Cumulative maltreatment, object relations, and symptomatology: An exploratory Rorschach investigatio

This study explored the relationship between maltreatment exposure, object relations, and symptomatology as measured by the Rorschach Inkblot Method (Meyer, Viglione, Mihura, Erard, & Erdberg, 201 1) and parent-report in a sample of 152 outpatient youth. Results indicated a complex relationship among the variables. We found limited support for a linear dose-response relationship between maltreatment and symptomatology. However, we found a significant linear and quadratic association between maltreatment and the Rorschach variable, EII-3, a measure of cognitive disorganization within an interpersonal context. These two effects showed a decrease in EUI-3 in the lower range of maltreatment, followed by an increase in EII-3 in the higher range of maltreatment. Additionally, six of the nine mediation models we tested yielded significant results. After adjusting object relations for severity of maltreatment and client age, the indirect effect of maltreatment showed that an increase in maltreatment was associated with an increase in experienced stress (mY), cognitive disorganization (EII-3), and traumatic imagery (Critical Contents) coinciding with a decrease in indicators of constriction (an increase in Complexity and Sy%, a decrease in F%). In contrast, the adjusted direct effect of maltreatment on these variables showed an increase in maltreatment was associated with a decrease in cognitive disorganization and traumatic imagery and an increase in indicators of cognitive constriction. These results suggest that object relations play a mediating role in the relationship between maltreatment and symptomatology and are key to understanding both constriction and flooding responses to trauma. The findings also highlight the value of using performance-based measures when evaluating trauma response. Future research is needed to replicate these results and to continue to identify and understand patterns of trauma response on multi-modal measures.