 2004; McCubbin, et al, 2011, 2013). However, unlike the earlier studies, the present study examined the emotional dampening for each of the six basic emotions and it was observed that emotional dampening occurred for all the six basic emotion categories except fear and surprise. One reason for non-observance of emotional dampening for the said two emotions may be the restricted range of scores resulting from confusion of these emotions with each other in their recognition (e.g., Guo, 2012). Here it is worth mentioning that the effect size of the emotional dampening observed for various emotions was though comparable with the correlations observed in earlier studies (Pury et al., 2004; McCubbin, et al., 2011, 2013), none of the correlations were found significant except the correlation of the accuracy of recognition of facial expressions of happiness with BP. Thus, statistically reliable dampening in relation to elevated blood pressure was noted for recognition of happiness only. Another analysis examining the link of recognition accuracy of positive, negative aroused and negative non-aroused emotions with SBP and DBP revealed that both SBP and DBP were correlated negatively with recognition accuracy of positive emotions (r = -.430 & -.414 respectively), negative nonaroused emotions (r = -.406 & -.322 respectively), and negative aroused emotions (r = -.276 & -.025 respectively). However, none of the said correlations were found significant (p>.05) though the magnitude of relationship (effect size) was moderately strong for each of the said relationships except for negative aroused emotions. The said pattern of relationship noted in the present study suggests that emotional dampening though involved all the emotion categories, the dampening was noted more for positive and negative non-aroused emotions and less for negative aroused emotions. This observation is a significant addition to the existing literature dealing with blood pressure related emotional dampening. The observed lower dampening of negative aroused emotions may be explained in terms of the hypersensitivity of hypertensive for such emotions. It has been noted that hypertensive individuals experience and express negative aroused emotions such as anger, hostility etc. more frequently as compared to others (Helmers, et al, 2000; Hosseini,et al, 2011; Guyll & Contrada, 1998; Yan, et al., 2003). This sensitivity to and frequent experience of negative aroused emotions among hypertensives may intrinsically prime them for these emotions which in turn may result in enhanced recognition accuracy (i.e., reduced emotional dampening). The said explanation, however, is fraught with the danger of overgeneralization inasmuch as the present study was conducted on normotensives and not on hypertensive individuals. The relationship of the emotion recognition accuracy with a single latent measure of blood pressure was also examined in the present study using Partial Least Squares (PLS) based structural equation modelling. This analysis was not only helpful to model and test the relationship of a single index of BP with recognition of latent emotion categories but is also more appropriate statistical tool for small sample data.

Two structural relationship models were tested – one relating the latent emotional categories of positive, negative aroused and negative non-aroused emotions with the latent construct of BP and the other linking aroused and non-aroused emotions (irrespective of valence) with blood pressure. Findings revealed that the latent construct of blood pressure significantly predicted dampening of positive and negative non-aroused emotions but not the negative aroused emotions (Fig.1). Moreover, when emotions were grouped based on arousal alone (disregarding valence and excluding the emotions of fear and surprise that were often confused by the participants), both aroused and non-aroused emotions were found be equally dampened by BP (Fig. 2).

Figure1:The relationship of latent construct of blood pressure with recognition accuracy of Positive, Negative Aroused, and Negative Non-Aroused Emotions (* p< .05)

Figure 2: The relationship of latent construct of blood pressure with recognition accuracy of Aroused and Non-Aroused Emotions (*p<.05) The findings of the PLS based modelling provides further support to our correlation based findings that elevated blood pressure is associated with dampened responding for positive and negative non-aroused emotions but not for negative aroused emotions. However, it brings to fore some newer insight into the relationship of BP and emotional dampening. For instance, it suggests that elevated blood pressure is linked with dampening of both aroused (happy and anger) and non-aroused (sad and disgust) emotions when emotional valence is disregarded. However, if valence and arousal both are considered simultaneously then emotional dampening in response to elevated blood pressure occurs for negative nonaroused emotions but not for negative aroused emotions. These observations indicate that arousal and valence interact with each other in determining the emotional dampening impact of BP. However, this speculation needs to be tested in future research using emotional stimuli with calibrated valence and arousal ratings. The findings of the PLS based modelling further add to the existing literature by demonstrating that BP modelled as a single latent construct (reflected in the variations in the SBP and DBP) is associated with emotionally dampened responding particularly for positive and negative non-aroused emotions. Despite the fact that the observed correlations and effect sizes in the present study were as strong as reported in earlier studies (Pury et al., 2004; McCubbin, et al., 2011; 2013), the correlations were not found statistically significant in the present study. One obvious reason for this is the small sample size (N=20) of the study as compared to earlier ones (Pury et al, 2004; N = 65; McCubbin et al., 2013; N = 96; McCubbin et al., 2011; N = 106). The power analysis using a two-tailed alpha value of 0.05, a power of 0.95, and an effect size of 0.3 showed that the correlations would have been significant on a sample size of 115. Another reason for the lower level effect size of non-significant correlations may be the fact that the relationship tested between the given variables may not be genuinely linear. It is well known that computation of linear correlation between curvilinear related variables often results in zero order or lower magnitude of correlation. To test the said possibility the present study re-examined the relationship of SBP and DBP with emotion recognition accuracy under the assumption of non-linearity (quadratic) of relationship. Compared to linear relationship, quadratic relationship with SBP was found to be significant for Anger (r= 0.635, p= 0.012), All Emotions (r= 0.607, p= 0.020), Four Emotions (r= 0.654, p= 0.009), Negative Aroused Emotions (r= 0.572, p= 0.034) and Negative Non-Aroused Emotions (r= 0.581, p= 0.030). Significant quadratic relationship

was also noted between DBP and the emotion Happy (r= 0.554, p= 0.044). Table-1 shows the variance explained by blood pressure in linear and quadratic models. Table 1: Variance explained by SBP & DBP for individual and composite emotions in linear and quadratic models Emotion SBP DBP Linear Quadratic Linear Quadratic Linear Quadratic R2 R2 R2 R2 Happy .219* 247(p=.089) .204* .307* Sad .150 .220 .077 .240(p=.097) Fear .014 .017 .035 .083 Anger .113 .403* .012 .117 Surprise .005 .018 .005 .014 Disgust .097 .268(p=.071) .072 .087 All emotions .175 .368* .074 .168 Four Emotions .207* .428** .101 .225 Positive .184 .200 .171 .249(p=.088) Negative Aroused .076 .327* .001 .049 Negative non-aroused .165 .338* .104 .185 (*p<.05, **p<.01) It is evident from Table-1 that both systolic and diastolic blood pressure explained a larger amount of variance under the assumption of quadratic relationship than linear relationship. Further, some of the relationships that were non-significant under the assumptions of linearity became significant when a curvilinear relationship was assumed.

Taken together, these observations suggest the possibility that the relationship between emotional dampening and BP is curvilinear (quadratic). Here it is worth noting that though the magnitude of correlation under curvilinear relationship assumption has increased substantially and some of the previously reported nonsignificant correlations became significant, a number of correlations are still non-significant. Thus, it is likely that the same effect sizes might have been found significant if a larger sample would have been used as indicated by the power analysis. The analysis of the scatterplot with quadratic curve fitted in the data revealed that wherever the quadratic relationship was found significant (see Table – 1) the nature of relationship was best modelled by an inverted U shape. Thus, the observation of inverted U shape relationship suggests that emotional dampening may occur not only in association with elevated blood pressure but also in response to reduction in blood pressure. However, the small sample size undermines the validity of such conclusions and necessitates future study using large sample. Conclusion: The findings of the present study corroborate the earlier observation that elevation in resting state blood pressure even in normotensive range is associated with emotional dampening as reflected by reduced emotion recognition accuracy. However, the lower sample size and lack of statistical significance of the findings limit the generalization of the findings and necessitate future research. The present study extends the earlier observations by suggesting the possibility that the relationship between BP and emotional dampening may be curvilinear (quadratic) and thus both elevation and depression in BP can dampen the emotional responding. This hypothesis is supported by the observation that compared to linearity assumption, under the assumption of curvilinear relationship the previously nonsignificant relations became significant and the magnitude of correlations increased substantially. Another major observation of the present study was that BP as a single latent variable (indexed jointly by SBP and DBP) is also associated with emotional dampening. However, the most important contribution of the present study is the

observation that emotional dampening though involves both positive and negative emotional valence, the magnitude of dampening may vary depending on the valence and level of arousal of the emotions. The elevation in BP results in greater dampening of positive and negative non-aroused emotions but not of negative aroused emotions. However, if emotions are categorised with respect to arousal (disregarding valence) the emotional dampening in association with elevated BP was noted for both aroused and non-aroused emotions. The observation that even minor alterations on either side of the resting BP can influence the accuracy of emotion perception has significant implications not only for researches dealing with hypertension and other cardiovascular disorders but also for emotion processing. References: Bruehl, S., & Chung, O. (2004). Interactions between the cardiovascular and pain regulatory systems: An updated review of mechanisms and possible alterations in chronic pain. Neuroscience and Biobehavioral Reviews, 28, 395–414. Chobanian, A.V., Bakris, G.L., Black, H.R., et al. (2003). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The Journal of the American Medical Association, 290(10):1312. Doi:10.1001/jama.290.10.1312-a. Duschek, S., Dietel, A., Schandry, R., & Reyes del Paso, G. A. (2009). Increased sensitivity to heat pain in chronic low blood pressure.European Journal of Pain, 13, 28–34. Duschek, S.,Schwarzkopf, W., &Schandry, R. (2008).Increased pain sensitivity in low blood pressure.Journal of Psychophysiology, 22, 20–7. Everson, S. A., Goldberg, D. E., Kaplan, G. A., Julkunen, J., and Salonen, J. T. (1998). Anger expression and incident hypertension.Psychosomatic Medicine,60, 730–735. Guo, K. (2012). Holistic Gaze Strategy to Categorize Facial Expression of Varying Intensities.PLoS ONE, 7(8): e4258. doi:10.1371/journal.pone. 0042585. Guyll, M., &Contrada, R. J. (1998). Trait hostility and ambulatory cardiovascular activity: Responses to social interaction. Health Psychology, 17, 30– 39. Helmers, K.F., Baker, B., O'Kelly, B., Tobe, S.W. (2000).Anger expression, gender, and ambulatory blood pressure in mild, unmedicated adults with hypertension.Annals of Behavioral Medicine, 22, 60-64. Hosseini, S.H., Mokhberi, V., Mohammadpour, R.A., Mehrabianfard, M., Lashak, N.B. (2011). Anger expression and suppression among patients with essential hypertension.International Journal of Psychiatry in Clinical Practice, 15,214-218. Jorm, A.F. (2001). Association of hypotension with positive and negative affect and depressive symptoms in the elderly.The British Journal of Psychiatry, 178:553-555. Mandal, M.K., & Rai, A. (1987).Responses to facial emotion and psychopathology. Psychiatry Research, 20, 317-324. McCubbin, J.A., Loveless, J.P., Graham, J.G., Hall, G.A., Bart, R.M., Moore, D.D., Merritt, M.M., Lane, M.D., Thayer, J.F. (2013). Emotional Dampening in Persons with Elevated Blood Pressure: Affect Dysregulation and Risk for Hypertension. Annals of Behavioral Medicine, DOI: 10.1007/s12160-013-9526-2. McCubbin, J.A., Merritt, M.M., Sollers, J.J. 3rd, et al. (2011). Cardiovascular emotional dampening: the relationship between blood pressure and recognition of emotion. Psychosomatic Medicine, 73: 743-750. Morris, M.C., Scherr, P.A., Hebert, L.E., Bennett, D.A., Wilson, R.S., Glynn, R.J., Evans, D.A. (2002). Association between blood pressure and cognitive function in a biracial community population of older persons. Neuroepidemiology, 21(3):123–30. Nyklíˇcek, I., Vingerhoets, A. J., & Van Heck, G. L. (1996). Hypertension and objective and self-reported stressor exposure: A review. Journal of Psychosomatic Research, 40, 585–601. Nyklíˇcek, I., Vingerhoets, A.J., Van Heck, G.L. (1998). The under reporting tendency of hypertensives: an analysis of potential psychological and physiological mechanisms. Psychology Health; 13:1–21. Nyklíˇcek, I., Vingerhoets, A. J., & Van Heck, G. L. (1999).Elevated blood pressure and self-reported symptom complaints, daily hassles and defensiveness.International Journal of Behavioral Medicine, 6, 177–189. Player, M. S, King, D. E., Mainous, A. G., &Geesey, M. E. (2007).Psychosocial factors and progression from prehypertension to hypertension or coronary heart disease.TheAnnals of Family Medicine, 5, 403-411. Pury, C.L.S., McCubbin, J.A., Helfer, S.G., Galloway, C., McMullen, L.J. (2004). Elevated resting blood pressure and dampened emotional response. Psychosomatic Medicine, 66:583–587. Rutledge, T., & Hogan, B.E. (2002).A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosomatic Medicine, 64, 758–766. Somova, L. I., Connolly, C., & Diara, K. (1995).Psychosocial predictors of hypertension in black and white Africans. Journal of Hypertension, 13, 193– 199. Wilkinson, D.Z., & France, C.R. (2009). Attenuation of positive and negative affect in men and women at increased risk for hypertension: a function of endogenous barostimulation? Psychophysiology. Jan; 46(1):114-21. DOI: 10.1111/j.1469-8986.2008.00757.x. Yan, L. L., Liu, K., Matthews, K. A., Daviglus, M. L., Ferguson, T. F., & Kiefe, C. I. (2003). Psychosocial risk of hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. The Journal of the American Medical Association, 16, 2138–2148.

Integrative Assessment of Interpersonal Dependency: Contrasting Sex Differences in Response Patterns on Self-Attributed and Implicit Measures Adam P. Natoli and Robert F. Bornstein Numerous clinical and experimental studies have reported that women are more dependent than men. These conclusions are based primarily on self-reported (or ―self-attributed‖) dependency scores, where women almost invariably obtain higher scores than men. However, this has not been true when implicit dependency scores (typically obtained via performance-based or projective tests) are examined. These patterns suggest that implicit—self-attributed test score discontinuities may differ across sex; it is therefore of interest to contrast the direction and magnitude of dependency test score discontinuities in women and men. Self-attributed scores of interpersonal dependency were obtained from the Interpersonal Dependency Inventory and Relationship Profile Test, while dependency was measured implicitly by the Rorschach Oral dependency Scale. Analyses of implicit—self-attributed test score discontinuities across sex in a sample of 1,508 undergraduates yielded a number of significant differences in direction confirming that women obtain higher self-attributed dependency scores than implicit dependency scores, whereas this pattern is reversed in men. Analyses comparing the magnitude of implicit—self-attributed test score discontinuities across sex yielded only one significant difference: Discontinuity between self-attributed scores of dysfunctional detachment and scores on an implicit measure of dependency was larger among women than among men. Findings are discussed within the frameworks of gender schema theory and social role theory. These results have implications for methodologies used in contemporary personality assessment; suggestions for continued research are offered. Dependency is characterized by a tendency to look to others for advice, support, and reassurance, behave in a compliant and cooperative manner, and be passive and acquiescent in interpersonal relationships. Numerous clinical and experimental studies have found women to appear more dependent than men (Ainsworth, 1969; Alonso-Arbiol, Shaver, & Yárnoz, 2002; Maccoby & Masters, 1970; Masling, 1986; Millon, 1981; Mischel, 1970; Parens & Saul, 1971; Walters & Parke, 1964). Indeed, sex differences in selfreported (or ―self-attributed‖) dependency scores are the norm in clinical and research settings, but this has not been true when implicit dependency scores (typically obtained via performance-based tests) are examined (Bornstein, 1995; Bornstein, Manning, Krukonis, Rossner, & Mastrosimone, 1993). Scores derived from self-report measures of dependency reflect the degree to which an individual attributes traits, feelings, thought patterns, motives, behaviors, and experiences that are associated with dependency to himor herself. Performance-based measures of dependency, particularly those identified as stimulus attribution tests (e.g., the Rorschach Inkblot Method [RIM]), evaluate implicit characteristics or traits.

In these performance-based measures individuals are presented with ambiguous stimuli to which they are asked to attribute meaning or interpret (e.g., create a story).

The individual’s attributions are determined in part by the characteristics of the stimulus and in part by the individual’s cognitive style, emotions, motives, perception, and need states. Scores on these measures are typically obtained through the use of standardized scoring and interpretation systems that quantify the participant’s responses and his or her approach to the task.

Moreover, performance-based measures continue to be popular clinical instruments worldwide, based on an extensive review of the literature (see Piotrowski, 2015, 2017). Despite the ability to evaluate the same construct using these two different methods, in the study of dependency as well as in other areas, there has developed a strong reliance on the use of self-report measures in personality and personality disorder (PD) research. In fact, Bornstein (2003) found 81% of published studies of personality pathology between 1991 and 2000 relied exclusively on Adam P. Natoli (Corresponding author Email: adamnatoli@mail.adelphi.edu, Voice 609-933-0747) and Robert F. Bornstein, Derner Institute of Advanced Psychological Studies, Adelphi University, 1 South Avenue, Garden City, NY 11530 Keywords: Dependency, Sex Differences, Personality Assessment, Multimethod Assessment, Test Score Discontinuity

self-report data. More recent studies (e.g., Bornstein, 2011; Cizek, Rosenberg, &Koons, 2008; Hogan &Agnello, 2004) have found similar trends and it is generally agreed that self-report methods have dominated the past several decades of personality and PD research (Rogers, 2003; Widiger & Samuel, 2005). This would not be noteworthy if different methods of assessing the same construct yielded similar scores. Yet, this is not always the case and many studies show only small to moderate associations (typically in the r = .20 - .30 range) between self-report and performance-based scores of analogous constructs related to personality and other individual difference variables (see Bornstein, 2002; Meyer et al., 2001; Mihura, Meyer, Dumitrascu, & Bombel, 2013; Zeigler-Hill et al., 2012). A number of researchers have argued that precision and depth of conceptualization can be improved through the use of multimethod assessment (Bornstein, 2015; Ganellen, 2007; Meyer et al., 2001) and that divergence between scores obtained using different methods can be used advantageously when understood within an appropriate context (Bornstein, 2002, 2009). Though there is often some convergence across dissimilar methods for assessing dependency, there are many instances in which studies of dependency have shown sex, or sex role orientation, to partially explain score differences between men and women (Bornstein et al., 1993; Bornstein, Bowers, & Bonner, 1996). Moreover, evidence suggests that implicit-self-attributed test score discontinuities may differ in women and men (see Bornstein, 1995, 2012); as a result, it is of interest to contrast the direction and magnitude of dependency test score discontinuities in women and men to better comprehend the role that respondent sex may play with respect to dependency assessment and test score discontinuity. The present study sought to evaluate intraindividual convergences and divergences between scores derived from two different methods (i.e., self-report and performancebased) for measuring interpersonal dependency, and investigate whether the direction and magnitude of dependency test score discontinuities differed between women and men. Specifically, we hypothesized that—consistent with extant research in this area—we would find higher self-attributed dependency scores than implicit dependency scores in women, but higher implicit dependency scores than self-attributed dependency scores in men. As a secondary, exploratory aim of this investigation we determined whether there were differences between men and women with regard to the magnitude of test score discontinuity regardless of direction. Method: Participants: As part of an ongoing program of research examining the antecedents and dynamics of interpersonal dependency, 1,508 undergraduate participants (1,158 women and 350 men) completed two self-report measures of dependency and one performance-based measure of dependency between 2006 and 2015. Their age range was 16-59 years-old, with a mean age of 19.11 (M = 19.06, SD = 3.30 for women and M = 19.29, SD = 2.12 for men). The breakdown of race/ethnicity of the sample is as follows: 60.2% Caucasian- American/White, 16.6% Hispanic-American, 10.5% Asian/Pacific-Islander, 10.3% African- American/Black, 2.2% Multi-Cultural, and 0.1% Native American; 4.1% of the students are from outside the United States. Measures: Interpersonal Dependency Inventory (IDI; Hirschfeld, Klerman, Gough, Barrett, Korchin, & Chodoff, 1977): The IDI is a 48-item questionnaire that asks participants to rate the degree to which each of a series of dependency-related self-statements is characteristic of his or her attitudes, feelings, or behavior using a 4-point Likert scale, ranging between 1 (not characteristic of me) and 4 (very characteristic of me). The IDI is comprised of three subscales: Emotional reliance on others (ER), Lack of social selfconfidence (LS), and Assertion of autonomy (AA). In addition to scores on these three subscales, a total IDI score is derived by subtracting the individual’s AA subscale score

from the sum of his or her scores on the ER and LS subscales. Accordingly, high IDI total scores reflect high levels of dependency. Internal consistency of the IDI subscales has been investigated in multiple subject samples with reliability coefficients ranging between .72 and .91 (Hirschfeld et al., 1977). The IDI subscales have also demonstrated temporal stability over a 17-week period, obtaining testretest correlations between .61 and .85 for the three IDI subscales (Frank, Kupfer, Jacob, & Jarrett, 1987).

Additional information regarding the construct validity of the IDI is provided by Bornstein (1994, 2005). Relationship Profile Test (RPT; Bornstein &Languirand, 2003): The RPT is a rationally derived 30-item questionnaire that asks participants to rate a series of self-statements using a 5-point Likert scale, ranging between 1 (not at all true of me) and 5 (very much true of me). These statements were derived from the theoretical and empirical literature on dependency, detachment, and healthy dependency. The statements were written to tap the four components of each personality style (i.e., cognitive, emotional, motivational, behavioral) and other core features of dependency, detachment, and healthy dependency. The RPT generates three subscale scores: Destructive overdependence (DO), Dysfunctional detachment (DD), and Healthy dependency (HD). Scores on each subscale are calculated by summing scores on 10 individual items that comprise that subscale. Thus, scores can range from 10 to 50 for each subscale, with higher scores reflecting higher levels of DO, DD, or HD. Acceptable internal consistencies of the RPT’s subscales have been reported, with coefficient alpha levels ranging from .68 to .83 (Bornstein et al., 2003). In the same study, Bornstein et al. (2003) found, as predicted, a significant inverse relationship between HD scores and both DO and DD scores. With the exception of HD scores in men (r = .27), 3- year reliability coefficients ranged from .49 and .64 and were comparable across gender (Bornstein &Huprich, 2006).

Further information regarding the construct validity of the RPT is provided by Bornstein et al. (2003). Rorschach Oral Dependency Scale (ROD; Masling, Rabie, &Blondheim, 1967): The ROD scale is used to derive a score of dependency from the content of Rorschach responses, administered either in standard or group format. Each response is assessed for the presence of oral dependent content; a response is defined as oral dependent if it falls into any one of the following categories: (a) foods and drinks, (b) food sources, (c) food objects, (d) food providers, (e) passive food receivers, (f) food organs, (g) supplicants, (h) nurturers, (i) gifts and gift givers, (j) good luck symbols, (k) oral activity, (l) passivity and helplessness, (m) pregnancy and reproductive anatomy, and (n) negations of oral percepts. One point is assigned for each oral-dependent Rorschach response. The number of oral-dependent responses is divided by the total number of responses to control for variations in response productivity. However, this study utilized the group Rorschach administration procedure to obtain a standardized number of responses (see Bornstein & Masling, 2005; Masling, 1986, 2002, for descriptions of this procedure). Thus, a greater number of oral-dependent responses reflect a higher level of dependency. Studies have reported interrater reliability to be quite high, with Pearson correlations generally above .90 when using either clinical or nonclinical data (Bornstein, 1996). Bornstein, Rossner, and Hill (1994) found ROD retest reliability coefficients for 16, 28, and 60 weeks to be .67, .48, and .46, respectively. Additional information regarding the construct validity of the ROD is provided by Bornstein (1996), and Bornstein and Masling (2005). Procedure: Participants’ IDI, RPT, and ROD scores were standardized (converted to Z), and then differences between self-attributed dependency scores (as measured by the IDI and RPT) and implicit dependency scores (as measured by the ROD) were calculated individually for each participant; a positive sign was assigned when self-attributed dependency exceeded implicit dependency, and a negative sign was used when this pattern was reversed. Independent sample t-

tests were then conducted to determine whether the direction and magnitude (using absolute values of differences in standardized scores) of implicit-self-attributed test scores differed across sex. Results: A series of independent sample t-tests was used to determine whether men and women differed in the direction of implicit—selfattributed test score discontinuity using SPSS © Version 21. Significant sex differences were obtained in six of seven comparisons (see Table 1). RPT Healthy Dependency (HD) was the only index of self-attributed dependency wherein implicit—self-attributed test score patterns did not differ across sex: The discontinuity between scores on the HD subscale of the RPT and ROD scores were virtually identical in women (M = -0.00, SE = 0.04) and men (M = -0.01, SE = 0.08). This difference, 0.00, Bca 95% CI [-0.17, 0.18], was not significant t(1506) = 0.05, p = .959, and yielded a trivial effect size, d = 0.0027. Taken together, the analyses summarized in Table 1 confirm that women obtain higher self-attributed dependency scores than implicit dependency scores, whereas men produce higher implicit dependency scores than self-attributed dependency scores for every IDI and RPT dimension except for the HD subscale of the RPT. Table 1: Direction of Implicit—Self-Attributed Test Score Discontinuity Across Sex Measure of Self-Attributed Dependency Women Men

M SD M SD t p 95% CI Cohen’s d IDI ER 0.05 1.36 -0.17 1.35 2.62* .009 [0.05, 0.38] .16 IDI LS 0.04 1.39 -0.14 1.39 2.09* .037 [0.01, 0.34] .13 IDI AA -0.06 1.39 0.19 1.42 -2.91* .004 [-0.42, -0.08] .18 IDI Total 0.07 1.38 -0.23 1.36 3.51** .000 [0.13, 0.46] .22 RPT DO 0.06 1.42 -0.19 1.35 2.90* .004 [0.08, 0.42] .18 RPT DD 0.04 1.39 -0.12 1.27 2.01* .045 [0.00, 0.31] .12 RPT HD -0.00 1.44 -0.01 1.49 0.05 .959 [-0.17, 0.18] .00 Note. n of women = 1,158; n of men = 350; df = 1,506 throughout. IDI = Interpersonal Dependency Inventory (Hirschfeld et al., 1977); ER = Emotional Reliance on Others, LS = Lack of Self-Confidence, AA = Assertion of Autonomy. RPT = Relationship Profile Test (Bornstein et al., 2003); DO = Destructive Overdependence, DD = Dysfunctional Detachment, HD = Healthy Dependency. Implicit dependency was assessed via the Rorschach Oral Dependency (ROD) scale (Masling et al., 1967). Equal variances not assumed for DD contrasts. *p<.05 **p<.001 A second series of independent sample t-tests was used to determine whether men and women differed with respect to magnitude of implicit—self-attributed test score discontinuity. Only one significant difference across sex was obtained (see Table 2):

Table 2: Magnitude of Implicit—Self-Attributed Test Score Discontinuity Across Sex Measure of Self- Attributed Dependency Women Men

M SD M SD t p 95% CI Cohen’s d IDI ER 1.07 0.85 1.06 0.85 0.07 .941 [-0.10, 0.10] .01 IDI LS 1.10 0.86 1.10 0.86 -0.07 .946 [-0.11, 0.10] .00 IDI AA 1.08 0.88 1.13 0.88 -1.02 .309 [-0.16, 0.05] .06 IDI Total 1.09 0.85 1.07 0.87 0.40 .688 [-0.08, 0.12] .02 RPT DO 1.14 0.86 1.07 0.84 1.21 .226 [-0.04, 0.17] .08

RPT DD 1.10 0.85 0.97 0.82 2.52* .012 [0.03, 0.23] .15 RPT HD 1.14 0.88 1.14 0.95 -0.10 .920 [-0.11, 0.10] .00 Note. n of women = 1,158; n of men = 350; df = 1,506 throughout. IDI = Interpersonal Dependency Inventory (Hirschfeld et al., 1977); ER = Emotional Reliance on Others, LS = Lack of Self-Confidence, AA = Assertion of Autonomy. RPT = Relationship Profile Test (Bornstein et al., 2003); DO = Destructive Overdependence, DD = Dysfunctional Detachment, HD = Healthy Dependency. Implicit dependency was assessed via the Rorschach Oral Dependency (ROD) scale (Masling et al., 1967). *p<.05 On an average, the magnitude of discontinuity between scores on the RPT DD subscale and ROD scores was larger for women (M = 1.10, SE = 0.02), than for men (M = 0.97, SE = 0.04). This difference, 0.13, Bca 95% CI [0.00, 0.31], was significant t(1506) = 2.52, p = .012, and yielded a small effect size, d = 0.15. Thus, aside from RPT DD, women and men do not differ in the magnitude of implicit—self-attributed test score discontinuity. Discussion: Our results suggest important differences across sex in terms of the convergences and divergences between self-attributed and implicit dependency scores. Women tend to present themselves on self-report tests as being more dependent than an implicit assessment of dependency would suggest, whereas men tend to present themselves as being less dependent than their implicit dependency scores indicate. In examining self-attributed—implicit dependency score discontinuities for IDI and RPT subscales more closely, relative to their implicit dependency scores women were found to report greater wishes for approval, attention, and support from others. They presented as possessing a strong desire for contact with and emotional support from others, and downplayed preferences for independence. Regarding men, findings indicate a propensity to minimize their wishes for contact with, and emotional support from others, and their desire for approval and attention from other people. Men’s selfattributed dependency scores also suggest a pattern of downplaying desires for help in decision-making and in social situations. In contrast to other subscale comparisons, on average, men and women in our sample reported levels of healthy dependency comparable to their implicit dependency needs: The mean difference between scores on the HD subscale of the RPT and ROD scores were very close to zero for both men and women.

Healthy dependency is characterized by flexible, adaptive, and appropriate support seeking; individuals high in healthy dependency perceive themselves as competent and others as trustworthy, and they are secure in intimacy and confident in their autonomy. Some key features of healthy dependency (e.g., situation-appropriate help seeking) have been found to be more strongly encouraged in women than men in many Western societies, suggesting a cross-sex difference should be found (Baumeister & Leary, 1995; Bornstein et al., 1996; Whiffen & Sasseville, 1991). Yet, results suggest that women and men in our college student sample attribute features of healthy dependency to themselves similarly. Beyond being more highly educated than a typical young adult, college students tend to score higher on measures of androgyny, which might account for these patterns. Our findings confirm differing directions of implicit—self-attributed test score discontinuities across sex. However, why might an individual’s sex have differential effects on explicit, self-report measures of dependency versus implicit, performancebased measures?

One approach to addressing this question is to interpret these findings within the frameworks of gender schema theory and social role theory. Both of these theories describe processes that may clarify the private, subjective experiences of test takers as they respond to different types of test items as well as the situational and societal influences that function within an individual during a multimethod assessment of interpersonal dependency. Gender Schema Theory: Gender schema theory (Bem, 1981, 1984) asserts that gender typing is the partial product of an individual learning to invoke society’s definition of

masculinity and femininity in his or her perceptions, and one’s self-concept becomes assimilated into the gender schema. In evaluating the gender clustering of words in free recall, Bem (1981) found that thinking of one gendered item enhanced the probability of thinking of a similarly gendered item, and demonstrated that sex-typed individuals readily endorsed sex-appropriate attributes while rejecting sex-inappropriate attributes. Gender-schematic information processing may be similarly engaged during the assessment of self-attributed dependency: Self-report measures of sex-typed traits are likely to engage gender schematic processing (see e.g., Bornstein, 2010). As a result, the individual applies this schematic selectivity to his or her self-perception and becomes more likely to respond to test items in a manner perceived as applicable to his or her own sex. In contrast, gender-typed schemas are less likely to be invoked by the ambiguous stimuli involved in the more implicit performancebased measures of dependency. Thus, while completing self-reports it may be that feminine gender-typed schemas promote women to perceive a stronger presence of dependencyrelated attitudes, feelings, or behaviors while masculine gender-typed schemas limit the acknowledgement of dependency in men. Social Role Theory: Social role theory (Eagly, 1987) emphasizes the influence culturally shared expectations about genderappropriate qualities and behaviors have on personality (see also Burn, 1996, for a parallel discussion involving gender socialization theory). Within this framework men and women are assumed to behave in ways consistent with gender stereotypes and are expected to inhabit the conventional social roles occupied by their sex within a particular society. Consistent with the main tenet of social role theory, the sex differences that were found in this study may be partially explained by differences in the expectation and perceived suitability of being dependent, which is likely to align differently with women and men. Compared to an implicit measure, the self-report measures of dependency were more vulnerable to the influence of an individual’s expectations about genderappropriate qualities and behaviors (see Bornstein & McLeod, 2016, for a discussion of this issue). Consequently, women were pressured to present themselves as dependent on self-report measures of dependency, whereas explicit measures provided men the opportunity to deny features of dependency and present themselves as less dependent than they may actually be. Limitations and Future Research Directions: A skeptic might argue that the present findings remain open to question because the validity of many RIM scores has been questioned in recent years. However, Bornstein’s (1999) meta-analysis of the criterion referenced validity of self-report and performance-based dependency scores indicated that the validity coefficient associated with ROD scores was comparable to, or larger than, that associated with every self-report index of dependency. Thus, limitations in the validity of one or more measures used in this study cannot explain these results (see also Mihura et al., 2013, for a discussion of this issue). As is true of most investigations, however, the current study is not free of limitations. First, the sample was recruited from an undergraduate student population in an eastern United States university. Consequently, there is less heterogeneity in terms of age and socioeconomic status than might be found within the general population. Second, although sex was measured, sex role was not; it may be that test score discontinuity also reflects varying levels of masculinity and femininity in women and men (e.g., Bornstein et al., 1996). Future research should measure masculinity and femininity as well as biological sex and assess dependency test score discontinuity within this context. Finally, this study only used one performance-based measure of dependency (i.e., the ROD); use of multiple implicit measures of dependency in future studies would strengthen the generalizability of the present findings. Sex differences comparable to those found here likely extend beyond self-report and

performance-based assessment methods; future studies should explore whether similar dependency test score discontinuities surface when informant reports are examined, as these perceptions may also be influenced by sex role expectations and stereotypes. Additionally, because sex and gender norms tend to vary between cultures, the sex differences in dependency score discontinuity found in this study are likely to vary across culture as well. Differences in social role effects on gender-stereotyped perceptions of others have been shown in some recent cross-cultural studies (e.g., Steinmetz, Bosak, Sczesny, & Eagly, 2014). The sex differences identified in this study are also not likely restricted to measures of interpersonal dependency. There are various gender-typed qualities (e.g., aggression, antisocial and histrionic traits) for which an individual’s sex and sex role orientation may partially explain score discontinuity. It would behoove researchers to examine implicit— self-attributed test score discontinuities in these domains as well. Future studies may find it useful to utilize semantic priming to more precisely evaluate the unique interactions between the psychological processes engaged by individuals as they complete an assessment and the societal influences concerning one’s sex on test scores. Finally, the patterns obtained in this study provide additional support for the clinical utility of multimethod assessment and the importance of understanding individual features that contribute to intra-individual convergences and divergences between scores derived from different methods. These results have implications for methodologies used in contemporary personality assessment, both with respect to basic science (i.e., laboratory research) as well as application (e.g., in diagnostic assessment and treatment planning). That is, considering the way in which an individual’s sex interacts with the assessment methods used can help clarify his or her underlying personality dynamics in heuristic and clinically useful ways. References: Ainsworth, M. D. S. (1969). Object relations, dependency and attachment: A theoretical review of the infantmother relationship. Child Development, 40, 969- 1025. Alonso-Arbiol, I., Shaver, P. R., &Yárnoz, S. (2002). Insecure attachment, gender roles, and interpersonal dependency in the Basque country. Personal Relationships, 9, 479-490. Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachment as a fundamental human motivation. Psychological Bulletin, 117, 497-529. Bem, S. L. (1981). Gender schema theory: A cognitive account of sex typing. Psychological Review, 354-64. Bem, S. L. (1984). Androgyny and gender schema theory: A conceptual and empirical integration. Nebraska Symposium on Motivation, 32, 179–226. Bornstein, R. F. (1994). Adaptive and maladaptive aspects of dependency: An integrative review. American Journal of Orthopsychiatry, 64, 622-635. Bornstein, R. F. (1995). Sex differences in objective and projective dependency tests: A meta-analytic review. Assessment, 2, 319-331. Bornstein, R. F. (1996). Construct Validity of the Rorschach Oral Dependency Scale, 1967-1995. Psychological Assessment, 8, 200-205. 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. (2002). A process dissociation approach to objective-projective test score interrelationships. Journal of Personality Assessment, 78, 46-68. Bornstein, R. F. (2003). Behaviorally referenced experimentation and symptom validation: A paradigm for 21st-century personality disorder research. Journal of Personality Disorders, 17, 1-18. Bornstein, R. F. (2005). The Dependent Patient: A Practitioner’s Guide. Washington, DC: American Psychological Association. Bornstein, R. F. (2009). Heisenberg, Kandinsky, and the heteromethod convergence problem: Lessons from within and beyond psychology. Journal of Personality Assessment, 91, 1-8. Bornstein, R. F. (2010). Gender schemas, gender roles, and expressive writing: Toward a process-focused model. Sex Roles, 63, 173-177. Bornstein, R. F. (2011). Toward a process-focused model of test score validity: Improving psychological assessment in science and practice. Psychological Assessment, 23, 532-544. Bornstein, R. F. (2012). From dysfunction to adaptation: An interactionist model of dependency. Annual Review of Clinical Psychology, 8, 291-316. Bornstein, R. F. (2015). Personality assessment in the diagnostic manuals: On mindfulness, multiple methods, and test score discontinuities. Journal of Personality Assessment, 97, 446-455. Bornstein, R. F., Bowers, K. S., & Bonner, S. (1996). Relationships of objective and projective dependency scores to sex role orientation in college student

participants. Journal of Personality Assessment, 66, 555-568. Bornstein, R. F., &Huprich, S. K. (2006). Construct validity of the Relationship Profile Test: Threeyear retest reliability and links with core personality traits, object relations, and interpersonal problems. Journal of Personality Assessment, 86, 162-171. Bornstein, R. F., & Languirand, M. A. (2003).Healthy dependency. New York, NY: Newmarket. Bornstein, R. F., Languirand, M. A., Geiselman, K. J., Creighton, J. A., West, M. A., Gallagher, H. A., &Eisenhart, E. A. (2003). Construct validity of the Relationship Profile Test: A self-report measure of dependency-detachment. Journal of Personality Assessment, 80, 64-74. Bornstein, R. F., Manning, K. A., Krukonis, A. B., Rossner, S. C., & Mastrosimone, C. C. (1993). Sex differences in dependency: A comparison of objective and projective measures. Journal of Personality Assessment, 61, 169-181. Bornstein, R. F., &Masling, J. M. (2005). The Rorschach Oral Dependency Scale. In R. F. Bornstein & J. M. Masling (Eds.), Scoring the Rorschach: Seven validated systems (pp. 135-158). Mahwah, NJ: Lawrence Erlbaum Associates, Inc. Bornstein, R. F., & McLeod, B. A. (2016). Beyond biology: Sex, gender, and personality disorders. In V. M. Brabender & J. L. Mihura (Eds.), Handbook of Gender and Sexuality in Psychological Assessment (pp. 211- 232). New York, NY: Routledge/Taylor & Francis. Bornstein, R. F., Rossner, S. C., & Hill, E. R. (1994). Retest reliability scores on objective and projective measures of dependency: Relationship to life events and interest interval. Journal of Personality Assessment, 62, 398-415. Burn, S. M. (1996).The social psychology of gender. New York: McGraw-Hill. Cizek, G. J., Rosenberg, S. L., & Koons, H. H. (2008).Sources of validity evidence for educational and psychological tests. Educational and Psychological Measurement, 68, 397-412. Eagly, A. H. (1987). Sex differences in social behavior: A social-role interpretation. Hillsdale: Erlbaum. Frank, E., Kupfer, D. J., Jacob, M., & Jarrett, D. (1987). Personality features and response to acute treatment in recurrent depression. Journal of Personality Disorders, 1, 14-26. Ganellen, R. J. (2007). Assessing normal and abnormal personality functioning: Strengths and weaknesses of self-report, observe, and performance-based methods. Journal of Personality Assessment, 30-40. 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. Hogan, T. P., &Agnello, J. (2004). An empirical study of reporting practices concerning measurement validity. Educational and Psychological Measurement, 64, 802-812. Maccoby, E. E., & Masters, J. C. (1970).Attachment and dependency. In P. H. Mussen (Ed.), Carmichael’s manual of child psychology (Vol. 2, pp. 73-157). New York, NY: Wiley. Masling, J. M. (1986). Orality, pathology, and interpersonal behavior. In J. Masling (Ed.), Empirical studies of psychoanalytic theories (Vol. 2, pp. 73- 106). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. Masling, J. M. (2002). Speak, memory, or goodbye Columbus. Journal of Personality Assessment, 4-30. Masling, J. M., Rabie, L., & Blondheim, S. H. (1967). Obesity, level of aspiration, and Rorschach and TAT measures of oral dependence. Journal of Consulting Psychology, 31, 233–239. Meyer, G. J., Finn, S. E., Eyde, L. D., Kay, G. G., Moreland, K. L., Dies, R. R., … Reed, G. M. (2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist, 56, 128-165. Mihura, J. L., Meyer, G. J., Dumitrascu, N., & Bombel, G. (2013). The validity of individual Rorschach variables: Systematic reviews and meta-analyses of the comprehensive system. Psychological Bulletin, 139, 548-605. Millon, T. (1981).Disorders of personality. New York, NY: Wiley. Mischel, W. (1970).Sex-typing and socialization. In P. H. Mussen (Ed.), Carmichael’s manual of child psychology (Vol. 2, pp. 3-72). New York, NY: Wiley. Parens, H., & Saul, L. J. (1971).Dependence in man. New York, NY: International Universities Press. Piotrowski, C. (2017). Rorschach research through the lens of bibliometric analysis: Mapping investigatory domain. Journal of Projective Psychology & Mental Health, 24(1), 32-36. Piotrowski, C. (2015). Projective test usage worldwide: A review of applied settings 1995-2015. Journal of the Indian Academy of Applied Psychology, 41(3), 9-19. Rogers, R. (2003). Standardizing DSM-IV diagnoses: The clinical applications of structured interviews. Journal of Personality Assessment, 81, 220-225. Steinmetz, J., Bosak, J., Sczesny, S., &Eagly, A. H. (2014). Social role effects on gender stereotyping in Germany and Japan. Asian Journal of Social Psychology, 17, 52-60. Walters, R. H., & Parke, R. D. (1964).Social motivation, dependency, and susceptibility to social influence.In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 1, pp. 231- 276). San Diego, CA: Academic Press. Whiffen, V. E., & Sasseville, T. M. (1991). Dependency, self-criticism, and recollections of parenting: Sex differences and the role of depressive affect. Journal of Social and Clinical Psychology, 10, 121-133. Widiger, T. A., & Samuel, D. B. (2005).Evidence-based assessment of personality disorders. Psychological Assessment, 17, 278-287. Zeigler-Hill, V., Fulton, J. J., & McLemore, C. (2012). Discrepancies between explicit and implicit selfesteem: Implications for mate retention strategies and perceived infidelity. Jr of Soc Psy, 152,670-686.

Rorschach Research through the Lens of Bibliometric Analysis: Mapping Investigatory Domain Chris Piotrowski This study presents the results of an exploratory bibliometric „topical‟ analysis with regard to mainly primary research regarding the Rorschach published in journal articles 2000-2016. The major aim is to a) determine the scope and breadth of investigatory areas most emphasized by researchers during this time frame, and b) prompt more advanced bibliometric study of the extant Rorschach literature in order to map the structure of scholarship and research domain regarding this popular assessment method. The database PsycINFO was selected to obtain the pool of references based on a „keyword‟ search of the term Rorschach. The search identified a total of 838 peer-reviewed articles from 2000 to 2016; of these, 747 were determined to be mostly „primary‟ articles and served as the data-set for the analysis. The author tagged each article with a topical descriptor and maintained a scoring template based on frequency counts across categories. The analysis identified 29 topical categories which represented at least 1% of the total distribution. The most prevalent researched topics were (in rank order): Norms, psychotic states, eating disorders, historical aspects, psychosomatic factors, treatment planning/outcome, aggression/hostility, personality, psychodynamic issues, depression, and personality disorders. Neglected areas of research were noted such as, assessment training, differential diagnosis, anxiety states, racial/ethnic differences, and social desirability. The focus on norms/normative comparisons was quite apparent. The potential impact of editorial preference/bias was discussed and limitations of the study were noted. Based on this analysis, it appears that recent Rorschach scholarship is a) not cohesive in character, and b) reflects diverse research domains representing disparate research interests. Hence, despite an extensive repository of literature, the Rorschach remains an emerging area of study with an opaque sense of direction for future research. Bibliometric analysis is a recognized and valid means of gaining an objective perspective on research trends of the extant literature (De Bellis, 2009). Thus, obtaining a limpid view on the scope of investigatory interest on specific research topics seems a worthwhile scholarly endeavor. Yet despite the vast volume of studies and repository of knowledge on the Rorschach method, little is known about the breadth of research emphasis and structure of published scholarship on this charismatic assessment technique. An online search of the PsycINFO database, conducted July 21 2016, highlights the perennial visibility and extensive volume of extant literature on the Rorschach, i.e., 641 books/book chapters, 1,020 dissertations, and 4,022 articles. This prodigious research interest, to some extent, reflects the continued popularity of the Rorschach over the decades as one of the top assessment techniques used in psychological practice (Piotrowski, 2015a; Wright et al., 2016), as well as interest internationally (e.g., Manickam & Dubey, 2005). However, bibliometric studies regarding the Rorschach have been sparse. Giegerich (2014) examined how personality assessment was portrayed in 6 popular introductory psychology textbooks. The analysis indicated notable negative bias with regard to coverage of projective techniques, particularly the Rorschach. Research trends on the Rorschach, from 1950-1985, have been found to show a slight resurgence of scholarly interest by the mid-1980s (Polyson et al., 1986), whereas Reynolds and Sundberg (1976), in a cited reference analysis, reported that the Rorschach was referenced highly, from 1951-1971, in the Buros Mental Measurements Yearbook. Piotrowski and Keller (1993) reported on the reference output for studies on the shading response in Rorschach research. Since there has been recent research attention devoted to bibliometric study on a myriad of psychological topics in the mental health field (e.g., Cox et al., 1995; Piotrowski, 2012) and across applied psychology disciplines (Cascio & Aguinis, 2008; Miles & Naumann, 2011; Piotrowski, 2016), a contemporary examination regarding the scope of research emphasis on the Rorschach seems warranted. The current bibliometric analysis is the first attempt to Chris Piotrowski, Ph.D. University of West Florida (USA) Email: cpiotrowski@uwf.edu Keywords: Rorschach Content Analysis, Bibliometric Analysis.

identify the breadth of investigatory interest on the Rorschach Test in published research. The focus will be on determining the main areas of research focus, based on individual study aim and design, across the pool of published articles (2000-2016), with a focus on the Rorschach. To that end, the aim is to identify the major „topical‟ areas of investigation in Rorschach research in recent years. Investigatory Approach: In order to obtain a comprehensive pool of articles on the Rorschach, a „keyword‟ online search, using the term Rorschach, was performed in the database PsycINFO. This scholarly file is a recognized major repository of published research in the social and behavioral sciences (Perdue & Piotrowski, 1991; Piotrowski et al., 2005). Moreover, PsycINFO indexes journals from allied fields and coverage is international in scope (Garcia-Perez, 2010). Thus, PsycINFO was selected since the Rorschach has garnered academic and professional interest across many disciplines and in many countries worldwide. The search produced 4,022 peerreviewed articles; of these, were published from 2000 to 2016. In order to target mainly „primary‟ research, references reporting corrections, commentaries/replies, editorial remarks, book and software reviews, and erratum were excluded. Thus, the dataset for this bibliometric analysis comprised 747 articles. Based on extensive experience conducting bibliometric analyses on various research topics and individual journals, the author reviewed each study and determined the main aim or focus of the article. A categorical template, delineating topical areas, was maintained. Each article was labeled with only 1 topical designation. A running-tab was maintained until all articles were reviewed. Although a number of issues of journals were declared a „special issue‟ on a select major topic/research area, some articles had a major emphasis outside of the intended area of focus. Readers should be aware that the current analysis does not weigh individual research findings, aims not to be evaluative, does not side on controversial issues, does not review the psychometric credibility of the Rorschach, nor clarifies the merits of the Rorschach for clinical assessment (see Meyer 2001). Simply, this study is descriptive in nature with the sole intent to present a „snapshot‟ on the scope and breadth of „topical‟ focus regarding scholarly research on the Rorschach, over the past two decades. Findings: Table 1 displays, in rank order, the major emphasized topical areas in Rorschach research since the year 2000. Only those topics that represented at least 1% of the dataset are noted. Research on normative data or issues has remained a perennial concern over many decades, particularly with regard to demographic groups, non-U.S. samples, and unique norms for children and adolescent samples (see Shaffer et al., 2007). The influence of psychoanalytic perspectives is evident in investigatory interest in schizophrenia and other psychotic states, psychosomatic formulations, psychodynamic factors, and psychotherapy process and outcome. To some extent, this orientation reflects research presented in psychoanalytically-oriented journals. In viewing the categorical rankings, a couple of observations are noteworthy. First, the prevalence of studies on various eating disorders. Second, a major focus on forensic psychology issues, such as forensic assessment, sexual offenders, psychopathy, and child abuse. Finally, an appreciation for the historical foundations of the Rorschach is reflected in a myriad of reviews to the present day. Noteworthy, although the Wood et al. controversy/debate (e.g., Garb et al., 2008; Mihura et al., 2013; Wood et al., 2003) has generated some attention in the literature in the form of primary research (n=10), much of the scholarly debate has been in the form of commentaries/replies and rebuttals (and thus not included in the current analysis). Scholarly „exchanges‟ reported in journals tend to inflate the exposure that select, controversial topics

receive based to some degree on editorial preference (Moustafa, 2015). Studies with a major focus on Rorschach variables/indexes are as follows (in rank order): Color (n=10), Movement (n=8), # of Responses (n=5), Ego Impairment Index (n=5), Mutuality of Autonomy (n=5), Oral Dependency (n=5), Texture (n=4), R- Perceptual Thinking Index (n=3). Neglected Areas of Research: Topical analysis frequently provides evidence on areas of sparse research interest. The current findings, regarding the distribution of major subject categories, identified several salient areas of psychological study largely neglected by Rorschach researchers. Most noteworthy: assessment training/education (n=6), examiner/examinee interaction (n=3), differential diagnosis (n=3), creativity (n=5), anxiety (n=3), race/ethnic differences (n=2), physically disabled (n=2), learning disabled (n=3), aged populations (n=4), pain conditions (n=4), grief states (n=1), social desirability (n=1). Preferential Editorial Selection: Publication bias entails issues related to editorial selection, non-significant results, and decision-making on the part of researchers regarding submission of their findings (e.g., Banks et al., 2012; Matias-Guiu & Garcia- Ramos, 2011; Torgerson, 2006). Although the current analysis does not directly address publication bias, the issue of editorial selection and preference may be a factor on whether an individual paper „sees the light of day‟. The current findings reveal a disproportional number of articles on norms/normative analysis and psychotic states, and few articles across a myriad of salient clinical issues. From a bibliometric perspective, such findings can reflect bias in the editorial process (see Bornstein 1991; Moustafa, 2015) and potential conflict of interest (Young, 2009). This effect may be particularly evident in studies on aggregated reviews of the literature (Coursol & Wagner, 1986). Interestingly, in a meta-analysis involving the Rorschach, Parker et al. (1988) commented, “The historical association between the Journal of Personality Assessment and the Rorschach may create an editorial bias favorable to the Rorschach” (p. 372). Limitations: First, this analysis reports on only the most recent 20% (2000-2016) of the extant research on the Rorschach presented in articles in the database PsycINFO; if a complete examination of archival articles (n=4000+) in the PsycINFO database was conducted, a more comprehensive, historical review would be evident. Undoubtedly, additional studies would have been identified via searches of adjutant databases in the social sciences and in MEDLINE. Second, this study reports a somewhat basic „topical‟ content analysis of the psychological literature, from the perspective of one examiner. Thus, a multi-rater design would enhance scoring reliability. By design, only 1 designation was permitted. A weighted scoring scheme would surely have produced a more refined, accurate ranking. Furthermore, in order to further our understanding of the structure and influence of scholarship regarding the Rorschach, more advanced bibliometric methods (i.e., citation analysis, citation mapping, co-citation analysis) are required (see Hjorland, 2013; Piotrowski, 2013), particularly as the intellectual structure and volume of published literature in the Assessment Psychology field expands over time (see Adair & Vohra, 2003, for a discussion). Lastly, this analysis did not include the „Gray‟ literature (Conference papers and proceedings, dissertations, working papers, Google postings), nor the great volume of unpublished papers that never see the light of day. Most of this literature is not archival. Indeed, the oft-referred to „File Drawer Problem‟ contributes to publication bias and limits findings in bibliometric studies (Franco et al., 2014; Rotton et al., 1995). Indeed, Lilienfeld et al. (2000) discussed the File drawer problem in their extensive review of the extant literature on projective techniques. Thus, to what extent „unpublished‟ studies on the Rorschach would have impacted the current results is not discernable.

Conclusions: a) Despite copious levels of scholarship on inkblots for the past century, Rorschach research, overall, seems a diverse enterprise with disparate intellectual pursuits. From an international perspective, the majority of Rorschach investigations overseas seem disengaged from Rorschach research in the USA. The potent impact of Exner‟s Comprehensive System, over several decades on the assessment field, has now been challenged by the R-PAS. Thus, there seems little cohesion in the field regarding the direction for future research on Rorschach assessment. b) There has been sparse attention in published articles regarding graduate-level training and internship opportunities with the Rorschach, perhaps reflecting diminishing levels of didactic coursework and clinical experiences which have been noted in the recent literature (Evans & Finn, 2016; Piotrowski, 2015b). Where advanced students and novice practitioners, with an avid interest in gaining competency in the Rorschach can turn, seems a perplexing conundrum. c) There appears to be a host of critical clinical areas that receive sparse investigatory attention. Whether this is a function of disinterest on the part of investigators or editorial preference/bias is difficult to ascertain. d) Contemporary Rorschach research tends to highlight competing academic and professional dictates; i.e., training in clinical mandate for in-depth, multimethod assessment protocols appears incongruent with the reality of expedited testing constraints in practice. e) Despite nearly a century of research, it appears that the Rorschach is an emerging area of study reflecting a myriad of scholarly -interests and academic orientations. f) The current findings are exploratory in nature; more advanced bibliometric methods need to be applied to the extant literature in order to elucidate the investigatory structure of Rorschach research.

Table 1: Major Topical Areas of Emphasis in Rorschach Research Indexed in PsycINFO (2000-2016) Total n= 747 Major topical areas of study n % Norms/Normative analyses (including the 28 reported in 2007 JPA Suppl. Int‟l samples)

Psychoses/Schizophrenia 6.5 Eating disorders Historical aspects Psychosomatic factors Treatment planning/outcome Aggression/hostility Personality 2.5 Psychodynamic issues 2.5 Depression 2.5 Personality disorders 2.5 Psychological trauma/PTSD Psychoanalytic perspectives Cross-cultural comparisons Reliability/Coding stability Validity issues Neuropsychology/Brain imaging Forensic assessment/issues Sex offenders R-PAS 1.5 Medical diseases 1.5 SIS-Inkblot Test 1.5 Psychopathy 1.5 Child sexual abuse 1.5 Suicide potential features 1.5 Wood et al. controversy (excluding comments/rebuttals) 1.5 Color 1.5 Movement response Drug abuse/Addiction Note. Values indicate # of articles; Categories with less than 8 articles are not reported.

References: Adair, J.G., & Vohra, N. (2003). The explosion of knowledge, references, and citations: Psychology‟s unique response to a crisis. American Psychologist, 58, 15-23. Banks, G.C., Kepes, S., & Banks, K.P. (2012). Publication bias: The antagonist of meta-analytic reviews and effective policymaking. Educational Evaluation & Policy Analysis, 34(3), 259-277. Bornstein, R.F. (1991). Manuscript review in psychology: Psychometrics, demand characteristics, and an alternative model. Journal of Mind and Behavior, 12(4), 429-467. Cascio, W.F., &Aguinis, H. (2008). Research in I/O psychology from 1963 to 2007: Changes, choices, and trends. Journal of Applied Psychology, 93, 1062-1081. Coursol, A., & Wagner, E.E. (1986). Effect of positive findings on submission and acceptance rates: A

note on meta-analysis bias. Professional Psychology: Research and Practice, 17, 136-137. Cox, B.J., Wessel, I., Norton, G.R., Swinson, R.P., &Direnfeld, D.M. (1995). Publication trends in anxiety disorders research: 1990-1992. Journal of Anxiety Disorders, 9(6), 531-538. De Bellis, N. (2009). Bibliometrics and citation analysis. New York: Scarecrow Press. Evans, F.B., & Finn, S.E. (2016).Training and consultation in psychological assessment for professional psychologists. Journal of Personality Assessment, 98, 785-798. Franco, A., Malhotra, N., &Simonovits, G. (2014). Publication bias in the social sciences: Unlocking the file drawer. Science, 345(6203), 1502-1505. Garb, H.N., Wood, J.M., Lilienfeld, S.O., Nezworski, M.T. (2005).Roots of the Rorschach controversy. Clinical Psychology Review, 25, 97-118. Garcia-Perez, M.A. (2010). Accuracy and completeness of publication records in the Web of Science, PsycINFO, and Google Scholar: A case study for the computation of h indices in psychology. Journal of the American Society Information Science & Technology, 61, 2070-2085. Giegerich, M. (2014). Personality assessment as portrayed in introductory psychology textbooks: A qualitative content analysis. Dissertation Abstracts International, 74(9-B). Hjorland, B. (2013). Citation analysis: A social and dynamic approach to knowledge organization. Information Processing and Management, 1313- 1325. Manickam, L.S., & Dubey, B.L. (2005). Rorschach Inkblot Test in India: Historical review and perspectives for future action. Journal of Projective Psychology & Mental Health, 12(1), 61-78. Matias-Guiu, J., & Garcia-Ramos, R. (2011).Editorial bias in scientific publications.Neurologia, 26(1), 1-5. Meyer, G.J. (2001). Introduction to the final special section in the special series on the utility of the Rorschach for clinical assessment. Psychological Assessment, 13(4), 419-422. Mihura, J.L., Meyer, G.J., Dumitrascu, N., & Bombel, G. (2013). The validity of individual Rorschach variables: Systematic reviews and meta-analyses of the Comprehensive System. Psychological Bulletin, 548-605. Miles, J.A., &Naumann, S.E. (2011). Research trends in the Academy of Management publications. Journal of Management and Marketing Research, 6, 1-31. Moustafa, K. (2015). Is there bias in editorial choice? Yes. Scientometrics, 105, 2249-2251. Parker, K. C., Hanson, R.K., &Hunsley, J. (1988). MMPI, Rorschach, and WAIS: A meta-analytic comparison of reliability, stability, and validity. Psychological Bulletin, 103(3), 367-373. Perdue, B., & Piotrowski, C. (1991). Online database use in psychology: A survey of academic libraries. Collection Management, 14, 133-137. Piotrowski, C. (2016). Mapping the research domain in the field of applied psychology: A bibliometric analysis of the emerging literature. Journal of the Indian Academy of Applied Psychology, 42(1), 11- 17. Piotrowski, C. (2015a). Projective techniques usage worldwide: A review of applied settings 1995-2015. Journal of the Indian Academy of Applied Psychology, 41(3), 9-19. Piotrowski, C. (2015b). Clinical instruction on projective techniques in the USA: A review of academic training settings 1995-2014. Journal of Projective Psychology & Mental Health, 22(2), 83-92. Piotrowski, C. (2013). Bibliometrics and citation analysis for the psychologist-manager: A review and select readings. The Psychologist-Manager Journal, 53-71. Piotrowski, C. (2012). Research areas of emphasis in professional psychology: Past and current trends. Journal of Instructional Psychology, 39(2), 131-135. Piotrowski, C., & Keller, J.W. (1993). The Rorschach and shading: Citation output from PsycINFO (1987- 1992). Psychological Reports, 72(2), 690. Piotrowski, C., Perdue, B., & Armstrong, T. (2005). Scholarly online database use in higher education: A faculty survey. Education, 125, 443-445. Polyson, J., Peterson, R., & Marshall, C. (1986). MMPI and Rorschach: Three decades of research. Professional Psychology: Research and Practice, 17(5), 476-478. Reynolds, W.M., &Sundberg, N.D. (1976). Recent research trends in testing. Journal of Personality Assessment, 40, 229-233. Rotton, J., Foos, P.W., Van Meek, L., & Levitt, M. (1995). Publication practices and the File Drawer Problem: A survey of published authors. Journal of Social Behavior and Personality, 10(1), 1-13. Shaffer, T.W., Erdberg, P., & Meyer, G.J. (2007). Introduction to the JPA special supplement on international reference samples for the Rorschach Comprehensive System. Journal of Personality Assessment, 89(Suppl 1), S2-S6. Torgerson, C.J. (2006). Publication bias: The Achilles‟ heel of systematic review? British Journal of Educational Studies, 54(1), 89-102. Wood, J.M., Nezworski, M.T., &Lilienfeld, S. O. (2003). What‟s wrong with the Rorschach? Science confronts the controversial inkblot test. New York: Wiley. Wright, C.V., Beattie, S.G., Galper, D.I., et al. (2016). Assessment practices of professional psychologists: Results of a national survey. Professional Psychology: Research and Practice, 47, 617-625. Young, S.N. (2009). Bias in the research literature and conflict of interest. Journal of Psychiatry and Neuroscience, 34(6), 412-417.

Fairy tales: The Emotional Processors of Childhood Conflicts in Dynamic Interpretative Lens Nilanjana Sanyal and Manisha Dasgupta Fairy tales operate in accordance to the preamble set forward by the fantasy world of children, which makes young readers to wander about in the enchanting world of magic, animation and anthropomorphism. Amidst providing aid to their leisure times and enriching their vocabulary, imagination and creativity, fairy tales essentially enable in “venting out” their emotions and unresolved conflicts in a safe ambience. The present article attempts to probe into the psychoanalytic nuances of six well-known fairy tales by the Grimm Brothers to unfurl their significance in enabling personality-development of young children along the penetrative lens. The psychoanalytic explanation of the Mother Complex, its splitting into the good-mother and bad-mother, the notion of self-concept and the development of the self-system along the different psychosexual stages towards growth and development to attain emotional autonomy and vitality have been noted in the fairy tales‟ characters of Little Red Riding Hood, Snow White and Seven Dwarfs, Hansel and Gretel, Cinderella, Rapunzel and the Sleeping Beauty. Implications of the selected fairy tales have also been discussed along psychoanalytic themes. The enchanting words, “Once upon a time…” appeal to children across the world, by indulging them to enter into a magical world of fantasy and imagination. Fairy tales have followed human societies though the ages and still play a significant part in children‟s lives. These stories have travelled through oral storytelling as well as print, in times and places of limited sources of entertainment as well as in large metropolitan areas of the electronic age. According to Marie-Lousie von Franz (1995), “Fairy tales are most generally human in their structure,” and “In each type of tale, one can study the most basic structures of human behavior.” Along the same tune, Bruno Bettelheim finds folk fairy tales of great value when it comes to the upbringing of children. In his book, The Uses of Enchantment (1989), Bettelheim studies their universal importance in understanding childhood development and states his opinions on the way children work through the psychological problems of maturing as: In order to master the psychological problems of growing up – overcoming narcissistic disappointments, oedipal dilemmas, sibling rivalries; becoming able to relinquish childhood dependencies; gaining a feeling of selfhood and of self-worth, and a sense of moral obligation – a child needs to understand what is going on within his conscious self so that he can also cope with that which goes on in his unconscious. He can achieve this understanding and with it the ability to cope, not through rational comprehension of the nature and content of his unconscious, but by becoming familiar with it through spinning out daydreams – ruminating, rearranging, and fantasizing about suitable story elements in response to unconscious pressures. By doing this, the child fits unconscious content into conscious fantasies, which enable him to deal with that content (Bettelheim, 1989). This task of bridging childhood fantasies and relating them to human behavior is carried out exceptionally well amidst the thematic ambience of varied fairy tales which get transmitted across generations mainly through oral-story-telling. According to Shapiro and Katz (1978),Bettelheim interprets the symbolic meaning of fairy tales in three levels: • Firstly, a character is described as representing crucial others in the child‟s life, such as parents or siblings; • Secondly, as representing an experienced part of the personality (good or bad self); and • Thirdly, as representing internal processes (id, ego, and superego). This form of analysis closely resembles the psychoanalytic interpretation of some projective techniques. Fairy tales carry Nilanjana Sanyal, Ph.D., Professor and Former Head, and Manisha Dasgupta, Ph.D., Asst. Professor, Department of Psychology, University of Calcutta, 92 A.P.C. Road, Kolkata 700009 (Corresponding email address: dasguptam80@gmail.com). Key words: Fairy tales, emotional processing, unresolved conflicts.

important messages to the conscious, the preconscious and the unconscious mind, on whatever level each is functioning at the time. By dealing with universal human problems, particularly those which preoccupy the child‟s mind, these stories speak to his budding ego and encourage its development, while at the same time, relieving preconscious and unconscious pressures. As the stories unfold, they giveconscious credence and body to Id pressures and show ways to satisfy these that are in line with ego and superego requirements (Bettelheim, 1978). It is by dint of fairy tales that the child fits unconscious contentinto conscious fantasies, which then enable him/ her to deal with that content. Fairy tales offer new dimensions to the child‟s imagination which would be impossible for him to discover as truly on his own. More importantly, the form and structure of fairy tales suggest images to the child by which he can structure his daydreams and with them give better direction to his life. Fairy tale is effectively a collective fantasy. As it is told and retold, elements of the story added by the individual teller fall away, like sifted sand, while the more universal themes remain, so it becomes valid for the group of people in general (Jung, 1961). Hence, the need is felt to explore six selected and widely popular fairy tales of the Grimm Brothers (Grimm and Grimm, 1975) in the canvas of interpersonal relationships and human behavior along psychoanalytic avenues. I. Little Red Riding Hood (Little Red Cap): Little Red Riding Hood (LRRH) is observed as a „colourful‟ personality; she is a „genuine‟ child, being naïve, disobedient, impulsive and playful. According to Bettelheim (1976), she is universally loved because, “although she is virtuous, she is tempted” (p. 172). LRRH‟s impulse to explore the woods after leaving home and not paying heed to the words of her mother reflects her Pleasure Principle being predominant. Major psychoanalytic interpretations emphasize the sexual connotations of the story as well as LRRH‟S oedipal fantasies (Fromm, 1951; Roheim, 1953; Fairbairn, 1972). It also reflects the heroine‟s separation anxiety and archaic fears, expressed in the form of the wolf, being temporarily separated from her mother (Coulacoglou, 2008). Fromm‟s (1951) interpretation emphasized the significance of the red hood of the heroine, which is said to symbolize menstruation and serves as a signal of her forthcoming feminity. Roheim (1953/ 1992) emphasizes the significance of the aggressive actions, which he claims to symbolize infantile oral aggression. He refers to the mechanisms of regression and projection whereby the infant‟s wishes to devour her mother are projected on the mother-grandmother-wolf. “Aggression is combined with regression and it follows the idea of being swallowed up, being beaten, which is the key aspect of this aggression. The cannibal child created a cannibal mother” (p. 152). Fairbairn (1972) argues that the story expresses anxiety over the destruction of the object (mother) as the heroine‟s need for incorporation takes the form of a devouring wolf. Bettelheim (1976) writes that this fairy tale expresses ambivalence between the pleasure and the reality principle. It also deals with the oedipal conflict reactivated in puberty. Little Red Cap‟s budding sexuality is directed towards her father-wolf who is an externalization of the dangers of overwhelming oedipal longings. The father is also portrayed as the hunter in his protective and rescuing role. Thus we may observe the splitting of the father figure into a ferocious and threatening animal and into a benign and helpful hunter. Kant (1995), adopting a Jungian perspective, argues that the wolf symbolizes the instinctive/ primitive nature of the protagonist. “She meets in the wolf part of her nature, the part of herself that she denied: a Red Cap who is dreamy, aggressive, impulsive, desperate and dangerously greedy in her search for life… As a wolf, she gets to know, an aspect of herself that is loose, that does not care about duties or about what others think about her” (p. 14). In other words, she confronts with the „shadow‟ aspect of her personality (Jung, 1951/ 1959a; 1954/ 1959a;

1961). The wolf symbolizes the instinctive or primitive nature of the heroine. He embodies the threat of all asocial, unconscious, devouring powers (the Id). II. Snow White and Seven Dwarfs: The queen-witch-stepmother represents the pre-eminent antagonist of both the female and child protagonist (Thomas, 1989). According to Bettelheim (1976), the story of Snow White deals with the oedipal conflicts between mother and daughter and warns of the disastrous effects of narcissism. The queen is said to be fixated at the stage of primitive narcissism and arrested at the oral incorporative stage. She is envious of Snow White‟s beauty and youth and wants to incorporate her as symbolized by her intention to eat her internal organs. The queen is engulfed by obsessive vanity and envy which direct her to engage in diabolic ploys (Coulacoglou, Sanyal and Dasgupta, 2013). Bettelheim interprets Snow White‟s temporary death as a preparation period before entering a more maturing stage, that of adolescence. The witch-stepmother assumes the most negative maternal characteristics. The witch as an archetypal image represents a threat to ego consciousness and its development. She can also be considered as an image for the development-inhibiting mother complex. The possession of a magical, talking mirror adds to her supernatural properties and narcissistic personality traits. “The mirror represents her obsession with her own beauty, her compulsive narcissism, a material medium, most often associated with beauty and selfabsorption” (Thomas, 1989, p. 70).Reflection and the mirror are extremely important themes in the fairy tale and in modern psychology. They are central to our understanding of how infants and young children develop consciousness and a healthy sense of self. Many psychologists have recognized the importance of the mother-child relationship in this process, Winnicott, being an eminent one (Winnicott, 1967).If this mirroring process is severely disturbed, the adult can develop Narcissistic Personality Disorder. Narcissism, as such, is a problem of not having enough mirroring where inadequate mirroring refers to both the total amount and the quality of the mirroring. The wicked step-mother fits the symptoms of narcissistic personality disorder, having symptoms of excessive rage and weak sense of self. The hatred of the Queen for Snow White sets the plot in motion, and her persistence to murder Snow White eventually leads to her own demise. This hysterical vanity and jealousy of the Queen is psychotic, reflecting too much of weakness in the self. The Queen‟s actions are teeming with underlying oedipal issues, as her insane jealousy brings her to murder her own stepdaughter. Instead of facing the reality of the passing of time, and ageing with grace while being joyful of her stepdaughter growing and maturing into a beautiful woman, she manically plans to rid herself of her opponent by killing her. The queen is guilty of intense narcissism and her reaction to Snow White surpassing her, prompting her to view her relationship with her daughter as a competition to be won. Such competition damages the connection between parent and child and leads to the child resenting the parent, and wishing for independence and to be free from parental supervision. From the point of view of Jungian psychology, it is the queen‟s animus which gets confronted when she looks into her own unconscious when gazing in the mirror in dreams and fantasies (Jung, 1961).The queen relies on this masculine „authority‟ to tell her if she is beautiful or not. This implies that the queen had a very critical and judging animus function. It is negative and powerful and functions to make her feel good about herself only so long as she satisfies the strict requirements of „beauty‟ that she holds for herself, owing to her damaged sense of self (narcissistic injury). The inner negative animus is never satisfied. The mirror in the story also symbolizes the threshold between consciousness and the unconscious, and by looking into it, one may look towards the depths of the unconscious. And, the image that a mirror produces is symbolic and can be made sense of in both

the unconscious and the conscious worlds (Von Franz, 1982). The seven dwarfs, according to Bettelheim, symbolize males arrested at a pre-oedipal existence. Girard (1999) notes, that Snow White may be considered as the eighth dwarf, since her sexuality is still at a latent phase of development. Schechtman (1993), in her Jungian analysis of Snow White, claims that the story reflects the bitter battle of a woman against time, against ageing and decline that come with middle age. The witch, as an archetypal image, symbolizes a threat to the ego. The liberation of the princess from the witchmother, through the love of the prince, represents the disengagement of the anima from the mother image. The witch seems to represent the archetype of the Dark Feminine. This archetype, which is the opposite of the Wise Old woman, entails traits like a devouring, regressive quality and a prehuman animalism. Heuscher (1974) is of the opinion that the story of Snow White reflects the ambivalent relationship between mother and child. The queen‟s materialistic personality threatens to destroy the child‟s spiritual development. The dwarfs represent supporting superego images, while the stepmother represents the inhibiting, punitive and cruel aspect of the superego. The journey of the child hero in the form of Snow White can often be compared to the developing years of adolescence, and after her mission has been fulfilled, the hero stands as a more mature and developed person on the brink of adulthood, to be married to the prince. The simple fact that an abundance of fairy tales end with a marriage and the hero living happily ever after suggests that the journey that particular hero took spanned from childhood to adulthood; with the struggles the hero faced, reflecting the struggles of children, finding their way through adolescence and towards maturity. The initial fright and unease that follows leaving home and the supposed safety of the parents‟ arms is overcome, and the heroes prove to themselves and the world that they are capable of surviving, and triumphing independently, without their help. III. Hansel and Gretel: The tale of Hansel and Gretel is a story (in the Grimm Bothers‟ version) of a boy and a girl who suffer rejection and are confronted with excessive hostility of their mother. She says to her husband, “Early tomorrow morning, we will take the children out into the forest where it is the thickest; there we will light a fire for them, and give each of them one piece of bread, and then we will go to our work and leave them alone. They will not find the way home again, and we shall be rid of them” (Hansel and Gretel, 2011). The mother generally represents the source of all food to the children, so it is she who now is experienced as abandoning them, as if in a wilderness. It is the child‟s anxiety of separation and deep disappointment when Mother is no longer willing to meet all his/ her oral demands which lead the child to believe that suddenly the Mother has become unloving, selfish, and rejecting. Since the children know they need their parents desperately, they attempt to return home after being deserted. In fact, Hansel succeeds in finding their way back from the forest the first time they are abandoned. The story tells about the debilitating consequences of trying to deal with life‟s problems by means of regression and denial, which reduce one‟s ability to solve problems. The story of „Hansel and Gretel‟ gives body to the anxieties and learning tasks of the young child who must overcome and sublimate his primitive incorporative and hence destructive desires. The children get lost in the woods and give full reign to their oral regression when they discover the little ginger-bread house which represents an existence based on the most primitive satisfactions. The children are hungry, both physically and psychologically. According to Bettelheim, a gingerbread house, which one can „eat up,‟ is a symbol of the mother, who in fact nurses the infant from her body. Thus, the house at which Hansel and Gretel are eating away blissfully and without a care stands in the unconscious for

the good mother, who offers her body as a source of nourishment. Bruno Bettelheim (1985)interpreted the story mainly in terms of the oral greediness of a child and the penalty for it stemming from internal structures. The witch, who is a personification of the destructive aspects of orality, is as bent on eating up the children as they are on demolishing her gingerbread house. When the children give in to untamed Id impulses, as symbolized by their uncontrolled voraciousness, they risk being destroyed. Only when the dangers inherent in remaining fixed to primitive orality with its destructive propensities are recognized does the way to a higher stage of development open up. Then it turns out that the good, giving mother was hidden deep down in the bad, destructive one, because there are treasures to be gained: the children inherit the witch‟s jewels, which become valuable to them after their return home – that is, after they can again find the good parent. This suggests that as the children transcend their oral anxiety, and free themselves off relying on oral satisfaction for security, they can also free themselves of the image of the threatening mother – the witch – and rediscover the good parents, whose greater wisdom – the shared jewels – then benefit all. This implies transcendental development on the part of the children as far as personality is concerned (Rogers, 1978, 1980; Maslow, 1971). The story ends with the child heroes returning to the home from which they started, and now finding happiness there. Having overcome the oedipal difficulties, mastering anxieties, sublimating those of the cravings which cannot be satisfied realistically, and learning that wishful thinking has to be replaced by intelligent action, the child is ready to live happily again with his parents. This is symbolized by the treasures Hansel and Gretel bring home to share with their father. Rather than expecting everything good to come from the parents, the older child needs to be able to make some contribution to the emotional well-being of himself and his family. Thus, industry is the virtue and real achievement of the school-age child who has fought through and mastered the oedipal difficulties (Erikson, 1968). Here, the two siblings cooperate in rescuing each other and succeed because of their combined efforts. The story directs the child toward transcending their immature dependence on their parents and reaching the next higher stage of development, namely, cherishing also the support of age mates (Freud, 1913/ 1953, 1926/ 1959b; Erikson, 1968). IV. Cinderella: Grimm‟s „Cinderella‟ is an example of a story in which the heroine is oppressed by her stepmother and stepsisters and made to slave for them, is met with no love and feels no sense of companionship. Eventually she is raised from the ashes of the fireside and marries a prince, with some help from the magic that is usually to be found in the world of fairy tales. Cinderella‟s change of fortune – her transformation from a ragged, kitchen wrench into a princess – is a characteristic of being a fairy tale hero. Bettelheim shows how Cinderella is a pubescent young girl, caught in the grip of sibling rivalry and perception of negative mother-image (who becomes like a stepmother and she herself like an unwanted orphan pinning for the love of her „dead‟ mother) (Heisig, 1977).The evidence of the fairy tale itself is that it was dark forces which constellated the problem at home between her and the others in the family, dark forces which provided her with temporary escape into fantasy, and dark forces which saved her. In Cinderella, the „body‟ is being used as a scene for acting out rivalry among siblings. „Through‟ the body or through the actions undertaken towards it by Cinderella‟s sisters, the cruelty representing the strength of the aggressive drive could be expressed. The sisters of Cinderella, who in the Grimms‟ version, were „beautiful yet evil‟ (Cinderella, 2011), tried to trick the prince by cutting off parts of their feet. They did so, on the advice and with the help of their mother, thus attempting to fit into the shoe, a slipper that Cinderella had lost and which could fit only her. The cherished „slipper‟ perhaps

represents phallic symbol in psychoanalytic terms (Freud, 1925/ 1961). It is the stepmother of Cinderella who forces her daughters to undergo these cruel practices as she wanted them to marry and to find, perhaps through marriage, social acceptance. According to Pines (2010), the early motherchild relationship is developed through the body; the attitude of the mother is practically felt via the skin. Pines (2010) states that “Through her handling of the child, the mother‟s skin may convey the full range of emotions, from tenderness and warmth and love to disgust and hate” (p. 8). A child who is vulnerable and does not have adequate adaptation and defense mechanisms to cope with emotional pain, uses the body to cope with it (Lemma, 2010). Such a child did probably not experience his or her mother as a mirror. Joyce (2005b) in connection with the theory of Winnicott, describes mirroring as a situation in which “the baby gazes into her eyes and sees himself” (p. 45). The theme of Cinderella seems to revolve around negative object-relations with the mother (being abused physically and emotionally by her step-sisters and step-mother) and finally finding the prince as life partner with the aid of her fairy God- Mother. The fairy God-Mother represents the good mother self in her fantasy world (Sullivan, 1953a, 1953b). It is ultimately the victory of good over evil, thereby bringing about the resolution of the Mother Complex of the heroine portrayed. Besides, the use of fantasy and the world of enchantment have been portrayed in the magical spell of the fairy God-Mother, which enable Cinderella to attend the royal ball on three consecutive days to fulfill her wishes. Thus regression defense has been used in a creative manner (Sanyal, 1992). V. Rapunzel: Rapunzel is the main character in the fairy tale in the form of a flower/ herb, a beautiful girl, an object of desire, and later a maiden in a tower. She is the enchanted object of the fairy-tale. The setting of this fairy tale refers to the well-known concept of binaries – the element of the two world; one – a representation of the real (non-magical) world, the other – representing the enchanted: the world of the couple and the world of the sorceress. The enchanted world is encapsulated within high walls. It is only visible through „a small rear window of the couple‟s house,‟ symbolizing the naughty peep hole (or Id impulses). The element of the two worlds is also observed in the enchanted world of the tower, again with „only a tiny window at the very top‟ versus the forest, representing the real world. Encapsulation is a theme. Trespassers must pay with their lives. The themes are trespassing/ transgression and death. The enchanted world is described as „splendid‟ and „beautiful‟ (the sorceress‟ garden), it is a desirable world. Desire is a main theme because it brings about the transgression. The „real‟ world of the couple is a world where desires are created, the magic or enchanted world where they are met. The sorceress‟s task is to interpret the laws of the enchanted world, uphold the division between the two worlds and to punish trespassers (symbol of the Super-ego). She symbolizes the gatekeeper and she epitomizes that which is magic. Rapunzel was originally the object of her mother‟s desire (herb/ flower/ lettuce), she is also the fruit (child) of her parents‟ sexual desire, and finally she is her mother‟s desire (she wanted a child). Owing to trespassing the enchanted world, the prince had become blind and could not perceive the world through his eyes, thus the world loses its distinction and he loses his ability to distinguish the different worlds he passes through. Had not the magic world been encapsulated by high walls, he could actually be trespassing without knowing it. Another theme is blindness, literal as well as symbolic. Rapunzel‟s lack of reflexivity, her placid demeanor, missing rebellion and great naiveté when she asks the sorceress why the prince is so much lighter than her to haul up into the tower is a blindness to her own situation. Another theme is the divine couple, the syzygy. In the real world, the prince is believed to be the most desired object. Thus, the most desired objects of the two worlds, the prince and Rapunzel constitute the divine

couple, the syzygy. The significance of giving birth to twins in the wilderness can also be interpreted as a syzygy – an amalgamation of the two worlds, the magic and the real. Further, Rapunzel is assumed to be a pubescent girl who is confined in the tower by the sorceress (the tower again symbolizing the phallus) (Freud, 1925/ 1961, 1924/ 1961). Bettelheim (1978)is of the opinion that what blocks an oedipal girl‟s uninterrupted blissful existence with the father is an older, illintentioned female (i.e., Mother). But since the little girl also wants very much to continue enjoying mother‟s loving care, there is also a benevolent female in the past or background of the fairy tale, whose happy memory is kept intact, although she has become inoperative. A little girl wishes to see herself as a young and beautiful maiden (which Rapunzel grows into) – a princess or the like – who is kept captive by the selfish, evil female figure (sorceress) and hence unavailable to the male lover. This is perhaps how oedipal guilt is overcome by the pubescent girl. The captive princess‟ real father is depicted as benevolent, but helpless to come to the rescue of his lovely girl. In a girl‟s oedipal fantasy, the mother is split into two figures, the pre-oedipal wonderful; good mother and the oedipal evil stepmother (Bettelheim, 1978).The good mother would never have been jealous of her daughter or to have prevented the prince (father) and the girl from living happily together. So for the oedipal girl, belief and trust in the goodness of the pre-oedipal mother, and deep loyalty to her, tend to reduce the guilt about what the girl wishes would happen to the stepmother who stands in her way. If the father is less attentive to his little girl than she desires, she can endure such adversity because a prince will arrive who will prefer her to all competitors. This makes the girl to love her mother more because she puts all her anger at the mother competitor, who gets what she deserves. Thus the child can have the best of both worlds, which is what she needs to grow up into a secure adult. In fantasy, Rapunzel can win out over the stepmother whose efforts to prevent her happiness with the prince fail. At the same time, children of both sexes in fantasy can retain at home the real father as protector and the real mother who dispenses all the care and satisfactions a child needs. Rapunzel is also depicted in the fairy tale to have beautiful hairs which form tresses (symbolizing her sexuality). It is via her tresses which the sorceress and the prince used to enter the confined tower and hence the enchanted world. Rapunzel was punished by the bad-mother after learning of her betrayal by cutting off her tresses (and thereby disrobing her off her eminent vitality). VI. Sleeping Beauty: Adolescence is a period of great and rapid change, characterized by periods of utter passivity and lethargy alternating with frantic activity, even dangerous behavior to „prove oneself‟ or discharge inner tension (Berk, 1994; Hurlock, 1999). This back-and-forth adolescent behavior finds expression in some fairy tales by the hero‟s rushing after adventures and then suddenly being turned to stone by some enchantment. „The Sleeping Beauty‟ emphasizes the long, quiet concentration on oneself and a period of withdrawing from reality. In major life changes such as adolescence, for successful growth-opportunities, both active and quiescent periods are needed. The turning inward, which in outer appearance looks like passivity (or sleeping one‟s life away), happens when internal mental processes of such importance go within the person that he has no energy for outwardly directed action. Fairy tales like „The Sleeping Beauty,‟ have the period of passivity for their central topic. It permits the budding adolescent not to worry during his inactive period: he learns that things continue to evolve. The happy ending assures the child that he will not remain permanently stuck in seemingly doing nothing, even if at the moment it seems as if this period of quietude will last for a hundred years (Bettelheim, 1978). The long sleep of the beautiful maiden has also other connotations. Whether it is Snow White in her glass coffin or Sleeping Beauty

on her bed, the adolescent dream of everlasting youth and perfection is just that of a dream. The alteration of the original curse, which threatened death, to one of prolonged sleep suggests that the two are not all that different. If we do not want to change and develop, then we might as well remain in a death-like sleep. During their sleep the heroine is a frigid one; and is in the phase of isolation as far as narcissism is concerned. In such self-involvement which excludes the rest of the world, there is no suffering, but also no knowledge to be gained, no feelings to be experienced. Any transition from one stage of development to the next is fraught with dangers and anxiety. A natural reaction to the threat of having to grow up is to withdraw from a world and life which imposes such difficulties. Narcissistic withdrawal is a tempting reaction to the stresses of adolescence, but, the story warns, it leads to a dangerous, death-like existence when it is embraced as an escape from the vagaries of life. The entire world becomes alive only to the person who herself awakens to it. Only relating positively to the other “awakens” us from the danger of sleeping away our life. Sleeping Beauty shares the experience of falling into a deep sleep at a crucial point in her psychosexual development which may be explained in the light of “Each reawakening or re-birth symbolizes the reaching of a higher stage of maturity and understanding” (Bettelheim, 1978). He suggests that “Change signifies the need to give up something one had enjoyed till then.” In his treatment of „Sleeping Beauty,‟ Bettelheim interprets the „curse‟ of the thirteenth wise woman fated to befall the young maiden in the fifteenth year of her age as symbolic of the arrival of puberty. Sexual awakening, and the isolation which accompanies it in the natural transition from childhood to adulthood, cannot be avoided. The end result is a transformation of perception which Bettelheim attributes to Sleeping Beauty‟s personal strength of character, but which the story seems to attribute merely to the passage of time: her world falls asleep and then awakens, finding her richly rewarded for the period of dormancy. Sleeping Beauty can thus become a model for all turning points in life where transformation requires isolation. Spinning is extremely tiresome work, which is a common metaphor for industriousness in fairy tales. The fairy tale historian Jack Zipes points out that before the Industrial Revolution, spinning was an essential occupation for women and considered a measure of a woman‟s worth. The episode of spinning in the tale of Sleeping Beauty (by dint of which the heroine pricked her finger) perhaps attempts to hint at industriousness, being a virtue of individuals (Erikson, 1968). A mythical and more cosmic frame of reference is also death within Sleeping Beauty. In the story‟s own context, the problem of life and death is introduced at the very outset. The king and the queen long for a child, as a way of insuring the continued life of the crown under their name after they die. And it ends with the statement that the maiden and her prince “live happily until their death.” The curse of death by dark forced which marks the birth of the girl is changed into a promise of rebirth. The overall feeling one is left with is that death is but a state of suspended animation. The tale does not argue the reality of life after death. It simply dramatizes the fundamental human desire for immortality. Critical observations resulting in conclusion: An important aspect of these stories is how they present protagonists that children can relate to, and show how those heroes overcome the problems they face – the problems children are afraid of having to face themselves. Hearing these stories allows the children reassurance that even though the situation seems desperate, the clever and dexterous child can take care of himself. The child hero presented in fairy tales is often the youngest child of the family or a stepchild, and so the hero is repeatedly isolated from his other siblings or from his parents, even oppressed and disadvantaged. The heroes are often small, seemingly unable to take care of themselves and have to rely on others, but

through the course of the story manage to rise above their woes. The presence of magic, the existence of enchanted beings and objects, and the frequent appearances of talking animals enthrall young readers, but at the same time reassure them that the parts of the stories that frighten them do not exist to taunt and torment them in reality. Fairy tales thus have a transcendental role as far as personality is concerned. This results in therapeutic “‟emotional processing‟ of unresolved conflicts at the level of their fantasy. Hence fairy tales essentially serve as thematic medium of working with emotions of children in a secure, trustworthy and unconditionally accepting ambience. References: Berk, L.E. (1996). Child Development, 3rd edition, Prentice-Hall of India Pvt. Ltd., New Delhi. Bettelheim, B. (1976). The uses of enchantment: The meaning and importance of fairy tales. (New York: Alfred A. Knopf). Bettelheim, B. (1978). The Uses of Enchantment.The meaning and importance of fairy tales.Harmondsworth: Penguin. Bettelheim, B. (1985). Cudowne I pozyteczne. O znaczeniach I wartoschiach basin. Warszawa: PanstwowyInstytutWydawniczy. Bettelheim, B. (1989). The uses of enchantment: The meaning and importance of fairy tales. NY: Vintage Books. Cinderella (2011).Received from the http:// en.wikipedia.org/ wiki/ Cinderella on August 25, 2011. Coulacoglou, C. (2008). Exploring the child‟s personality: Clinical and cross-cultural applications of the Fairy Tale Test. Springfield Illinois: C.C. Thomas. Coulacoglou, C., Sanyal, N., and Dasgupta, M. (2013). The Fairy Tale Test: Manual (Indian) 2nd edition, Hogrefe, USA. Erikson, E.H. (1968). Identity: Youth and crisis. New York: Norton. Fairbairn, R. (1972). Psychoanalytic studies of the personality. London: Routledge & Kegan. Franz, Marie-Louise von (1995).Shadow and Evil in Fairy Tales, (Revised Ed.) Shambala Publications, Inc., Boston USA. Freud, S. (1913/ 1953). Totem and taboo.In Standard edition (Vol, 13). Freud, S. (1924/ 1961). The dissolution of the Oedipus complex. In Standard edition (Vol. 19). Freud, S. (1925/ 1961). Female sexuality.In Standard edition (Vol. 20). Freud, S. (1926/ 1959 b). The question of lay analysis.In Standard edition (Vol. 20). Fromm, E. (1951). The forgotten language: An introduction to the understanding of dreams, fairy tales and myths. New York: Hot, Rinehart & Winston. Girard, M. (1999). Les contes de Grimm: Lecture psychoanalytique (Grimm fairy tales; psychoanalytic lecture). Paris: Imago. Hansel and Gretel (2011).Received from the http://en.wikipedia.org/wiki/ Hansel_and_Gretel on August 25, 2011. Heisig, J.W. (1977). Bruno Bettelheim and the Fairy Tales.https://nirc.nanzan-u.ac.jp/en/files.../JWH- Bruno-Bettelheim-and-the-Fairytales.pdf Heuscher, J.E. (1974). A Psychiatric Study of Myths and Fairy Tales. Springfield, Illinois: Grove Press, Inc. Hurlock, E.B. (1999). Child Development, 6th edition, Tata McGraw-Hill Edition, New Delhi. Joyce, A. (2005b). The first six months: The baby getting started. In: E Reiner, A. Joyce, R. James, M. Twyman& Ch. Clulow (Ed.) Human Development: An Introduction to the psychodynamics of growth, maturity and aging. London, NY: Routledge Jung, C.G. (1951/1959a). Aion: Researches into the phenomenology of the self. In Collected works (Vol. 9, pt.2). Jung, C.G. (1954/ 1959a).Archetypes and the collective unconscious.In Collected works (Vol9; Pt. 1). Jung, C.G. (1961). Memories, dreams, reflections (A. Jaffe, ed.). New York: Random House. Kast, V. (1995).Folklore as therapy. New York: Fromm International Publishing Corporation. Lemma, A. (2010). Under the skin: A psychoanalytic study of body modification. London, NY: Routledge, Taylor and Francis Group. Maslow, A.H. (1971). The farther reaches of human nature. New York: Viking. Pines, D. (2010).In Scheir, K.The consequences of the neglect of children‟s developmental needs. The relationship of the siblings. www.mellanrummet.net/ nr28-2013/artikel-consequencesoftheneglect.pdf Rogers, C.R. (1978). The formative tendency. Journal of Humanistic Psychology, 18(1), 23-26. Rogers, C.R. (1980). A way of being. Boston: Houghton. Roheim, G. (1953). Fire in the dragon and other psychoanalytic essays on folklore. Princeton, NJ: Princeton University Press. Roheim, G. (1953/ 1992). Fairy tales and dream.Psychoanalytic study of the child, 8, 393-403. Sanyal, N. (1992). Where regression is creative: An illustration from Tagore. Samiksha, Vol. 46, 101-114. Schectman, J. (1993). The stepmother in fairy tales.Bereavement and the feminine shadow, Sigo Press, Boston. Shapiro, R. & Katz, C.L. (1978).Fairy tales, splitting and development. Contemporary Psychoanalysis, 591-02. Sullivan, H..S. (1953a).Conceptions of modern psychiatry. New York: Norton. Sullivan, H.S. (1953b). The interpersonal theory of psychiatry. New York: Norton. Thomas, J. (1989). Inside the wolf‟s belly. Sheffield, U.K.: Sheffield Academic Press. Winnicott, D.W. (1967). Playing and Reality. In P. Lomas (ed.). The Predicament of the Family: A Psychoanalytical Symposium. London: Hogarth Press and the Institute of Psychoanalysis.

Efficacy of Cognitive Drill Therapy in Treatment of Specific Phobia Bhavana Arya, Sandhya Verma and Rakesh Kumar Specific phobia is a highly prevalent condition which may interfere in occupational and social life of persons affected with this disorder. Cognitive Behavior Therapy and Desensitization Therapies have been well documented as effective treatments for phobia. Cognitive Drill Therapy (CDT) is a potential candidate for addition into the family of cognitive therapy which can address a large number of fearful conditions which could be conceptualized as stimulus-bound anxiety in persons having anxiety disorders. In this paper, we are reporting a case study of a person with specific phobia who was treated with CDT. The application of Cognitive Drill Therapy resulted in significant reduction in the phobic condition. Specific phobia is an anxiety disorder in which exposure to specific object or situation elicits a disproportionate fear reaction. The affected person may go at a great length to avoid an encounter with objects and situations of phobia and if avoidance is not possible then the person tends to remain in distress as long as he/she remains in the presence of such object/situation. Even an anticipation of the encounter with phobic object/situation tends to trigger fear response. The person usually remains aware of the unreasonableness and the excessive nature of the fear but this awareness and realization does not help him/her to get hold of the fear response. Cognitive behavior therapy (CBT) is an effective form of treatment in most anxiety disorders (Lipka et al. 2013). Brand et al. (2011) reported effectiveness of two sessions of CBT in phobia. Virtual reality exposure therapy (VRET), and exposure and response prevention (ERP) are also well established therapies for phobia (Price et al., 2011). Dr. Rakesh Kumar developed a novel form of treatment approach known as Cognitive Drill Therapy (CDT) based on the theory of conditioning, exposure, cognitive appraisal and linguistic pattern to address anxiety disorders, specifically phobia and OCD (Kumar and Dubey, 2016).The case based data generated so far suggest that CDT could also serve to reduce irrational fears in conditions of phobia and OCD (Kumar, et al., 2012; Dwivedi & Kumar, 2015). CDT conceptualizes phobia in following four components, popularly known as OBSD analysis: 1. Objects: It relates to all objects/situations that trigger phobic reaction e.g. closed places, insects, animals, crowd etc. 2. Body-Mind Reactions (BMR):It implies physiological and psychological reactions such as rapid heartbeat, breathing difficulty, sweating, dry mouth, mind going blank, trembling, dizziness etc. triggered by actual exposure or anticipation of exposure to the objects of phobia. 3. Safety Measures: The pattern of avoidance or measures taken to curb the phobic reactions such as taking someone while being in the presence of objects/situations of phobia is hinted at. 4. Danger Perception: It relates to the threat perception and the linked thoughts. It is also called as Imagined Feared Consequences (IFC) such as thoughts of getting heart attack, becoming unconscious, catching germs, developing fatal diseases etc. It is hypothesized that persons affected with phobia, remain struck in first three components which taken together are classified as Top Layer. The affected person rarely addresses the threat perception which is classified as Bottom Layer. Persistence of distorted threat perception maintains the phobic reaction; hence, addressing this bottom layer directly in the therapy would lead Bhavana Arya, Ph.D. Asst. Professor, The IIS University, Jaipur, India. Sandhya Verma, Ph.D. Scientist, Defence Institute of Psychological Research, DRDO, Delhi, India. Rakesh Kumar, Ph.D. Head, Department of Clinical Psychology, Institute of Mental Health & Hospital, Agra-282002, India Email: jain.imhh@gmail.com Keywords: Cognitive Drill Therapy (CDT), Specific Phobia, Exposure Therapy, Desensitization.

to rapid and substantial improvement in the phobic reactions. In CDT the thoughts of threat perception are listed and their time-frame of future is converted into past or present and then the affected person is required to keep on verbally or sub-vocally repeating (called drill) the converted thoughts. Verbal exposure in this form can elicit mild to severe BMR for which periodic BMR rating is obtained on a scale of 0-100 where 0 refers to no fear or BMR and means maximum. With continued repetitions, the affected person experiences sharp drop in fear reactions and BMR within a few minutes. The process is accomplished for all identified objects/situations and thoughts of threat perception. We are reporting a case study in which specific phobia was treated by using CDT in this paper. Case Summary: Mrs. X, a 53 year old female suffered from fear of using public washrooms. 12 years ago she was travelling by road. Her family stopped over at a highway hotel to use the facilities. Two days later she was hospitalized due to severe urine infection. The doctor informed her that this was due to using an infected toilet. Since then she had been avoiding any public washrooms. With time she even stopped using the other washrooms in her own house except the one in her room. No one was allowed to use her washroom. She would never go out of her house for more than a couple of hours in case she needed to use the washroom. She quit her full time job as an office assistant and picked up a part time job close to her house so that she could rush home in case she needed to use the washroom. Once a fun-loving woman, she stopped going out, watching movies and going on vacation and became completely home-bound. X was diagnosed with specific phobia on the basis of significant clinical distress on account of persistent anxiety and impairment in social and occupational areas since the past 12 years. On a subjective scale of global rating of her phobia on 0-100 scale, she rated it as 100, the maximum fear. Her OBSD analysis was characterized by following components: 1. Objects of Phobia: All washrooms except the one in X‟s room. Specifically following washrooms of following places were identified: guestroom, cinema hall, train, hotel, shopping mall, her office, neighbors and relatives. 2. Body-Mind Reactions (BMR): Severe BMR even with the thought of using other washroom characterized by rapid heart rate, breathing difficulty, sweating, tightness in muscles etc. 3. Safety Behaviors: Complete avoidance of all other washrooms except her own. She has even down-graded her occupation and restricted and re-designed her life around this condition. 4. Danger Perception: Following thoughts of danger perception were identified: a. She may develop urine infection once again b. In case she catches infection, it would be highly painful c. In case of catching urine infection, she would have to be hospitalized once again d. She will suffer once again with the urine infection Cognitive Drill Protocol: The following components of Cognitive Drill Therapy were executed in 8 sessions. Psycho-education: This is a very important component of CDT wherein the patient was educated about the nature of phobia and the nature of anxiety curve seen during exposure to objects/situation of phobia. A definite diagnosis of specific phobia was given to X. She was also explained the two layer structure of her phobia. The top layer consisted of using washrooms and the bottom

layer was the cognition of being infected. The cognition reflected a future perspective. It took almost three sessions to provide psychoeducation to X as she was deeply conditioned with the fact that using a washroom which was used by someone else will surely lead to infection. She was made aware that her experience of urine infection had occurred in the past but her cognitions about it stretched to the future. Imagined fear consequences were explained to X. Drill statements: Following drill statements were formulated corresponding to her thoughts of danger perception. In drill statements, the future tenseof thoughts of danger perception were converted into past or present tense.  I have developed urine infection once again;  I have developed urine infection, it is highly painful;  I have developed urine infection, I am hospitalized once again;  I am suffering once again with the urine infection. Execution of Cognitive Drill: Having done with psycho-education and drill statements, Cognitive Drill was implemented. The drill was implemented in following manner: “Imagine the object of phobia and keep on repeating drill statements one by one.” The objects and drill statements were taken up in sequential manner one by one. When the fear got reduced to one object and one drill statement; then next object or drill statement was taken up. For example, she was required to imagine and repeat “I am using washroom of my office, I have caught urine infection”, this drill was performed. Moment to moment BMR rating at an interval of about 30 seconds were obtained. If BMR escalated to high level, pauses of 1-2 minutes were given. When BMR got reduced in pause, the drills were resumed. When she became comfortable with this drill, the next drill was implemented, e.g. „I am using my office washroom, I have caught urine infection and got hospitalized”. Like this all objects and thoughts of danger perception were taken up. Homework and Daring: Homework occupies a very important place in CDT. X was asked to repeat the danger statements at home in between sessions. X was also encouraged to use other washrooms. She could use it on fifth day of therapy without feeling any anxiety. Termination: Therapy was terminated after eight sessions when X reported using other washrooms with minimal or no fear reaction. She reported feeling empowered after having used it. Post Therapy Assessment: Again subjective global rating of phobia reaction was obtained on a scale of 0-100. She reported minimal fear of using other washrooms on this assessment. X also showed a significant upliftment in her mood and general satisfaction. Follow Up: Two weekly follow-up sessions were conducted in which X reported maintained improvement. She reported fleeting thoughts of having urine infection while using the washroom in her office but she was able to push them aside. Discussion: The application of CDT produced significant changes in the phobic reactions of X. Her overall functioning showed positive gains. She had significant improvement in her functioning and general satisfaction levels. Cognitive drill effectively exposes the patient to his/her deeper level of thoughts of danger perception and verbal exposure provides a unique opportunity to expose the patient to the underlying maladaptive cognition which maintains the phobic reaction. A simple exposure to the objects without an exposure to the feared consequences, takes longer time in habituation whereas the exposure to the underlying thoughts tends to accelerate the dissolution of phobic reaction. In reality, the person is not phobic to the objects of phobia as such; instead he/she is scared to the possibilities of feared outcome which was

urine infection in this case. Exposure to wash rooms, simply triggers the cognitive processes that implicate repetition of the painful outcome of the past. Cognitive drill therapy also enhances self-efficacy; the person comes to realize that if such an event gets repeated, he/she would be able to handle it. She could now push away the thoughts of urine infection while using other washrooms and felt confident that although repeated infection could be a problem, she would be able to handle such an infection and the resultant pains. The cognitive re-interpretation is a natural outcome of cognitive drill therapy. Conclusion: The case work-up suggested the role of Cognitive Drill Therapy in reducing phobic reaction to specific objects. This work-up points out to the need for large scale studies on various kinds of phobias using CDT. Also, long-term follow-up should be conducted to see if the acquired gains are maintained. Formal assessments through standardized tools would ensure objectivity. Moreover, independent evaluator could be engaged in assessing the course and outcome of CDT in phobic condition to further enhance objectivity. References: Brand, S., Annen, H., Holsboer-Trachsler, E., & Blaser, A. (2011). Intensive two-day cognitive-behavioral intervention decreases cortisol secretion in soldiers suffering from specific phobia to wear protective mask. J. of psychiatric research, 45(10), 1337-1345. Dwivedi, S., & Kumar, R. (2015). Efficacy of Cognitive Drill Therapy in Agoraphobia with Panic Disorder: A Case Study. SIS J. of Proj. Psychology and Mental Health, 22(2), 150-157. Eysenck, H. J. (1979). The conditioning model of neurosis. Behavioral and Brain Sciences, 2, 155– 199. Eysenck, H. J., & Rachman, S. J. (1965).Causes and cures of neurosis. London: Routledge & Kegan Paul. Kumar, R. Sameer, A., & Singh, B. (2012).Preliminary Test of Cognitive Drill as an Intervention. Indian J. of Clin. Psycho, 39, 67-74. Kumar, R., & Dubey, B. L. (2016). Cognitive Drill Therapy: A Potent Application of the Principles of Psychology for OCD and Phobia. SIS J. of Proj. Psychology and Mental Health, 23(2), 125-126. Lipka, J., Hoffmann, M., Miltner, W. H., & Straube, T. (2013).Effects of Cognitive-Behavioral Therapy on Brain Responses to Subliminal and Supraliminal Threat and Their Functional Significance in Specific Phobia. Biological Psychiatry.76(11):869-77 Pavlov, I. (1927). Conditioned reflexes. London: Oxford University Press. Price, M., Mehta, N., Tone, E. B., & Anderson, P. L. (2011). Does engagement with exposure yield better outcomes? Components of presence as a predictor of treatment response for virtual reality exposure therapy for social phobia.J.of anxiety disorders, 25(6), 763-770. Watson, J. B., & Rayner, R. (1920).Conditioned emotional reactions. Journal of Experimental Psychology, 3, 1–14.

Paperless Policy of SIS The Members of SIS are invited to Contribute to the Paperless Policy of Somatic Inkblot Society by opting for Soft Copies of SIS Journal of Projective Psychology and Mental Health instead of Print Version. The soft copies of every issue will be delivered directly on members Email. This will not only save our trees and be environment friendly but also would be time efficient. Write to me directly for opting out print version of SIS Journal on my Email ID: bldubey@gmail.com Bankey L. Dubey

Response to the Blank Card of Thematic Apperception Test (TAT) and its Correlation with Personality Factors Anand Manjhi and Sunita Purty The blank card (Card 16) of Thematic Apperception Test has extraordinary value in clinical assessment because it has no structure and pure projection. It provides an opportunity to the subject to come out with whatever is buried near the unconscious through writing a form of free association. The present study attempted to investigate the responses to the blank card of TAT and correlate with personality profile of the subject. The study was conducted at Post-Graduate Institute of Behavioral and Medical Sciences, Raipur (India). The sample consisted of 60 subjects of which 30 persons had alcohol dependence syndrome diagnosed as per ICD-10 DCR (WHO, 1992) and 30 normal controls, who selected through purposive sampling technique. The blank card (card 16) of TAT and 16 PF Form A (Hindi version) were administered on the subjects individually. The findings indicated that the factor C of 16 PF was positively correlated with the (n) rejection and factor B, F and L were negatively correlated with (n) dominance, succorance and blame avoidance respectively on blank card of TAT. Personality may be defined as the underlying causes within the person of individual behavior and experience. After reviewing several definitions of personality in psychology, theology, philosophy, law, sociology and common usage, Allport (1937) proposed an operational definition that has become a classic definition of personality, i.e., “Personality is the dynamic organization within the individual of those psychophysical systems that determine his unique adjustment to the environment.”According to Mischel, (1986) personality is the distinctive pattern of behavior (including thoughts and emotions) that characterize each individual’s adaptation to the situation in his or her personality. There is an emphasis on the idea that each person has a unique personality. Even identical twins, who have exactly the same genetic make-up, have different personality although they probably also have more in common than unrelated people (Plomin, 1990). The TAT (Murray, 1943) is one of the most commonly used projective measures of personality for clinical purposes (Rossini & Moretti, 1997; Watkins et al., 1995). It consists of a set of 20 black and white pictures depicting relatively ambiguous situations. In a typical TAT study, participants are asked to make stories about the pictures, and the stories are scored for several underlying themes (e.g., affiliation, aggression; Murray, 1943). Since its inception, researchers have used the TAT to evoke creative responses, but rarely included the blank card (No. 16) in their assessment procedures. In the Analysis of Fantasy, Henry has emphasized the importance of the blank card and writes “the extreme challenge which it makes for the subject who must create for himself the entire scene as well as its people, events, and plot development” (Henry, 1956). The blank card serves as a momentary challenge to the subject’s creativity. During 1940s, many clinicians were using a limited number of cards and abbreviated scoring systems to save time in administration and scoring. In earlier studies the blank card was used to tap subjects’ creativity. But in terms of personality, the studies are lacking, to the best of the researchers’ knowledge. The present research was planned to investigate the responses to the blank card of TAT and its correlation with personality factors. Methodology: Sample: The sample consists of 60 subjects, of which 30 persons had alcohol dependence syndrome diagnosed as per ICD-10 DCR (WHO, 1992) in the age range of 18-50 years, having education at least of 10th standard who were taken from the OPD of Post- Graduate Institute of Behavioral and Medical Science, Raipur, and 30 matched normal controls were also selected following Anand Manjhi, Asst. Professor, and Sunita Purty, Lecturer, Dept. of Clinical Psychology, Post-Graduate Institute of Behavioural and Medical Sciences, Raipur (C.G.) Key words: Alcohol Dependence Syndrome, Personality

purposive sampling. Persons with history of other substance abuse, severe physical illness, mental retardation, epilepsy and other neurological and psychiatric disorder were excluded from the study. Tools: Following tools were administered individually to the subjects: Socio-demographic and clinical data sheet: A self-prepared socio-demographic and clinical data sheet was used to collect basic information; e.g. age, education, marital status etc. General Health Questionnaire (GHQ)-12: This questionnaire was developed by Goldberg (1972), consisting 12 items on behavioral and psychological functioning. The questionnaire screens out healthy persons with possible mental health issues on the basis of psychiatric morbidity. Michigan Alcoholism Screening Test (MAST): The MAST was developed by Selzer in 1971, consisting 24-items screening instrument. The test was applied on alcohol dependent group to identify the severity of alcohol abuse and dependence. 16 P. F. - Form A: The Hindi adaptation of 16 PF (Kapoor, 1970) was administered to all subjects. The blank card (card 16) of Thematic Apperception Test: In this study, only blank card (card 16) of Thematic Apperception Test (TAT; Murray, 1943) was used as stimulus. Card 1 was administered as sample card for orientation before administering the blank card. Procedure: The socio demographic data was collected from both the groups. The General Health Questionnaire-12 was administered for screening the normal control group and those who scored less than 3, were included in the study. Persons with alcohol dependent syndrome group were screened by Michigan Alcoholism Screening Test (MAST), subjects scoring more than 13 were taken for the present study. The 16 PF Form A (Hindi Version) and the Blank Card (card 16) of TAT were administered to all the subjects individually. Statistical Analysis: The data was analyzed by using statistical package for social sciences (SPSS 16.0). Pearson correlation (r) was applied to see the relationship between responses on TAT blank card and personality factors. Results Table 1: Shows the socio demographic characteristics of alcohol dependent patients and normal controls Variables Alcohol dependent patients (N=30) Normal Control (N=30) df χ² Age Below 30 years 8 (26.7%) 23 (76.7%) 15.02** Above 30 years 22 (73.3%) 7 (23.3%) Education in years Up to 12 years 21 (70.0%) 10 (33.3%) 8.08** More than 12 years 9 (30.0%) 20 (66.7%) Residence Rural 17 (56.7%) 10 (33.3%) 3.30 Urban 13 (43.3%) 20 (66.7%) Religion Hindu 23 (76.7%) 24 (80.0%) 0.10 Non-Hindu 7 (23.3%) 6(20.0%) Marital status Unmarried 20 (66.7%) 13 (43.3%) 3.30 Married 10 (33.3%) 17 (56.7%) Family type Nuclear 18 (60.0%) 21 (70.0%) 0.66 Joint 12 (40.0%) 9 (30.0%) Occupation Unemployed 21 (70.0%) 16 (53.3%) 0.66 Employed 9 (30.0%) 14 (46.7%) Family income per month Up to Rs. 25000 18 (60.0%) 19 (63.3%) 0.071 More than Rs. 25000 12 (40.0%) 11 (36.7%) **p<0.01 .

Table 2: Personality profile of Alcohol Dependent Patients and Normal Subjects on 16 PF Test Variables Alcohol Dependent Patients (N=30) Normal Control Subjects (N=30) df t-value

Mean SD Mean SD Factor A 5.00 1.74 4.70 1.56 0.703 Factor B 3.87 1.76 4.77 1.96 1.873 Factor C 2.47 1.72 3.53 1.96 2.242* Factor E 5.33 1.96 5.40 1.96 0.133 Factor F 5.40 1.52 5.57 1.38 0.444 Factor G 6.07 1.76 6.43 1.52 0.862 Factor H 5.53 2.01 5.50 1.63 0.070 Factor I 4.93 1.39 5.67 1.77 1.787 Factor L 7.30 1.72 5.03 1.63 2.294** Factor M 6.57 1.94 6.83 1.51 0.594 Factor N 6.67 1.75 6.30 1.86 0.787 Factor O 6.17 1.76 5.57 1.40 1.217 Factor Q1 6.17 1.55 6.17 1.68 0.000 Factor Q2 5.53 2.03 5.57 1.65 0.070 Factor Q3 4.73 1.44 5.37 1.92 1.446 Factor Q4 5.77 1.45 5.83 1.42 0.180 **Significant at 0 .01, *Significant at 0.05 level . Table 3: Correlation between 16 personality factors and needs on blank card of TAT Variables Agg Dom Exp Sex Succ Cha Aba Bla Ha Pas Rej Factor A .261 .322 -.078 -.097 -.195 -.234 .209 .000 .000 .130 -065 Factor B -.380 - .322* -.078 .232 .347 -.057 -.121 -.201 .090 -.039 .026 Factor C -.230 -.199 -.153 .059 .039 -.311 -.071 -.230 .039 .303 .434* Factor E .063 -.098 .236 .088 -.354 -.402 -.221 -.037 .000 .000 .236 Factor F -.359 .063 .357 -.022 -.386* .107 .000 .074 .059 .134 .134 Factor G -.172 .115 -.165 -.116 -.077 -.010 .241 .100 .051 .629 .372 Factor H .286 .011 .063 .286 -.202 -.342 -.075 -.050 -.090 .079 .135 Factor I -.240 .085 -.085 -.037 .016 .111 -.044 .281 -.228 -.065 .179 Factor L .237 .042 -.205 .255 .269 -.047 .132 -.361* -.059 -.190 .138 Factor M .055 -.122 -.219 .113 -.215 -.009 .148 .334 -.041 .076 .017 Factor N .139 -.260 -.337 -.048 -.194 .130 .191 -.072 .323 -.194 -.129 Factor O -.198 .265 .128 -.096 .160 .283 -.146 .125 .096 -.096 .160 Factor Q1 .127 -.009 -.029 .218 -.036 -.204 .107 -.142 .036 -.254 -.036 Factor Q2 .015 -.029 -.138 -.134 .245 .129 ..030 -.050 .078 .078 .022 Factor Q3 -.232 -.119 .050 .035 -.094 .240 -.169 .035 .063 -.016 .142 Factor Q4 -.177 -.020 .324 .023 .101 .417 -.302 .160 .489 .132 .287 *P<0.05 Agg= Aggression, Dom=Dominance, Exp=Exposition, Sex=Sex, Succ= Succorance, Cha=Change, Aba=Abasement, Bla=Blame avoidance, Ha=Harm avoidance, Pass=Passivity, Rej=Rejection Discussion: Table 1 shows the socio demographic characteristics of both the study groups. For this purpose the χ² was used. It is very clear from the table that, there is significant difference found between alcohol dependent group and normal control group in the age

and education variable respectively. In alcohol dependent group only 26.7% subjects were below 30 years and 73.3 % were more than 30 years whereas 76.7% were below 30 years and only 23.3% were having above 30 years in normal group. It is also clear from the table that 70% of the subjects were having

education less than 12 years and only 30% were having more than 12 years of education in the alcohol dependent, whereas only 33.3% were less than 12 years of education and 66.7% were having more than 12 years of education among normal subjects. While table 2 showed group difference between study groups, t-test was used to analyze the result. On the basis of test results it was found that the alcohol dependent patients were found to be significantly low (factor C) in frustration tolerance. This may be explained because of their unsatisfactory conditions for which they are easily annoyed and emotional in nature and have neurotic symptoms like sleep disturbances and psychosomatic complaints, but on the other hand normal control subjects are more emotionally stable, are realistic about their life and have good ego strength (Alcohol dependent patients: M= 2.47 ± 1.72, Normal control subjects: M= 3.53 ± 1.96, t=2.242, p>0.05 level). Similar finding has been found in a study done by Gross and Carpenter (1971), where they found that in 16 PF, factor C was low among alcoholics. Based on the findings they concluded that alcoholics are emotionally unstable. Another similar finding has been concluded by a study done by IPAT staff (1963) in alcoholics using 16 PF. They also state alcoholics to have more concrete thinking, have lower scholastic capacity. A study conducted by Costello (1978) on alcoholics using 16 PF also found that alcoholics have low scores on factor C (easily frustrated, emotionally unstable) which also support the present study. Further in the present study we found that Alcohol dependent patients tend to be high on Factor L which indicates that they are more doubtful and mistrusting than normal control subjects. They are often involved in their own internal life, are not concerned about others in comparison with normal control subjects (Alcohol dependent patient: M=7.30 ± 1.72, Normal control subjects: M= 5.03 ± 1.63, t=2.294, p>0.01 level). A similar study has been conducted by Kirchner et al. (1974) in a sample of 49 male alcoholics who were assessed on 16 PF. They found that alcoholic males were more Suspicious (factor L) than normal control subjects. Another study conducted by Costello (1978) on alcoholics concluded that alcoholics on 16 PF have high scores on factor L which also support the present study. Table 3 showed correlation between needs on blank card of TAT and 16 personality factors in groups of alcohol dependence syndrome. Analysis was done with Pearson correlation and (r) values are shown in tables. In the present study factor B of 16 PF was negatively correlated with (n, dominance) response of blank card of TAT. It indicates that persons with alcohol dependence syndrome have low mental capacity or have low intelligence; they try to control the environment to some extent in the direction of their needs and sentiments. Positive correlation was found in factor C of 16 PF and (n, rejection) blank card of TAT, which indicates that alcohol dependent patients are low in frustration tolerance for their unsatisfactory conditions. Because of that they get easily annoyed, so they keep or exclude themselves from the environment or people. Further we found that Factor F was negatively correlated with (n, succorance) on the blank card, which indicates that persons diagnosed with alcohol dependence syndrome are sober and simple in nature but they have insecure feelings and they need others’ support and nursing to guide or advise them. Negative correlation was found between factor L of 16 PF and (n, Blame avoidance) on the blank card of TAT, which shows that they are less trusting and get involved in sociopathic acts in order not to be rebuked by others and to avoid blame. It is notable that the correlational studies between responses on blank card of Thematic Apperception Test and 16 Personality Factor

have not been studied in persons with alcohol dependence syndrome, to the best of our knowledge. Thus more refined studies are required to focus on such findings. Conclusion: Since 1946, researchers have used picture cards from the TAT as stimuli to evoke creative responses. The TAT manual provides some general guidelines for an evaluation of the responses. These guidelines are based on Murray’s personality theory, which revolves around the concepts of “needs” (tendencies in the individual’s personality) (Vane, 1981). The present study was designed to investigate the relationship of needs on blank card with personality factors where the authors found that factor C of 16 PF was positively correlated with the (n) rejection and factors B, F and L were negatively correlated with (n) dominance, succorance and blame avoidance respectively on the blank card of TAT. Further, it may be used as normative date provided the sample size is increased and becomes representative. References Allport, G.W. (1937). Personality-A psychological interpretation. New York: Henry Holt and Company Costello, R. (1978). Empirical derivation of a partial personality typology of alcoholics. Journal of Studies of Alcoholism, 39, 1258-1266. Goldberg, D. (1972). The detection of psychiatric illness by questionnaire: A technique for the identification and assessment of non-psychotic psychiatric illness. London, New York: Oxford University Press. Gross, W. and Carpenter, L. (1971). Alcoholic Personality; reality or fiction? Psychological Reports, 28, 375-378. Henry, William E. (1956). The Analysis of Fantasy. New York: John Wiley and Sons. IPAT, Staff (1963). Information Bulletin No. 8 to the 16 PF Handbook. Champaign, IL Institute of Personality and Ability Testing. John H. Kirchner and Stanleys. Marzolf (1974) personality of alcoholics as measured by sixteen personality factor questionnaire and house-tree-person colorchoice characteristics. Psychological reports: volume 35, issue 2, pp. 627-642. Kapoor, S.D (1970). 16 PF. VSJ 1970 Hindi Edition, Form A The Psycho-Centre, T-22, Green Park, New Delhi. Mischel, W. (1986): Introduction to Personality. Fort Worth, Chicago: Holt, Rinehart and Winston, Inc. Murray, H. A. (1938). Explorations in personality. New York: Oxford University Press. Murray, H. A. (1943). Thematic Apperception Test Manual (TAT). U.S.A.: President and Fellows of Harvard College, Press Murray, H. A. (1965). Uses of the thematic apperception test. In B. I. Murstein (Ed.), Handbook of projective techniques (pp. 425–432). New York: Basic Books. Plomin, R., Chipuer, HM.,&Loehlin, JC. (1990). Behavioral Genetics and Personality. In LA Pervin (Ed.), Handbook of personality: Theory and Research (pp. 225-43). New York, New York: Guilford. Rossini, E. D., & Moretti, R. J. (1997). Thematic Apperception Test (TAT) interpretation: Practice recommendations from a survey of clinical psychology doctoral programs accredited by the American Psychological Association. Professional Psychology: Research and Practice, 28, 393–398. http://dx.doi.org/10.1037/0735- 7028.28.4.393. Selzer, M.L. (1971). The Michigan Alcoholism Screening Test (MAST): The quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 1653-1658. Vane, J.R. (1981). The Thematic Apperception Test: A review. Clinical Psychology Review, 1, 319-336. World Health Organization, (1992).The ICD-10 Classification of Mental and Behavioural Disorders, Geneva. A.I.T.B.S. Publishers & Distributors (Rrgd.) Delhi-51. SIS Abstracts Download

The soft copies of the abstracts of published papers of all issues in SIS Journal of Projective Psychology and Mental Health commencing from Volume 1 (Launching year 1994) to the current year can be downloaded free of cost from the website of Somatic Inkblot Society on following URL: SIS Abstracts: http://somaticinkblots.com/abstracts/ Copyright ©1994. SIS Center, India/Anchorage

Mindfulness, Emotion Regulation, and Subjective Well-Being: Exploring the Link Satchit P. Mandal, Yogesh K. Arya and Rakesh Pandey Most studies though report that emotion regulation (ER) mediates the relationship of mindfulness with subjective well-being (SWB), there is also an unexamined conjecture that ER skills cultivate mindfulness which consequently enhances SWB. Present study attempts to empirically tests which of the said two models better explains the mindfulness-well-being relationship. Two hundred eleven adults were assessed on the self-report measures of the said constructs. Initially we tested the mediational model assuming that the use of ER (cognitive reappraisal & suppression) would mediate the mindfulness-SWB relationship. This model was found to yield a good fit to the data with some minor modification. The test of alternative model that assumes ER as an antecedent factor in mindfulness – well-being relationship was also found to be a good fit to the data. The comparison of both models revealed that later model yielded a better fit compared to the former model. These findings suggest that the alternate possibility that better emotion regulation helps to attain a mindful state which in turn enhances health/well-being appears to be a better explanatory model than the conventional model which assumes that mindfulness exerts beneficial health effects through its emotion regulatory effect. The findings also implied that there may be a circular relationship between mindfulness and emotion regulation. However, such speculations need to be empirically tested in future. The beneficial role of mindfulness has been extensively explored in promoting selfregulatory behaviors and health/well-being (Mandal,et al, 2011; Mackenzie, et al., 2006; Grossman, et al., 2004). A bulk of empirical evidences support the idea that mindfulness develops positive psychological resources (Mandal et. al., 2011), induces self-regulatory behaviours, enhances happiness and positive emotional experiences (Brown & Ryan, 2003) reduces stress (Mackenzie, et al.,2006), improves positive functioning (Micheal& Graham, 2011) as well as psychological wellbeing (Brown & Ryan, 2003; Prazak, et.al, 2012). The mindfulness based intervention (MBI) techniqueshave also been found to be potentially effective in relapse prevention (Segal et al. 2010), alleviating negative psychological symptoms of anxiety (Baer 2003; Desrosiers,et al.,2014), eating disorders (Morone, et.al., 2008) and fibromyalgia (Grossman, et.al, 2007). Researchers have tried to explore the mediational processes through which mindfulness promotes health and enhance positive functioning and well-being. For instance, Chambers, et al.,(2009) noted that mindfulness improves health and well-being by influencing some aspects of emotion regulation such as relaxation and metacognitive insight. Researchers have documented the mediational role of emotion regulation and other emotional traits in mindfulness-health relationship (Mandal et al, 2011; Nykicek, 2011). The mindfulness not only enhances the use of adaptive regulation strategies such as cognitive reappraisal (i.e., restructuring of the emotional cues before the initiation of the emotional responses; Nykicek, 2011) and positive re-appraisal (Hanley& Garland, 2014; Goldin& Gross, 2010) but also reduces the habitual maladaptive use of suppression of emotions by promoting emotional acceptance (Chambers, et.al, 2009). The present study focuses on the said dual emotion regulatory mechanisms i.e. cognitive reappraisal (antecedent focused emotion regulation) as well as expression suppression (response focused emotion regulation). The response focused emotion regulation (e.g., suppression) generally leads to reduced positive affect (Gross & Levenson, 1997) and well-being (Gross & John, 2003) whereas the use of antecedent focused emotion regulation like cognitive reappraisal enhances positive affect and interpersonal functioning (Gross & John, 2003) and reduces negative emotional experiences (Ochsner & Gross, 2004). The existing direct and indirect empirical Satchit Prasun Mandal, Research Scientist ‗B‘, DRDO (Email: satchit.prasun@gmail.com), Yogesh Kumar Arya, Ph.D., Associate Professor (Email: yogeshatbhu@gmail.com), and Rakesh Pandey, Ph.D., Professor & Head, (Corresponding author) (Email: rpan_in@yahoo.com) Department of Psychology, Banaras Hindu University, Varanasi, India-221005. Key words: Mindfulness, emotion regulation, cognitive reappraisal, expression suppression, subjective well-being

evidences support the possibility that the beneficial effect of mindfulness on health and well-being may be an indirect (or mediated) effect resulting from its emotion regulatory effect i.e., by enhancing the use adaptive emotion regulation strategies (e.g., cognitive reappraisal) and reducing the use of maladaptive strategies. The available empirical evidences support the idea that emotion regulation may be a mediational link between mindfulness –health/well-being relationship (Mandal et al, 2011; Nykicek, 2011). However, an alternate possibility also exist that has never been subjected to empirical verification i.e., emotion regulation is an antecedent factor in mindfulness – health/well-being relationship and thus the direct effect of mindfulness on health/wellbeing is likely to be potentiated by greater use of adaptive and lower use of maladaptive emotion regulation strategy. This alternative hypothesis may be found in the traditional Buddhist texts. According to the traditional Pali scriptures like Satipatthana sutra (Arousing of Mindfulness) the qualities of mindfulness arise through complete transfiguration of mind by contemplating on body, feelings and consciousness (Soma Thera, 2010). Mindfulness based interventions programs like acceptance and commitment therapy (ACT) and dialectic behavioral therapy (DBT) chiefly focus on modifying some emotional traits such as emotional self-regulation, emotional acceptance, observing feelings without judgment and effective modulation of affect for cultivating mindfulness and inducing its related benefits (Cardaciotto, 2005; Linehan, 1993). These practices mainly prioritize the role of emotional awareness, acceptance, and regulation in cultivating mindfulness and alleviating sufferings as well as increasing well-being. These observations support the alternative possibility that adaptive emotion regulation may be a prerequisite (an antecedent factor) for developing mindfulness and thus may influence health/well-being directly as well as indirectly by enhancing the quality of mindfulness. The present study aims to empirically test and verify whether emotion regulation is a potential mediator of the mindfulnesshealth/well-being relationship or is it an antecedent factor that enhances mindfulness that in turn enhances health/well-being. The later model assumes mindfulness as mediator of the emotion regulation – health/well-being relationship. The present study tests and compares both the alternative model of mindfulness – health/well-being relationship using the covariance based structural equation modeling approach. Method: Participants: The present study was conducted on a sample of 211 adults belonging to different colleges and universities of the Varanasi city (India). Their age ranged from 20 to 33 years (mean age = 23.08 years and S.D= 2.63 years) and all of them belonged to middle class socio-economic status. It was an incidental sampling with almost equal number of both sexes (Males = 109, Females = 102). None had history of chronic illness. Measures: The Five Facet Mindfulness Questionnaire (FFMQ; Baer, et al., 2006) is a 39 item measure that assesses five facets of mindfulness viz., observing (8 items), describing (8 items), acting with awareness (8 items), non-judgment of inner experiences (8 items) and non-reactivity to inner experiences (7 items). The Hindi version of the FFMQ (Mandal, Arya and Pandey, 2011) was used in the present study. The Hindi version of the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) developed by Khetrapal and Baijal (2007) was used to assess the use of two emotion regulation strategies viz., cognitive reappraisal and expression suppression. Positive and negative affectivity was assessed using the Hindi version of Positive Negative Affect Schedule (PANAS; Watson, Clark and Tellegan, 1988) developed by Pandey and Srivastava (2008). It consists of 20 mood related adjectives (10 positive and negative) that assesses two global dimensions of affect: positive and negative

(Watson et al, 1988). Life satisfaction was assessed using the Hindi version of Satisfaction with Life Scale (SWLS; Diener, et.al., 1985), adapted by Dubey and Pandey (2010). The SWLS is a 5-item global measure of life satisfaction. Procedure: The aforesaid self-report measures were administered either individually or in small groups (in accordance with standard instructions of each of the measure) after getting informed consent the participants. Before collecting back the questionnaire booklet, all participants were requested to ensure that they have responded to each items of every questionnaire/scale. Results: Initially the first hypothetical model assuming emotion regulation as mediator of the mindfulness – well-being relationship was tested. In this model the latent construct mindfulness was represented by a regression based composite score using the raw scores of all the five dimensions of mindfulness. The two domains of emotion regulation (cognitive appraisal and suppression) were used as mediator variables. The positive affect, negative affect, and life satisfaction were used as criterion variable. None of the goodness of fit indices for this base model was found to be in acceptable range except the ratio of maximum-likelihood chi-square to the degrees of freedom [χ2/df =3.64, GFI=.92, AGFI=.82, TLI=.73, CFI=.85, RMSEA=.112, SRMR=.083].However, after two post hoc modifications (allowing life satisfaction to influence negative affect and positive affect respectively) the revised model (Figure 1) yielded a satisfactory model fit. The various goodness fit indices valuesassociated with this model were found to be in acceptable range [χ2(2) = 3.580, p >.05, χ2/df =1.79, GFI=.99, AGFI=.94, TLI=.94, CFI=.99, RMSEA=.06, SRMR=.02].

Figure 1: The mindfulness - subjective well-being relationship model assuming emotion regulation strategies as mediator (non-significant paths indicated by broken line and significant paths by dark line) It is evident form Figure-1 that mindfulness exerts a significant and direct effect on all the components of SWB viz., positive affect (path coefficient .28, p<.01), negative affect (path coefficient -.33, p<.01) and life satisfaction (path coefficient .40, p<.01) as well as one aspect of emotion regulation i.e., suppression (path coefficient -.35, p<.01). The reappraisal was found to have significant direct effect on positive affect (.14, p<.01) whereas suppression was having a direct but negative effect on life satisfaction (-.16 p<.05) respectively. Rest of the possible direct effects was not found significant. Apart from the aforesaid direct effects of mindfulness on various components of wellbeing, some indirect effects (mediated effects) were also found significant. Such significant indirect effects have been presented in Table- 1. It is evident from Table 1 that mindfulness

exerted a significant indirect effect on positive affect through life satisfaction (indirect effect = 13.495, p<.05) as well as through suppression and life satisfaction (indirect effect =1.922, p<.05). Similarly mindfulness indirectly influenced negative affect through life satisfaction (indirect effect =-18.347, p<.01) as well as through suppression and life satisfaction (indirect effect = -2.614, p<.01). Mindfulness also indirectly influenced life satisfaction through suppression (estimate 7.539, p<.01) and reappraisal (estimate .05, p<.05). Overall, the observed indirect effects suggest that the use of suppression (and to some extent cognitive reappraisal) mediates the relationship between mindfulness and SWB. Table 1: The Indirect Effects of Mindfulness on different components of SWB Mindfulness On Positive Affect Mindfulness On Negative Affects Mindfulness On Life Satisfaction Indirect paths Estimate Indirect paths Estimate Indirect paths Estimate

Through Reappraisal (path c * e)

1.712

Through Suppression (path a * h)

-3.923 Through Suppression (a * b) 7.539**

Through Suppression ( a * g)

1.227

Through Reappraisal ( c * f)

-.077

Through Reappraisal (c * d) .050

Through Suppression, Life Satisfaction (a * b * n) 1.922*

Through Suppression, Life Satisfaction (a * b * m) -2.614**

Through Life Satisfaction ( r * n)

13.495*

Through Life Satisfaction ( r * m)

-18.347**

Sum of all indirect effects 18.356*

-24.962**

7.589** **p<.01, *p<.05, The alternative model was also tested in which the domains of emotion regulation were considered as antecedent of mindfulnessand the composite score of the latent construct of mindfulness was hypothesized to directly influence various domains of well-being. After two minor modifications this model (Figure - 2) was found to fit the data satisfactorily as indicated by acceptable values of various goodness of fit indices [X2(2) = 2.067, p >.05; X2/df =1.033, GFI=.99, AGFI=.96, TLI=.99, CFI=1.00, RMSEA=.01, SRMR=.02].

Figure 2.The mindfulness - subjective well-being relationship model assuming emotion regulation strategies as antecedent factor (non-significant paths indicated by broken line and significant paths by dark line) It is evident from figure 2 that like earlier model (Figure 1) mindfulness was found to have a significant direct effecton all the components of subjective well-being viz.,

positive affect (path coefficient = .4, p<.01), negative affect (path coefficient = -.32, p<.01), and life satisfaction (path coefficient = .27, p<.01). Similarly, suppression was found to have a significant direct but negative effect on mindfulness as well as life satisfaction (path coefficients -.36 and -.16, respectively; p<.01). However, reappraisal was found to exert a direct significant effect on positive affect alone (path coefficient .14, p<.05). Some of the indirect effects in the previously mentioned model (especially the indirect effect of suppression on different components of SWB) were also found to be significant (see Table – 2). Observation of Table reveals that suppression reduces positive affect indirectly by reducing mindfulness (indirect effect = - .444, p<.01)and life satisfaction (indirect effect = -.155, p<.05) on one hand and by simultaneously decreasing mindfulness as well as life satisfaction on the other (indirect effect = -140, p<.05). Similarly, suppression was found to indirectly enhance negative affect by reducing mindfulness (indirect effect = .547, p<.01) and life satisfaction (indirect effect = .190, p<.01) as well as by simultaneously reducing both mindfulness and life satisfaction (indirect effect = .211, p<.01). The comparison both the models (figure 1 and figure 2) revealed that the model assuming emotion regulation as an antecedent factor in mindfulness-subjective well-being relationship(figure 2) was a better fit compared to the model which assumes emotion regulation as a mediator of the mindfulness – subjective well-being relationship (Figure 2). The observed lower values of the information theoretic measures associated with alternate model (Figure 2; AIC=40.06, BCC=41.37, BIC=103.75, ECVI=.191, CAIC=122.75) as compared to the original model (Figure 1; AIC=41.58, BCC=42.89, BIC=105.27, ECVI=.198, CAIC=124.25) provides empirical support to the said conclusion. Discussion: The findings of the present study though provide support to the notion that the observed positive effect of mindfulness on health and well-being may be mediated by its emotion regulatory effects, the alternate possibility that better emotion regulation helps to attain a mindful state of mind which in turn enhances health/well-being appears to be a better explanatory model than the former. In other words, the findings support the notion that emotion regulation is an antecedent factor in the mindfulness-subjective well-being Table 2: The Indirect Effects of Suppression on different components of SWB through mindfulness Suppression on Positive Affect Suppression on Negative Affects Suppression on Life Satisfaction Indirect paths Estimate Indirect paths Estimat e Indirect paths Estimate

Through Mindfulness (path b * p)

-.444**

Through Mindfulness (path b * q)

.547** Through Mindfulness (path b * r)

-.549**

Through Mindfulness and Life Satisfaction ( b * r * n)

-.140*

Through Mindfulness and Life Satisfaction ( b * r * m)

.190**

Through Life Satisfaction (d * n) -.155*

Through Life Satisfaction (d * m) .211**

Sum of all indirect effects -.739**

.948**

-.549** **p<.01, *p<.05,

relationship. However, the conventional model (that has also received some empirical support in earlier literature) that assumes emotion regulation as mediator of the mindfulness-subjective well-being relationship cannot be completely rejected or overruled inasmuch as this model also yielded a good fit to the data. These findings brings to fore an alternative explanation of the observed beneficial effect of mindfulness on mental health. This alternative explanatory model (that has been found to be a better fit than the mediational model) suggests that non-use or reduced use of suppression (but not the more use of reappraisal) leads to a mindful state awareness which in turn enhances the subjective well-being of an individual. In other words, decrease in the tendency to suppress emotional experience or reduced experiential avoidance leads to greater tendency to be mindful i.e. non-evaluation of experience, emotional acceptance and expressivity, flexible awareness. These findings alsosuggest that people who are less likely to suppress or modulate their emotional experiences tend to be more emotionally accepting, non-reactive and flexibly aware as well as keen observer of the present life experiences which in turn increase their life satisfaction, positive affectivity and reduce negative affectivity. This enhanced mindfulness and related qualities (i.e., vivid and flexible awareness over the internal/external stimuli), being dispassionate and non-reactive to emotional experiences in turn leads to better health and well-being.It can be said that suppressing authentic emotional experiences creates a sense of conflict between inner experience and outer expression or a sense of being inauthentic to one‘s true self, (Higgins, 1987; Rogers, 1951) which turns an individual hyper-evaluative and reactive to experiences that leads to lack of life satisfaction (Michalos, 1985; Sheldon, et.al., 1997). It has also been noted that reduction in the use of expression suppression reduces these discrepancies and inauthenticity which are further associated with the increased non-judgmental acceptance of the inner experiences that directly reduces negative affect (Mandal, et.al., 2012) and increased satisfaction with life. However, it is important to reiterate again that the initial hypothesis (i.e., emotion regulation mediates the mindfulness – subjective wellbeing relationship) could not be out rightly rejected because this model also met the contemporary standards of a good fit highly satisfactory model. Although the alternative possibility is more protuberant but the former hypothesis may not be rejected. The observation that both models may be equally fit leads to the other possibility that there may be a reciprocal or circular relationship between mindfulness and emotion regulation. Garland, Gaylord and Fredrickson (2011) thought that mindfulness and its positive emotional consequences follow a reciprocal upward spiral relationship which counters the self-perpetuating damaging effects of negative emotions and finally promotes positive functioning as well as well-being. The same explanation can also be applied to the mediating effects of enhanced emotion regulatory capacities in mindfulnesssubjective well-being relationship. Taken together, the present findings suggest yet another possibility that adaptive psychological processes are reciprocally related to each other or alternatively, ―gain spirals‖. However, the proposed existence of a circular relationship between mindfulness and emotion regulation needs further empirical verification. Conclusions: The findings of the present study though provides support to the notion that the observed positive effects of mindfulness on subjective well-being may be mediated by the emotion regulatory effects of mindfulness, the alternative theoretical formulation seems to be a better explanatory model to understand the health promoting effect of mindfulness. Further, the observation of two opposite but equally probable model suggest that possibility of the circular relationship between mindfulness and emotion regulation. However, it would be premature to make such

concussions until such speculation is empirically verified. References: Baer, R. A. (2003). Mindfulness training as clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 125–143. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006).Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848. Cardaciotto, L. (2005). Assessing Mindfulness: The Development of a Bi-Dimensional Measure of Awareness and Acceptance. Un Published Ph.D.Thesis, Drexel University. Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clin.Psy Review, 29, 560–572. Desrosiers A, Vine V, Curtiss J, Klemanski DH. (2014). Observing nonreactively: A conditional process model linking mindfulness facets, cognitive emotion regulation strategies, and depression and anxiety symptoms J.of Affective Disorders. 165, 31-37. Dubey & Pandey (2010). Hindi adaptation and psychometric evaluation of satisfaction with life scale. Unpublished manuscript. Garland, E. L., Gaylord, S. A., & Fredrickson, B. L. (2011). Positive reappraisal mediates the stressreductive effects of mindfulness: An upward spiral process. Mindfulness, 2(1), 59-67. Goldin, P., & Gross, J., (2010). Effect of mindfulness meditation training on the neural bases of emotion regulation in social anxiety disorder. Emotion, 10, 83– 91. Gross J. J., &Levenson, R. W. (1997).Hiding feelings: the acute effects of inhibiting positive and negative emotions. Journal of Abnormal Psychology, 106, 95– 103. Gross, J.J., & John, O.P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348-362. Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., &Kesper, U. (2007). Mindfulness training as an intervention for fibromyalgia: evidence of post intervention and three year follow-up benefits in wellbeing. Psychotherapy and Psychosomatics, 76, 226– 233. Grossman, P., Niemann, L., Schmidt, S. &Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 35-43. Hanley, A. W., Garland, E. L., & Black, D. S. (2013).Use of mindful reappraisal coping among meditation practitioners. Journal of Clinical Psychology, 70(3), 294–301. Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94, 319-340. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. NY: Guilford Press. Mackenzie, C. S., Poulin, P.A., Seidman-Carlson, R.(2006). A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Applied Nursing Research 19 (2), 105-109. Mandal, S. P., Arya, Y. K., & Pandey, R. (2011). Mindfulness, Emotion regulation and Subjective wellbeing: An Overview of Pathways to Positive Mental Health. Indian Journal of Social Science Researches, 8 (1-2), 159-167. Mandal, S. P., Arya, Y. K., & Pandey, R. (2012). Mindfulness and Mental Health: Mediational Role of Positive and Negative Affect. Journal of Projective Psychology & Mental Health, 19 (2), 150-159. Michalos, A. C. (1985). Multiple discrepancies theory (MDT). Social Indicators Research, 16, 347-413. Micheal, L. S., & Graham, J. R. (2011). Mindfulness, subjective well-being, and social work: Insight into their interconnection from social work practitioners. Social Work Education, 30, 1, 29-44. Morone, N. E., Greco, C. M., & Weiner, D. (2008). ―I felt like a new person‖—The effects of mindfulness meditation on older adults with chronic pain: Qualitative narrative analysis of diary entries. Journal of Pain, 9, 841–848. Nyklíček, I., (2011). Mindfulness, emotion regulation, and health. In: I. Nyklíček, A. Vingerhoets, & M. Zeelenberg, Emotion regulation and well-being (pp. 101-118). New York: Springer. Ochsner, K. N., & Gross, J. J. (2004). Thinking makes it so: A social cognitive neuroscience approach to emotion regulation. In R. F. Baumeister& K.D. Vohs (Eds.), Handbook of Self-Regulation: Research, Theory, and Applications (pp. 229−255). New York: The Guilford Press. Pandey, R., & Srivastava, N. (2008).Psychometric evaluation of a Hindi version of Positive-Negative Affect Schedule. Industrial Psychiatry Journal, 17, 59- 54. Prazak, M., Critelli, J. W., Martin, L. A., Miranda, V., Purdum, M. & Powers, C. (2012).Mindfulness and its role in physical and psychological health. Applied Psychology: Health and Well-being, 4, 91-105. Rogers, C. (1951) Client-centered Therapy: Its current practice, implications and theory. Boston: Houghton Mifflin. Segal, Z. V., Bieling, P., Young, T., MacQueen, G., Cooke, R., Martin, L., et al. (2010). Antidepressant monotherapy vs. sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry, 67, 1256–1264. Thera, S. (2010). The Way of Mindfulness: The Satipatthana Sutta and Its Commentary. Access to Insight, http://www.accesstoinsight.org/lib/ authors/ soma/wayof.html Watson, D., Clark, A., &Telegan, A. (1988). Development and Validation of brief measure of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070.

Recovery-Focused Behavior Therapy (RFBT): A Case Study Rakesh Kumar and Raj Kumar Sahu Recovery-Focused Behavior Therapy (RFBT) is a very recent conceptualization which is being shared in this paper which illustrates the application in a case of severe OCD. The patient is presented with an imaginary scenario of perceived recovery and he/she is to conceptualize and demonstrate the behaviors preferably at action level which he/she would be emitting upon the desired and perceived recovery. The patient being presented here is a 36 years old female with six and half year‟s history of severe OCD having secondary depression and suicidal attempts. She has been in psychiatric treatment for the past six years which resulted in temporary therapeutic outcomes.Exposure and Response Prevention or Cognitive Drill Therapy were the choices available to us for dealing with her severe OCD symptoms. Her score on Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was 32 out of a maximum of 40 which indicated extreme severity of OCD. In view of her pervasive OCD behaviors and the accompanied distress, it was thought that exposure to the objects of contamination and her underlying fears would amount to activation of very severe body-mind reactions (BMR). Hence, a highly gentle form of psychological method got developed on the fly which produced extra-ordinary improvements within three sessions of one hour each. The method is termed as Recovery-Focused Behavior Therapy (RFBT). Her Y-BOCS scores dropped to 17 out of maximum of 40 just after three daily sessions punctuated by one day gap due to Sunday; suggesting a substantial reduction in OCD symptoms at the level of moderate severity from the baseline extreme severity. Her affect and self-efficacy also improved perceptibly. The improvement was clinically corroborated with her behaviors with contaminated objects, reports of her husband, our own observations and her reports. The therapeutic intervention is discussed in details in the case study. There are a few studies that examined the prevalence of Obsessive-Compulsive Disorder (OCD) in India. Khanna et al (1993) reported a lifetime prevalence rate of 0.6% in Indian sample; about 17% of OCD patients are reported to have major depressive disorder (Bhattacharyya et al., 2005). Khanna et al. (1990) identified four reliable clusters in OCD – Washing, checking, thoughts of past and embarrassing behavior. Despite voluminous researches, the exact cause of OCD has not been discerned yet. However, both biological and psychological mechanisms are theorized to contribute to the onset and maintenance of OCD. Exposure and Response Prevention (ERP) was developed in 1960s for the treatment of OCD and still it is the most recommended and widely used treatment option specifically for predominantly compulsive type. The data from Randomized Controlled Trials attest to the efficacy of ERP in OCD (Jónsson&Hougaard, 2009). Other forms of psychotherapies such as Cognitive Behavior Therapy and Cognitive Drill Therapy (Kumar et al., 2012) are also used to address the problems in OCD. Exposure-based therapies trigger anxiety reactions in the patients by exposing the patients to the objects of their OCD. The triggered anxiety reaction may escalate even to a very high level. Because of this anxiety-provoking nature of exposure therapies, some patients fail to engage themselves into the protocols of exposure therapies, thereby depriving themselves from the option of powerful form of behavioral treatment. The procedures of cognitive restructuring are aimed at reducing the pain of anxiety evoked by exposures. Although, exposure is used as a behavioral test to examine if exposure to the objects of OCD still elicit anxiety reaction after addressing the underlying maladaptive cognitions. The status of current knowledge regarding psychological treatment suggests that effective forms of psychological treatment are available which can lead to improvement in OCD. In view of the anxiety reactions triggered by exposure and its impact on the patient, a natural upgrade to the line of thinking, is to formulate and revise the treatments in a manner that elicit minimal anxiety reactions in such patients and successfully address the problems. With this perspective, a novel form of intervention was applied in a case of OCD. The case is being presented ahead. Rakesh Kumar, Ph.D. Senior Clinical Psychologist; Raj Kumar Sahu, Psychiatry Resident; Institute of Mental Health and Hospital, Agra-282002 India Email: jain.imhh@gmail.com Key Words: OCD, Exposure-Response Prevention, Cognitive Drill Therapy, Behavior Therapy, Solution Focused Brief Therapy.

Clinical Background of the Case: Mrs. V, a 36 years old married female from lower socio-economic status was apparently well about six and half years back, when she started experiencing increased disgust while cleaning the feces/urine of her one and half years old son. She had to clean the floor and clothes of her son repeatedly about 4-5 times a day and began to ensure that everything is clean. Her husband noticed that she was spending more timewhile taking bath up to 45 minutes and was taking bath 2-3 times a day. She also started taking more time in cleaning activities such as washing her hands and feet 10-12 times a day. Her husband observed that she has developed extreme disgust for cats and crows because of soiling of clothes in the verandah. She then began to clean floor and clothes soiled by cat/crow multiple times andcontinued until she got subjectively convinced that the floor and clothes were cleaned. Her duration of sleep got reduced because she was now spendingmore time in the cleaning chores. She reported lack of sleep because she was unsure whether she has cleaned everything. She also started checking doors and windows to ensure if they were properly bolted.The thoughts of dirt and contamination were occupying her mind most of the time. She began to havesuicidal ideation because she was finding herself unable to get rid of the thoughts of contamination and the cleaning tasks. Her condition was deteriorating. She was not allowing her saree to get in touch with the floor. She avoided sitting on the floor and even was not allowing her son to sit either. The task of preparing her son to go to school was now assigned to her husband. She was finding it difficult to do cooking. In the kitchen her mind was getting preoccupied if any cat has entered inside and licked the milk. She kept covering the milk pot and kept a match box over to ensure that it was not licked by cat. The routine activities were getting delayed by 1-2 hours. It was creating distress in the family. Her husband used to become angry over her behaviors and tried to convince her that the objects are cleaned and cat was not inside the house. Her husband took her to private psychiatrist in the nearby city. She got intermittent and short-lived relief because of psychiatric treatment. She was getting perturbed both by the disorder as well as the cost of treatment. She even attempted suicide to get rid of all the distress. At this point she approached us and was diagnosed as a case of OCD with secondary depression. Her psychiatric treatment was initiated accordingly and also a referral for psychological treatment. At the time of intake in psychotherapy, Yale-Brown Obsessive- Compulsive Scale (Y-BOCS) was administered to assess the severity of her OCD. She scored 32 out of a maximum of 40 on Y-BOCS. The rated severity was extreme. She had prominent symptoms of both obsessions and compulsions. Psychological Intervention: Given the nature of stimulus-bound anxiety, we had a choice of Exposure and Response Prevention; and Cognitive Drill Therapy. Due to her extreme distress she was not amenable to cognitive restructuring. Also, it was apparent that exposure therapy would elicit severe anxiety in her already anxious and depressed state of mind. The exposure could further sensitize her which could lead to drop out and non-compliance of psychological treatment. At this point, a novel form of intervention was designed for her in the very first session of psychotherapy. Altogether, five sessions were conducted and the work-up is summarized below: Session-1 conducted on 24th September 2016: Today, I (RK, First Author) had a middle aged lady with six and half years h/o severe OCD of contamination type and pathological doubts and moderate to severe depression. She is on regular psychiatric medication. CDT was an obvious choice but would be painful and timeconsuming. A number of OCD behaviors were shared by her. I, instead of choosing CDT, employed exposure in a non-threatening and gentle manner. I explained her that when she would be free of OCD, how she would be touching dirty objects! She will then become comfortable in touching dirty objects, will not clean herself, touch other objects with dirty hands with ease and would not have any

discomfort in her body and mind (Body-Mind Reactions: BMR). She quickly understood the idea and the process. I modeled touching dirty objects and kept repeating in the following manner: “When she will be free of OCD, she will touch dirty objects in the manner, I am touching; she will not clean herself, touch other objects as I am touching and will not have BMR”. Then, I asked her to do the same with a number of objects. She touched several dirty objects and repeated that she will touch dirty objects like this, will touch other objects like this, will not clean herself and also there will be no BMR. This was the first session with a novel format of exposure. I decided to monitor the progress and repeat the same procedure in next session. This form of exposure in disguised and gentle form amused both of us. Session-2 conducted on 26th September 2016: Today I conducted the second session on this lady. The master idea being implemented was the following: *How would you handle dirty objects upon recovery? - show me”. She demonstrated by touching several dirty objects such as bathroom tap, cistern, sitting on the floor. I also showed her cat videos from youtube and she was at ease. She was also able to touch contaminated objects with ease having little signs of BMR. I trained her husband to deal with her in a similar manner. She now began to develop optimism in treatment. Let us see how she progresses. We decided to pursue the same form of exposure and monitor her condition. Session-3 conducted on 27th September 2016: Today I conducted the third session on the lady with OCD. She is showing tremendous improvement. She is now extremely comfortable in touching dirty objects; she is allowing her saree to get in touch with the floor which she was not doing; she is comfortable in sitting on the floor, even she could lie down on the floor, she was able to walk over dirty objects on road with no sign of distress, she touched her arms and face with dirty hands, she allowed her son to sit on the floor and then sit on her lap, she is able to touch her son and husband with dirty hands. She has become quite optimistic and acknowledging substantial improvement. She said now she can touch any dirty object, she even asked me to tell any dirty objects I wanted her to touch and hold. She told that she would not stop cleaning objects in her house. Her husband remained present in all the sessions. He was being trained as a cotherapist. She said that now onward she would free her husband from domestic work. She would do all domestic work and help her husband in family occupation. Her affect has become euthymic. Session-4 conducted on 28th September 2016: The fourth session was conducted today. She is quite fine. She is able to sit and lie down on the floor, comfortable to touch toilet objects and touch her husband. Nothing much is left to do for me. She gave elaborate descriptions of the activities and handling of contaminated objects with ease. She is highly motivated and can touching dirty objects within normal limits. Now she stopped verbalizing her problems and difficulties. She mostly talks of solutions; how she would handle contaminated objects. In the first two sessions, I was active and doing exposure on her, now she has become active in describing normal behaviors and handling dirty objects. On the baseline last week, her Y-BOCS score was 32 (O=16; C=16) out of a maximum of 40 which was rated as Extreme Obsessions and Compulsions. The most recent data on Y- BOCS today yielded a score of 17 (O=10, C=7) which indicates moderate level of OCD. Session-5 conducted on 29th September 2016: The fifth and last sessionwas conducted today. She came with changed clothes. She is quite comfortable. She is not holding her saree now to prevent touch with the ground and allowing her son to be on her lap. She is able to view Google images and videos of cats and crows. In treatment setting, no object of OCD could trigger BMR in her. She is at ease with all the objects. Her depression has uplifted. She received ECT, medication and RFB therapy. Her husband is advised not to discuss her past behaviors of OCD as merely talking of OCD symptoms can trigger the BMR. He is also advised not to put her in

challenge mode as challenging her can be intimidating and trigger BMR. She is advised to continue with her medicines and the manner of handling things as taught in therapy sessions. Her husband confirmed to the substantial improvement. At the end she said, if any BMR gets triggered, she will remember me and the method taught to handle the situations. She is now put on follow up to examine maintenance and generalization of therapeutic gains. Component and Mechanisms of Treatment: Having done first two sessions, I considered and contemplated upon the nature and mechanisms of this novel form of treatment. The pertinent observations of this treatment were: 1. The patient was required to put herself psychologically in imagination in future and report „when she would be recovered from her problems completely, then how would she handle contaminated objects? - show me‟. This statement was coupled with additional suggestions that „She would not need cleaning herself, and there would be no discomfort‟. Modeling was done by the therapist to demonstrate her, how she would be touching the contaminated objects without discomfort and cleaning herself. I myself touched a couple of contaminated objects to show her the manner of touching. Then she picked up and touched contaminated objects and repeated verbally at the same time that, she will be touching contaminated objects like this; she will not need cleaning and there would be no discomfort. 2. One by one she was required to demonstrate and verbalize above with 8-10 dirty objects present in therapist‟s office. She touched all the objects in similar manner. In the next sessions, she touched dirty objects in the bathroom. 3. Her story of OCD was heard by me for 30 minutes and then I initiated the treatment in the same session without psychoeducation. In subsequent sessions, I did not initiate the discussions on her problems of OCD and I discouraged her and her husband to narrate the problems. I told them that merely talking about the problems can trigger anxiety reactions; hence it is not required to dwell into the narration or discussion of the problems. 4. Second session onwards, she reported a subjective feeling that her mind is now turning towards normal state. In the first session, she specifically had mentioned that let us see if her mind gets disengaged from OCD. 5. In the second session, she reported negligible improvement. But when I systematically interviewed her regarding her behavior towards contaminated objects, she was showing some positive signs and I continued to apply the same procedure. 6. Since she is receiving the psychiatric treatment also, it would be difficult to partition the effects of this psychological intervention vis-à-vis psychiatric treatment. But the improvement in general is wellcorrelated with the onset of psychological treatment combined with continuing psychiatric treatment. Following components and mechanisms occurred which might have contributed to her progress and successful handling of contaminated objects. 1. Suggestibility: She complied and accepted the suggestions through verbal persuasion and modeling and got engaged in the handling of contaminated objects as suggested to her. 2. Goal-Focused Thinking: We presented her the goal, that at the end of treatment, she would be naturally handling contaminated objects in a manner she was handling prior to the onset of her OCD. When the goal of treatment was clear, her mind got engaged in goal-oriented thinking and behaviors. 3. Motivation to Change: She had very high motivation to change. She was struck and did not know how to approach the task. This method of dealing helped her to put her motivation to change into action. 4. Exposure: The exposure was involved but the anxiety activation was blocked cognitively when an imaginative scenario of future time, i.e when she is recovered, was

presented to her. This future perspective successfully blocked anxiety activation and she directly got into the handling of contaminated objects without covert feelings of anxiety and overwhelming emotions. 5. Response Prevention: The compulsive response was also blocked through cognitive mediation when I said that upon recovery she would not need cleaning. 6. Time-Reference: Anxiety by nature is an apprehension and uncertainty regarding future. In anxiety the mind projects into the future and becomes scared. In this method, imaginative future apprehensions were converted into sense of security devoid of anxiety. Also, the time-reference was in operation when, I presented her a cognitive framework of future. The future perspective at cognitive level and emission of desired behaviors in the current time, here and now, rapidly aligned together and a shift might have took place cognitively. This resulted in adaptive cognitive re-interpretation, that, when she is handling contaminated objects in the present time, she can also do the same behaviors of handling contaminated objects in future. 7. Imagery Focus: A person in psychological distress has two imageries: (a) healthy imagery representing perceived healthy behaviors (b) Unhealthy imagery representing perceived unhealthy behaviors. This imagery could be global representation of one‟s self or any specific domain of the self-such as contamination, doubts. The awareness of the unhealthy imagery and the behaviors representing unhealthy imagery evokes an anxiety response. The person wants to live according to the healthy imagery. When a person adopts an approach of removing unhealthy imagery and the unhealthy behaviors, it paradoxically attracts disproportionate attention and the unhealthy imagery gets reinforced. The more he tries to eliminate unhealthy imagery, the more he gets into the mental trap and anxious patterns. For most efficient treatment, we need to take away all the attention of the person from unhealthy imagery and self and focus on the perceived healthy imagery. Since, healthy self-imagery already exists in the mind; the person understands what healthy behavior is and how it is emitted. A simple and straightforward 'focus shift' from unhealthy to healthy imagery does wonders when we ask "show me how you are going to do when you are fully recovered". Fully recovered means two things (1) A centering on healthy imagery (2) De-centering from unhealthy imagery. “Solution-Focused Brief Therapy (SFBT) is an evidenced-based psychotherapy approach that was developed by Steve de Shazer (1940-2005), and Insoo Kim Berg (1934-2007) and their colleagues in the late 1970‟s in Milwaukee, Wisconsin. SFBT is futurefocused, goal-directed, and focuses on solutions, rather than on the problems that brought clients to seek therapy.” (http://www.solutionfocused.net). The approach adopted by us is similar but not identical to the approach of Solution-Focused Brief Therapy. Hence, instead of placing it within the framework of SFBT, we are considering assigning a different label “Recovery Focused Behavior Therapy” to this approach, because this would help us to elaborate, make innovations and test it extensively on more cases of OCD and other psychiatric disorders. References: Khanna S, Gururaj G, Sriram TG. (1993) Epidemiology of obsessive-compulsive disorder in India.Presented at the First International Obsessive-Compulsive Disorder Congress. Capri: March 9-12, 1993 Bhattacharyya S, Reddy YC, Khanna S (2005) Depressive and anxiety disorder comorbidity in obsessive compulsive disorder. Psychopathology. 38(6):315-9. Kumar.R.,Sameer.A., Singh.B. (2012). Preliminary Test of Cognitive Drill as an Intervention.Indian Jr. of Clinical Psychology. 39, 67-74. Jónsson H, Hougaard, E. (2009) Group cognitive behavioural therapy for obsessive-compulsive disorder: a systematic review and meta-analysis. ActaPsychiatricaScandinavica. 19(2):98-106 Khanna, S., Kaliaperumal, V.G., Channabasavanna, S.M. (1990) Clusters of obsessive-compulsive phenomena in obsessive-compulsive disorder. British Journal of Psychiatry.15(6):51-4

SIS Society Honors Early Adventures into Space and Others of Note Wilfred A. Cassell • April 12th 1961 Soviet cosmonaut Yuri Gagarin is first man in space • May 5 1961 American astronaut Alan Shepherd is second man in space • February 20, 1962 John Glen is first U.S. astronaut to orbit earth • June 16th 1963 Soviet Cosmonaut Valentina Tereshkova is first woman in space • June 20, 1969 Neil Armstrong & Buzz Aldrin from the U.S.walk on the moon • July 17, 1975 U.S. and U.S.S.R. space craft dock; crews work together for two days • June 18th 1983 Sally Ride is the first American woman in space • Oct. 15, 2003 Yang Liwei, China’s first astronaut • 2011 Guillaume Nery Without the aid of breathing equipment reached a record depth of 384 feet in the Greek port of Kalamata • Chris Hadfield the first Canadian to walk in space. He took some45,000 photographs in orbit and published 192 of them in his public educating 2015 book entitled “You Are Here: Around the world in 92 Minutes”. • Sylvia Earle – An American oceanographer who spent her career developing huge marine parks • Craig Venter – This American scientist who built the first man made genone (i.e. “LifeM made in the laboratory”)during the early years of this century. In addition to the above list of death defying brave adventurers into new special horizons for human life, I would like to add to the ever growing list, the names of two American astronauts: Scot and Mark Kelly. These are identical twins who in a Jeffrey Kluger 2015 Time magazine article were described as “Born factory loaded with the exact same genetic operating system”, “While there is quite a bit of data (on human health) for six months NASA needs to run long duration tests. So NASA needs subjects to run long duration tests”. “The biggest problem with our exploratory ambitions is, simply, us. The human body is a purpose –built machine, designed for the one -G gravity of Earth. Take us into the zero G of space and it all comes unsprung. Bones get brittle eyes lose their shape, hearts beat less efficiently since they no longer have to pump against gravity, and balance goes awry. So NASA needs subjects to venture out to run long duration tests. In a perfect experiment, every research subject in space would also have a control subject on the ground – someone with, say, the exact genes and a similar temperament , so that you could tease apart the changes that come from being aloft for 12 months from those that are a result of growing one year older on Earth”. In the Kelly brothers – and only the Kelly brothers- NASA has the two person sample group SIS clinicians and researchers are encouraged to actively seek opportunities to join with the various international investigators presently studying the medical, psychiatric and psychosocial factors both on-orbit and post-spaceflight. While a Google search engine currently has publications, unfortunately none relate to SIS projective testing. Last August at a meeting of the American Psychological Association, a panel of American NASA psychologists spoke about their two general goals: first to “weed out candidates with potential for space stress induced mental illness and second, to get rid of people with the wrong psychological “stuff”. Interest in the former was first brought to the Wilfred A Cassell, M.D., FAPS, APC.,Editor Emeritus, SIS J. of Proj. Psycho.& Mental Health, Director, SIS Center, Anchorage (USA) Email: siswilfredacassell@yahoo.com Kew Word: Space and Mental Health

public’s attention in February 2007 when an American (Female) astronaut Lisa Nowk “allegedly tried to kill or kidnap a woman whom she perceived as a competitor to the affections of a fellow astronaut William Oefelein”. While one case means little statistically, it is consistent with the known scientific data regarding the emotional instability of many women during the premenstrual phase, as well as their higher incidence of certain mental health disorders (e.g. Major Depression). We now need toboth train space scientists with regard to the significant potential for adapting SIS Body-Mind-Spirit technology for both health screening, psychological treatment and research! Members of our SIS Society are encouraged to be optimistic regarding the power of scientific technology to improve life on our planet and prevent its destruction by deranged individuals threatening modern forms of warfare. I am stimulated by the Canadian astronaut Chris Hadfield’s hopeful optimism about the value of science in our ever evolving modern world. He expressed this on 5/27/2015 in a 30 minute Skype session to high school students on Vancouver Island and published in the Saanich News as follows: We need to generate enough electricity to make the world sustainable, it is of enormous benefit for our species, and we need democratization of intellect. It is important to have a longer -term view. Coming back from space, having gone around the Earth 100 times and seeing its resiliency, I’m optimistic about humanity on Earth” Relevant References: Fassbender C, Goeters K.M. Results of the ESA study on selection of European astronaut applicantsActa Astronaut 1992 Jul; 27:131-8 Fassbender C. Goeters K.M. Psychological evaluation of European applicants: results of the 1991 application selection campaign Aviat Space Envir Med 1994 Oct 65 (10Pt1):925-9 Sekiguchi C., Umikura S, Kume M, Psychological evaluation of Japanese astronaut applicantsAviat Space Environ Med 1994 Oct.65(10Pt 1)920-4 Santy P.A. Jones D.R. An overview of international issues in astronaut psychological selectionAviat Space Environ Med 1994 Oct.65 (10Pt1):900-3 Collins D.L. Psychological issues relevant to astronaut selection Hum Perf Extrem Environ 2003 Spring 7(1): 43-67”

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Rakesh Pandey, Ph.D. Prof. & Head, Dept of Psychology, Banaras Hindu University, Varanasi-221005 Email: rpan_in@yahoo.com (2012-2015)

STATEMENT SHOWING OWNERSHIP AND OTHER PARTICULARS ABOUT SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH Place of Publication: Mathura-281122 Periodicity of Publication: Half Yearly Editor: Dr. Naveen Gupta Nationality: Indian Address: Hindustan Institute of Management and Computer Studies, Farah, Mathura-281122 U.P. Owner: Somatic Inkblot Society Printer’s/Publisher’s Name: Mr. Sunny Kushwah I, Dr. Naveen Gupta, hereby declare that the particulars given above are true to the best of my knowledge and belief. Sd/ Dr. Naveen Gupta, Editor-in-Chief SIS Journal of Projective Psychology and Mental Health Published by Dr. Naveen Gupta, on behalf of Somatic Inkblot Society at IMPERIAL COMPUGRAPHICS 2/12, Swadeshi Bima Nagar, Civil Lines, M.G. Road, Agra – 2 Email : imperialprintersagra@yahoo.com Phone No. 0562-4045083

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH: ACHIEVEMENTS Journal in WHO Listing Members of Somatic Inkblot Society will be glad to know that SIS Journal of Projective Psychology and Mental Health has been listed by World Health Organization (Global Forum for Health Research) among 25 indexed journals that have published the highest number of articles on mental health from LMICs in Latin America, Africa and Asia (Medline and PsycINFO). Extract from table-6 of “Research Capacity for Mental Health in Low - and Middle - Income Countries: Results of a Mapping Project “(www.globalforumhealth.org) is given below:

Rank Journal Country Language Revista de Psicoanalisis Argentina Spanish Revista de Neurologia Spain Spanish Revista Brasileria de Psiquiatria Brazil Eng.,Spani.,Portuguese Arquivos de Neuro-psiquiatria Brazil Portuguese Acta Psiquiatrica y psicologica de Amercia Laina Argentina Spanish Journal of the Medical Association of Thailand Thailand English, Thai 7 British Journal of Psychiatry UK English Acta Psychiatrica Scandinavica Denmark English Salud Mentale Mexico Spanish Vertex Argentina Spanish Journal of Personality and Clinical Studies India English Social Psychiatry and Psychiatric Epidemiology Germany English Revista Medica de Chile Chile Spanish South African Journal of Psychology South Africa Afrikaans, English Psychological Reports USA English South African Medical Journal South Africa Afrikaans, English The Australian & New Zealand Jr. of Psychiatry Australia English International Journal of Social Psychiatry U. K. English Psychiatry Research Ireland English Social Science & Medicine U. K. English Revista De Saude Publica Brazil Portuguese International Journal of Geriatric Psychiatry U. K. English SIS Journal of Projective Psychology and Mental Health India English Journal Brasilerio de Psiquiatria Brazil Portuguese Psychiatry and Clinical Neurosciences Australia English

Journal in ProQuest Listing: We are glad to inform you that SIS Journal of Projective Psychology & Mental Health has been listed in academic research database ProQuest Psychology Journals™. ProQuest is a company in Michigan, United States. It is a leading provider of electronic databases for academic libraries. Databases are used in over 20,000 academic libraries around the country and around the world including some of the most prestigious higher education institutions such as Harvard, Yale, Princeton, Oxford etc. ProQuest provides abstracts and indexing for more than 640 titles, with over 540 titles available in full text. Users get access to charts, diagrams, graphs, tables, photos, and other graphical elements essential to psychological research.

Abstracted in “APA” Psyc INFO “ Regd. No. 71632/99, RNI Delhi SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH

January 2017

EDITORS EMERITUS : Wilfred A. Cassell, MD, FAPA, Director, SIS Center, Anchorage, AK.99516 E-Mail: siswilfredacassell@yahoo.com

Bankey L. Dubey, Ph.D., Director SIS Centre,4406 Forrest Rd, Anchorage, AK 99517, E-mail: bldubey@gmail.com

EDITOR-IN-CHIEF : Naveen Gupta, Ph.D., Director, Hindustan Institute of Mgt.& Computer Studies, Farah, Mathura-281122, Email: dr_naveengupta@yahoo.com

EXECUTIVE EDITOR: Rakesh Kumar, Ph.D. Senior Clinical Psychologist Institute of Mental Health & Hospital, Agra-282002 (India).Email: jain.imhh@gmail.com

EDITORS : Anand Dubey, MBA, 4406 Forrest Road, Anchorage, AK 99517 Email: anand.dubey@gmail.com

L. Sam S. Manickam, Ph.D., Prof. Clinical Psycho., JSS University, Mysore-570004, Email: lssmanickam@gmail.com

Christopher Piotrowski, Ph.D. Research Consultant, University of West Florida, 504 Concordia Blvd. Pensacola, FL 32505 (USA) Email: cpiotrowski@uwf.edu

NilanjanaSanyal, Ph.D., Prof. Dept. of Psycho. University of Calcutta, 92 A. P. C Road, Kolkata-700009 Email: sanyal_nilanjana2004@rediffmai.com

PUBLICATION MANAGER: Brijesh.K.Gupta, MBA

EDITORIAL CONSULTANTS : Abhilasha Singh, Ph.D., India AiloUhinki, Ps.D., Finland Amool R. Singh, Ph.D., India Anatoly B. Khromov, Ph.D., Russia Arvind K. Keshary, Ph.D., India Barry A. Ritzler, Ph.D., U.S.A. Brig. D. Saldanha, M.D., India Carina Coulacoglou, Ph.D., Greece David J. Sperbeck, Ph.D., USA. Dharmendra Jain, D.M., India Dilpreet Singh, M.B.A. India Edward M. Petrosky, Ph.D., U.S.A. H. Kumar, Ph.D., USA JashobantaMahapatra, Ph.D., India Jayanti Basu, Ph.D., India Joachim von Weissenberg, M.Sc. Finland Lisa Milne, Ph.D., Australia M. Andrew Mayo, Ph.D., USA. M.P.Singh, Ph.D., India Manisha Dasgupta, Ph.D., India Nalini Mishra, Ph.D., India Padma Dwivedi, M.A., USA Paola Nicolini, M.A., Italy Prasant K. Roy. M.Phil, India RadheShyam, Ph.D., India Rakesh Pandey, Ph.D., India Ranjeet Kumar, Ph.D., India Robert B. Williams, Ph.D., Canada SandhyaraniMohanty, Ph.D., India Sanjukta Das, Ph.D. India Stefano Reschini, M.A., Italy Sudhir Kumar, M.D., India SuprakashChaudhury, M.D., Ph.D.,India Yasho V. Verma, Ph.D., India Yogesh K. Arya, Ph.D., India