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DIAGNOSTIC M M M OF THE
BENDER VISUM, MOFCE GESTAIFF TEST
MVMBD
h / / / ?
_ fl,
S^L!MR'LF»OFES8IIR
<-:\j-1s-W-&S-hj! -- /~\-t-'.
Dean of the School^ of/Sucation
J CTX><J^4^v^<_/ Dean "of* tke Graduate School : ' ' "
mfmrnsm* diagnostic ACTORS OF
tm mmm visrni, wmm ® m m TEST
THESIS
Presented to the Graduate Council of the
North Texas State University in Partial.
Fulfillment of the Requiraaents
For the Degree of
MASTER OF SCimiE
»y
ILarry Vernon Goff, B. S.
Denton, Texas
August, 1936
TABLE m cms m&s
PAGE CHAFTER-
I , XHBMXMCCUM , , . I
S K I I M ^ IN«LE%@ ©NIL TXTSOXY RELATED STUDIES STATWESIT OF FIRAFOLEM IFYGMM&GKAA
u* mmmmm ^
SIJJIJEETS LUTMRKITL M O T M PI?©CEDYI»E
I I I , H O I S ALFFI KFTCSBSKM , 2 9
I V . M M R , COTICUJSM'S, AI© :IECT-WISKFT\*RIONS . . . , , 3 2
BISXTLOGRAPHY • 3 7
em&pvm j
Visual Motor Gcatalt feat, introduced hy
£MM*T* Bender p) in 1938, is IMM4 <m the §MNNM1 lii»y of
@®®talt pf®ti®i4®®r* tom&Sng to ftwtwlfc 9*tai9&Mt§ pea?-
caption la affeetest not only % flit characteristic© of wtwt in
toeing pweelveA, bat «l*o %y the eonUtioi of the |@fwlvlif
ovgesiijsm as a whole. the p < M ©f perception is in a ©®n-
stunt state of flux due to the clyjiastio ctaMOtartsfcUNi of the
imcl m) Jjj |>§|g t#f||, r#i g ffjg%
otanlsvrfs peareeptlGn of m «§*j®ct m tltartta* ten* «
pathologic®! ®t®t« uffectiisg the organise would tend l» change
the porceprticm of a atiimilus. With thou®
Bender ®«&«©t«aS nim@ ©f darfgna to be uses «
•tiaulus figures for the Bender »i>«I Hotor GeataXt test.
Since ite introduction„ that Bender Hestalt fart has
ajecoae a widely uacxi instrument in psychological testing.
It i® un6 % aasiy ©Mnieiati® m& institutions as part of
o hattery of inatrwiisiits for psychological evaluation. &
general t!u? fast is rej|ar«ied at a gootl screening cievicc,
©specially in the area of organ!© bruin pathology* iww«rt
Hewtler, Wrtt* Shoot*» mi Sriak hav© iadteatod that whm
mtmm esses mm removed, the val idi ty of the Bendsr fe&tiilfc
test for pre<liietlKi brain Samga disappear s..
Paschal m i Sut tsU (15, p .7 l ) , In developing an ufejeetiw
aooring method for th« Bonder Gmtalt* concluded that the t e s t
i s a Measure ©f h p aspect of &@o strength. Individuals
who Manifest extraae ctwiations in the i r rsftoduetisn of the
design are f e l t to be those who possess l i t t l e eg© atren&th,
and are eenaideretl to be suffering a m severe pittwlegip
than thos© iAm i^produce the figure© wit!* Btirasr deviations*,
CwBsmitt m i l*etiia P I -. c m t e t e d m itwmtigatim designed to
detemine i f the g jn te r $e§t«|g_ «A the f * % factor « the
X e i ^ . a M 0 t t @ tli# s«m $mrnmmm of e§@ strength* t h e i r
study eoiisiateci of sdtttalstering the Bender flestslt Test ant
the torsciiscti tea twoKty-*five psydbistvic $efri«*tis ©£ i»ix©&
disgMttis* Correlations between Bender Cestalt Z mmm sad
f * % values on the jRor^chae^ were not sigfiifioant. I t «f»
aawslttlaA that the two factors; were not measuring the smae
thing* and that i t could not b© assumed that ego strength wis
the j«iilM*y v«pJWile measured by the Boeder Seata l t . ffew
IndSIL Gestalt and the F % factor art the aoraoheeli n^y
mm®vm d i f fe rent f toe t i sns In d i f fe rent groups* or even he*
twssan i i f f e e w t individuals*
the Bento Mater gestal t t e s t has been described
ae « t e s t taMoli i s unaffected by cul tural and other ftutors
which plague « n y other test©* B M m r , fe ixot ta (1®) «d*
B l i s t e r e d the jgmdar Qeatalt to t h i r ty - f ive persons of
3
seven cultural groups. The results indicated that variations
in reproduction of the designs will occur between cultural
groups* Investigating a different factor, the motor technique
by which the test if executed, HePherson and Pepin (11) found
that in their sample, performance m the Sender (gestalt wag
independent of motor techniaue. These findings were inter-
preted as indicating that reproduction of the Bender gestalt
figures is raore influenced by covert perceptual responses
than by motor technique.
Another factor which could confound diagnostic inferences
made from the lender Gestalt is that of practice. Eosenthal
and Jnber (18) found that simple practice alone, without con-
cumitant clinical improvement could improve the Bolder gestalt
performance of psychiatric patients. However, the learning,
curve for the group varied considerably fro® patient to patient,
with same patients ev«i reversing the direction of the learning
curve. Simular results were found by Addington (1) in a
test-retest study of forty-three schizophrenic patients with
a period of fourteen to seventeen day# between Bander Gestalt
administrations. Patients reproduced the Bender gestalt
figures with fewer deviations on the second testing as
measured by both Hutt*s diagnostic signs and the Paschal and
Suttell scoring system. These findings could be of importance
in considering ret est improvement as a sign of clinical im-
provement of the patients* as is often done.
Another capacity In which the Bolder gestalt is used is
tha t of an indication of tit# tendency toward or probability of
iiBproveBi&nt i«: p»ychi*tric pat ients , fasclsiX and Sut te l l
(15#p,82)# f e e l that 1® score® m the B«i©r Qertult may be
related to a ttndoioy to recover. Slui lar conclusions w s
d m i by flMMMfn nasi Paschal (19), In ttntir study, peyohtetrie
pKtiwts of d i f fe ren t diagnosis were cUbrixilstcrw! the Bender
(Seatalt. fhese mm patients were emliapt^ a year l a t w and
mt«d as ^iqpwvedT or "uBilappovsil". f s t i e n t s rated tm
p p # had a lower i n i t i a l »©@to on the Sender fl—fit than
tlMM* who rated w uoi«prov<*r,
Related S ts^ iw
Irt the p a M A of bmmdng a poptl&r pqyofaaetiKic ins t ru-
aant* the Bender C*HrtaU.t f u s t has given r i se to considerable
said debate. This dlimgroommt has centered
around tha ab i l i ty of tSw tos t t o . l i f f a r a n t i a f between
SNsyctoogsiriie disorders. Tho debate an t o the Bender Stestalf
f e a t *« value to d i f f e r en t i a l diagnosis resulted front i t s i»e
B@ «t projective technique by aom@ cl inic ians . Htex L. Hatt
(11, p, 53), in Ills analytical interpretat ion of Bender Qeafcalt
p?0t»e50la# assigns s^aijolic raeaiiiiig to ttso s t i a m t e
f igures . Itor «xawple# in Figure 3, he fee l s tha t th© in te r -
nal diamond repres«st» a e m i t l {®or« specif ical ly a vaginal)
symbol.
Other o.lir*ielajis» aaeh sa« festal ma& Su t t e l l , me a
scoring grostdtare yielding <pi®.t.ttativ<a vcwtilts whleh ere
converted into Z n©#r©». Many etu&ieg havts gram out of t f »
controversy of systematic observation using certain diag-
nostic factors or signs vermis objective scoring. Bowland
and Deabler (M) found that both methods successfully differ-
entiated between groups of normals, neurotics, schizophrenics,
and organics significantly better than chance. Sadler at al.
(14) concluded that for their group, a simple ranking was as
effective as objective scoring in differentiating between
psychotic and nonpsychotie. Lonstein (12) also successfully
distinguished between a psychotic and nonpsychotic group,
using the Paschal and Suttell scoring method.
Using both Hutt*s diagnostic signs and the Pascal and
Suttell scoring method, Addington (1) found the difference
between means for a schizophrenic and a normal group to be
significant, but not sufficiently great or reliable to
allow for individual prediction, the Bender Sestalt was
successful in differentiating between groups, but could not
answer the question: "Is the patient psychotic?" Addington
suggests the Bender iestalt should be used as a screening device,
In a study comparing the gender Sestalf protocols of
twenty-five normals (social drinkers but non-A.A. msnbers),
Cumutt (6) found alcoholics to have higher Bm&wp Gestalt
scores, using the Paaoal and Suttell method. Group means were
also significantly different. Curnutt also empirically de-
rived certain signs which were successful in differentiating
between alcoholics and normals. Similar results were obtained
by Robinson (17), using paretics, schisophrenics» and normals.
6
Results of this study indicated that the lender Gestalt
was successful in differentiating psychotic front normals, and
was sensitive to cortical defect. However# overlap precluded
the use of a score in differentiation of schizophrenia or
organic deterioration in an individual patient.
In yet another study, Zolik (22) found significant dif-
ferences between Bender Gestalt scores of delinquent, and non-
delinquents, using the Pascal and Suttell scoring system.
Certain scoring factors were found to he signifleant. The
factor of asymmetry was found to be significant on designs
three, five and six, a® was the item of dots, dashes and
circles on two of the three figures where it is scored (fig-
ures three and five). Tremor was found to be significant on
two of four figures, four and seven, where it is scored. The
scoreable item of second attempt, scored cm all figures, was
found to be significant only on figure four. The item of
dashes and wavy lines was significant on figure one, and
extra angles was found to be a significant item on figure
seven.
In a study conducted in 1951, Hanvik (f) obtained neg-
ative results using nineteen factors as a basis of scoring
Bender Gestalt Protocols. These factors consisted of char-
acteristics such as erasing of the figure, retracing of the
figure, rotation of the figure, perseveration, and changes
in size. Subjects for this study comprised two groups, a
neurotic group consisting of patients with a functional
backache complaint, and a noiroal group consisting of patients
with a proven organic disease of the back. The groups were
compared by judging cos the basin of presence or absence of the
nineteen scoring factors. Only tm significant differences
were found in the factors, those being erasure of figures
and retracing of figures, the functional group of subjects
exhibited fewer of both of these factors. All fmm judges
combined were unable to differentiate the protocols of the
two types of patients in a maimer significantly different
from chance.
In an attempt to separate depressed and non-depressed
patients, Tucker and Spielberg (21) also found negative re-
sults. Using the Pascal and Suttell scoring system. Bander
Sestalt protocols of the two groups were evaluated. The
sample included psyehotlcs, psychoneurotics and patients with
a character disorder. Subjects were compared on twenty
separate Bender Sestalt item scores. Of the twenty, only two,
tranor and distortion, were significant at the .05 level, and
none at the .01 level. It was concluded that the Bender
Sestalt scored by the Pascal and Suttell method did not seem
to offer clinical usefulness in detecting emotional depression
for the sample studied.
In a similar study, also using psychotics, neurotics and
patients with character disorders, Taokin (if) could not
differentiate between the clinical groups. For his sample,
the Bender Sestalt was of dubious effectiveness in
8
differentiating between functional psychiatric disorder®, as
it failed to separate hospital patients with a functional
psychosis from those hospitalized with neurosis.
It is obvious front the research in the area that the
effectiveness of the Bender flestalt in differential diagnosis
is not a question on which there is total agreement. Nor
is there total agreement as to what method of interpreting
design reproductions is the best. Similarly, there is
disagreeiatn m to the significance and validity of scoring
itema and factors used in the interpretation of Bender
Seatalt protocol®.
The factor of rotation is felt to be of significance by
both Pascal and Suttell (IS) and Hutt and Briskin (10)» and is
used as a scorable deviation in both systems. Griffith and
Taylor (7) compared the nuwber of records of schisophrenics ,
neurotics and patients with character disorders in which
the factor of rotation of the figure occurred. Rotation was
found to have occurred In the records of twenty percent
of the schizophrenic patients, and sixteen percent of the
records of neurotic patients. These results led the ex-
perimenters to conclude that rotation was of diagnostic
significance.
Hannah (8) attempted to ©how that factors other than
mental pathology tend to produce abnormalities in the way
Bender Gestalt designs are reproduced. It was suggested by
Hannah that rotation is produced by the maimer in whicl. • the
9
stimulus figures are presented rather than by something with*
In the person. On Bender 6egta.lt cards, design® are oriented
horizontally and copied, by the eiibject on paper that has
horizontal sides much shprter than the vertical sides. This
requires that the person rotate the reproduction ninety
degrees in order to preserve the orientation of the desl-m
on the card. It was hypothesed by Hannah that comparable
populations would produce fewer rotations if the stimulus
card was presented to thora with the design oriented to the
short edge of the cards as it normally is to the long edge.
A new set of cards was constructed to meet the above require*
merit®. Two groups of psychiatric patients were administered
the Render Gestalt, one group receiving the standard set of
stimulus cards and the other receiving the experimental cards.
The average number of rotations produced by the group receiv-
ing the standard set of cards was approximately three time® as
great as the average number of rotations produced by the group
receiving the experimental cards. The results demonstrated
one way in which abnormalities can be produced by the manner
in which the design is oriented on the card an which it is
presented.
Reviewing the literature available, Billingslea (3)
concluded that the Bender gestalt seems to discriminate between
psychotic, nonpsychotic and nonpsychiatric subjects, whether
objective scoring or systematic inspecion is used. However, it
seems that if both methods of interpretation are equally valid,
10
m quick inspection of the protocol for presence or absence of
certain diagnostic sipis or factors would be of more use than
a quantitative Index representing scores cm a test such a© the
Bender gestalt. Many clinicians use an inspection of the
Rorschach rather than a laborious scaring procedure in order
to sav-' time by picking out the factors which they consider to
be ©f diagnostic significance.
Secondly, difficulty arises in attempting to assign a
particular cut-off point for determining the need for psy-
chiatric treatment. Pascal and Suttell (15,p.35-36) set a
cut-off point of sixty for distinguishing between patient
and nonpatient groups. This procedure scans valuable for
use in screening, but in differential diagnosis the value of
a quantitative index is lessened. In addition, the cos-
version ©f test results to a quantified index using standard
scores as do Pascal and Suttell 1® necessarily based on
group information. Pascal and Suttell state: " . . . the
burning question often put to psychological examiners — *Is
he psychotic?1 — is not very well answered by a quantitative
score except in extreme cases." (15,p.39)
Thirdly, clinicians must deal with individuals, not
groups, which would seem to argue against quantification of
scores. Also, the psychologist functioning in a clinical
setting must integrate information from many sources and
Instruments, and again quantitative scores are of dubious
value in thle task.
XI
As in any quantitative scoring procedure, the variability
and reliability of the scorer is also an important extraneous
variable which must be considered. Pascal and Suttell (IS)
provide a self teaching method far their scoring procedure,
consisting of scoring a series of Bender Gestalt protocols
provided in their manual. After this practice, they feel the
novice should be able to score records within three to four
points of their scoring. However, a total raw scores variation
of only osne point will result- in a slight but discernible
change of one point in the standard score. This variation
becomes very important in the many borderline cases encountered.
Pascal and Suttell themselves report a variability between
their scoring of from four to five points (IS,p.15).
In addition » jaany factors used in one procedure are also
used in the other. For example Pascal and Suttell (15) list
rotation and variability in angulation as do Hutt and Briskin
(10). Therefore, it would seen that an inspection system would
yield the same general type of factors to be considered as
would an objective scoring system.
Pascal and Suttell (IS,p.92) state that their system
makes m attempt at psychiatric diagnosis or at relating
specific deviations to diagnostic categories. They feel
that in clinical practice the subject is usually a patient|
thus, the need for psychiatric assistance ia a "given" (15,p.77),
However, clinicians are often called on for such information.
Hutt and Briskin (10,p.88-91) attempt to relate specific
12
deviations to diagnostic classification, which if effective
would seem to increase the usefulness of the Bender Sestalt
itt clinical practice.
Statement of Problem
It is- obvious from the research studies cited that there
is some dispute as to the effectiveness of the Sender Visual
Motor Gestalt test la differential diagnosis, the purpose of
this study is to investigate the value of the Bender gestalt
In this area.
fhe primary purpose of the study is to evaluate the
ability of the Bender Gestalt to differentiate between two
groups of psychiatric patients. The study attests to sepa-
rate the patients m the basis of lender gestalt. protocols
scored for the presence of certain diagnostic signs listed
by Hutt and Briskln (10#p.88*-91). This is done to detensine
whether the presence or absence of particular signs is indicative
of a pathological state of schizophrenia or psychoneurosis»
as proposed by Hutt and Briskin (10).
A second aspect of the study concerns itself with the
ability of the Sender gestalt to differentiate between psy-
chiatric patients and normals, this is to be done by examining
the Bender Sestalt protocols of normal subjects for the
presence or absence of Hutt and Briskin*s (10) diagnostic
signs and comparing them to protocols of psychiatric patients
which have also been scored for these signs.
IS
Hypotheses
the Sender Sestalt has b m m m a widely used diagnostic
instrument despite the fact its usefulness in this capacity
has hem questioned.
If the Bender Seatalt is a useful instrisaent f'm use in
differential diagnosis, and if the diagnostic sifp# proposed by
Jfwtt and Briakin (10,p,88~91) are diagnoatically valid, a
difference in the frequency of occurrence of these signs
atauld occur to the protocol of psychiatric patients with
different diagnoses* In this ease* the frequency of occur*
te ac® thaae sipj# is an index of diagnostic categorisation.
3to wder to study the effectiveness of the Bander Seatalt
in differential diagnosis, the following hypotheses wem
proposed:
1. Significant differences exist between the Bender
H H S l iWjaAl lltl, Protocols of psychiatric patients
diagnosed as schizophrenic and those psychiatric patients
diagnosed as psychoneurotic, m the basis of the frequency
of occurrence of various diagnostic signs proposed by Hutt
a»d Briakin (10,p.88-91).
2. Significant differences exist between the Bender
SSBsL Mates Iffitill $SS$. protocols of psychiatric patients
and those of rrnvrnX subjects in the freijueney of occurrence
of the diagnostic signs proposed by Htttt and Briakin (10,
p.88-91).
CHAPTER mnumsmm
1. Addington, Milton C*, "A Note cm the Pascal and. Suttell Scoring System of the Bender Gestalt test*" Journal of Clinical Psychology* VIII, (1952), 312-313.
2. Bender# Lauretta, 4 fMml Mafttt |®SSii£ lf®£ •&&!& CliBtical Use. Research Monograph Number 3» American 'OrtSpsyoiatric Association, 1938*
3. Billingslea, Fred Y., "The lender Gestalt* A Review and a Perspective," Psychological Bulletin* LJC5 (March, 1963), 233-251*
Bowland, John A* and Herdis L. Deabler, "A B C Diagnostic Validity Study? Journal of Clinical Psychology* XII, (195§), 82-8 *
5. Curnutt, Robert H« and William B. Lewis, "The Relationship Between 2 Scores on the Bender Gestalt and f < % m the' Rorschach," .fetal M .SlMal teffMftSK* t£S54),
i. ... • "The Use of the Bender Gestalt With an Alcoholic and Non-Alcoholie Population," j£ ffWMk psychology, IX, (1953) * 281-290*
7. Griffith* Richard M. and Vivian H. Taylor, "Incidence of B-G Figure Rotat ~ XXXV, (February, B-G Figure Rotations, ' ||^al o|
8. Hannah, Lewis 0*, "Causative Factors in the Preset ion of Rotation on the G-B designs," Journal gf Consulting Psychology. XXII, (May, 1958), 398-399.
9. Hanivk, Leo J., "Note on the Limitations of the Use of the Sende# Gestalt Teat m a Diagnostic Aid in Patients With a Functional Complaint," Journal ClialoidL. Psychology, VII, (1951), 194.
10. Hutt, Max L. and G. J. irisfcla, |he Clinical Use of the ~ * ed Baider Gestalt Test. New VSIK, Grune ancTstratton,
lit
15
II.
fwqgfffc MBffi.raring.T JSSB, JM& M lSS3.§S|,|Y,i SSSfflliBiS » e«ited
by Molly Harrower, SprKgfieid, Illinois, Charles C. fhoraas Co., 1960.
12. Lonstein, Muvvy, nA Validation Study of a Bender Gestalt
(195§S j 2 M E S 8 i Psychology. m i l ,
13. Mcpherson, Marian W. and toretta A* Pepin, "Consistency of Reproductions of lender Geetalt Designs," Journal of Clinical Psychology. XI5 (1955), 163-166. •
1%. Nadler, Eugene B. and Others, "Objective Scoring V® Clinical Evaluation <rf the Jender 8«>taXt," Journal si CHnioaX Psychology. XV ? (1959), 39-%.
15. Pascal, Gerald E. and Barber# J. Stittell, the Bender Gestalt feat* New York, ©rime and Strotton, 1951.
16. Peixrotta, H. E., "The Bander Gestalt Motor feet as a Culture Free test of Personality." Journal of Clinical
- ,M X, (19SH)» 369-372.
17. Robinson, Harney M., "Bender Gestalt Performance of Schizo-gnfraic* and faretlcs," a&ffiESl Si fUnic.1 y«vchologv. IX j (X9I3) » 291«"293»
18. Rosenthal, David and Stanley 0. Imber, "the Effects of Mephenesin and Practice ©n the Bender gestalt Perfor-
i s ^ &
19. Swensen, C. H. and G. R. Pascal* "A Hot® on the lender Gestalt feat as a Prognostic Indicator in Mental Illness," Journal of Clinical Psychology. or, (1953), 398*
20. Tarakin, Arthus i.# "the Effectiveness of the Bender Gestalt trntJto Biffer^tial Magnosis," journal & Consulting Psychology. XXI, (1957), 355-357.
21. fucker, John E. and Mimi J. Spielberg, "Bender Gestalt test Correlates of Emotional Depression," Journal of Consult-
(January, 1958), ^6.
22. Zolik, Edwin S., "A Comparison of the Bander Gestalt Repro-ductions of Deliquents and. Non-Deliqpents," Journal of Clinical Psychology* XIV, (1958), 2*-26.
CHAPTER II
mmmim
Subjects
Two groups of subjects, clinical and norraal, were used
in this study. The normal group was composed of thirty-nine
students moiled in freshman or sophomore psychology courses
at North Texas state University. The group consisted of
twenty-one males and eighteen fswales. The age range for
subjects in this groiqp was from eighteen to forty-seven
years, with a a m age of 21*5.
The clinical group consisted of thirty-seven patients at
the Wichita Falls State Hospital* Wichita falls, Texas. These
patients were diagnosed as either schizophrenic or psycho-
neurotic by a hospital staff. The schizophrenic group con-
sisted ©f twenty-two patients diagnosed as sia^le, catatonic*
paranoid, and chronic undifferentiated schizophrenics. The
psychoneurotic patients ware diagnosed a® obsessive compulsive,
conversion reaction, mixed, depressive, or hysterical psycho-
neurosis. Ages for the clinical group ranged from fifteen to
forty-nine, with a mean age of 28.1* Fourteen .Males and
twenty-three females made up the group. Education of the group
ranged frost the ninth gr«de to thfe bachelor's • degree, with a mean
education of 11.7 years.
16
17
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f i g M * * o f a t l « a » t ^
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| H f l l i 5
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tTMi '^lltilhiii^i Jlft ffef mffii'iiHt' Jc M t A f 1 ifjfii
p H l t » # f t i i e toigH J # i f i
If y f ^ niCBtlSi . i l I | | t
iillH mmmmm4mmm tm Mi (WfiW<W***&• ^Swipi ^Ifr^^Ww^WPP'^^^plw- ^wffljpjap
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I B j i t i d m j f f l ' i i i . i M i X i O i 41"#% d M h f c * * j i i L i i l 1 i | ' i i L ' | L ' l _
«p Mm* Wumi f i p i ^ l F d w e t i v B o f u t t snq^Ui« f f^wi^ te | im| t f f i i f i t y ,
i M M B d M i i e u i t y *
l i t n t l w i © f t h t - a a j ^ r #9U4i Wf • ITJLgpyHW* St 0 i .s i w i t t I S t o SCI & < r n m m s o t o i a e ^ g m i
If
« m, f -ff fi*f|(i lfhft-Jrjf -£fi|iK&b IjjSjt T"jiitMiBfi gr"i jlJiXjjl"*r dft -itfiL'lf^fi J£L i j j M f m ftifrrjift' iiVTilTillifi fflr
sm+ w* m SSpPti* iHT ^hrnrn^iimm f# IM®
12* SiaijoimtiGn «# AddUa* ft ^ mtgtml OiMdlJUaiar Afr|§¥% Jm*
%h&6& fMfcOKI mc* tiMkfti iHhsMi* idiii&h lfe.it:t" sind Iferl 'kJ ft •" -PaV* Wli,-lw TJj9 - ^8F '™*^?r p ' l' .W. ''WW^ 1wNPr #pfe1£?s W w - P W w P l P 7P1 f | | M P •JWWflPV'WIPP'W
feed mm ss«5Ttial iof AUgnotfcle elaasiflaatltm. fUtf Btatfci
% * .the: p98ttn of fiir® «» W8 of the phmommt in Htm
wmuhMiI g*t»p is sufficiimt to «89ff the dlapMwtlc «*§»
pwiwtofoB #f Ml poMp.** (3f»,IQ« Mwm»( for this study ffi&lUf* Y l l j M V W l * 41k l^ ' 4 V « < M . . { Ah 4BJM tf-vlUk A # mttfmufa # itttt
Jill
giwyp will ust Im wiBpteti to meet Hit wtomim «tort«l itwre*
•Jliie l* mmmmmf hwmm® not all of tfctM twtwt.ni $m%mm M j f W M n c s r l « ^ | t 4 t ^ l * ^ r a ^ W f t y l t ^ a E M r M r . £•>!*#&«*>£»<. » > * f * ? ^ J | *
SPJw wWiWWW*5P®W|fe SPifiPPjiPw W5M|U IWPG &&&&immiiM%mh.l a ]m# m€mwtlfe iriatj tiaasu In htm*mMmtm m4M* Wkm
PM9MW of th& «Ht%* *hich no# to MmIm whether fc^s« mriUtont
factors will it useful |» (Uftes-Rtl&I diagnose.
Ttm |M@«teM» to B^Uil&tmtimi #f tha Iwatey ftirtalt
«mnmtm mm® wm m* ltetisil. $m tlie mmil »pm# *»
«^rt»i«twiia Br^r Qestfiit Mp$ im ft pw| e itu»i;t Ion.
f to P«M^ki |»Mttlmi ppDj etii i'hu Wm&m Qcgtait wis w
e wbite MM iJi « SWM % using « opatme p?oj tor.
ito J^rtt ^ ylM)i «ss.«» f|p« mm mmm& m Urn
«AJ«at»* »« «mt pmMoS to mmrn# mm fteo^t
mm* m* mrn$mi» *w» ig$mm -MmU ttm t» «npwte« «ch
20
design. The designs were to lie copied on a sheet of plain white
8 1/2 fey H inch paper. Paper and pencil for reproducing the
designs were provided. Standard instructions for administering
the lender Sestalt test were followed. Subjects were volunteers
and were told nothing about the nature of the study being con-
ducted. The procedure of administering the Bender Sestalt Test
in a group testing situation was used to conserve time, for
Bowland and Deabler (2) found the technique of administration to
have no effect on test performance.
The Bender Sestalt test protocol for each subject was
examined for the presence of the twelve diagnostic factors
listed above. Frequencies of occurrence were recorded and
tabulated for the group.
The lender Sestalt femt protocols for the clinical group
were obtained £%m the files of patients at the Wichita Falls
State Hospital, Wichita Falls, Texas. These protocols were
produced by the patients during regular testing at the
hospital, in which the Bender Sestalt Test wa® a part of the
test battery administered there for evaluation and diagnostic
purpose®. Although the tests were administered by various mem-
ber® of the regular staff at the hospital, it was assumed that
the examiner did not Influence the test performance. In cases
where more than one protocol was available for a patient, the ear-
liest administered record was used* Psychiatric diagnosis for each
patient was obtained from the files, and subjects were placed
either in the neurotic or schizophrenic group according to
21
that diagnosis. Each protocol was then scored for the same
factors as were those in the normal group, and the frequencies
for each factor were.:, recorded.
The statistical procedure for the study was a two by
twelve chi square desipi. f m ©hi square tables were con-
structed to test the two hypotheses proposed. The first was
constructed to test the relationship between diagnostic
classification of neurotic m psychotic, and twelve diagnostic
signs, the second table was to test the relationship between
these same signs and classification of normal or abnormal,
using the psychotic and neurotic groups conafoined to form the
abno«ual or psychiatric patient group, the .OS level of
significance was required for rejection of the null hypothesis.
6 B S 9 1 B i M M U M U *
cSSopS'yal i lat i ' i le A * « o c l a t l « n » M S *
2* Bowlsxid, John A . *m4 He*dia k SmNUvw "A 1 1 M a g N N r t i e V k U 4 i t y study* SmmrnH « f e i . l i i i e e l wi|rtw>1imy, i l l ( M 5 6 ) , « M 5 T
3* M M i _Mtt fc» m & 8* «!• C l i g i l c a l Use fff tfao
SwPSwt®!!-^ JWBHP#
2-2
CHAPTER III
RESULTS AND BISCUSSI©
In order to test two hypotheses concerned with the
effectiveness of the Bender Visual Motor Sestalt ftest in
differential diagnosis, two preliminary ohi square distri-
butions were constructed. After preliminary construction
of two chi square tables, the expected frequencies for four
scoring factors were not sufficiently large for use in
statistical treatment. Consequently# these four factors were
emitted from the design* resulting in a two by eight chi
square design. The factors omitted were collision» use of
margin* fragaentation, and elaboration or doodling.
The first chi square distribution computed mm designed
to test the hypothesis that the Bander iestalt fast could [
distinguish between normal and clinical groups. The analysis
yielded a chi square value of 18.56, which with seven degrees -
'Of freedom yields a significance level of less than .01. This
value is sufficient to reject the null hypothesis* this
finding indicated that significant differences do eyist be-
tween Bander Qestalt records of nonaals and psychiatric
patients on the eight scoring factors used in the study. '
A second chi square distribution was computed to test
the second hypothesis, which stated that significant differences
©list between the neurotic and schizophrenic subgroups of the
23
24-
afclntcMi f&tevpt m tts« of mmmmmm of t Ik- e j ht-
•earing imt&m* fi*« ehi s wa» value «8»tate*sdi wit# **009
iAiA <mtm Mg* #tn—t at tfcft VaHBtiUNMi lfV<4, fts#
#|m iNtt#w fitestbsl'fc fullfwi fsi s«w®ts totaiMtt ttsy®@ifei,0
aiuI ypy taatKtft pat» Aanfca •
As it «vw&t nC ttw s pSSw fisSisgpi Ifwn t@®tj«*
&Bg $|M| jMNNKMl ^^^tes£#§ tMI 4rlfl,<ffll-I QtaS 4ifHIP$~
iitiftiiaiiii it®®*© @iisgj feegt# • ftw# wmmi ogiMiBWted to #§t€tnliiii
JMf fWf9ltSB9 4MUlfA lllfcWCNWI i- ftj. fflttlfiltl* jffl fit®
tw® gf tlw ffl I,nl ff! I gi p fflft tint Iwftf > @C tint
fit# tiJgqfc #f fffljgt »iM-g#"ffyM9l f-|»jlKy»'t#WtM flOflpOSSS
f$K# flftffllff-il yity 4n | til© fltfyfltWlriitf1 ®|f tfy» *l<f»$j»>t
graup* ®A« QORtaviaaii yieldad a dii square value of 14«87t
afeygMjjfc ^f%|j lfflffi'iilPflff ffffr ,uJfc mSr fftlffiil' Filfftellill i £H£rt ^ Tijil(|((rffi jr Wr T
WwUMBTO WJbfiVI mWtWWpl WWfSmWmm IWm lt^mM| IPBMBI fP I9p|p
tft® .OS lcvtl* fHis diffo»®iie« wis pwt mmi t
rejection of mUl hj/pothesi«4 The; eigniflamt iiffWMm
fii ftliw S ihs SwSw *tii© Qestslt was ffrtlf> t® ftiift<*f»f "-Mly A£.ff p«iti®t.® te^EWS* p«Bii»li» Maui, a^dbafles*
i© f* » |^ fd^bt ^ SBBBS® teitgUft ® ">><
seaMM wajjuft &t IS.33 h&I f itraisaesS bv fehs? nuHHtaJL
*r™ '»« " S5 •Wplfl'TIflP' j |r W9'Pw*,WW' 'Sf-'WWW
—r*ttifiiili'hiii ijiftM iftfflft' fiwfftii AtrBlfa iirn- -w n imiriiiii ii illiIrrFfft $&%&,*&*<-• j^ I' ^ ^"fw j|| -ifrrwim rnfiir im MStiffik,*. #•
®Hwi iw© ifeppyyB®X€i os. yppoiyy.# *3EtiuB
Ai S MPI ¥#!.» w« msf fiiigniflcaiif it #»» MWHff|f
««MMMM1 ter this study, fm t'hla MfA« Ite BmOm
®m%<* mmmi, §m ei^it d£e»»eetic ians, caawll not »ltifer«
entiatt- InHwmii immkI. a^ awo tie fejwsta «ipiifiMStl^
25
fcofctm tbmi chance, file results support the *iypothesi;ied
ml&timfM® Ifilmffi ffc©®ii«©f of aesnnRoe of the scoring
factor® end Wm classification of tls® two groups.
Statistical treatment of tint data Jjidieot® that thc-
Qoatalt toot tcmd for eight diagnostic si®w m
deviation®> mm mxmm&tui lit aifferssitiatiag betvoon mmnal
subjects miI p^pMntsle potionto as a group. it
would seen? that the Stutter Geatalt scared for the following
diagnostic sigpis is m useful JMtMMBt for aiapioatic aoot
1, Position of tho flnt
2*
I*
U»e of Spwe J •« tmitnialYi
b» eo£i@trict©d
c*
Xaolatod Xncrmac or N f n » i i*i 8i«e |WI®*SSB O®
Of flfltfM A otftMNP than the foUoss** 3n§ ia ' atypical s (1J jyRi w* jh
Hfcooi loft suargim aiyi top of page mr ifaimr mm Air limnr TE ^ ^ iMiiilrMi JE&aifcaiwidMfc
will Jk rlg&it margin an! "Htm Sman 2 4mmlnsnst 12) t&O
7wppfl)pBP*sSjF**vflP'"H,Wp *»• HL opr jH
Ufpf loft«hondi «K»WW of the page.
89000 IwtwMii 2 droving* is igoro thfm 1/2 of th© 'IWli' liflh fV*l ir fi' iiii jti'frtyft" 4m ifritfli liffltifr A milfrk nflri
1Ip6%IP Ip*. eitlicr figppo* 0JNHOO botWWBSL 2 m. -Mk v jfejiWEi iffiiiWft Jmik
Jwl iCMfc 11$ Mni liWrnnnMiBtftftf i rtfi nflrti mt\ urtmhr n™ ijM*iii nninnflir jm* jmfernr
^BRIW®Wplwy^ Immm #1 ""•SPr Im VBFjErapipiPl ™PS W*
W5 J&S* ni iftlfti MWi tWlk iflifeL aS»l8fti tfeffj-liriiiftti
mmm B^BQB %mmk m Btm wmm than b. An immsm m flmmm® In litfl of a £t#u»e9 of of l®oat V% of tiw «w* VWpBillli®® iwtA# te S%i#ElSS| mo o #f
AtowsiSBS w s S in tte wBBt 9$ i$0im9 or by S/$ mm m le«e of the-
26
*f„ Closure Difficulty
5. Crossing Difficulty
6. Curvature Difficulty
7. Change in Angulation
8. Rotation
s* mild b. moderate c. savers
dimensions used in the preceding or subsequent drawing.
Saps, ©vtworktag, erasures, increased pressure at points where part© of the de-sign Join cm another.
Redrawing, sketching, erasures, increase of pressure at the point of line crossings in any figure.
Any changes in the curves in a figure, such as in-creased amplitude, spik-ing, flattening, irreg-ularity, changes in »i®a.
Any change of more than 5 degree® in the repro-duction of an angle. Increased acuity. Decreased acuity.
Rotation of the major axis of a figure. S to IS degrees IS to 80 degrees 80 to 180 degrees
The ohi square values derived to test the second hypo-
thesis were not significant'at the level required for this
study, the hypothesis stated that significant differences
would exist between a group of neurotic patients and a group
of schizophrenic patients on the basis of certain diagnostic
signs. The rejection of this hypothesis is interpreted as
indicating that for the sample studied, the Bander Gestalt
*e*9*d for the factors used in this study, was not effective
in differentiating between a neurotic and a psychotic group
significantly better than chance.
27
After computation of two additional chi square values,
'til® ability of the Bender Sestalt to separate individuals
according to diagnostic group could be examined more closely.
The results of this procedure indicated that the Bender Gestalt
was successful in differentiating between a group of m m m l
subjects and a group of schizophrenic subjects, thus, on
the basis of the scoring factors used in this investigation,
the lender iartalt seems to be sensitive to severe psycho-
genic pathology. However, this ability did not hdld true
whan the Bender fegfalf w m required to differentiate between
a norraal group and a neurotic group, these findings indicate
that performance on the scored categories of the Bender
Sestalt does not seem to be a sensitive indicator ©f the less
severe pathology of psychoneurosis. Differences observed
between the m w m X and clinical groups, therefore, would seem
to be due to the psychotic patients included to the clinical
group.
The negative results obtained in the attempt to diff-
erentiate between neurotic and psychotic groups may have
occurred for several reasons. First, the scoring factors
used in this study m y not have been sensitive enough for
psychoneurotic disorders. Use of finer measures to determine
the presence or absence of deviations could increase the fre-
quency of scoring of amm deviations. Also, sc«ne factors
which were not scored see® to be significant. For example,
2S
numbering of the figures by the subject was found to occur
often la the neurotic group and also in the records of noriaal
subjects, who also produced several of the other scoring fac-
tor®. The inclusion of additional signs which occur frequently
could increase the differential diagnostic ability of the test*
In addition, all of the diagnostic signs proposed by Hutt
and Briskin (3) were not used. Out of their list of twenty-
five, twelve signs were chosen for this study, and four of
these were discarded in order to statistically treat the data.
Another consideration concerns the use of all ei#it
factors for scoring the protocols of all groups. Hutt and
Briskin (3,p.§8> „ list certain factors or signs as related to
particular diagnostic categories, fhe two diagnostic cate-
gories and the factors used £tor scoring in thin investigation
wee presented below in the wanner in which Hutt and irialcin
feel they are related.
A. Classical or Essential Psyohcmeurosis
a. Space: either excessive or constricted. b. Closure difficulty: especially if present on two
01* ns re B c. Crossing difficulty: figures 6 and 7. d. Curvature difficulty. e. Angulation difficulty. f. Rotation difficulty: wild (especially with
depressive®).
i. Schizophrenia
a. Placement, first figure in abnormal position. b. Space: very uneven use of space. c. Angulation: if severe. d. Rotation: severe. e. Cohesion or isolated decrease in lateral sisae.
29
Is a strict test of Hutt and Briskin's system all eight
factor© would not have been scored on protocols for all groups.
However, tills study was designed to test the ability of cer-
tain selected factors proposed fey Hutt and Briskin as being
of diagnostic significance, rather than to test a particular
scoring system ©r to attempt to relate specific deviations
to particular diagnostic categories.
the results obtained in till® study tend to support other
studies such a® that conducted by fucker and Spielberg (7),
utter® the gender Gestalt was unable to separate depressed
from non-depressed patients. Similarly, farokin (6) was
unable to differentiate between a psychotic and neurotic
group. The failure of the Bender Gestalt to separate a
neurotic and psychotic group in this study also supports the
findings of a study by Hanvik (2).
These findings conflict with those of Bewland and Beabler
(1). In their study, they were successful in differentiating
between psychotiee, neurotics, and normals. Robinson (S)
m m also able to successfully differentiate between schizo-
phrenic, paretic, and noasnal groups, and using the Pascal and
Suttell scoring method, Umstein (H) was successful in sep-
arating psychotic and nonpaychotic groups.
k conclusion concerning the theoretical assumptions of
the Bender Sestalt Imt as used in this study can also be made.
The theoretical foundation for the Bender Gestalt maintains that
mental illness or pathology of an individual will affect the
30
visual motor perception of that person* The results of this
study cast some doubt as t© the extent to which this assua©tion
is valid. As measured by the eight scoring factors used in
this study, the severity of the pathology seems to be a very
important variable" la the quality of the Bender Gestalt re-
productions. Psychotic patients were successfully differ-
entiated imm normal©* and a group of psychiatric patients
was separated from a group of normals, which was interpreted as
being a result of the presence of psychotic patients in the
group. Therefore, this part of the results of the study
supports the theory behind the lender Oeatalt test.
However, this was not the ease when the Bender Sestalt
was required to separate a group of psychotics from a group
of neurotics, and when an attempt was made to separate a
group of neurotics from a group of normals, the failure of the
Remdet* Gestalt in these tasks indicates that the test, as
scored in this study, is not sensitive to less severe forms of
pathology. It seems that these forms of pathology do not
produce the severe disruptions of the individualfe visual
motor perception as do mire severe forms of mental illness.
'She inability of the Bender Qestalt to make the fine dis-
tinction between neurotics .and nownals may be due to the rather
coarse nature of the scoring factors used in this study. There
seem* to be need for development of scoring factors fine enough
to be sensitive to the less severe forms ©f mental pathology and
still remain evident enough to be observed by a system of
inspection.
CMfttt KDtoMWIW
% CkjgMvfr 1| jMeMtedtt Jl ggwweJB j** If $%£31i ftb^flk *9$ ft flft 0 Ifll4^ tfl*»'g!M%llft#» Jflfc J**- PPMrJMii».j| fpfflKPS #*• im' m* jpWWIiMMF£ I* JP 1* 1p9MGP9VMP%J»W
Validity Study," Journal of Qinloal gwefaBtom* XXX* (1956), 82-8**.
2. Hanvik, &e© «!•• *A Note on Hi» ttAltrtlont of the Uoe of l»Itw JHN9NMRF' BflreEEyitW" TMKPI» 9m #1 liMppPPwWC? «#Q IHR WitSi a fteMS'fe-loii®! Coraplaiiit »*# t f CM*y.2§l ftev* f l l » <***), m » -T-^rrr.«»-r^T-ra«w»
3. ftfttf Mm !»• ma& G. 4* Bgiski^t jait; _Clinical Uae of the llffiiiHft ffi^jrjjPf I B p S f P l ^ s§l<* «1»JW»**WH||( «#lwt
%, teto^letof itowy* VajJUSfttiOR StM$y ©f 8 B&ftdex' CtestsXt Smv&m §mmm$n J — M l of Conaniting giivchologay. XMSX,
5. Waibimm, gamy $»# 8 M w 6©#t«J.t f^oawimee of
' " " ' mtirn and faretiisa.* Journal of tliMml %m» ix, a « D » m«a§I . "
f* T&sfoin* Arthus S., ^The Sf$Mrt&*WMM of ths landa* ©estal* UNsftfc In fttapMNKlttf* jj ygg |« Psvoholo^o;. XXS« (19S7)« 3&I»SS7«
?* Tucker, John £« end MSijti SpttfUMrg, *tNi«r Gestalt %-WmW PI
^Ull l|# wS*tiW
i m , VtrY* # f „ . . m 1 r < t ^ * * * * *
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m m of mm & m t o Visual Motoy tesfeult In d i l l M l s l
*ltl«TO#l#» Hi A t ifcAml i a# #jhdhft S4.rnmmmm i.m m4mmm,„„ B£#^Wh»
(fjne^ ®tiSM&§ Mac*& i?a&tesii u&in<r & nso bi# p i«ht f4ii
WpiRlHI 4fMM pt#
Wfc&mtMmmiMk* SlfattSSEteB mmm$ik%%mM. 4m mm
mtm4mtmmi fe MMpufta @# Mww»fe. 9mma J&taisa toilifiaw£*y|: immi a*Awt*« 4 ^ ^ * 1 1 ? i P ' a J f ' f B p w ^ p ^ F 9 r o F w W 9 F P WWJr^pron? ^ i p p i p f w W f S P P r I r w * ^ * J F w *
i s t e r e d Use J t e s t cd t -a—t l a a g m t p t a t t i n g MmtkUm*
jf-% 3>e. Jt MStsStiSMkM^L irt'#litll'i1illi ill?! #> fflfirff Nt ^ W i w <pp»i j»# yiraWMPlHpiMP H* • flM>flwlipWWiftt W**™9 ^ P f f P i P l 1P§»
I f t S f e 1 ^ b l Jffir wMp j ^ Y - j g r f f t % I f ^ | g i ^ y K ^ ! i & Ma* fltlM,, $$ ,m I'lififii'f^iMMdyiteLi^ttML '-M dftft* <gfe lBgt!.- feSfe •Jjf Mfk^tm
M l * M Hospital mm ms^mrnA i t t t a c of tlia
riowml p « i « thm ibasis of ciglvJ- d.Ugnosti<2 f«etOV£ l i s t e d
Ijy Hutt arid BrisKXii ( 1 ) ,
tli® f l i f f i t l s ^ t a l « «t«MAt 8 i j t f f t « B t 4 i l A n M C »
ei t ls t t he ^ d a y Visual Gu-gtalt f i t o ^ t o g ^ I e
of ^ t i « t s M®$m®m «s s^ i i i»^ tami« i w l t l ^ e
p sych i a t r i c p a t i ^ j t s i l ^ s m @ i a» p t y t t e M i N t k , an tete
of the fjeepw««y c m a w « M o* variotis dlngtmutin # % m
P ^ m ^ I i f i i l «nd M i M s ( l | | 9 t H » f i t ) (
®»i4i mm mm eonf^wa % the mm* 'Aw iM
« P » « w a u e <^5taUiod « i i not p e t « n g | m y i e l d « a i ^ i f - i -
« w s « t m l f i M i w W m t Hm wnt towiwi t e ^ s
S2
is
•tudty. It &m bm mrmlw£®t& that te tilt atuAicd, tfc*
Wmnim Bwtilt w i not «ffm* Jn« Ia Mfunklam ncuMtie
PBwXwwTS ZITOi p^X&WmWB•
In mstet? to xuftl^r MJaeet* tfes 4*ff«mitla2. diti: ;oatic
ability of tht 9mtov G«tait9 two additional relitiaMltfpi
tMMI ltyi^^|^Mai jjfjhft ftltf SME1S WJlllMI ##P
tins flwt «£ ttm* mw dMpui t t <rt«n*Iit» «batlMV •* art Hm
Wm&* Cottflt <**04 s t i f f M m m r a mumtt gpM# m§ «
p«yo*iettc PW| MspMi of aoiU^^TOic fgUm&B* H fM«
i»i4WMJxi§ tte; Hemfer jS«8*elt w mioo saful In iffItoNHtlMHllls
bmtim ttw tuft pwips. ftwwar9 in Hm mmmA #f Ute «h»
a«se®t*ii*»y r*l*ti«n«hip0 MAM, tt># Sailfeif Gfratalt newM not
AlffMftttefc* I d f u s e ntmrotic ant a MM& group tlgRill*
onitiy &®fct©r ttem
ffet mmma ttypettonU ftttcAi Alpiftf&Mt AiffcMNRQM *ti*t
mm Wm$m Visual mtm §mMt 1m* p»fw«*i» #C w -
[email protected] Mi tbos* of M i l «Atf «oit« In thro
of m m p of oavtftiit <uagm»st:;e Bigm gm§m®£ $m *** mI
Briskln pp.aS-Sl}.
9fc« cki «ftHDP» v aue L»©riv*?a Hsm tcctlag this
was found t» feft «l(pafftawt ®t iMtHf tfcan Hit ,M lMNriL lltii
M4b %**& «f mmms%® tt» mmytwiM «# tM«
yathMtiUu It «ni Im mftliiAaA tkt ttw Binder jfH&t w» ywcw
ewinittl in 4Utf)NiMMtl«tlag wmmmI m&$m#& tmm i^stei^«le
pttltBkc,
3M>
The conclusion can be Made f'mm the data obtained In this
study that the lender fijeatalt fast is a useful and effective
psychological instrument in distinguishing between m m m l
subjects and psychiatric patients as a group. The lender
tostalt. scored for the presence or absence of eight diagnostic
signs proposed by Mutt and Briskin (X) was also effective in
differentiating between normals and psychotics. However, this
effectiveness was not maintained, in an attempt to separate
psychotic# from neurotics and normals from neurotics.
The results obtained from this study would seem to give
support t© those who feel the loader Sestalt is « valuable
•ereening device, but of dubious value as an instrument for
use in differential diagnosis. The scoring factors used in this
study seem to be sensitive to the more severe ferns of mental
pathology, but rather insensitive to the less severe illness
of psychoneurosis.
The conclusions based cm findings of this study seem to
indicate that in situations where individuals are to fee screened
to establish a general level of mental health* the Bender Gestalt
is a useful! instrument. This would also seen to be the ease in
a situation requiring a dichotomy between normal and severe pathology.
However, in a situation where a fine distinction is to be made
between an emotionally stable and emotionally unstable or
neurotic condition, the Bender Sestalt*s value is diminished.
Also, in instances where differential diagnosis as to neurosis
or psychosis is required, the lender Gestalt would seen to be of
15
dubious valitw m iwrni by tho ei&t di**no«tio (tfpw mm*
in iiwMtlfiMiai*
iCWil emst nmn b& t§M& apujld SttWSfe in
« ehsm^e Is the fMtapi *f M s @t«§y» Timtt th« i»c of «
1nw« M p U tmiM I m m * tfe* ctaee te mw® of the MMWlaff
f»atara to *mmp« 4Mp*la&ly i» ttw clinical jp'1^* fM#
dwsg^ t#wuWi fe# w « m m d w M b l * If «Imi t»o «f
tb» eUnio»a p w | were e^el ia #4m to & « aoiW,l ps§s#»
X* tiM* «tw4y*-4!i0 •*•• »* th* »sw»tie grctup w i ft*»
aAiiiwriwiMte WgMfi nw.fr HMtt-tfti ttf* this! ffldf t&6 M i W l
®ww» • tliis ocndd be na Iqpwtwt fe®t«r la thai IwsMJify ©f
tha Bfintwr tagfft&f to Mptvstft iwsiaJs fwtt atmtlAft,
fit® « M of war® spring factor «m*M aloe Jmm**# th»
fiWta» gagtnlt'g offaetlvoMM -In ®®psi»iisig groups of Utimmft
tttflgMMtl* olMtt&ftoiitton* Jin l i M i l la ttl€ -»i*WW of ItafiMi
MUX iaevaao* 4ht vovdUMy of 4*viirti«i* mmmi* to tfct# toy* a
*id«r vie# Of Hi© iisAl¥ia«sls vimml end «aotor fONMCftlffi owi
be AswirMe ' '•
Xft addition* a qpftmatia attoapfc to mlitt «9«tifio
dafttatian* aMwowai on iaato ttaataXt m g m i m t U m to pf»
tletlla* /lihwwwtici fS$t:tmi*i,8» «mm«1iI iafM vaXwatlXfe fe#
diapiaatlc «®e #f ttif twater giwtttlt*
1 . M ( g t t « M m r *
3 6
BIBLIOGRAPHY
Books
M i W t tettretts, VisualJfatog frwrtjalt Test and Ito Clinical
Association, IfSS.
Mutt, Max L. m l 6. J, Briskin, tt« Clinical Use of tlm la» yitei Beato aestalt tot, i5» Yor!<, Gnmc aai ifcmCfK# JMrPtt#
fcy SppiagfieM,' Illinois, Ctia*I©ii C» fh®i»®
Menem®*, Quim, Psychological gtefelatiesu Met* ¥@i&f asl® tfitay ®pbSI 0^0® I»e*t INKS-.*
S M M & t CtaMld ft* aril ftaftNNNi J# S^teili fhlt E-end i- Gostalt YMrts* IlMr IfMk* ISmhmi Mid MMttfltt* 1951.
' Articles
Addiagtomt Ntt&sp C*t mk Hot« on ttie W m m l and StfttdLl Scoring Sy»t«a of the Sssnde* Geateslt Test," Jauawl of Clinical PsvcholoCT. fill, (1SS2), 312-S13.
Billing*lt*, Fred f»# The Bimdei? Qeetalti k Umlm mi a fumectlv«$ W®m&mlmle&X MiMtM* tX 01aroh, M 9 ) » 2S3-251.
Swl«nt» John A. ml- HertUa h, Suite. nk 8 G Diagnostic Validity Study," Journal Clinical Psychology. XII, CUSiJ, #2«4&. • '
Cuwaitt, Robert H. M l William S. Lewie, "The Eelationahip »«*w«ait 1 Scores on the Bander Geatalt and f • % on the Rorschach.* Journal gf Clinical PsvcholoCT. X, (1S5^) , MUVP*
. . * "fh« 0s© #f *he w w w n E ^ B * ^ » S E w ® S r B , w l ! ^ ^ 3 E w w d i MwdttaaMle f©
uUtlcw." Journal of taii&iial YmtMlm. XX. (19S3) # 2®# l#»9ll 0
37,
38
Griffith, Richard tt» and Vivian H. Taylor, "Incidence of B-8
• XtfftMhalU
Hannah, Lewis D.» "Causative Factors in the Production of m the 8*® ©©slaps*" b m i , (May, 1958)
Rotation on the B-G Designs," Journal o: • " V W * « w *
Hanvik, &eo J., "A Note on the limitations of the Use of the Balder Gestalt Test as a Diagnostic Aid in Patients With a Functional Complaint," Journal of Clinical Psychology, VII, (1951), 19**.
tonstein, Mtory* "A Validation Study of a Bender-Gestalt Scoring SystOT," (1954), 377»i7i.
Mcpherson, Marian W* and J*oretta A. Pepin, "Consistency of Reproductlions «f Bender Gestalt Designs", Journal of Clinical Psychology* XI, (1955), 1&3*1©6*
Sadler, Eugene B. and Others, "Objective Scoring Vs Clinical evaluation of the Bender Gestalt," Journal of Clinical - " * t, XV* (1959), 39-%.
Perixotta, H. E.t "The Bender (Sestalt Motor Test as a Culture Free Test of Personality," M gBjfflMMttt' X* (195^), 369*372. , . . ,
Robinson, Nancy M.» "Braider Gestalt Performance of Schizophrenics andi Paretics*M Journal of Clinical Psychology. IX, (1953), 291-293.
Rosenthal* David and Stanley D. Imber, "The Effects of Mephenesin and Practice On the Bender Sestalt Performance of Psychiatric Outpatients," Journal of Clinical Psy-cology. XI, (1955), 90-92.
Swensen, C. H. and 6. t. Pascal, WA Note on the Bender Gestalt feat' a® a Prognostic Indicator in Mental Illness," Journal # Clinical Psychology, IX* (1953), 398.
Taiakin, Arthur S., "The Effectiveness of the Bender Sestalt Test in Differential DiagnosisJournal, of Consulting Psychology. XXI# (1957)! 355-357.
39
ftseker* Joha £• «m& Ulai J. Spi@lli©i»g, 6©®talt fwt Owwelat®® ©f finatieoial Immml of Consulting M^0£M* XXXX§ (J*nu*vyt ASSS)* §®>*
Zelik* M&im 8*t m& Comparison of ftta Romtap Seirfcait tea*
ductions of ©eli«p®ti§ msS Journal of Clinical ftevoholiigy, XIV* (1S58), 2**26* ™
