Children's family drawings and internalizing problems

Visual Expressions of Children's Strengths, Difficulties and Wishes in Person Picking an Apple from a Tree Drawings among Preschoolers Living in Areas of Persistent Political Violence

The present study sought to inquire into the subjective experience of 156 preschoolers (age 4-6.9 years) living in an area of political violence in Israel (on the border with the Gaza Strip) during a period of massive bombing. Children were invited to draw a Person Picking an Apple from a Tree (PPAT), and were interviewed on their sense of self-potency using the CAMP, a measure of potency. Teachers were asked to report problems in executive functions using a few BRIEF scales; and mothers filled out a questionnaire for maternal distress (BSI), a measure of their child strengths and difficulties (SDQ), and were asked to provide their assessment regarding the extent to which their child was exposed to political violence. Findings reveal associations between mothers' distress, the degree of exposure of their child to trauma, and the child's emotional symptoms. PPAT analysis identified four main factors: Tree Generosity, Person Agency, Vividness, and As-Real-R. Positive associations were found between self-potency and the main factors of the drawings; negative associations were found between the child's difficulties in executive functions and the drawing's four main factors; and two small negative associations were found between the child's emotional symptoms and Tree Generosity and As-Real-R factors. The following associations were found within each gender group: mothers' depression degree was associated with boy's Tree Generosity, and mother's perceptions of their girl's exposure to trauma was related to Person Agency, Tree Generosity, and As-Real-R factors; furthermore, a significant difference was found between the narrative focus of drawings in this sample and the narrative focus of drawings of a sample of the same age group from a non-war zone. In addition, narrative focus was found to be related to children's self-potency. The discussion deals with the study's findings through the prism of developmental psychology, self-agency, object-relations, and art-therapy theories.

Dialoguing With Images: An Expressive Arts Method for Health Research

Despite the increasing integration of arts-based methods within qualitative research, few expressive arts methods have been studied to understand their process, rationale and impact on the inquiry process. We conducted a grounded theory study on family experiences of paediatric HSCT where we simultaneously adapted and studied a 'dialoguing with images' (DI) expressive arts process as method. Fifteen family members participated in two interviews, drew an image and were guided through the DI method. We articulate the social process shared by researchers, participants and the images as they co-constructed knowledge through the DI method. The four distinct phases of the method include: 1) containing the imaginative space within an outer and inner frame, 2) creating an embodied image: image work is an expressive, generative process, 3) a shared, participatory aesthetic interpretation and 4) crystallizing stories of illness. The findings are grounded in expressive arts theory and philosophy, hermeneutics and analytical art psychotherapy theory.

The Experience of Mothers from the Israeli Jewish Ultra-Orthodox Sector after Disclosure of Their Child's Sexual Abuse as Manifested in Drawings and Narratives

Child sexual abuse is present in all strata of Israeli society. However, there is scant research on the emotional experiences of non-abusing mothers after disclosure. In particular, no studies have examined the experiences of these mothers from the Jewish Ultra-Orthodox community in Israel. The current study analyzed the drawings and short narratives of 21 Israeli Ultra-Orthodox mothers to explore the effects of the disclosure of their child's sexual abuse. A phenomenological approach was used to analyze the drawings and yielded four different phenomena: (1) squiggles that represented distress, (2) the mother-child relationship, (3) pseudo-sweet houses, and (4) split drawings. The drawings were either colorful, sweet or shallow, or alternatively were in black and white. As confirmed by the narratives, these drawings primarily expressed the negative emotions of shock, sadness, distress, guilt, and failure as mothers. While some mothers reported breaking down and that pain had permeated their daily lives others coped by dissociating the painful experience, putting up a façade of normalcy, or splitting their lives into two parts corresponding to before and after the disclosure.

Intimate Partner Violence, Parenting, and Children's Representations of Caregivers

Children's representational models of self and relationship quality with caregivers in the context of intimate partner violence (IPV) were investigated using family drawings created by children in their first-grade year. The present study examines the mediating role of mothers' and fathers' sensitive parenting behaviors in the relations between IPV and children's representations of relationship quality with mothers and fathers. The sample (N = 947) is drawn from a longitudinal study of rural poverty exploring the ways in which child, family, and contextual factors shape development over time. Results of analyses indicate significant associations between IPV, sensitive parenting, and children's representation of relationship quality with mothers and fathers. There was a significant indirect effect from IPV on children's representation of relationship quality with fathers through paternal parenting behaviors. The findings from this study suggest that exposure to violence may affect how children view their family relationships and that fathers' parenting behavior is a key mediating process. Implications of the findings and directions for future study are proposed.

Perceptions of Child Abuse as Manifested in Drawings and Narratives by Children and Adolescents

Child abuse is an underreported phenomenon despite its high global prevalence. This study investigated how child abuse is perceived by children and adolescents as manifested in their drawings and narratives, based on the well-established notion that drawings serve as a window into children's mental states. A sample of 97 Israeli children and adolescents aged 6-17 were asked to draw and narrate what child abuse meant to them. The drawings and narratives were coded quantitatively. The results indicated that participants did not perceive a distinction between abuse and violence and referred to them interchangeably. Almost half of the participants focused on emotional abuse. The most frequent type of abuse within the family was between parents and children, and the most frequent abuse outside the family was peer victimization. Most of the drawings were figurative and realistic and half of the drawings included words suggestive of the participants' attempts to be heard and fully understood. The vast majority of drawings did not include the figure of the artist, about a third of the drawings employed dissociative techniques (i.e., included positive objects, were unrelated to abuse, used words alone, or did not follow the instructions), and almost half of the narratives were dissociative or characterized by negative resolution, describing feelings such as sadness, humiliation, and loneliness. These findings suggest the emotional pain associated with the abuse or violence and the use of dissociative mechanisms to bypass the pain. The findings are discussed in light of the literature on children's disclosure.

"I Have No Hope": The Experience of Mothers in Polygamous Families as Manifested in Drawings and Narratives

Polygamy is associated with lower marital satisfaction and is known to involve sexual, physical, and emotional abuse on the part of the husband. Less is known about the experience of mothers in polygamous families. This study was designed to shed light on the experiences of women in polygamous families in a sample of 80 Israeli Arab mothers living in polygamous families who use social services, domestic violence agencies, and health centers. Mothers were asked to draw their experiences in their families and to provide narratives for the drawings. A phenomenological approach was used to analyze the drawings, and yielded five different pictorial phenomena: (1) pseudo-sweetness, (2) houses, (3) the absentee father and the estranged mother, (4) incorporation of graphic symbols and lettering that represented distress, and (5) growth and development. Most of the drawings were restricted and shallow, indicating a complex emotional state of despair and distress. The central feelings that emerged from the drawings were negative emotions of anger, sadness, loneliness, and powerlessness. While some women longed for romantic relationships with their husbands, others expressed the desire for revenge and justice. Dissociation and parentification, as central coping strategies, emerged from the drawings and the narratives. The findings are discussed theoretically and clinically.

Perspectives on Social Suffering in Interviews and Drawings of Palestinian Adults Crossing the Qalandia Checkpoint: A Qualitative Phenomenological Study

The current study examined the psychological experience of Palestinians who daily cross an Israel Defense Forces (IDF) checkpoint to reach their schools or places of employment. The study employed an interpretative phenomenological analysis of semi-structured interviews and drawings to capture a depth insight regarding the psychological meaning of crossing the Qalandia checkpoint on a daily basis among 20 adult participants (10 males, 10 females). Three themes emerged. The first theme described deep feelings of distress and desperation and included the categories of humiliation and dehumanization, non-existence, rage, and pessimism and helplessness. The second theme concentrated on the participants’ coping strategies of avoidance and dissociation, which usually characterize maladaptive trauma coping style, as well as exhibited aggressiveness toward their fellow community members, while the third theme described the social fragmentation of the Palestinians’ solidarity. Furthermore, three pictorial phenomena emerged from the participants’ drawings: squared restricted drawings, the use of multiple black tiny objects, and the use of split drawings. These phenomena supported and validated participants’ verbal expressions. We suggest understanding these findings in light of the term “social suffering.”

The mediating role of parenting in the associations between household chaos and children's representations of family dysfunction

Children's drawings are thought to reflect their mental representations of self and their interpersonal relations within families. Household chaos is believed to disrupt key proximal processes related to optimal development. The present study examines the mediating role of parenting behaviors in the relations between two measures of household chaos, instability and disorganization, and how they may be evidenced in children's representations of family dysfunction as derived from their drawings. The sample (N = 962) is from a longitudinal study of rural poverty exploring the ways in which child, family, and contextual factors shape development over time. Findings reveal that, after controlling for numerous factors including child and primary caregiver covariates, there were significant indirect effects from cumulative family disorganization, but not cumulative family instability, on children's representation of family dysfunction through parenting behaviors. Results suggest that the proximal effects of daily disorganization outweigh the effects of periodic instability overtime.

New scoring method of the family drawing for sexually abused preschoolers

This study assesses whether the global psychological adjustment score on the family drawing, derived with a new scoring method, can predict the presence of internalized and externalized behavior problems among sexually abused children. A family drawing was completed by 78 sexually abused children, and three questionnaires were administered to the nonoffending parent. The results indicate that a poorer global psychological adjustment score on the family drawing is associated with a higher probability of clinical thresholds for internalized and externalized behavior problems in children who have been sexually abused, even when controlling for parents' psychological distress, child's age, number of stressful events experienced by the child, and type of sexual abuse.