Alexithymic characteristics in responses to the Synthetic House-Tree-Person (HTP) Drawing Test

Personality traits and the expression area of synthetic house-tree-person drawings in early adolescent Japanese

This study surveyed the expression areas of the Synthetic House-Tree-Person drawing test (S-HTP test, Mikami, 1995) for Japanese early adolescents. The S-HTP test is a projective method in which subjects are asked to draw a house, tree, and person. The expression area is defined as the area of each drawn item, such as the house, tree or person. The participants consisted of 186 Japanese junior high school students and their S-HTP drawings were analyzed using path analysis. The relationships between the expression areas of each item in the test and the students’ personality traits were examined. The personality traits were measured using the Five-Factor Personality Inventory for Children (FFPC, Soga, 1999). The results show that personality traits of high conscientiousness were associated with larger houses (p < .10) and trees (p < .10). In addition, higher scores on openness to experience (p < .01) and on agreeableness (p < .05) correlate with bigger person figures as their size, whereas higher scores on neuroticism correlate with smaller figures as their size (p < .01). The findings also indicate that the total fitness of the model was sufficient (CFI = .984, RMSEA = .021). These findings may aid the development of useful criteria for future psychological assessments.

Analysis of the synthetic house-tree-person drawing test for developmental disorder

BACKGROUND

Some patients cannot draw three subjects on the same page during the synthetic house-tree-person drawing test (S-HTP). We call this phenomenon "no synthetic sign". The aim of this study was to clarify the pathological meaning of no synthetic sign and investigate its use for the early detection of developmental disorders at a pediatric primary care center.

METHODS

We administered the S-HTP to 283 people who consulted the child psychosomatic medical clinic of Okayama University Hospital in 2007-2012. We diagnosed developmental disability based on DSM-IV-TR criteria and compared findings between the different diagnostic groups.

RESULTS

A total of 241 patients completed the S-HTP (S-HTP group) and 22 patients were not able to complete the S-HTP, but did complete the HTP (an original version of the S-HTP) or tree test (HTP group). Significantly more people in the HTP group had autism spectrum disorder (ASD) compared with the S-HTP group. Full-scale intelligence quotient was significantly lower in the HTP group compared with the S-HTP group.

CONCLUSIONS

There were two types of patients with no synthetic sign. The first involved patients with a suspected mental age younger than 5 years 11 months. The second type consisted of patients with ASD. Although drawing ability reflects multiple domains, it may help in early identification of children with developmental problems and facilitate earlier initiation of interventions.

A Psychometric Study of the Kinetic-House-Tree-Person Scoring System for People with Psychiatric Disorders in Taiwan

Objective/Background

The Kinetic-House-Tree-Person (KHTP) drawing test is widely used by psychiatric occupational therapists in Taiwan; however, very little support has been provided through studies examining its psychometric properties. The aim of the study is to validate a scoring system for the KHTP on a group of people with psychiatric disorders.

Methods

A total of 66 individuals with psychiatric disorders were recruited for this study along with 53 college students as a comparative group. Each participant completed the KHTP test. Half of the individuals with psychiatric disorders (33 people) completed the KHTP again following a 2-week period. The KHTP scoring system contains 54 items representing drawing characteristics. Two independent raters determined the score of the drawings, with the validity and reliability of the KHTP scoring system being subsequently examined by the Rasch and traditional analysis.

Results

The results reveal both validity and unidimensionality of the KHTP scoring system, demonstrating acceptable test—retest reliability. The intraclass correlation coefficient of the scoring system's inter-rater reliability was .76, with significant statistical differences found between the KHTP scores of college students and individuals with psychiatric disorders.

Conclusion

The KHTP scoring system has acceptable construct validity, inter-rater reliability, and test—retest reliability. Because drawing tests have the advantage of expressing nonverbal characteristics, the scoring system should prove to be very useful for those who are unwilling or unable to communicate verbally. This study therefore provides valuable information for clinical application, particularly for the psychiatric rehabilitation professions.

Association between pretransplant psychological assessments and posttransplant psychiatric disorders in living-related transplantation

The authors examined pretransplant assessment in order to predict posttransplant occurrence of psychiatric disorders in living-related transplantation (LRT). Before LRT, the authors administered the Integrated House-Tree-Person Drawing Test (I-HTP) and 20-item Toronto Alexithymia Scale (TAS-20) to 31 donor-recipient pairs undergoing living-related liver transplantation (LRLT) and 65 pairs undergoing living-related kidney transplantation (LRKT). After LRT, the authors examined the occurrence of psychiatric disorders for the recipients and donors. Pretransplant, two psychological indicators,-alexithymia, a lack of verbalized emotion and abnormal projective drawings such as truncated tree representation-were significantly related to the manifestation of paradoxical psychiatric syndrome (PPS) in LRLT and LRKT. The occurrence of PPS was significantly related to recipients' guilt feelings toward living donors, but these were strongly superseded by recipients' desires to escape from approaching death just before LRT. These results suggest that pretransplant psychological assessment is useful for predicting posttransplant occurrence of psychiatric disorders.