An impairment rating scale for human figure drawings

Abstract

A series of items believed to be related t o organic brain damage was collected from a survey of clinical and research literature of human figure drawings. The purpose of this study was to determine which items were both reliable and valid. Alcoholics were used as Ss since as a group they show high variability on braindamage testingc2). METHODSubjects. Ss were 80 ambulatory, detoxified chronic male alcoholics with a mean age of 43.1 years and a mean of 11.9 years of education, selected randomly from among inpatients who were participating in a treatment program described by Bell(l). Ss had been drinking for an average of 23 years and problem drinking for 9.6 years. They were tested after an average of 16.9 days from their last drink.Measurements. Ss were asked to draw a person and then one of the opposite sex according t o standard Draw-a-Person instructions. They also were administered the Wechsler-Bellevue I (') and the Halstead-Reitan (4, 6 , battery of tests sensitive to organic brain damage. An Impairment Index, Performance I& (PI&) and a clinician's ratings served as validating criteria.Halstead's Impairment Index was modified by including the Trail Making Test (with cutting points between 12 and 13) and scoring the Finger Tapping Test according to the criterion of Vega(5) for the dominant hand. The following additional tests contributed t o the Impairment Index used with standard cutting pcints: Category, Rhythm, Speech and the Time, Memory and Location components of Tactual Performance. The range of this modified Impairment Index (11) was from 0 to .8.A clinician unfamiliar with the research rated each S's drawings for organicity present, partially present, or absent. As an approximate check cn these ratings the authors also scored the drawings on the same dimension. They attempted, as much as possible, not t o be influenced by their knowledge of the items under investigation. The clinician's ratings correlated with those of the authors .48 and .71, both coefficients significant (p < .OOl). PI& and I1 were correlated -5 5 (p < .OOl); the clinician's rating was correlated .26 ( p < .05) with the I1 and -.38 (p < .OOl) withPIQ.Each of the 15 items believed to be related t o brain damagec3) was scored on a %point scale. A score of 0 was given when the item was absent, a score of 1 when the item was present on one drawing, and a score of 2 when the item was present on both drawings. Two addiction counselors scored both figure drawings for all Ss, and their scores were correlated to determine interjudge reliability. Ratings for both judges on each item then were averaged. RESULTSOnly items significantly correlated with the 11, the primary criterion of validity, were retained. Five of the 15 items were found to be valid according to this criterion. These items were:1. Figure off balance.

Human figure drawing in adults: An update of the empirical evidence, 1967–1982.

“…A number of global figure drawing measures have been successfully related to various criterion measures among normal and clinical populations: articulation scores with the complexity of personal constructs as measured by Kelly's Role Construct Repertory Technique (Phillips & Phillips, 1976); H-T-P diagnoses with MMP1 diagnoses (Pryor & Butler, 1969); Koppitz intellectual maturity scores and Witkin's psychological differentiation scores with a self-concept questionnaire (Jegede & Bamboye, 1981); sexual elaboration with eight of 12 criterion measures of psychopathology (Carlson et al, 1973); overall DAP score with the Piers-Harris self-concept scale (Ottenbacher, 1981); Witkin's articulation scale with Oltman's measure of psychological differentiation and with five of six ratings of subject psychological differentiation done by therapists (Russakoff, Fbntana, Dowds, & Harris, 1976); global organicity rating and a Projec-tive Impairment Rating scale of organicity with the Wechsler-Bellevue and modified Halstead-Reitan organicity measures (McLachlan & Head, 1974); and complexity scores with self-descriptions as extraordinary, non-average, primitive, and sensual (Sallery, 1968).…”

The Draw-A-Person Test and Body Image

“…In addition, interrater reliability for the figure height/size indices was found to be between .62 and .99 (Adler, 1970; Attkisson, Waidler, Jeffrey, & Lambert, 1974; Bailey et al, 1970; Baugh & Prytula, 1974; Bolton, 1972; Bolton, Donoghue, & Langbauer, 1973; Kay, 1978) and interrater reliability for omission/inclusion indices was found to be between .52 and .98 (Adler, 1971; Attkisson et al, 1974; Baugh & Prytula, 1974; Maloney & Glasser, 1982; McLachlan & Head, 1974).…”

Human figure drawings and house tree person drawings as indicators of self-esteem: A quantitative approach

“…Reviews indicate there has been relatively little support for single signs related to the content of the drawings or in making subtle differential diagnoses (Kahill, 1984). In contrast, global ratings of such areas as level of adjustment (Maloney & Glasser, 1982;McNeish & Naglieri, 1993;Yama, 1990), cognitive maturity (Chappell & Steitz, 1993;Fabry & Bertinetti, 1990;Heiberger, Abell, & Johnson, 1994;Naglieri, 1988), impulsiveness (Oas, 1984), and the presence of organic impairment (McLachlan & Head, 1974) have been able to demonstrate acceptable levels of validity.…”