Case Studies with the Rorschach Test: A Systematic Literature Review.

Abstract

This systematic review provides the first comprehensive synthesis of Rorschach case reports published over the past 50 years. A total of 217 articles published between 1974 and 2025 were identified through searches in Scopus, PsycInfo, and PubMed, complemented by manual screening of the Journal of Personality Assessment, Rorschachiana, and the Therapeutic Assessment Bibliography. Publication volume increased steadily across decades. Exner's Comprehensive System was the most frequently used coding system, followed by the School of Paris and, more recently, R-PAS. Strong associations emerged between coding systems and language of publication: CS and R-PAS articles were published almost exclusively in English, whereas School of Paris contributions appeared predominantly in French. R-PAS case studies were more often published in higher-ranked journals, whereas School of Paris contributions appeared more frequently in non-indexed journals. Most case reports focused on children, adolescents, and young adults, although demographic variables such as ethnicity and cultural background were rarely reported. The Rorschach was used primarily in clinical settings, commonly within multimethod assessments integrating psychostructural and psychodynamic perspectives. Reporting transparency varied considerably, highlighting the need for clearer reporting standards and greater openness in future Rorschach case study publications.