Guo Huibing, Feng Bin, Ma Yingqiao, Zhang Xueyi, Fan Huiyong, Dong Zaiquan, Chen Taolin, Gong Qiyong
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.
Front Psychiatry. 2023 Jan 4;13:1041770. doi: 10.3389/fpsyt.2022.1041770. eCollection 2022.
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.
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.
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 . Publication bias was assessed using a funnel plot, Rosenthal's fail-safe number ( ), and the trim and fill method.
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, < 0.001), followed by the house (OR = 3.95, < 0.001), the tree (OR = 2.70, < 0.001), and the person (OR = 2.16, < 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 thought-specific indicators included , , , and ; and common indicators of mental disorders included , , , , and .
These findings can promote the standardization of the HTP test and provide a theoretical reference for the screening and clinical diagnosis of mental disorders.
作为一种常见的投射测验，房树人（HTP）绘画测验受到了研究人员越来越多的关注。然而，用于选择和解释绘画指标的方法仍缺乏一致性。
本研究旨在通过对HTP测验的应用进行系统评价和荟萃分析，将绘画指标纳入精神障碍的筛查或分类过程。
于2022年5月对以下电子数据库进行检索：PubMed、Web of Science、Embase、EBSCO、中国知网（CNKI）、维普资讯（VIP）和万方数据。由两名研究人员独立进行文献的筛选和核对。分析了关于使用HTP测验诊断精神障碍的实证研究以及提供绘画特征出现频率具体数据的研究。荟萃分析共纳入30项研究，包括665个独立效应量和6295名参与者。采用比值比（OR）衡量HTP测验绘画特征与精神障碍患病率之间的关联强度，并设定了……。使用漏斗图、罗森塔尔失安全数（……）和修剪填充法评估发表偏倚。
结果显示，50个绘画特征在以往研究中至少出现过3次，其中39个能够显著预测精神障碍。HTP测验可分为以下四个维度：房子、树、人以及整体。这些维度反映了画面的结构、大小和其他特征。结果表明，精神障碍的最强预测因子是整体（OR = 4.20，……<0.001），其次是房子（OR = 3.95，……<0.001）、树（OR = 2.70，……<0.001）和人（OR = 2.16，……<0.001）。有效的预测因子可分为以下四种类型：项目缺失、怪异或扭曲、细节过多以及小或简化。亚组分析表明，情感特异性指标包括……；思维特异性指标包括……、……、……和……；精神障碍的常见指标包括……、……、……、……和……。
这些发现可促进HTP测验的标准化，并为精神障碍的筛查和临床诊断提供理论参考。
