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DISCUSSION • The validity of the DAPA categories was examined, strengths and limitations of the procedure. • The results were explained and compared and contrasted with those detailed in the literature review and the results of the pilot study, in which the content was controlled. • The interactions and correlations of the 13 variables from the DAPA procedure were discussed and compared with impressions from the literature taking account of the limitations of the procedure for the effect sizes produced by the t-test. • The discriminant procedure was discussed and compare the final outcome with previous investigations and predictions. Section 2: Reliability Study An abbreviated version of this study, together with the first study (section 3) appeared in an article by S. Hacking, D. Foreman and J. Belcher (1996) 269 . Purpose of the Study The amount of rating in this set of studies was considerable. A little over 1000 paintings were rated for the main study and the first study by the author for this research. It was necessary to find out if the rater's judgement of pictures was a contributing factor to significant differences in discriminating variables. There are various ways of conducting inter-rater reliability tests on human subjective judgements. There is nothing unscientific 269 S. Hacking, D. Foreman and J. Belcher (1996), The Descriptive Assessment for Psychiatric Art: a new 216
about subjective judgments but care is needed in making them credible. It is essential to be able to demonstrate that at least two people can independently come to fairly similar judgments. Multiple rating of the whole test would be time consuming, costly and impractical since it is better to employ more than two people; two people closely involved can reach an understanding which is not apparent in the written material and over hundreds of ratings, the significance of small deviations decreases. The more people employed, the greater the risk of individual variation on rating areas which are not clearly defined. Inter-rater reliability statistics judge the extent to which agreement is reached, usually by reporting the correlation between raters, together with a summary of the agreements and disagreements on level of rating. This study took a small sample of pictures (1%) from the total amount of pictures previously rated by the author, and used a relatively large number of judges. The object was to find out if several people independently could give the same or similar scorings using the DAPA scale to the scoring given by the author; if so, it can be reasonably deduced that the author's rating was consistent within the test categories. Choice of Subjects Raters: 7 first year art students (6 females 1 male 19-24 yrs.) from a local University were recruited as raters. They had no previous knowledge of the DAPA or of other art tests. Art students were chosen because the training would take some time, concentration way of quantifying paintings by psychiatric patients, J. Nervous and Mental Disease , V.184(7):425-9. 217
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The psychopathology of everyday art
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Table of Contents Page Number Chapt
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List of Illustrations, Figures and
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quality. 113 Table 5: Reliability s
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Table, boxplot and spreadplot 1e (b
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Table 19: Correlation for DAPA vari
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Acknowledgements, thanks and forewo
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concludes on the effectiveness of t
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or drawing progresses, relationship
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The link between genius as a produc
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again by a multidisciplinary team w
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theoretical foundation relating art
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the content of which was seemingly
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approach. Some of the major critici
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Gestalt Analysis Rudolph Arnheim ha
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molar level and not by individual e
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Attempts to lists characteristics o
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tests are still popular in assessme
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investigation of artwork, but few h
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expressions of a disordered psyche.
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own paintings, or on interpretation
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pointing to integrative or global j
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Chapter Two: Review of the recent l
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etrieved from the Psychlit, which p
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a major proportion of the study mat
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psychopathology, something which is
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3 13 5 5 5 1 3 2 10 0 0 2 11 0 0 3
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social/developmental energy theorie
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advanced from all types of papers b
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Art therapists begin their career f
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talent and therefore do not fit in
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2. Research studies There were two
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Method of study or description of t
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olds and only 2 with over 60s. The
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form of this expression and how it
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Content: 16 studies reported change
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Pictures by bipolar depressives sho
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This section does not deal strictly
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correlation of art elements with de
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of form 154 . The formal elements w
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ecognise and work through the situa
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Conclusion The use of art was not i
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Thematic interpretation varied with
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(2) to find out how the art relates
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There were 7 demographic variables:
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No. 1 judges 2 3 4 60 No. 2 Study 3
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satisfactory classification as it i
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or non-art tests which were not see
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favoured (12% n=6) over post measur
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procedures, or publishing bias, sin
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Table 8b. Analysis of variance perf
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spread between subjective and objec
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are linked to those artistic charac
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3 Demographic variables were used f
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Table 2. Diagnostic groups for 70 s
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However, there were few tests which
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include recognisable or identifiabl
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and emotional indicators in drawing
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The DDS (1988) study was an explora
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which were not significant - and I
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eliability studies or studies which
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Thematic variables Table 1: reliabi
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etween grades of the same diagnosis
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personally expressive images than '
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to trees (52); size of figure (75);
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Table 4: reliability statistics and
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Line Table 5: reliability statistic
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Purpose or use of line contained on
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Shape variables (study no.) (o) obj
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Colour Table 7: reliability statist
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number of colours. Furthermore with
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subcategories were congruous and al
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(35, 46, 36, 38, 33); and indicator
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Summary: There are unresolved defin
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Summary: The effect which distingui
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Summary: Striking variation in glob
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Reliability: Perseveration is a non
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(including schizophrenics) against
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The studies are difficult to sum up
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indicate greater agreement (even th
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Two weaknesses lie in the simple ca
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of drawing areas and to quantify wh
Page 166 and 167: Is Meta Analysis appropriate for th
Page 168 and 169: techniques which compensate for unr
Page 170 and 171: drawing evaluation with comments fr
Page 172 and 173: There are few answers to this criti
Page 174 and 175: attention to overall effect sizes t
Page 176 and 177: The 'File Drawer Problem' (refer ba
Page 178 and 179: Table 2. All variables for 11 studi
Page 180 and 181: Less than a third of the drawing ar
Page 182 and 183: Case study and controlled research
Page 184 and 185: potential for psychiatric populatio
Page 186 and 187: only are discussed (indicators whic
Page 188 and 189: specific areas of positivity could
Page 190 and 191: Rating Guide (Hacking & Foreman 199
Page 192 and 193: Table 2: Summary table of expected
Page 194 and 195: Previous methods of assessing atomi
Page 196 and 197: cases as to whether informed consen
Page 198 and 199: It was decided to use a large mixed
Page 200 and 201: paintings was not reliable enough t
Page 202 and 203: computed on any of these levels. Gr
Page 204 and 205: The DAPA (Descriptive Assessment fo
Page 206 and 207: The extremes of the distribution fo
Page 208 and 209: The difficulty with using t-tests i
Page 210 and 211: addition it leaves out other variab
Page 212 and 213: nebulous for reasonable conclusions
Page 214 and 215: identified were included in the stu
Page 218 and 219: and the test used terminology which
Page 220 and 221: How the data were structured Althou
Page 222 and 223: How well does the method agree? Tab
Page 224 and 225: - 76% - of the scales were rated wi
Page 226 and 227: Green Blue Brown White Black Intens
Page 228 and 229: All of the scales were understood b
Page 230 and 231: Table 1: Demographics for experimen
Page 232 and 233: classify, even as in and out patien
Page 234 and 235: score for each subject was a ratio
Page 236 and 237: each participant received the same
Page 238 and 239: Results Interaction effects: The me
Page 240 and 241: was no evidence of impoverishment f
Page 242 and 243: Chapter 5. Results This chapter pre
Page 244 and 245: appendix 2) and these were left in
Page 246 and 247: fairly small, less than 0.1, indica
Page 248 and 249: Red, Green, Black, Drawn Line, Emot
Page 250 and 251: 1. Neither schizophrenics nor depre
Page 252 and 253: schizophrenia was indistinguishable
Page 254 and 255: Black: Black is the darkest colour
Page 256 and 257: the other groups since no confidenc
Page 258 and 259: Drawn line: The normal distribution
Page 260 and 261: proportions of empty space in the p
Page 262 and 263: 1. Depressives showed significantly
Page 264 and 265: function contributed significantly
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the discriminant analysis. It will
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Subordinate Analyses Interaction ef
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Table 15: showing correlations betw
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2. Intensity showed a correlation o
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quality and reliability of their me
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as being unreliable, would be metho
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There would be a correlation betwee
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Figures 3. Map of Associations betw
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Schizophrenic pictures showed corre
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The DAPA results for depression are
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abusers 308 , but not the schizophr
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Control pictures showed the only as
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yellow Structural variables Figures
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directly, to answer this question.
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yellow and green, its removal would
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Schizophrenics used little colour e
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directly to the environment; assess
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influence on apparent negativity. W
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ather than for schizophrenia 335 .
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Supporting this point, the focus ar
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Several kinds of difficulties were
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portraiture, so it is difficult to
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1, as generally the scores for schi
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numbers resulted in differentiation
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at or above the usual level. Person
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size (_=0.36) which contrasts wildl
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sets had all the identified high ef
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hospital; the mean of up to 10 pain
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eliability of the test and shows th
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Chapter 7. Conclusion This thesis r
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probably because the form variables
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etween different groups of patients
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previously unexplored, which comple
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statistical tests and missing data
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psychopathology in clinical diagnos
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6 scales to categorise commonalitie
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Orientation of the researcher, what
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Validity Analysis of controlled stu
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_ 2 _ _ _ _ 2 _ .3_ 1 1 _ B _ 2 1 2
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6j. Standard differences from mean
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Correlation table 16 for DAPA varia
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eliefs to depression. cannot be mat
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Table 4: summarising changes or sig
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Table 6: summarising changes or sig
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13 22y. male Violence and substance
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Crosstabulations 1-6: contingency t
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Crosstabulation 3: ORIENTATION By B
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Crosstabulation 5: FORM OF EXPRESSI
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Reliability Study Chapter 4 - Metho
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Raters R1-7 score for ORANGE, pics
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-4_ _ R-A _________________________
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e _ _ -4_ _ R-A ___________________
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c _ _ e _ _ -4_ _ R-A _____________
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Appendix 3 Table of Authorities 1.
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connection from victim to victimize
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Hodnett, M.L. (1973), A broader vie
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Muller-Braunschweig, H. (1975), Psy
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Siegel, L. (1988), The use of mural
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Psycho-Analysis , V.6(2):183-200. 3
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10 Fagin, I. (1983), Images of grow
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Institute Creative Arts Therapy Rev
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psychotics, Perceptual and Motor Sk
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Appendix 4 Development of the Descr
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D.A.P.A. DESCRIPTIVE ASSESSMENT OF
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INTENSITY DEFINITION: Firstly, the
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SPACE >10% >25% >55% >80% >100% DEF
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Part 2 Rating Sheet for DAPA: Hacki
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Rating Sheet for Casenotes DAPA ver
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D.A.P.A. DESCRIPTIVE ASSESSMENT OF
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Intensity DEFINITION: The brightnes
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Form sheet for Artists. Side 2. DAP
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Appendix 5 Permission for study, in
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North Staffordshire Health Authorit
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Psychiatry Dept., School P.G. Medic
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Bibliography 418
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Psychiatry, 152(suppl.1): 33-57. Ca
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V.11: 139-143. Kaplan, F.F. (1996),
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Reuven, S.K. (1998), Reversal of a
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Blackwell. Arrington, D. (1992), Ar
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MacGregor, J.D. (1989), The Discove
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Research (ICD-10 DCR), Geneva: Auth
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