Use of the Rorschach and Thematic Apperception Test in Persons With Mental Retardation

The need to access the internal mental life of a patient during the diagnostic process is essential and is ordinarily accomplished through self-report data during the psychiatric diagnostic interview. Because of cognititve and verbal limitations, persons with mental retardation, however, are ill-equipped to fully participate in the psychiatric interview. The ability of projective tests to access the patient's inner mental life provides a very helpful diagnostic aid, especially for persons with mental retardation. Psychologists may erroneously assume that such patients may not be able to comply with the testing format. This article addresses the literature on this subject, as well as providing new research data on the use of these instruments from a psychiatric clinic population, and presenting relevant case examples. The Rorschach is especially useful in identifying psychotic processes and thought disorder in persons with mental retardation. The Rorschach and Thematic Apperception Test are also useful in providing generalized treatment planning, but also in identifying problems in aggression and sexually aberrant behavior. Guidelines for using projective tests will be given, as well as recommendations for the psychological evaluation of persons with mental retardation presenting with psychiatric disorder.