Traumatic loss and helplessness: qualitative analysis of responses in the Rorschach

Pérdida traumática e impotencia: análisis cualitativo de las respuestas en Rorschach

Perda traumática e desamparo: análise qualitativa das respostas no Rorschach

PAPERS

Traumatic loss and helplessness: qualitative analysis of responses in the Rorschach

Perda traumática e desamparo: análise qualitativa das respostas no Rorschach

Pérdida traumática e impotencia: análisis cualitativo de las respuestas en Rorschach

Silvana Alba Scortegagna^I; Anna Elisa de Villemor-Amaral^II

^IUniversidade de Passo Fundo, Rio Grande do Sul, Brasil

^IIUniversidade São Francisco, Itatiba, Brasil

^{Contato com as autoras}

ABSTRACT

The aim in this paper is to compare the answers on the Rorschach's inanimate motion (m) and blood content (Bl) between sexual abuse victims and non-victims. Among the protocols of 76 individuals between 10 and 14 years old, 29 were selected. Qualitative analysis showed that the victims presented: a) narratives with m responses, suggesting the presence of feelings of helplessness and powerlessness; b) replies with m or Bl associated with contents far more violent and destructive; c) images filled with morbid characteristics. The findings support evaluation practices, illustrate the traumatic effects of sexual abuse and ascertain the validity of Rorschach's test for the ideographic approach, derived from the responses' qualitative analysis, and also from the normothetic perspective derived from the structural summary.

Key words: Psychological assessment, Rorschach, Validity, Victimization, Documentary research.

RESUMO

Este trabalho propõe comparar as respostas no Rorschach de movimento inanimado (m) e de conteúdo sangue (Bl) de vítimas de abuso sexual e não vítimas. De 76 protocolos de indivíduos entre 10 e 14 anos de idade, foram selecionados 29. A análise qualitativa evidenciou que as vítimas apresentaram: a)narrativas com respostas m sugestivas da presença de sentimentos de desamparo e impotência; b) respostas com m ou Bl associadas a conteúdos bem mais violentos e destrutivos; c) imagens carregadas de características mórbidas. Os achados auxiliam nas práticas avaliativas, ilustram os efeitos traumáticos do abuso sexual e ratificam a validade do Rorschach para a abordagem idiográfica, proveniente de análise qualitativa das respostas, além da perspectiva nomotética extraída do sumário estrutural.

Palavras-chave: Avaliação psicológica, Rorschach, Validade, Vitimização, Pesquisa documental.

RESUMEN

Este trabajo se propone comparar las respuestas en Rorschach de movimiento inanimado (m) y contenido (Bl) de la sangre de las víctimas de abuso sexual y no víctimas. De protocolos de 76 personas entre 10 y 14 años de edad, se seleccionaron 29. El análisis cualitativo demostró que las víctimas eran: a) narrativas con respuestas sugestivas de la presencia de m sentimientos de desamparo e impotencia; b) respuestas con m o Bl asociada al contenido mucho más violento y destructivo; c) imágenes de características mórbidas. Los resultados ayudar en las prácticas evaluativas, ilustran los efectos traumáticos de abuso sexual y confirmar la validez del Rorschach a la idiográfica, enfoque proveneinte de análisis cualitativo de las respuestas, así como la perspectiva de estructural contenido extraído cerrado.

Palabras clave: Evaluación psicológica, Rorschach, Validez, Victimización, Investigación documental.

Loss is a common event present in people's lives and can represent both a growth-promoting catalyst and a burden that is difficult to manage. Everything depends on the external circumstances or internal factors referent to the ability to cope. Some variables that influence the response to trauma stem from the external stressor. This includes its magnitude and severity, as well as its unpredictability factor and duration (Carlson, Furby, Amstrong, & Schlaes, 1997). A repetitive and highly violent event entails more severe psychological effects than relatively non-violent and unique incidents (Breslau & cols., 1998). Other variables stem from the subject. To give an example, individuals with previous, non-elaborated trauma experiences tend to respond to a new trauma situation in a more maladaptive manner (Resnick, Yehuda, Pitman, &Foy, 1995), just like individuals with a history of mental trauma are more predisposed to a pathological trauma response (McFarlane, 1989; Waysman, Schwarzwald, &Solomon, 2001), due to the fragility of their adaptive resources.

A study on repetitive mistreatment episodes in childhood indicates that these experiences tend to exert a pervasive effect on personality development (Cassidy & Mohr, 2001). Other variables involve the traumatic event in a binding situation between individuals. If a traumatic situation is provoked by another person, the trend is to arouse a more severe psychological reaction than an impersonal trauma experience, like a natural disaster (Briere, 1997). The situation gets even more acute if the bond is marked by great proximity and dependence, like in the case of incest, when the family bonds between the perpetrator and the victim enhance the probability of a Post-Traumatic Stress Disorder (PTSD) even further, entailing profound damage for the ego and relationships with other people across the lifetime (Trickett & Putman, 1993; Van der Kolk, 2003).

Although initial studies focused on PTSD in the problems of Vietnam war veterans, other circumstances should be highlighted, such as sexual, physical and/or verbal abuse; real or perceived abandonment forms and the experience and/or witnessing of violent practices. Cases of childhood sexual abuse, for example, remit to an intolerable reality that can combine the experience of these three circumstances. Registers of this traumatic event go far beyond the occasional pain or physical marks the children suffer, mainly referring to the pain of perceiving that their first objects of love act towards its annihilation while, on the opposite, they should provide protection and care. The parents' infringement on the limits of the children's subjectivation, by invading them with their sexuality, reducing them to objects of their own enjoyment, signals the absence of the paternal function, entailing feelings of helplessness and severe developmental damage (Bollas, 1992).

The severity of the damage resulting from these inappropriate or insufficient conditions for children's mental constitution is directly proportional to their developmental period (Finkelhor, 1995). When these vents happen during the first formation years, for example, they can weaken the initial bases of identity construction.

One of the most devastating aspects of the traumatic experience is definitely the impact on the ego, which implies, among other things, the loss of a meaning for oneself. Consequently, the ability to think, the ability to investigate and symbolize become precarious and impair the understanding of and adjustment to the world. Damage to self-esteem, depression and anxiety symptoms are frequent, which are common in studies that aim to characterize this population in order to provide for evaluation and intervention measures, as well as to validate instruments to respond to these demands efficiently (Cerney, 1990; Clinton, & Jenkins-Monroe, 1994; Shapiro, Leifer, Martone, Kassen, 1990).

Among the available literature, studies that use less direct and intrusive psychological investigation techniques are of interest, which permit the expression of the self through hardly structured tasks. That is so because these techniques permit revealing particularities from the internal world, in an indirect manner but free from the individual's deliberate control, and are particularly useful in situations that are susceptible to manipulation or cover-up attempts, which is the case for the Rorschach Method (Exner and Sendin, 1999).

The first studies using the Rorschach in trauma victims involved individuals in war periods, while facing a severe tempest at sea (Shalit, 1965). That study was the first to demonstrate increased inanimate motion (m) (Kaser-Boyd & Evans, 2008), which was consistently confirmed later on in trauma research (Armstrong & Kaser-Boyd, 2003; Holaday & Whittenberg,1994; Holaday, 2000; Levin & Reis, 1997; Sloan, Arsenault & Hilsenroth, 2002; Van der Kolk & Ducey, 1989).

The proliferation of assessment studies in different traumatic situations present discoveries referent to the large number of m responses in Rorschach protocols. Van der Kolk and Ducey (1989) and Levin and Reis (1997) indicated m as the best discriminator between veterans with and without PTSD. Sloan et al. (2002) reported m findings in marines who served in the Gulf War, and Holaday and Whittenberg (1994) in a group of children and adolescents with severe burns. The authors concluded that the production of m responses is a sign that the individuals are experiencing a significant amount of tension, discomfort and situational stress. In accordance, other aspects attributed to m responses related to suffering, feelings of invasion by external forces and disturbing ideas and experiences of helplessness (Campo, 1980; Exner & Sendin, 1999; Weiner, 2000;Vargas da Silva, 1987).

Some studies have attempted to determine the relation between different types of mistreatment and the Rorschach indicators. As regards sexual abuse in children, Leifer, Shapiro, Martone and Kassem (1991) measured the psychological functioning of 79 girls between five and 16 years of age, with and without a history of sexual abuse. The authors discovered that the victims differ in their high scores of distorted perception (X-%); diffuse shading response (SumY); special codes (Sum6 and WSum6); uncommon and hostile contents; and responses with contents of objects penetrating others. A positive Depression Index (DEPI) and drop in the number of R were also verified. In summary, the sexually abused girls demonstrated more disturbed thinking, a higher stress level related to their adaptive abilities; described human relationships in a more negative form and demonstrated greater concern with sexuality than the comparative group.

It is interesting to observe that, according to some authors, children with PTSD can present, besides the presence of the schizophrenia index (SCZI), lower X+% responses (Holaday, 2000). The research by Friedrich, Einbender and McCarty (1999) also sustained that sexual abuse victims' contact with reality was more negatively affected, as illustrated by the higher X-% and WSum6 indices, and confirmed other findings (Leifer et al., 1991). In addition, Perfect, Tharinger, Keith and Lyle-Lahroud (2011) also reported the combined presence of personalized responses (PER), SumY, achromatic colors (SumC'), texture (T), and PTI associated with the severity of the sexual abuse. These discoveries supported the idea that victims of more severe sexual abuse can turn inwards, be more defensive, internalize affection, feel powerless or be more prone to uncommon thought processes (Exner, 1993).

Other Rorschach indicators evidence that the harmful effects of mistreatment affect self-esteem. From a theoretical viewpoint, mistreated children have less possibilities of successful accomplishment to transpose the tasks of their development phase and, as a result, do not believe in their abilities to cope with challenging situations (Kim & Cicchetti, 2006). The recent study by Perfect et al. (2011) investigated whether the Rorschach and the Minnesota Multiphasic Personality Inventory MMPI-A (Butcher & cols., 1992) would be capable of determining the characteristics of victims of several types of mistreatment (sexual abuse, physical abuse, neglect, emotional mistreatment) and their severity. Participants included 157 adolescents, 91 girls and 66 boys, between 14 and 17 years of age, from different cultures and low-income families.

Among the results, the Rorschach revealed lower scores on the egocentrism index (EgoIndex), increased number of morbid responses (MOR) and presence of PER responses in young abuse victims, which suggests that victims of more severe physical abuse are more susceptible to a damaged self-image. The variables Afr, SumY and SumC' demonstrate a significant association with different forms of mistreatment, confirming the existence of anxiety-related symptoms and attempts to avoid emotion (Clinton & Jenkins-Monroe, 1994; Shapiro & cols., 1990). As regards increased SumY and SumC' responses, these sustain the idea that victims of more severe sexual abuse are more prone to feeling anxious and tightening their emotions (Arnon, Maoz, Gazit, & Klein 2011; Clinton & Jenkins-Monroe, 1994; Leifer & cols., 1991; Shapiro & cols., 1990; Zimmerman & Dillard, 1994). Evidence of a lower Afr signals the understanding that severe mistreatment victims tend to avoid emotional experiences.

In an analysis of psychological trauma in sexual abuse victims, in 90 psychodiagnosis protocols, interpreted according to the Argentinean Rorschach school, Gravenhorst (2002) found indicators that support the findings mentioned. The following stand out: small number of responses (as a result of traumatic damage experience); drop in F+% (or FQ+% in the Comprehensive System CS), and extended F+% (or FQx+% in CS); reduced reality index (IR). These results suggest a severe pathology, associated with the operational disruption of the ego and failure to adapt to reality. Other significant elements were skeleton and blood contents; direct sexual responses (failed repression) and persecuting, aggressive and violent male figures. Some of the special phenomena were: act of tolerance in the present or past as a sign of having passively borne a violent action; and presence of MOR responses in the identification of damaged, destroyed, broken, dead objects.

The contents the victims identify in the ambiguous Rorschach stimuli, representing a form of reflecting internal feelings, have been reported in other studies. Some data suggest that adults who were sexually abused in childhood give responses that reflect feelings of body inappropriateness, sexual focus, and a sense of having been violated and hurt, as verified in the anatomy (An), sex (Sx) and blood (Bl) responses (Armstrong & Loewnstein, 1990; Friedrich & cols., 1999; Kendall-Tackett, Williams & Finkelhor, 1993). Leifer & cols. (1991) found that girls who were victims of sexual abuse report sexuality concerns in responses with explicit Sx contents and refer to the body as broken and hurt. These concerns can reflect traumatic sexualization.

High response scores with unusual and uncommon contents, such as Sx and Bl, were equally defined as strong sexual abuse markers (Friedrich, Jaworski, Huxahl, & Bengston, 1997; Friedrich & cols., 1999; Kendall-Tackett, Williams & Finkelhor, 1993), which suggests the presence of anguish and severe damage in child victims.

In accordance with some of the data presented, a final study by Scortegagna and Villemor-Amaral (2009), in Brazil, presented some differences for the Rorschach variables in CS. The authors evaluated 76 children between 10 and 14 years of age, 64 (84.2%) girls and 12 (15.8%) boys, 36 (47.4%) of whom were victims and 40 (52.6%) non-victims of sexual abuse. Significant contributions between both groups were found in the m determinant and Bl content. An, MOR, Sx and FQ- responses were more frequent in the victim group. As verified, the presence of distorted self-perception and reduced self-esteem in the victims can derive from the victimization process.

If, on the one hand, there are many variables that mark the agreement among these studies, on the other, some disagreement exists. To give an example, some researchers found no changes in self-esteem with lower EgoIndex levels among adolescent sexual abuse victims when compared to the normative group (Clinton & Jenkins-Monroe, 1994; Holaday, Armsworth, Swank, & Vincent, 1992) or with non-victims of sexual abuse (Leifer & cols., 1991; Owens, 1984). This was justified, considering that a damaged sense of the self has to originate in individuals with a history of severe and long-term mistreatment (Herman, 1992).

Other disagreements related to the variables MOR, Afr, SumC and SumY. Some studies report on the enhanced presence of MOR responses in the protocols of young people with a sexual abuse history than in children with chronic conditions (Shapiro, Leifer, Martone & Kassem, 1990). Others report the opposite (Arenella & Ornduff, 2000; Friedrich & cols., 1999; Friedrich, Jaworski, Huxsahl, & Bengtson, 1997) or, differently, relate these indicators with the severity and duration of the sexual abuse (Friedrich & cols., 1999). Some studies could not find differences in Afr (Leifer & cols., 1991; Owens, 1984), SumC or SumY (Owens, 1984) among abuse victims either. But the authors consider that these incongruences can be attributes to difficulties to better characterize the comparison groups.

As observed, further research is needed to determine whether these findings are repeated or not, as well as to verify whether there exist other forms of estimating the validity of the Rorschach to identify traumatic experiences. With that aim in mind, this research departs from the hypothesis that, beyond the frequency of indicators, differences would be verified in the qualitative analysis of responses containing m and Bl when comparing the expressions associated with these indicators between victims and non-victims of sexual abuse.

Method

Source

Twenty-nine protocols of individuals between 10 and 14 years of age were analyzed, which were divided in two groups: 18 (62%) in the victims group, 15 (83.3%) girls and three (16.7%) boys, and 11 (38%) in the non-victims group, nine (81.8%) girls and two (18.2%) boys. The children were in primary and secondary education, their socioeconomic level was characterized as medium-low, and they were obtained from the study by Scortegagna and Villemor-Amaral (2009). The analysis material only included protocols with coded answers, with the m determinant and Bl contents.

The child victims had suffered intra-family sexual abuse and lived with the family or had been institutionalized. To include and exclude these participants, the following criteria were considered: a) sexual abuse incidents in which the perpetrator(s) involved a child or adolescent for his/her own satisfaction through acts like touching, kissing, caressing the genital areas, masturbating, with or without digital penetration or with the genital organ in the vagina and/or anus; b) the perpetrator was five or more years older than the child; c) at the time of data collection, the child was not living in the same place of residence as the perpetrator; d) abuse was proven as documented in the patient files.

Non-victim children attended primary and secondary public schools. To include and exclude these participants, the following participants were considered: a) not having a documented history of sexual abuse; b) not being under psychotherapeutic treatment; c) not presenting any specific learning and behavior-related complaints.

Instrument

Rorschach method - a personality research instrument that consists of 10 inkblot images, in which the subject is expected to answer the question "what does this look like". This tool was applied according to the CS (Exner, 1999).

Procedure

To achieve the study objectives, the 76 protocols from the earlier study were fully analyzed. After applying the inclusion criteria, 29 protocols remained, which were divided in two groups, one consisting of victims and another of non-victims. In the qualitative analysis of the Rorschach responses, the expressions were considered, mainly the use of qualifiers that emphasize damage suffered.

Results and Discussions

Tables 1 and 2 present the description of the protocol number, image number and Rorschach responses of the sexual abuse victims and non-victims, coded with m.

As observed in Table 1, the m types lead to considerations about how victims see themselves and perceive objects. One of the core aspects of motion responses in general is to give meaning to experiences, to experiences of life, which lead to the understanding of psychic representations, that is, of how they start to constitute the internal world (Vargas da Silva, 1987). In these circumstances, the m responses seem to express aspects related to the victims' suffering, which Weiner (2000) described as an intense activity of non-deliberate disturbing ideas, thoughts of anguish and powerlessness to prevent situations that affect their own destiny. Exner and Sendín (1999) also understand these characteristics, commonly found in individuals with PTSD (Levin & Reis, 1997; Van der Kolk & Ducey, 1989), as experiences of helplessness.

Similarly, this understanding can be compared to what Campo (1980) describes when indicating that the m responses reveal feelings of threat and invasion by external forces, without control by an extremely fragile and vulnerable ego. According to the author, the experience of this situation of internal danger arouses feelings of conflict that take the form of irritability, anguish or depression, which was also confirmed in other studies (Armstrong & Kaser-Boyd, 2003; Holaday & Whittenberg, 1994; Holaday, 2000; Levin & Reis, 1997; Sloan, Arsenault & Hilsenroth, 2002). Among the images referred, the following stand out: "some blood drops are falling", "blood is falling", "blood streaming", "nest... it's breaking, crumbling", "a lot of blood falling onto the people". It should be observed that the qualitative aspect the object movement is involved in relates to something that is falling, which according to Weiner (2000) can provoke the deduction that something bad is happening, with a complete loss of voluntary control.

In addition, it is important to observe that most m responses in the child victim group have been associated with Bl, An and Sx contents, which points towards the existence of a fragile ego, threated by forces beyond control, within a context of attack against the body. The high response indices with unusual and uncommon contents, such as Sx and Bl, were reported as a strong indicator of sexual abuse (Kendall-Tackett, Williams & Finkelhor, 1993) supporting the presence of anguish and signs that the children are suffering severe damage, are invaded and hurt, in accordance with earlier studies (Armstrong & Loewnstein, 1990; Friedrich & cols., 1999; Gravenhorst, 2002).

Another frequent association is between m and SumC' and SumY, indicating the experience of persecutory feelings related to the condition of being a victim, invading anxiety, beyond control. These are related to the emotional experiences of helplessness (Exner, 2003) and, as observed, support the idea that victims of more severe sexual abuse are more prone to feeling anxious and tightening their emotions (Clinton & Jenkins-Monroe, 1994; Leifer & cols., 1991; Shapiro & cols., 1990; Zimmerman & Dillard, 1994).

Among responses with these characteristics, the following expressions are highlighted: "two black clouds meeting", "a black ship coming", "the liver of a person bleeding because it's, kind of, one darker and one lighter color". Also, the motion responses reflect the presence of a synesthetic feeling, as something that is being experienced but which, in the case of m, beyond a human condition, induces thoughts about a more direct and still present relation with the traumatic experience process.

For the sake of a better explanation, it is important to analyze the m responses in the group of non-victims (Table 2) in order to grasp the dimension that not just the frequency, but the type of expression indicates a feeling of control loss, as m does not cease to have its common implications, but not destructive and disorganizing like in the earlier answers. In this segment, the narratives gain milder contents, without devastating and violent connotations. Themes of typical female clothing are referred, highlighting gender narcissism and identification (Vargas da Silva, 1987), keeping in mind that most participants in the sample are girls. The expressions include: "dress flying", "dress spreading", "waterfall dropping", "walls moving inwards", "water rising", "yolk running", "smoke escaping", "leaves dropping".

In the comparison between the two groups, the expressions of abuse victims' m responses mainly differ because they are loaded with elements that emphasize Bl and AG contents, in which the devastating and violent aspect is dominant. The effects of destructive trends emerge in the narratives as "attacking each other", "blood in the vagina", "fighting", "explosion", "stone-throwing", "nest crumbling and birds falling", "liver bleeding", among others. Next, in Tables 3 and 4, the protocol number, image number and the sexual abuse victims and non-victims' responses are presented, coded with Bl contents, respectively.

The responses to the colored stimulus in the Rorschach are considered related to the type of resonance and management of the emotional impact. Images II and III, for example, differently from images VIII, IX, X, with multiple colors in overlapping and clearer nuances, intensely show bright red in contrast with black, and tend to arouse more primitive emotions like aggressiveness, or emotions linked with sexuality (Weiner, 2000).

In view of this stimulus, both child victims and non-victims gave more Bl responses, precisely related to images II and III, but in a quantitative and qualitatively very diverse form. In the victim group, Bl responses were abundant, loaded with disturbing, aggressive and violent elements, such as "dog run over", "dirty with blood", "frog crushed", "mice eating insects and there's blood", "dead animals". The human and animal motion projected also appears imbued with violent interactions, including "two people, one wanting to attack the other", "two dogs fighting", "women fighting". Other narratives reveal the conditions of vulnerability and lack of protection in the persistent identification of small and hardly powerful creatures, like a little bird, little mice, cockroach, little animals. In the non-victim group, only three responses contained Bl, without aggressive interactions with humans or animals and, also, hardly destructive, that is, imbued with a situation that can happen in daily life at home, like cutting oneself.

Finally, it is important to highlight another type of content that appears in the MOR responses which, despite the lack of a significantly higher statistical frequency in the victim group, appear more numerously among these children, even when not accompanied by m and Bl. Table 5 exemplifies these responses.

Initially, it is noteworthy that six out of ten responses indicated above come from the same child (P 36), who in turn gave few m (1) and Bl responses (three, two of which contained MOR), demonstrating that, in this case, the perception of the ruined and lifeless body is a much more acute indicator of the damage suffered. Therefore, the perception of a damaged or unworthy body, an even fragmented or injured sense of the self in sexual abuse victims, in comparison with non-victims, were equally identified through the MOR responses (Table 5), in line with the literature (Gravenhorst, 2002; Perfect & cols., 2011). Beyond the implications of the quantitative increase in these responses in the victim group, the qualitative approach seems to reveal the children's perceptions of a destroyed or malfunctioning body, with unwanted characteristics, reflecting the identification with a damaged, dilacerated body, victim of an aggression.

The responses issues indicate an identification of the abuse victims as internally experiencing a suffered and fragmented body, in which the abusive acts were experienced as highly intruding, capable of compromising the development of the sense of self. The frequent expressions of the contents crushed can express signs of lack of prohibition, of an adverse environment, and of violence against the body passively undergone (Gravenhorst, 2002). The recursive images evoked as "crushed cockroach", "crushed frog", "a crushed mouse", "a crushed bat", "a trodden snail", "crushed butterfly", witness the bodily and psychic damage, an annihilated, dilacerated and dead body.

These expressions also indicate the choice of small and hardly powerful or repugnant animals, like the mouse, cockroach, frog, snail, which appear represented as victims of an aggression, support a clearly consumed identification with fragile objects that cause disgust, revealing a highly depreciated image. According to Weiner (2000), like in the case of human figures, an emphasis on small animals indicates the possibility that subjects consider themselves as worthless, insignificant, and that they can be easily trodden. The recurrent morbid thematic contents are frequently associated with recent loss experiences and thematic situations, as easily perceived in the qualitative analysis.

Final Considerations

In the Rorschach, the subjects' responses to the stimuli can be loaded with dislocated representations and affections. When this happens, the narratives in view of the images reveal a close associative correspondence with the experiences lived and with the symbolic world.

In these circumstances, while the repetition of thematic contents can be objectively determined by counting its frequency, considering the ratios, proportions and derivations, assessing whether an image is dramatic requires not only a quantitative, but also a qualitative approach of the data (Weiner, 2000), considering word for word what is said in the composition of the image visualized.

With that aim, this study showed interesting results. As verified: a) the expressions of m responses in abuse victims, differently from non-abuse victims, suggested the presence of feelings of helplessness and powerlessness, associated with external circumstances beyond control, which therefore serve as an alarm, a sign of conflict and tension, resulting from the victimization; b) the content of the abuse victims' expressions containing m or Bl was far more violent and destructive than the few cases expressed by non-victims; c) the child abuse victims who did not reveal the m determinant or Bl contents reported destroyed images loaded with morbid characteristics.

These elements illustrate some of the devastating effects of sexual abuse on the victims and are in line with earlier studies that support the utility of the Rorschach, regarding both the identification of these situations and the support they demand. In addition, they refer to the awareness that the effects of sexual abuse are not monolithic and demand further attention to these children's individual needs. The belief that the Rorschach is a more appropriate instrument to understand trauma victims' psychological functioning, inform about resulting chronic effects and help to direct treatment was again reported in recent studies (Katsounari & Jacobowitz, 2011; Perfect & cols., 2011).

Finally, although the qualitative approach is more aligned with an idiographic perspective and the study sample is relatively limited, these results can somehow be generalizable or should at least serve as signals for further case by case investigation. Research should definitely continue, mainly involving male victims, who were very limited in this sample. Such studies can support the present findings or not and enrich the research and knowledge process in this area.

Contato com as autoras:

Universidade de Passo Fundo, Curso de Psicologia - IFCH

Campus I, BR 285 - Bairro São José - Caixa Postal 611

CEP 99001-970 - Passo Fundo/RS, Brasil

E-mail: [e-mail] ; [e-mail]

Recebido em: 19/11/2012

Reformulado em: 19/03/2013

Aprovado em: 03/04/2013

Sobre as autoras:

Silvana Alba Scortegagna: Ph.D. in Psychology, Universidade São Francisco. Professor, Stricto Sensu Graduate Program in Human Aging, Universidade de Passo Fundo.

Anna Elisa Villemor-Amaral: Ph.D. in Sciences, Unifesp/EPM. Post-Doctoral degree, Université de Savoie, France. Associate Professor, Stricto Sensu Graduate Program in Psychology, Universidade São Francisco.

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Publication Dates

• Publication in this collection
  21 May 2013
• Date of issue
  Apr 2013

History

• Received
  19 Nov 2012
• Accepted
  03 Apr 2013
• Reviewed
  19 Mar 2013