The Use of the Hand Test with Children and Adolescents: A Review

Exploring the hand test with medically ill children and adolescents

Pediatric psychologists use the tools of assessment to evaluate the psychological functioning of youth with chronic and acute medical illnesses. This study is an exploration of the use of a performance-based measure, the Hand Test (HT; Wagner, 1983), with pediatric medical patients. A sample of medical inpatients (n = 27) and psychiatric outpatients (n = 24) were administered the HT, a self-report measure, and a parent-report behavior rating scale. Results indicate that the psychiatric group scored higher than the medical group on HT Aggression, Withdrawal, and Pathological scores. The Aggression (d = 0.90) and Pathological (d = 0.80) variables were particularly robust in differentiating between groups, but the Crippled variable did not differ between groups. Hierarchical logistic regression demonstrated the incremental validity of the HT over behavior ratings alone in the classification of clinical groups. Analyses indicated that the HT can add important information in the differentiation of medically ill children from those with psychological disturbance.

Hand test AGG and AOS variables: relation with teacher rating of aggressiveness

The purpose of this study was to determine the extent to which the Hand Test (Wagner, 1983) variables Aggression (AGG) and the Acting Out Score (AOS) were able to differentiate a group of children who were identified as aggressive and referred for psychological assessment by their teachers from a nonreferred, control group. Hand Test scores of 37 children who had consecutive referrals for psychological assessment because of aggressiveness were compared to the Hand Test scores of 37 children, matched on age and sex, from a nonreferred group. Through the use of an analysis of variance, AOS and AGG were found to significantly differentiate between the two groups. Spearman (rho) correlations between AGG and AOS scores with aggressive-referred status were rho = .45, p = .0001, and rho = .32, p = .006, respectively. Also, diagnostic efficiency statistics demonstrated moderate to high overall correct classification rates for AOS > or = 0 and AGG > or = 2 in identifying children in the aggressive-referred group. The results of this study provide support for the validity of the AGG and AOS scores in the assessment of aggressive behavior in children and demonstrate the utility of the Hand Test to identify aggressive tendencies in children.

Use of the Hand Test in the classification of psychiatric inpatient adolescents

This study investigates the extent to which 2 Hand Test variables, the Pathology summary score (PATH) and the Acting Out Score (AOS), were able to differentiate among 3 groups of adolescents. Thirty psychiatric inpatient adolescents diagnosed with various Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) behavioral and emotional disorders were compared to 30 outpatient and 30 nonclinical adolescents matched on age, grade, and sex. An analysis of variance demonstrated the ability of both PATH and AOS to significantly differentiate among the 3 groups. Multiple regression equations utilized PATH and AOS as significant predictors of inpatient status (p < .0001) and general patient (inpatient and outpatient) status (p < .0001). Utilizing diagnostic efficiency statistics, overall correct classification was found to be highest for PATH > or = 3 and AOS > or = 2. These findings support the application of the Hand Test as a useful assessment tool for adolescents suspected of having psychiatric disorders and present evidence for the use of PATH and AOS for classification purposes in ways that are clinically meaningful.

Prediction of criminal behavior in young Swedish women using a group administration of the Hand Test

2,074 Swedish girls and adolescents were administered a group version of the Hand Test. About ten years later, 80 of these subjects had committed crimes serious enough to be entered on the General Police Register. These young women offenders were then matched by age with nonoffenders and the two groups compared on 17 quantitative Hand Test variables. Significance was found for the Tension and Pathology scores, suggesting that these young female lawbreakers were characterized as youngsters having scores indicating anxiety and other forms of psychopathology rather than innate hostility.