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tests are still popular in assessment, diagnosis and treatment decisions, probably because of what Swenson (1968) 69 described as "a random partial reward schedule" due to the occasional case where projective drawings gave an indication of a client's problem, although clinical caution in their interpretation seems rare 70 . There have been very few empirical studies, reflected in the lack of confidence in statistical approaches, and these mostly still lack methodological validity 71 . The focus has been to isolate the diagnostic content through association of symbols or identify 'markers' 72 . However, some studies show naive raters can globally categorise pictures of patients and non-patients through 'intuitive' feelings of abnormality 73 and can be reliable. Thus it seems that there is Psychological Bulletin , V.70:20-44, advised researchers attend to characteristics of the work rather than unrelated hypotheses and criticised interpretive assumptions. Hammer (1968, op.cit.) and others after made similar recommendations, but Cathy Malchiodi (1994) op.cit. was able to make virtually the same criticisms describing the term 'assessment' as a misnomer, most tests as directives, and that few interrater studies, reliable and valid scoring systems were available. 68 E.F. Hammer (1968) op.cit., Clinical Application of projective drawings; Swenson's eight year reviews of research (C.H. Swenson, Empirical Evaluations of Human Figure Drawings, Psychological Bulletin 1957, V.54:431-466, and 1968 op.cit.) concluded that "Machover's hypotheses concerning the DAP have seldom been supported by the research" and more recent publications have nothing to add: Scott (1981) Measuring Intelligence with the Goodenough-Harris Drawing test, Psychol. Bull. V.89:483-505; Kahill (1984), op.cit.; Abell (1994), op.cit. 69 Swenson (1968) op.cit. p.370. 70 Most writers acknowledge the appropriate uses for the DAP are with body image disorders, such as this example: Sandy K. Reuven (1998), Reversal of a body image disorder (Macrosomatognosia) in Parkinson's disease by treatment with AC pulsed electromagnetic fields, Intl. J. of Neuroscience 1998, V.93:1-2. Abuses of the process continue, for example, the use of the Goodenough-Harris Draw-a-Man test, as developmental indicator for adult psychiatric populations, despite the lack of research evidence for it, general admonition (inc. the authors) and numerous studies condemning the practise as unreliable. 71 The claim by the authors of the Diagnostic Drawing Series, a standardised evaluation from 3 pictures, to have demonstrated replicable differences between patients (B. Cohen et al., 1988, op.cit.) is discredited at length in the reliability analysis, Chapter 2 of this thesis. 72 Recent studies (over the last 22 years), both empirical and other are discussed in the literature review, Chapter 2. 73 Bernard I. Levy and Elinor Ulman (1967), Judging Psychopathology from Paintings, J. Abnormal Psychol. , V.72(2):182-7; Ulman and Levy (1968), An Experimental Approach to the Judgement of Psychopathology from Paintings, Bull. Art Therapy , V.8(1):3-12; Ulman and Levy (1973), Art Therapists as Diagnosticians, Am. J. Art Therapy , V.13:35-8. These articles reprinted three times (1975, 1984 and 36
something recognisable about the artwork which has not been isolated. Projective testing approaches continue to be developed 74 , and recently there have been encouraging developments based on more rigidly defined formal criteria with children 75 . The research contribution of Art Therapy to assessment issues Wadeson's (1976) table of psychiatric characteristics of art from the previous literature had little empirical basis 76 . Gantt and Schmal's (1974) annotated bibliography of art therapy literature over 33 years 77 listed 1175 items from English and foreign language sources: only 39 were classified as 'research' and not all dealt with art therapy. There was little attempt at replication, reliability, and definition of terms. Linda Gantt and J. Howie's (1979, unpublished) chart of correspondences between characteristics of the artwork of patients and the DSM111 seemed to offer an alternative framework for 1992) show that from 55 judges of varying backgrounds, some art or psychiatry related, all predicted patient status better than chance; Linda Gantt (1990) tested 6 art therapy graduates on 30 pictures between 6 DSMIIIR groups and attained the same results: A Validity Study of the Formal Elements Art Therapy Scale (F EATS) for diagnostic information in patients' drawings , Unpublished Doctoral Dissertation, U. Pittsburgh, Pensylvania, U.S.A. 74 For the main projective tests in use today, see D. Arrington (1992), Art-based assessment procedures and instruments used in research, in H. Wadeson, A Guide to Conducting Art Therapy Research , Mundelein, IL: Am. Art Therapy Assn., pp.157-178. 75 Micheal S. Trevisan (1996), Review of the Draw A Person: Screening Procedure for Emotional Disturbance, Measurement and Evaluation Counselling and Development V.28(4):225-8. Reviews the DAP:SPED by J. Naglieri and S.I. Pfeiffer (1992) Performance of disruptive behaviour disordered and normal samples of the DAP:SPED, Psychological Assessment , V.4(2):156-159 with a complex and comprehensive projective approach to assess 55 items of emotional disturbance in children. 76 Wadeson and Carpenter (1976), Comparative Study op.cit. were unable to relate characteristics of different diagnostic groups of patients to a table derived from general analysis of expectations from the literature. 77 L. Gantt and M. Schmal (1974), Art Therapy, A Bibliography (1940-73) (George Washington University and National Institute of Mental Health (NIMH), U.S.A (unpublished). 37
Page 1: The psychopathology of everyday art
Page 4 and 5: Table of Contents Page Number Chapt
Page 6 and 7: List of Illustrations, Figures and
Page 8 and 9: quality. 113 Table 5: Reliability s
Page 10 and 11: Table, boxplot and spreadplot 1e (b
Page 12 and 13: Table 19: Correlation for DAPA vari
Page 14 and 15: Acknowledgements, thanks and forewo
Page 16 and 17: concludes on the effectiveness of t
Page 18 and 19: or drawing progresses, relationship
Page 20 and 21: The link between genius as a produc
Page 22 and 23: again by a multidisciplinary team w
Page 24 and 25: theoretical foundation relating art
Page 26 and 27: the content of which was seemingly
Page 28 and 29: approach. Some of the major critici
Page 30 and 31: Gestalt Analysis Rudolph Arnheim ha
Page 32 and 33: molar level and not by individual e
Page 34 and 35: Attempts to lists characteristics o
Page 38 and 39: investigation of artwork, but few h
Page 40 and 41: expressions of a disordered psyche.
Page 42 and 43: own paintings, or on interpretation
Page 44 and 45: pointing to integrative or global j
Page 46 and 47: Chapter Two: Review of the recent l
Page 48 and 49: etrieved from the Psychlit, which p
Page 50 and 51: a major proportion of the study mat
Page 52 and 53: psychopathology, something which is
Page 54 and 55: 3 13 5 5 5 1 3 2 10 0 0 2 11 0 0 3
Page 56 and 57: social/developmental energy theorie
Page 58 and 59: advanced from all types of papers b
Page 60 and 61: Art therapists begin their career f
Page 62 and 63: talent and therefore do not fit in
Page 64 and 65: 2. Research studies There were two
Page 66 and 67: Method of study or description of t
Page 68 and 69: olds and only 2 with over 60s. The
Page 70 and 71: form of this expression and how it
Page 72 and 73: Content: 16 studies reported change
Page 74 and 75: Pictures by bipolar depressives sho
Page 76 and 77: This section does not deal strictly
Page 78 and 79: correlation of art elements with de
Page 80 and 81: of form 154 . The formal elements w
Page 82 and 83: ecognise and work through the situa
Page 84 and 85: Conclusion The use of art was not i
Page 86 and 87:
Thematic interpretation varied with
Page 88 and 89:
(2) to find out how the art relates
Page 90 and 91:
There were 7 demographic variables:
Page 92 and 93:
No. 1 judges 2 3 4 60 No. 2 Study 3
Page 94 and 95:
satisfactory classification as it i
Page 96 and 97:
or non-art tests which were not see
Page 98 and 99:
favoured (12% n=6) over post measur
Page 100 and 101:
procedures, or publishing bias, sin
Page 102 and 103:
Table 8b. Analysis of variance perf
Page 104 and 105:
spread between subjective and objec
Page 106 and 107:
are linked to those artistic charac
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3 Demographic variables were used f
Page 110 and 111:
Table 2. Diagnostic groups for 70 s
Page 112 and 113:
However, there were few tests which
Page 114 and 115:
include recognisable or identifiabl
Page 116 and 117:
and emotional indicators in drawing
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The DDS (1988) study was an explora
Page 120 and 121:
which were not significant - and I
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eliability studies or studies which
Page 124 and 125:
Thematic variables Table 1: reliabi
Page 126 and 127:
etween grades of the same diagnosis
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personally expressive images than '
Page 130 and 131:
to trees (52); size of figure (75);
Page 132 and 133:
Table 4: reliability statistics and
Page 134 and 135:
Line Table 5: reliability statistic
Page 136 and 137:
Purpose or use of line contained on
Page 138 and 139:
Shape variables (study no.) (o) obj
Page 140 and 141:
Colour Table 7: reliability statist
Page 142 and 143:
number of colours. Furthermore with
Page 144 and 145:
subcategories were congruous and al
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(35, 46, 36, 38, 33); and indicator
Page 148 and 149:
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
Page 158 and 159:
The studies are difficult to sum up
Page 160 and 161:
indicate greater agreement (even th
Page 162 and 163:
Two weaknesses lie in the simple ca
Page 164 and 165:
of drawing areas and to quantify wh
Page 166 and 167:
Is Meta Analysis appropriate for th
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techniques which compensate for unr
Page 170 and 171:
drawing evaluation with comments fr
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There are few answers to this criti
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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
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Case study and controlled research
Page 184 and 185:
potential for psychiatric populatio
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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 216 and 217:
DISCUSSION • The validity of the
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
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Red, Green, Black, Drawn Line, Emot
Page 250 and 251:
1. Neither schizophrenics nor depre
Page 252 and 253:
schizophrenia was indistinguishable
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Black: Black is the darkest colour
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the other groups since no confidenc
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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
Page 266 and 267:
the discriminant analysis. It will
Page 268 and 269:
Subordinate Analyses Interaction ef
Page 270 and 271:
Table 15: showing correlations betw
Page 272 and 273:
2. Intensity showed a correlation o
Page 274 and 275:
quality and reliability of their me
Page 276 and 277:
as being unreliable, would be metho
Page 278 and 279:
There would be a correlation betwee
Page 280 and 281:
Figures 3. Map of Associations betw
Page 282 and 283:
Schizophrenic pictures showed corre
Page 284 and 285:
The DAPA results for depression are
Page 286 and 287:
abusers 308 , but not the schizophr
Page 288 and 289:
Control pictures showed the only as
Page 290 and 291:
yellow Structural variables Figures
Page 292 and 293:
directly, to answer this question.
Page 294 and 295:
yellow and green, its removal would
Page 296 and 297:
Schizophrenics used little colour e
Page 298 and 299:
directly to the environment; assess
Page 300 and 301:
influence on apparent negativity. W
Page 302 and 303:
ather than for schizophrenia 335 .
Page 304 and 305:
Supporting this point, the focus ar
Page 306 and 307:
Several kinds of difficulties were
Page 308 and 309:
portraiture, so it is difficult to
Page 310 and 311:
1, as generally the scores for schi
Page 312 and 313:
numbers resulted in differentiation
Page 314 and 315:
at or above the usual level. Person
Page 316 and 317:
size (_=0.36) which contrasts wildl
Page 318 and 319:
sets had all the identified high ef
Page 320 and 321:
hospital; the mean of up to 10 pain
Page 322 and 323:
eliability of the test and shows th
Page 324 and 325:
Chapter 7. Conclusion This thesis r
Page 326 and 327:
probably because the form variables
Page 328 and 329:
etween different groups of patients
Page 330 and 331:
previously unexplored, which comple
Page 332 and 333:
statistical tests and missing data
Page 334 and 335:
psychopathology in clinical diagnos
Page 336 and 337:
6 scales to categorise commonalitie
Page 338 and 339:
Orientation of the researcher, what
Page 340 and 341:
Validity Analysis of controlled stu
Page 342 and 343:
_ 2 _ _ _ _ 2 _ .3_ 1 1 _ B _ 2 1 2
Page 344 and 345:
6j. Standard differences from mean
Page 346 and 347:
Correlation table 16 for DAPA varia
Page 348 and 349:
Page 350 and 351:
Page 352 and 353:
eliefs to depression. cannot be mat
Page 354 and 355:
Table 4: summarising changes or sig
Page 356 and 357:
Table 6: summarising changes or sig
Page 358 and 359:
13 22y. male Violence and substance
Page 360 and 361:
Crosstabulations 1-6: contingency t
Page 362 and 363:
Crosstabulation 3: ORIENTATION By B
Page 364 and 365:
Crosstabulation 5: FORM OF EXPRESSI
Page 366 and 367:
Reliability Study Chapter 4 - Metho
Page 368 and 369:
Raters R1-7 score for ORANGE, pics
Page 370 and 371:
-4_ _ R-A _________________________
Page 372 and 373:
e _ _ -4_ _ R-A ___________________
Page 374 and 375:
c _ _ e _ _ -4_ _ R-A _____________
Page 376 and 377:
Appendix 3 Table of Authorities 1.
Page 378 and 379:
connection from victim to victimize
Page 380 and 381:
Hodnett, M.L. (1973), A broader vie
Page 382 and 383:
Muller-Braunschweig, H. (1975), Psy
Page 384 and 385:
Siegel, L. (1988), The use of mural
Page 386 and 387:
Psycho-Analysis , V.6(2):183-200. 3
Page 388 and 389:
10 Fagin, I. (1983), Images of grow
Page 390 and 391:
Institute Creative Arts Therapy Rev
Page 392 and 393:
psychotics, Perceptual and Motor Sk
Page 394 and 395:
Appendix 4 Development of the Descr
Page 396 and 397:
D.A.P.A. DESCRIPTIVE ASSESSMENT OF
Page 398 and 399:
INTENSITY DEFINITION: Firstly, the
Page 400 and 401:
SPACE >10% >25% >55% >80% >100% DEF
Page 402 and 403:
Part 2 Rating Sheet for DAPA: Hacki
Page 404 and 405:
Rating Sheet for Casenotes DAPA ver
Page 406 and 407:
D.A.P.A. DESCRIPTIVE ASSESSMENT OF
Page 408 and 409:
Intensity DEFINITION: The brightnes
Page 410 and 411:
Form sheet for Artists. Side 2. DAP
Page 412 and 413:
Appendix 5 Permission for study, in
Page 414 and 415:
North Staffordshire Health Authorit
Page 416 and 417:
Psychiatry Dept., School P.G. Medic
Page 418 and 419:
Bibliography 418
Page 420 and 421:
Psychiatry, 152(suppl.1): 33-57. Ca
Page 422 and 423:
V.11: 139-143. Kaplan, F.F. (1996),
Page 424 and 425:
Reuven, S.K. (1998), Reversal of a
Page 426 and 427:
Blackwell. Arrington, D. (1992), Ar
Page 428 and 429:
MacGregor, J.D. (1989), The Discove
Page 430 and 431:
Research (ICD-10 DCR), Geneva: Auth
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