Abstract


OBJECTIVE: Objective personality tests (such as the MMPI-2 and PAI) used to screen gestational carriers (GCs) often show defensiveness. This study investigates the utility of incorporating a projective assessment measure such as the Thematic Apperception Test (TAT) into the psychological screening process to better understand personality functioning of potential GCs. view more

OBJECTIVE: Objective personality tests (such as the MMPI-2 and PAI) used to screen gestational carriers (GCs) often show defensiveness. This study investigates the utility of incorporating a projective assessment measure such as the Thematic Apperception Test (TAT) into the psychological screening process to better understand personality functioning of potential GCs.
DESIGN: GC candidates' TAT protocols were scored using 3 validated scoring systems. These were compared both within the sample (accepted vs. not accepted) and against norms published for women matched for demographic characteristics.
MATERIALS AND METHODS: 4 cards of the TAT (1, 2, 3GF, & 13MF) were administered as part of the psychological evaluation process for 39 GC candidates. TAT protocols were then scored using multiple scoring systems as a way of quantifying the responses. Scoring systems included the Scoring Scheme for the TAT, the Rating Scales for Emotional Tone and Outcome, and Apperceptive Norms. Scores of accepted GCs (n=31) were then compared to norms published for women using both t-test and chi-square analyses. Comparisons were also made within the sample between women accepted as GCs (n=31) and those not cleared psychologically (n=8).
RESULTS: Card 1 typically elicits themes about self-image, relationships with authority figures, and achievement. When compared to norms on Emotional Tone, women accepted as GCs were significantly more likely to report themes of sadness (p<.001). On cards that typically elicit themes of loss and depression (3GF & 13MF), accepted GCs' mean scores were significantly more positive in tone (p<.05). Comparisons on Apperceptive Norms revealed significant differences across multiple cards. When compared to norms on card 1, accepted GCs endorsed items suggesting compliance in response to authority at a significantly higher rate (p<.001). On card 2, accepted GCs were significantly more likely to endorse themes of pregnancy (p<.001) as well as themes of improving one's educational status and maintaining traditional family values (p<.05). Card 13MF typically elicits themes of sexual conflicts. Accepted GCs were significantly less likely to report negative themes of illicit sexual activity or wrongdoing and more likely to interpret images as more wholesome (p<.05). When comparisons were made within the study sample (accepted vs. not accepted), women not accepted based on their psychological evaluation showed a restricted range of emotion on all cards and a tendency towards describing outcomes that were less favorable and more indeterminate than women who had been accepted as GCs.
CONCLUSIONS: This study shows there are unique qualities in the TAT profiles of GC candidates that distinguish them from the general population. Incorporating projective measures designed to bypass psychological defenses often present on objective tests can provide a more comprehensive profile of personality functioning and aid mental health professionals in determining the psychological appropriateness of potential GC candidates.

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