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Perception and Language: Using the Rorschach with People with Aphasia V Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Summer 1-1-2016 Perception and Language: Using the Rorschach with People with Aphasia V. Terri Collin Dilmore Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Collin Dilmore, V. (2016). Perception and Language: Using the Rorschach with People with Aphasia (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/93 This Worldwide Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. PERCEPTION AND LANGUAGE: USING THE RORSCHACH WITH PEOPLE WITH APHASIA A Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By V. Terri Collin Dilmore, M.A. August 2016 Copyright V. Terri Collin Dilmore 2016 PERCEPTION AND LANGUAGE: USING THE RORSCHACH WITH PEOPLE WITH APHASIA By V. Terri Collin Dilmore Approved July 27, 2016 ________________________________ ________________________________ Alexander Kranjec, Ph.D. Sarah Wallace, Ph.D., CCC-SLP Assistant Professor of Psychology Associate Professor of Speech-Language Pathology (Committee Director) (Committee Co-Director) ________________________________ ________________________________ James C. Swindal, Ph.D. Lori Koelsch, Ph.D. Dean, McAnulty Graduate School of Associate Professor of Clinical Psychology Liberal Arts Director of Undergraduate Psychology Professor of Philosophy (Committee Reader) ________________________________ Leswin Laubscher, Ph.D. Chair, Department of Psychology Associate Professor of Psychology iii ABSTRACT PERCEPTION AND LANGUAGE: USING THE RORSCHACH WITH PEOPLE WITH APHASIA By V. Terri Collin Dilmore, M.A. August 2016 Dissertation supervised by Alexander Kranjec, PhD This study explored the use of the Rorschach with eight individuals diagnosed with mild to moderate fluent or non-fluent types of aphasia to consider the extent to which the Rorschach captured aspects of language impairment not otherwise probed by traditional neurolinguistic measures. A ninth participant, with Wernicke’s aphasia, produced non-scorable responses and was therefore left out of all analyses. Of primary interest was whether the Rorschach, historically understood as a projective psychological instrument, would allow individuals living with language impairment to recognize, retrieve and coherently express words that reflected their thoughts. At the same time, this study sought to explore how the ambiguous nature of Rorschach inkblots could be leveraged together with traditional neuropsychological and linguistic measures, to provide insight into the relationship between perception, thought, psychological process and language - a multimethod assessment approach to describe the complex phenomena surrounding aphasia. iv This study demonstrated that individuals with reduced language function were able to provide responses to inkblots presented in a Rorschach assessment that were sufficient in number and quality to allow scoring and interpretation. Spearman’s rank-order correlation coefficients were calculated for WAB-R AQ score, CLQT Language Functions Domain Scores, the Rorschach cognitive processing simplicity, complexity scores and, the thought and perception EII and severe cognitive scores. Correlations among neurolinguistic and Rorschach cognitive processing and thought and perception variables, indicate a clear and intuitive relationship between these different measures. Finally, participants were administered a confrontation naming task in which a series of 10 black and white line drawings representing images of the most popular responses for each of the 10 Rorschach cards were presented. Results from that task confirmed that study participants could accurately retrieve the word for the most common responses, suggesting that object naming is not a limitation in the population of individuals with mild to moderate aphasia. Although differences between small groups of individuals with fluent and non-fluent aphasia could not be validated with significance testing, descriptive analyses showed some differences in means and standard deviations of Rorschach variable scores between the two groups. Specifically, individuals in the non-fluent aphasia group, who had more impairment in language ability, provided more vague responses, were typically only able to provide one defining characteristic of the blot (i.e., blends), and produced more communicative distortions (as measured by the thought and perception variables) than compared to individuals in the fluent aphasia group. The participant group, as a whole, produced a high degree of vague responses, was found to produce more simplistic descriptions of the blot, and typically only produced one defining characteristic of the blot (i.e., blends) - as compared to the neurotypical population. v This study shows that the Rorschach can be administered to a population of individuals with mild to moderate fluent or non-fluent aphasia to generate scoreable results, with named objects comparable to those in norms derived from a neurotypical population. Limited amount and quality of supporting description of those named objects provided by the participants, however, limits the utility of the Rorschach from a psychological assessment perspective. In light of the dependence of this instrument on verbal ability, future studies might consider modified application of the Rorschach with administration that allows non-verbal responses (e.g., drawing, picture taking) as a means of supplementing participant verbal responses – to develop a richer understanding of the individual’s perception, and insight into their psychological state. vi ACKNOWLEDGMENTS There are many people that have helped to mold and support me as an individual, mother, academician and clinician. First, I would like to thank all the individuals that volunteered their time to participate in my study. It was a pleasure spending time with you and I very much appreciate your willingness to explore my study questions with me – thank-you! I would like to thank my husband, Bob, and two children, Sadie and Kerry. I began the clinical psychology program at Duquesne when my son, Kerry, was 7 weeks old and my daughter, Sadie, was 14 months old. Through lows and highs we have triumphed together as one unit, and I feel so blessed and extremely fortunate to have each one of you in my life. You all mean so much – more than can be expressed in text. I love you so much! I would like to thank my in-laws, Jim and Georgia Dilmore. Thank-you for your flexibility, support and most of all love. I appreciate and love the both of you very much! I would like to thank my mom, Mary. Mom we’ve done it! Can I get an AMEN?! Thank- you for supporting me, through good and bad, meltdowns, self-doubt, and all! I like and love the person and mother you are, and your example makes me a better person. Thank-you for passing on the strength of the Collin women! Please hear when I say, thank-you, I love you! Last, I would like to thank all the members at Howard University Counselling Center for bringing me into my own. You have all helped me bring into focus, aspects of me that were unturned and not completely realized. I feel I have a more complete sense of myself, where I have come from – both black and white parts – and who I want to be. This internship year was transformative for me both as an individual and as a budding psychologist. Thank-you from the bottom of my heart! I love you HUCS! HOWARD! vii TABLE OF CONTENTS Page ABSTRACT ................................................................................................................................... iv ACKNOWLEDGMENTS ............................................................................................................ vii LIST OF TABLES ........................................................................................................................ xii LIST OF FIGURES ...................................................................................................................... xii CHAPTER ONE: INTRODUCTION AND CONCEPTUAL FRAMEWORK ............................. 1 Theory and Background ...................................................................................................... 2 Past Research and the Present Study .................................................................................. 8 Purpose and Significance of the Present Study ....................................................... 9 CHAPTER TWO: CONCEPTUALIZING APHASIA ................................................................ 11 Models of Language ......................................................................................................... 15 Speech Fluency ................................................................................................................. 18 Word Production and Language Errors ............................................................................ 21 Comprehension Deficits and Semantic Naming Deficits ................................................. 25 Traditional Methods of Understanding and Assessing Language Impairment ................. 28 CHAPTER THREE: ASSESSMENT AND THE RORSCHACH ..............................................
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