Assessing Aggressivity with Comprehensive System-Revised Part I

The Rorschach Gacono & Meloy Extended Aggression Scores: An Updated Review

Abstract

The determination of a patient’s aggressivity is a function of assessing multiple factors including a patient’s personality vulnerabilities, their past behaviors and potential future circumstances. Evaluating the nature and predominance of aggressive drive, impulse control, affect lability, inhibitory mechanisms, cognitive deficits, and conscious and unconscious attitudes (e.g., use of devaluation; presence of internal identifications and imagery) is essential. All of these issues have correlates in the Comprehensive System (Exner, 2003; also CS-R; Fontan & Andronikof, 2022) and supplemental Rorschach data (primitive defenses, Cooper, Perry & Arnow, 1988; Lerner & Lerner, 1980; object relations phenomena, Kwawer, 1980; extended aggression scores, Gacono & Meloy, 1994). Pre-oedipal personality organization and primitive object relations also imply attitudes toward others that are derogatory and/or distorted (all linked to aggressivity; Rose & Bitter, 1980). Coding of aggressive Rorschach imagery is essential but not sufficient for understanding aggressivity.  In part one of this two article series we discuss the origins, development, reliability and validity of the Gacono & Meloy’s Extended Aggression scores (1994; AgC, AgPast, AgPot, AgV, & SM; see also Gacono & Smith, 2022).