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Guo H, Feng B, Ma Y, Zhang X, Fan H, Dong Z, Chen T, Gong Q. Analysis of the screening and predicting characteristics of the house-tree-person drawing test for mental disorders: A systematic review and meta-analysis. Front Psychiatry 2022; 13:1041770. [PMID: 36683989 PMCID: PMC9848786 DOI: 10.3389/fpsyt.2022.1041770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 11/15/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The house-tree-person (HTP) drawing test has received growing attention from researchers as a common projective test. However, the methods used to select and interpret drawing indicators still lack uniformity. OBJECTIVE This study aims to integrate drawing indicators into the process of screening for or classifying mental disorders by conducting a systematic review and meta-analysis of the application of the HTP test. METHODS A search of the following electronic databases was performed in May 2022: PubMed, Web of Science, Embase, EBSCO, CNKI, VIP, and Wanfang. Screening and checking of the literature were performed independently by two researchers. The empirical studies published on the use of the HTP test in mental disorders and studies providing specific data on the occurrence frequency of drawing characteristics were analyzed. A total of 30 studies were included in the meta-analysis, including 665 independent effect sizes and 6,295 participants. The strength of the association between drawing characteristics of the HTP test and the prevalence of mental disorders was measured by the ratio (OR) with a 95% CI. Publication bias was assessed using a funnel plot, Rosenthal's fail-safe number (N fs), and the trim and fill method. RESULTS The results revealed 50 drawing characteristics that appeared at least three times in previous studies, of which 39 were able to significantly predict mental disorders. The HTP test can be divided into the following four dimensions: house, tree, person, and the whole. These dimensions reflect the structure, size, and other characteristics of the picture. The results showed that the greatest predictor of mental disorders was the whole (OR = 4.20, p < 0.001), followed by the house (OR = 3.95, p < 0.001), the tree (OR = 2.70, p < 0.001), and the person (OR = 2.16, p < 0.001). The valid predictors can be categorized into the following four types: item absence, bizarre or twisted, excessive details, and small or simplified. The subgroup analysis showed that the affective-specific indicators included no motion, leaning house, and decorated roof; thought-specific indicators included excessive separation among items, no window, loss of facial features, and inappropriate body proportions; and common indicators of mental disorders included no additional decoration, simplified drawing, very small house, two-dimensional house, and very small tree. CONCLUSION These findings can promote the standardization of the HTP test and provide a theoretical reference for the screening and clinical diagnosis of mental disorders.
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Affiliation(s)
- Huibing Guo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Student Affairs Management, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Bin Feng
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Yingqiao Ma
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Xueyi Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,College of Medical Technology, West China Hospital of Sichuan University, Chengdu, China
| | - Huiyong Fan
- Institute of Education, Bohai University, Jinzhou, China
| | - Zaiquan Dong
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.,College of Medical Technology, West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
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Tuite DR, Luiten JW. 16PF research into addiction: meta-analysis and extension. THE INTERNATIONAL JOURNAL OF THE ADDICTIONS 1986; 21:287-323. [PMID: 3721637 DOI: 10.3109/10826088609074836] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Meta-analysis of 34 studies on Cattell's 16PF test reveals ragged egos (C-), guilt (O), distrust (L), frustration (Q4), alienation (G-), vague identity (Q3-), alarm (H-), resentment (Q1), quasi-autism (M), scattered intellect (B-), grandiosity (E), autonomy (Q2), infantilism (I), avoidance (A-), and deviousness (N). The aberrant scores on E, G, I, Q1, and Q2 discriminate addicts from suicidals and the chronically ill or unemployed. We found nine types of addicts in our developmental study of 83 members of Alcoholics Anonymous. On the more stable second-order 16PF factors, 43% were highest on Autonomous, 37% on Desperate, 16% on Tough Poise, and 4% on Extravert. Profiles differed more by sexual preference than by gender. Recidivism was highest among homosexual men (38%) and the desperate (25%). Only the Fourth and Fifth Steps of the AA program seem crucial to recovery. Treatment programs based on these and tailored to sexual preference and the second-order personality types seem highly advisable.
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