Depressive Symptoms in Projective Tests

 

Are Depressive Symptoms Associated with Negative Emotional Tone and Low Agency in Projective Tests?

This is a study published in 2021 by Joo and Park from the University of Iowa and Korea University. They examined the relationship between depressive symptoms, emotional tone, and agency in projective tests.

A negative cognitive bias is the tendency to attribute a negative meaning, rather than a positive or neutral meaning, to an ambiguous stimulus. People with depression tend to display a negative cognitive bias. In Beck’s model, a negative cognitive bias may contribute to the development of depression. However, the reverse causal direction may also be valid: depression may lead to a negative cognitive bias. For example, McGrath and Repetti found that children with depressive symptoms were at greater risk of developing negative cognitions later in life. There therefore appears to be a bidirectional relationship between depression and negative cognitive bias, creating a destructive cycle in which depression and negative cognition contribute to one another’s development.

Studies of the narrative life stories of people with depression have identified a recurring motif in which a positive event is followed by a negative event that overshadows it. People with depression also tend to tell life stories that are less coherent, include less information about time and place, present events in a less organized manner, and make fewer references to resolution and subjective perspective than the stories told by people without depression.

A sense of agency is the feeling that we can influence our environment. Agency has a positive effect on mental health. People with a strong sense of agency experience fewer negative emotions, less distress, less anxiety, and less depression than people with a weak sense of agency. People with low agency feel vulnerable to arbitrary harm caused by external forces. Studies have found an increase in agency-related themes in the narratives of clients undergoing psychotherapy around the time that their mental health improves. Stories containing themes of agency have also been perceived as having a more positive emotional tone than stories without such themes.

For these reasons, Joo and Park hypothesized that depression would be associated with an absence of agency-related themes in narratives, and that this absence might be one reason why the narratives of people with depressive symptoms tend to have a more negative emotional tone.

The study included 80 university students, half of whom were women. The participants completed a questionnaire assessing depressive symptoms and told stories in response to the following three TAT cards: Card 1, depicting the boy and the violin; Card 8BM, depicting an operation; and Card 13MF, depicting a woman lying in bed while a man stands with his back to her and his arm covering his face. These three cards were selected because they had frequently been used in previous TAT research. I should note that, in my opinion, Card 13MF is not appropriate for presentation to children. The researchers and their assistants rated the agency and emotional tone of the stories on five-point scales.

The following example, taken from the article, illustrates a story containing themes of agency in response to Card 1:

The teacher told the boy, “Sit here and become the instrument. Feel it deep within your heart and soul.” And so Peter found himself sitting there an hour later with his violin, his bow, and a cloth protecting the violin from scratches. It had been a boring hour. The other students had been instructed not to speak to him until he saw the light. He did not understand the task he had been given. As far as he could tell, he was sitting in a rather dark room staring at a piece of wood.

Another hour passed. Was this some strange and cruel form of torture? Peter considered getting up and leaving. After all, the door was not locked. Yet something drew him to remain. The third hour passed like the previous two, quietly and silently, but then something changed.

Peter looked at the instrument. He saw the gleam of the varnish and noticed the artistic carving of the wood from which the violin had been made. The strings drew him in like an elusive muse. He lifted the violin and brought the bow to the strings.

“You may leave now,” the teacher said, peering through the doorway.

Peter looked at her while holding the violin. He smiled.

“I think I’ll stay a little longer.”

The following example, also taken from the article, illustrates a story without themes of agency in response to Card 1:

The young boy has practiced the violin diligently throughout the past week, but he is still having difficulty playing the piece correctly. His parents, who are excellent violinists, are disappointed by his difficulties with the piece. Instead of praising him for the effort he has made during the past week, they tell him that his playing is not good enough and that he needs to continue practicing. As can be seen in the picture, the boy feels discouraged and lacks the motivation to continue playing because he is extremely frustrated with the piece.

The following is an example of a story with a positive emotional tone in response to Card 13MF:

The man came home during his lunch break and surprised his wife with her favorite book. He did not have enough money to buy her flowers for every anniversary, but she loved reading, and so the book was enough. She kissed him warmly and led him to the bed. Afterwards, he dressed carefully so as not to wake her. He admired her breasts as he put on his socks, wiped his forehead, and returned to work.

The following story has a negative emotional tone and was told in response to the same card:

The woman lying in bed is the mother of the man who is standing, and she has had her wisdom teeth removed. The terrible pain has left her unable to brush her teeth. One morning, when the man went to see how his mother was doing, she sighed heavily, and he had to shield his eyes and nose because of her bad breath. He then left the room and went to the bathroom to vomit because the foul smell was too strong.

A difficult story indeed.

We now turn to the findings of the study.

The more depressive symptoms the participants reported on the questionnaires, the less positive the emotional tone of their stories and the lower their level of agency. The greater the participants’ agency, the more positive the emotional tone of their stories. The fewer agency-related themes the stories contained, the more negative their emotional tone. In other words, agency mediated the relationship between depression and negative emotional tone in the stories.

Questionnaires address conscious thoughts and emotions, whereas TAT stories may contain unconscious elements. Consequently, TAT narratives do not always correlate with questionnaire results. The association found in this study between depressive symptoms reported on questionnaires and the emotional tone of the stories is therefore particularly interesting.

Joo, M., & Park, S. W. (2021). Depression is associated with negativity in TAT narratives: The mediating role of agency. Current Psychology, 40(6), 3065–3072.

McGrath, E. P., & Repetti, R. L. (2002). A longitudinal study of children’s depressive symptoms, self-perceptions, and cognitive distortions about the self. Journal of Abnormal Psychology, 111(1), 77–87.