D I S C R I M I N A T I V E A N D I N C R E M E N T A L V A L I D I T Y R E L A T E D T O D E P R E S S I V E SYMPTOMS

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1 Studia Casuistica, 2012, 2, Supplement 2& & & & & & & & 62 D I S C R I M I N A T I V E A N D I N C R E M E N T A L V A L I D I T Y R E L A T E D T O D E P R E S S I V E SYMPTOMS Z OLTÁN V ASS 8 Abstract The objective of this study was the investigation of incremental validity of the ESPD analysis in depression. In the study, 266 participants were included. All participants were White and Hungarian, randomly selected in various workplaces and in psychiatric institutes. Forty-three percent (n = 115) were male, ranging from 13 to 78 years of age (M = 36.21, SD = 14.47). Participants were divided into two groups based on depressive symptoms. The depression group included participants with depressive symptoms (as assessed from previous diagnosis, clinical interview and data from heteroanamnesis). Means of the two groups (participants with or without symptoms of depression) were compared with independent-samples t-tests. Several group differences were found between participants with or without depressive symptoms. Significant differences were found in a total of 73 variables; 64 (88%) variables are conceptually plausible and consistent with our accumulated diagnostic knowledge (represented e.g. in DSM-IV). Nine of them (12%) are unclear or problematic. They need to be reformulated or a more thorough examination. A large amount of items were found that correspond to our general body of diagnostic knowledge related to depression. K EYWORDS: psychometric validity, expert system, depression, projective drawings 8 Institute of Psychology, Károli Gáspár University, Budapest

2 Studia Casuistica, 2012, 2, Supplement 2& & & & & & & & 63 As it was demonstrated in the previous paper of this thematic issue, the methodology used in the ESPD research (Vass, 2006, 2012) proved to be useful. However, is it true for other psychological features, too? To answer this question, the objective of this study was the replication of the previous paper (i.e. the investigation of incremental validity), but involving another psychological disorder: depression. Method Participants The investigated sample was the same as in the previous paper. Procedure The procedure was exactly the same as in previous paper but participants were divided into two groups based on present depressive symptoms. The depression group included participants with depressive symptoms (as assessed from previous diagnosis, clinical interview and data from heteroanamnesis). Data analysis Means of the two groups (participants with or without symptoms of depression) were compared with independent-samples t- tests. Results Several group differences were found between participants with or without depressive symptoms. Significant differences were found in a total of 73 variables; 64 (88%) variables are conceptually plausible and consistent with our accumulated diagnostic knowledge (represented e.g. in DSM-IV). Nine of them (12%) are unclear or problematic. They need to be reformulated or a more thorough examination. As shown in Table 1, participants with depressive symptoms were characterised with high values of the following interpretations, computed from the semantic network: anxiety, depressive mood, helplessness syndrome, inadequacy feelings, inferiority feelings, inhibited personality, insecurity feelings, low egostrength, low self-esteem, negative selfconcept, repression, rigid defenses, and role conflict. They were also described with s of anxiety, body narcissism, confusion over sexual identification, dependence, depressive mood, emotional or social maladaptation, feeling that the world is dangerous, gender role confusion, hypersensitivity, impulsivity, inadequacy feelings, inadequacy feelings with compensatory defenses, inferiority feelings, inhibited personality, low drive level, low

3 Studia Casuistica, 2012, 2, Supplement 2$ $ $ $ $ $ $ $ 64 ego-strength, negative self-concept, precarious control of body impulses, and rigid defenses. Heuristic estimation yielded the following results: negative self-esteem, sensitivity, generalized discontent, neuroticism, narcissistic and dependent personality disorder, and general mood disturbances. Drawings f rom participants with depressive symptoms showed more information in each information scales. Participants with depressive symptoms scored significantl y lower in noncompliance, test resistance, passivity, e vasiveness and superficiality in interpersonal relations. On the contrary, participants without depressive symptoms scored significantly higher in the following interpretations, derived from the semantic network: mental health, controlled emotionality, determination, flexibility, and humor in dealing with a threatening situation. Heuristics reinforced mental health and s added spontaneity to the previous features. Conceptually unclear or unacceptable interpretations in the depressive group were higher scores on impairment organic scale, socially outgoing tendencies, assertiveness and heuristic estimation of paranoid personality disorder, and lower scores in psychosexual immaturity, psychosomatic conditions, unbalanced selfconcept, and heuristic estimation of immaturity and s of body image distortion. Discussion Results of the fifth study replicated the diagnostic usefulness of the prcedure described in the previous paper in this thematic issue, but it involved another psychological feature. As in the case of aggression, a large amount of items were found that correspond to our general body of diagnostic knowledge related to depression (Buck, 1948/1992; Machover, 1949; Hammer, 1958; Levy, 1958; Bolander, 1977; Hárdi, 1983/2002; Mitchell, Trent & McArthur, 1993; Urban, 1994; Jolles, 1996). An interesting result is that depression was related to more characteristics than aggression. A possible reason is that depression is a more general and manyfaced phenomenon than aggression; it accompanies to various psychological disorders. It is also important to note that depression has a variety of comorbidity and a broad range from normal functioning to psychotic adjustment, and it can be a state or a long-lasting condition. References Bolander, K. (1977). Assessing Personality through Tree Drawings. New York: Basic Books.

4 Studia Casuistica, 2012, 2, Supplement 2& & & & & & & & 65 Buck, J. N. (1948). The H-T-P technique; a qualitative and quantitative scoring manual. Journal of Clinical Psychology, 4, Buck, J. N. (1992). (Revised by Warren, W. L.). House-Tree-Person Projective Drawing Technique Manual and Interpretive Guide. Los Angeles: Western Psychological Services. Diagnostic and Statistical Manual, Fourth Edition, Text Revision DSM-IV-TR. Washington, DC: American Psychiatric Association. Hárdi, I. (1983/2022). Dinamikus rajzvizsgálat. Budapest: Medicina. Jolles, I. (1996). A Catalogue for the Qualitative Interpretation of the House- Tree-Person (H-T-P). Los Angeles: Western Psychological Services. Levy, S. (1958). Projective Figure Drawings. In: Hammer, E. F. (Ed.). Clinical Application of Projective Drawings. Springfield: Thomas, Urban, W. H. (1994). The Draw-A-Person Catalogue for Interpretative Analysis. Western Psychological Services: Los Angeles. Vass, Z. (2001). A klasszikus pszichometriai validitás-koncepció és a heurisztikus tesztértelmezési koncepció összehasonlítása (A comparison of the classic concept of psychometric validity and a concept of heuristic test interpretation). Testforum 2001, Test Committee of the Hungarian Psychological Association (A Magyar Pszichológiai Társaság Tesztbizottsága), Budapest (Hungary), 21th September Va s s, Z. (2006). A rajzvizsgálat pszichodiagnosztikai alapjai. Budapest: Flaccus. Va s s, Z. (2012). A psychological interpretation of drawings and paintings. The SSCA Method: A Systems Analysis Approach. Budapest: Alexandra Publisher. Machover, K. (1949). Personality Projection in the Drawing of the Human Figure (1st ed.). Springfield, Ill. C. C. Thomas. [11th ed. 1980]. Mitchell, J., Trent, R., McArthur, R. (1993). Human Figure Drawing Test (HFDT). Los Angeles: Western Psychological Services

5 Studia Casuistica, 2012, 2, Supplement 2# # # # # # # # 66 Non depressive Depressive Interpretation M SD M SD t df p anxiety depressive mood helplessness syndrome inadequacy feelings inferiority feelings inhibited personality insecurity feelings low ego-strength low self-esteem negative selfconcept repression rigid defenses role conflict impairment organic scale neg. self-esteem sensitivity gen. discontent pen neuroticism paranoid personality disorder

6 Studia Casuistica, 2012, 2, Supplement 2" " " " " " " " 67 narcissistic personality disorder dependent personality disorder all mood disturbances information from major syndromes information from heuristic scales total information from major and minor syndromes anxiety anxiety anxiety assertiveness body narcissism confusion over sexual identification dependence depressive mood depressive mood

7 Studia Casuistica, 2012, 2, Supplement 2" " " " " " " " 68 depressive mood emotional or social maladaptation feeling that the world is dangerous gender role confusion hypersensitivity impulsivity inadequacy feelings inadequacy feelings inadequacy feelings with compensatory defenses inferiority feelings inferiority feelings inhibited personality low drive level low ego-strength negative selfconcept

8 Studia Casuistica, 2012, 2, Supplement 2" " " " " " " " 69 precarious control of body impulses rigid defenses socially outgoing tendencies controlled emotionality determination evasiveness and superficiality in interpersonal relations flexibility humor in dealing with a threatening situation mental health noncompliance passivity poor judgment psychosexual immaturity psychosis psychosomatic conditions test resistance unbalanced selfconcept mental health immature features

9 Studia Casuistica, 2012, 2, Supplement 2$ $ $ $ $ $ $ $ 70 distortion of body image evasiveness evasiveness psychosis spontaneity Note. Because of large number of variables, only significant (p < 0.05) differences are reported. Table 1 Group differences of participants with (n=79) and without (n=180) depressive symptoms