Depression and the Thematic Apperception Test: Toward systematic scoring and diagnosis

The Thematic Apperception Test (TAT) is a widely used projective measure of personality. However, little attention has been paid to using the TAT as a diagnostic measure of depression. While there are various measures for assessing depression, these are mostly paper and pencil, self-report measures, which are useful, but have limitations. The use of the TAT as a projective measure of depression might assist a psychologist in gaining relevant information that other measures of depression might not uncover.;The current study sought to take a step towards developing a systematic TAT scoring system for depression by comparing various predetermined, quantifiable TAT variables to a self-report measure of depression. The variables in this study, which included Negative Story Outcome, Space-Time Constriction, Depressive Content, and Total Word Average, were derived from cognitive-behavioral and psychodynamic theory. The first independent variable was Negative Story Outcome and was based on the balance between positive, negative, and neutral story outcomes. The second independent variable, Space-Time Constriction, was based on the expansion, neutrality or constriction of space-time in the TAT responses. The third independent variable was the frequency of themes containing Depressive Content in the TAT responses. The fourth independent variable was the average story length or Total Word Average.;Forty-seven college students (32 women and 15 men) volunteered to participate in this study. The participants were administered ten TAT cards (1, 2, 3BM, 4, 6BM, 70F, 8 BM, 90F, 10, and 13MF) and completed the Center for Epidemiological Studies Scale of Depression (CES-D). The TAT variables were scored by the principal examiner using Likert scales and simple tallies. The Negative Story Outcome and Space-Time Constriction variables were scored using Likert scales. The Depressive Content variable was calculated as the total number of instances of depressive content. The Total Word Average was calculated as the sum of the number of words in each story divided by the number of cards administered.;The relationship between CES-D scores and the independent variables on the TAT were analyzed using stepwise multiple regression. The results of the multiple regression analysis showed that scores derived from TAT narratives were extremely effective (R =.751) in predicting reported depression. TAT narratives that included higher levels of depressive content, higher levels of space-time constriction, and negative story outcomes were associated with higher levels of reported depression. The Total Word Average variable was not significantly correlated with the dependent variable and therefore was not included in the regression model. Interrater reliability for the TAT variables was established by comparing the scorings of the principal investigator with the scorings of a second examiner on five randomly selected protocols. The results revealed moderate agreement for the Space-Time Constriction variable (Kappa = 0.51), good agreement for Story Outcome (Kappa = 0.61), and good agreement for the Depressive Content variable (r = 0.74).;The results of this study suggested that the TAT scoring variables may be useful in identifying depression in college students. The depressive themes and biases reflected in the TAT narratives of depressed individuals may be manifestations of the negative cognitive schemas that predispose an individual to developing depression. While the scoring system utilized in the current study has promise, it requires further elaboration and refinement, particularly with regard to interrater reliability. These early results have revealed that aspects of the TAT narratives are highly correlated with depression and may assist in the diagnosis of the disorder.