Mark L. Goldstein, Ph.D.
Both the Association of Family and Conciliation Courts (2006) and the American Psychological Association (2009) recommend that multiple data gathering strategies be utilized in custody evaluations, and cite the use of psychological tests as one of the possible methodologies. Formal psychological testing has been a core component of a clinical psychologist’s training, so it is not surprising that most psychologists do utilize psychological tests as a component of their custody evaluations. Bricklin (1999) commented that there has been an increase in the number of psychologists who use tests in custody cases over the years. Bow and Quinell (2001) surveyed custody evaluators and reported that psychological testing was the fourth most preferred procedure in custody evaluations. They also related that 91% of respondents used psychological testing of parents and that 61% tested children, 53% tested spouses and 21% tested significant others. Stahl (2011) has opined that “it is best to include some psychological tests and parenting inventories in nearly all custody evaluations, but to maintain caution in interpreting and potentially over-interpreting the test data (p. 111).”
Personality testing is often employed in the assessment of the adults, and may also be used in evaluating the children. Studies (Ackerman and Ackerman, 1997; Hagen and Castagna, 2001; Wangberg, 2000) have shown that the Minnesota Multiphasic Personality Inventory (MMPI), and the more recent versions of the instrument of the instrument (MMPI-2 and MMPI-2-RF) is the most widely used personality instrument in custody evaluations. However, projective personality tests have also been used frequently.
The Ackerman study (Ackerman and Ackerman, 1997) queried 201 custody evaluators about their use of psychological tests in custody cases, asking each to list all tests employed for evaluating adults and children, and the percentage of time that each was used. The study indicated that the Rorschach Inkblot Method (Rorschach) was the second most widely used tests with adults in custody evaluations; 48% of the respondents used this test and respondents employed the Rorschach 64% of the time. In addition, the Thematic Apperception Test (TAT) was used by 29% of respondents and these evaluators employed this test 56% of the time in custody cases. Other projective tests, including the Sentence Completion Test, Projective Drawings, and the House-Tree-Person Test (HTP) were also utilized by some evaluators in custody evaluations, but to a lesser degree than the Rorschach or TAT.
Hagan and Castagna (2001) reanalyzed the Ackerman survey data and also found that the Rorschach was the second most widely used instrument in custody evaluations. However, they related that the Rorschach was utilized in only 31% of all evaluations. The TAT was employed in 16% of evaluations. By contrast, the Sentence Completion test was used in 19% of all custody assessments, reflecting more actual use than the TAT.
Projective tests have also been utilized in assessing children and adolescents in custody matters. In the Ackerman study (Ackerman and Ackerman, 1997), only 8% of respondents reported that they did not test children. The Children’s Apperception Test (CAT) was the most widely used instrument, with 37% of respondents reporting use of the test in custody cases, and those respondents reporting that the CAT was used 53% of the time. 35% of the respondents related that they employed the Bricklin Perceptual Scales (BPS), 29% of the respondents related that they used the Sentence Completion Test, 27% indicated that they used the Rorschach, 24% reported that they employed Projective Drawings, 19% related that they utilized the House-Tree-Person Test HTP), while 19% reported use of the Kinetic Family Drawing (KFD) and 16% indicated use of the Perceptions of Relationships Test (PORT). Other lesser used projective tests included the Roberts Apperception Test for Children (RATC).
In the reanalysis conducted by Hagan and Castagna (2001), the BPS was used in 26% of evaluations, the CAT was used in 22% of cases, Projective Drawings were used in 20% of cases and the KFD was used in 16% of custody evaluations. Furthermore, they reported that the HTP was employed in 14% of cases, the Rorschach was used in 13% of cases, the PORT was used in 10% of cases and the RATC was employed in 8% of cases.
Wangberg (2000) reported that psychological tests were used 80% of the time by surveyed psychologists who conducted custody evaluations. The most used projective tests in custody evaluations of adults were the Rorschach and Projective Drawings. The most used projective tests in evaluations of children were the BPS and the PORT.
Projective tests in general have been the subject of much controversy in the psychology literature. In addition, there has been controversy over the use of projective tests in family court matters. In all fairness, the use of psychological tests, particularly projective tests, is limited. Erickson, Lilienfeld and Vitacco (2007a) have pointed out that there has been minimal research on psychological tests related to visitation as well as abuse and neglect. They have also noted that there are problems due to the lack of empirical support, the attachment to psychoanalytic theory and a lack of peer-reviewed publications.
Although the Rorschach has typically been cited as the most widely used projective instrument, Erard (2007) has suggested that the Rorschach is a performance based instrument. Weiner (2013) argued that the Rorschach is a relatively unstructured and performance based personality assessment tool, and that it is unfair to label the Rorschach as a projective instrument. Weiner (1997) had previously commented that the Rorschach could generate structural, thematic and behavioral data. Ackerman (2001) related that the Rorschach was “a cognitive perceptual task and not an exploration of unconscious projections of unmet needs and unresolved conflicts (p. 141).”
The Rorschach has been widely used in custody cases, as reflected in surveys of custody evaluators (Ackerman and Ackerman, 1997; Hagan and Castagna, 2001). The literature suggests that the Rorschach has utility in detecting thinking disturbance, and to a lesser degree in detecting interpersonal dependency. Even Rorschach critics such as Erickson, Lilienfeld, and Vitacco (2007a; 2007b) have acknowledged the usefulness of the Rorschach in detecting thought disturbances and interpersonal dependency.
In the hands of a competent evaluator, the Rorschach has been shown to have good inter-rater reliability (80-90% agreement), as well as good test-retest reliability (70-80%) over a three-year period (Weiner, 1997). In a recent study (Mihuri, et al, 2012), the authors evaluated peer-reviewed validity literature for the 65 primary variables for the Rorschach Comprehensive System (Exner, 2003). They found that the variables with strongest support were those that assessed cognitive and perceptual processes (Perceptual Thinking Index, Synthesized Response). In total, 13 variables had excellent support, 17 variables had good support and 10 variables had modest support. Finally, they found that those variables with the least support tended to be very rare, for example Color Projection, or relatively new scales, for the Egocentricity Index.
Global meta-analyses have shown that the Rorschach, as a whole, possesses modest validity that may even approach the validity of the MMPI-2 (Hiller, et al, 1999). In this analysis, 30 randomly selected studies were examined and determined that some variables were valid, but that there was not support for the Depression Index, the Egocentricity Index, and the ability to assess for Post Traumatic Stress Disorder. Bornstein (2012) has proposed strategies for documenting the construct validity of Rorschach test scores, including performance-based test scores.
Erickson, et al (2007a, 2007b) have argued against the use of projective tests, including the Rorschach, the TAT, Human Figure Drawings, the BPS, the PORT, and other instruments. They have commented that there are significant questions regarding both the validity and reliability, that the norms of the Exner Comprehensive System for the Rorschach are inaccurate, and that these flawed norms lead evaluators to overestimate psychopathology (Shaffer, et al, 1999; Wood, et al, 2003; Wood, et al, 1996). Some studies have reflected that the Rorschach may identify normal adults as having a maladjustment or severe mental illness (Grove, et al, 2002). There has also been concern about psychometric properties of the Rorschach and poor inter-rater reliability of some scores is poor (Acklin, et al, 2000; Guarnaccia, et al, 2001). In another study (Wood, et al, 2001), it was demonstrated that the Depression Index had little association with clinical depression. Furthermore, Lilienfeld and his colleagues (2001) have stated that there is little support for the validity of many scores on the Rorschach.
Dawes (1994) has reflected that the Rorschach appears to be most valid when used as a perceptual test, rather than as a projective test. It appears that most proponents of the Rorschach (e.g. Weiner, 2012) agree with this point of view.
In their 2007 article (Erickson, et al) also report a problem with the Rorschach’s reliance on unpublished or unavailable studies in the manual. In particular, they cite that some of the samples used to create the adult norms were duplicates. Erard (2007) noted that the test was re-normed (Weiner, 2005; Exner and Erdberg, 2003). He also related that the Acklin study (Acklin, et al, 2000) that most scoring decisions had acceptable to excellent levels of reliability. Another study (Parker, et al, 1988) showed modest validity, comparable to the MMPI, while Ganellen’s study (1996) demonstrated that the Rorschach was superior to both the MMPI and MCMI-II in assessing serious psychopathology. In addition, in peer-reviewed journals publishing personality assessment articles, the Rorschach was second only to the MMPI in the number of articles Butcher, et al, 1992) supporting the reliability and validity (Ritzler, 1996). Finally, Meyer, et al (2002) found that 95% of the ratings had excellent reliability.
A new system for administering, scoring and interpreting the Rorschach was recently developed (Meyer, et al, 2011). This system, the Rorschach Performance Assessment System (R-PAS) was designed to make the best possible use of existing clinical evidence as well as scientific evidence. Erard (2012) reported on the use of the R-PAS in forensic evaluations related to psychological injury cases. However, there is no data yet related specifically to custody cases.
There have been only a handful of articles on the use of the Rorschach and its use in custody evaluations. Hoppe and Kenny (1994) found that 40% of subjects involved in custody evaluations were in a high lambda group, in comparison to only 5% of non-litigants. They suggested that this reflected cognitive simplicity, as well as a withdrawal from affect and poor impulse control. They also discovered that 51% of the custody litigants did not have a well-developed problem-solving style, in comparison to only 20% of the non-litigant population. They found that 25% of the litigants gave a reflection response, supposedly indicative of narcissism. Finally, the results reflected that 30% of the male litigants and 19% of the female litigants had a positive finding on the Coping Deficit Index.
Schultz (2014) examined the impact of online information on the Rorschach test results in custody matters. The exposure of online information appeared to most significantly impact the variables associated with perceptual accuracy and reality testing. Those with access to online information on how to fake “good” had a lower number of responses, and higher scores on the X+%, the XA%, the WDA% and the number of popular responses.
Singer, et al (2008) discussed the use of Rorschach data to determine personality characteristics of parents who are divorcing, particularly deficits in managing interpersonal conflict, ability to modulate control, ability to collaborate and coping deficits.
Archer (2006) and Weiner (2007) cited empirically based data in support of the use of the Rorschach in forensic evaluations, including custody cases. Evans, et al (2008) proposed that the Rorschach be employed as a component of a comprehensive child custody and parenting plan evaluation. Calloway (2005) has argued that the Rorschach is uniquely suited for use in child custody evaluations.
In my experience in conducting over 1100 custody evaluations over the past 35 years, the Rorschach has some value. The bulk of the research suggests that the Rorschach has utility in detecting thought disorders. In this writer’s professional opinion, there is no better instrument for assessing thought disorders, particularly underlying thought disorders. In addition, I have found the Rorschach useful in looking at interpersonal issues, which certainly may play a role in one’s ability to function well as a parent.
While I would agree that many of the Rorschach ratios and percentages have limited validity and reliability, some of these may be very beneficial in custody evaluations. This is particularly true in that most custody litigants are quite defensive on objective tests like the MMPI-2, the MMPI-2-RF, the MCMI-3 and the PAI. Research has clearly demonstrated that custody litigants have higher scores on validity indices measuring defensiveness. As a result, one often encounters valid, but highly defensive protocols with little useful data. Given the straight-forward nature of the questions, many intelligent litigants respond in such a way as to present themselves in a favorable light with no discernable psychological problems. By contrast, the Rorschach is more difficult to fake, because litigants typically do not know how to respond. As a result, the Rorschach may shed light about psychological issues. For example, in one recent case, both parents presented with barely valid MMPI-2-RF and MCMI-3 protocols, and no significant findings on any of the clinical scales. By contrast, the Rorschach of one of the parents revealed significant problems with impulse and affect control (evident by the primary use of color and color dominated form responses and an elevated Affective ratio), supporting the contention of the other party and the children. In another case, one parent contended that their spouse was narcissistic, but there was no elevation on the Narcissistic scale on the MCMI-3. However, the Egocentricity index on the Rorschach was very elevated, supporting this claim, and collateral interviews with past therapists confirmed a diagnosis of Narcissistic Personality Disorder.
In my opinion, the Rorschach may be used to assess thought disorders and interpersonal problems, but also employed to either support or not support issues of concern delineated by the parties. It would be inappropriate to utilize Rorschach data in a vacuum.
In contrast to the usefulness of the Rorschach, the other projective tests appear to lack adequate reliability or validity for the most part. The Thematic Apperception Test (Murray, 1943) is the secondly most widely used projective in custody cases, but has a paucity of research in custody matters. Ackerman (2001) has opined that the CAT and TAT can be useful in custody evaluations. He also commented that the TAT can help in picking up themes related to interpersonal relationship issues, depression, victimization and nurturance issues. However, the TAT has been criticized for its lack of standardization, clinically insignificant incremental validity, common ad hoc administration and lack of training by most students and clinicians (Ball, et al, 1994; Groth-Marnat, 2003; Hunsley, et al, 2003; Rossini and Moretti, 1997). The administration varies widely among evaluators, with most clinicians failing to use an adequate number of cards (Hibbard, 2003; Hibbard, et al, 1994). In addition, the TAT may be subject to an “inhibition effect” whereby subjects successfully restrict the overall personality measure when attempting to suppress true personality features (Lilienfeld, et al, 2000).
Even if the TAT is properly administered, there is nonetheless weak internal consistency, weak test-retest reliability and limited construct validity (Entwisle, 1972; Fineman, 1977; Lilienfeld, et al, 2000; Winter & Stewart, 1977). Furthermore, others (Garb, et al, 2005) have argued that results may actually decrease the accuracy of clinical judgments, because evaluators may attend too much to the invalid information.
There are some supporters of the TAT as well. Several authors (Erard, 2007; Erickson, et al, 2007) have noted that the TAT has promise in assessing object relations, as with the systematic and validated Social Cognition and Object Relations Scale (Westen, 1991). The Cramer Defense Scales (Cramer, 2006; Cramer, 1991) and the Affect Maturity Scale (Thompson, 1986) have also had support as useful methodologies.
Erard (2007) has opined that the TAT is also valuable in assessing parent-parent relationships as well as parent-child relationships, both clearly important in custody evaluations. Hibbard (2003) noted that there are three systems for coding the TAT, adding to the reliability and validity of the instrument. He also related that the TAT is more robust than Lilienfeld and colleagues have stated.
As previously noted, there are no studies of the TAT in child custody evaluations. There have been some studies that have examined the TAT in assessing physically and sexually abused children (Freedenfeld, et al, 1995; Ornduff & Kelsey, 1996; Pistole & Ornduff, 1994). In addition, there has been one study (Costantino, et al, 1991) that demonstrated the ability of the TAT to identify Attention Deficit Hyperactivity Disorder in children.
It is this evaluator’s impression that the TAT, and other apperception tests (CAT, RATC) should be used with great caution, if at all, in custody evaluations because of the total lack of research related to child custody evaluations. However, the apperception tests may hold some promise in the future for assessing relationship issues, which are an important feature of custody cases.
Even more than the TAT, figure drawings including the Draw-A-Person Test (DAP), the Draw-A-Person-in-the-Rain (DAP-R), the House-Tree-Person Test (HTP) and the Kinetic Family Drawing (KFD) lack reliability and validity. Robinson (2012) conducted a validity study of projective drawings and reflected that projective assessment of drawings would be enhanced by having a unifying methodology for administration, scoring and interpretation of these tests. He offered a new approach, the Psychological Study of Images Captured and Electronically Measured (PSICEM). Previously, Joiner, et al, (1997) noted that size, detail and line heaviness were related to emotional distress in children’s drawings, while others disagreed (Riethmiller & Handler, 1997) offered an alternative opinion.
Ellis (2000) utilized projective drawings as well as other instruments in assessing sexual abuse allegations in child custody cases. Lyons (1993) assessed the use of Kinetic Family Drawings, free drawings and dot to dot drawings in families experiencing custody disputes.
Finally, Incomplete Sentences have also been employed in custody evaluations, but appear to have minimal support for their use. Nonetheless, some well-known figures in child custody evaluations, including Ackerman (2001) support their use. He indicated that “Some form of incomplete sentences test should be used with parents and adolescents in child custody evaluations (p. 143).” He added that any series of open-ended questions that provides an opportunity for the subject to respond was adequate, and that it was not necessary to employ a formal sentence completion test.
For the most part, sentence completion instruments have not been studied. However, in one study (Blumentritt, 1997) investigated the reliability and validity for the 18-item halves of the Sentence Completion Test of Ego Development (Hy & Loevinger, 1996. Although there was high inter-rater, reliability was low and reflected poor reliability.
Overall, this evaluator would not support the use of either projective drawings or sentence completion instruments for use in custody evaluations, due to their lack of reliability and validity, as well as the lack of any studies of these tools in custody cases.
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