Assessing the Personality Profile with ADHD Characteristics Using the Rorschach Performance Assessment System (R-PAS)

Objectives Assessment of ADHD typically includes rating scales completed by parents, teachers, and/or patients themselves. However, rating scales may be subject to rater bias effects, and raters may not recognize the patient’s implicit qualities and underlying personality processes. In contrast, the Rorschach test permits standardized, in vivo observation and coding of behaviors as outcomes of implicit personality processes, and, thus, it may assist clinicians in the formulation of contextualized treatment decisions. By using the Rorschach Performance Assessment System (R-PAS), a performance-based personality test characterized by empirical foundation and psychometric efficiency, we conducted an observational study to investigate in depth personality and its implicit qualities in children with ADHD who were not on medication. Methods After reviewing thoroughly the previous studies on ADHD and the Rorschach and discussing their contradictory findings, we compared the data of our sample (N = 31) with the R-PAS normative children’s group. Results Several Rorschach variables differed from R-PAS norms and indicated the presence of unconventional perceptions characterized by non-cognitively mediated interactions and difficulties mentalizing human behavior. Conclusions Overall, it appears that hyperactivity and impulsivity are associated with unconventional and sometimes mistaken processing of information especially relevant to people and relationships. Although we compared the Rorschach profiles to norms rather than a matched control group, our findings could provide useful information for understanding the personality functioning beyond manifest symptoms or symptom reports of children with ADHD.