The Influence of Adjustment Factors to Human Figure Drawing Test (HFDT)
Indicators of Low SES Filipinos
Daniella Morga Doreen Flores Tyrone Reden Sy Ateneo de Manila University ADJUSTMENT FACTORS ON HFDT 2
Abstract The purpose of this study is to discover the relationship between adjustment factors and the drawing characteristics of human figure drawings of lower SES Filipinos. There were 65 Filipino workers who participated in this study, majority of which came from a provincial bus company. A questionnaire composed of demographic questions, and scales for the adjustment factors, and a blank sheet of paper for the human figure drawing test (HFDT) was given to respondents. The HFDT outputs of respondents were evaluated by the three researchers. Interrater reliability for global quality of drawings (0.68), bizarreness (0.67) and specific indicators (0.79) were within acceptable ranges. No significant correlations were found for quality, bizarreness and specific indicators. However, it was found that those who had only elementary education had higher mean scores for depression and they were also more anxious. Counterintuitively, those who had a monthly family income of 1,000 to 5,000 had better quality and less bizarre drawings despite being more anxious than the rest of the respondents. When only the data for bus company workers were analyzed (n=41), it was found that those who were more depressed tend to have lower quality of drawings and those who had more bizarre drawings tend to have more intrusive thoughts and were more depressed. Keywords: HFDT, adjustment factors, low SES Filipinos ADJUSTMENT FACTORS ON HFDT 3
The Influence of Adjustment Factors to Human Figure Drawing Test (HFDT) Indicators of Low SES Filipinos Even in childhood, the human figure is one of the first and most often drawn among all subjects (Cox, 1993; McCarty, 1924). Initially used by psychologists and educationists to assess a childs development and intelligence, the drawing of the human figure evolved into being used as a tool to diagnose personality disorders as well as emotional maladjustments in both children and adults and has become one of the most frequently used assessment instrument (Yama, 1990; Koppitz, 1968; Handler, &Reyher, 1964; Machover, 1949). In the Philippines, the demand for psychological evaluations in different situations is increasing, especially for the Philippine government (Dans-Lopez & Tarroja, 2010). More and more Overseas Filipino Workers (OFWs) that have been deployed are reported to experience psychological breakdown, commit illegal acts and encounter problems in adjustment resulting for repatriation due to premature contract termination and consequently, becoming additional burdens to their respective families (Dans-Lopez & Tarroja, 2010). Against this backdrop, there are calls to find ways to minimize these occurrences through psychological evaluation before deployment (Dans-Lopez & Tarroja, 2010). According to Machover (1949), deep and often unconscious feelings and motives may be accessed through various means of self-expression. Further, she saw that an effective instrument for this expression is the drawing of human figures. The human figure is suggested to be a representation of the self in the environment, indicating desires, defects and deficiencies, compensation, or a combination of all (Handler, 1985, p. 177). The nonthreatening nature of drawing human figures allows for the inner feelings and conflicts to be expressed nonverbally (McNeish, 1993). Drawings have been used to raise awareness on potential problems in ADJUSTMENT FACTORS ON HFDT 4
psychological functioning among and between different populations (Dans-Lopez & Tarroja, 2010; Zalsman, Netanel, Fischel, Freudenstein, Landau, et al., 2000; Lev-Wiesel, 1999; McNeish, 1993; Naglieri & Pfeiffer, 1992; Marsh, Linberg, and Smeltzer, 1991). However, studies on the relevance and effect of culture on human figure drawings have mixed findings. Some studies found that there were differences in drawings of children among different cultural groups, such as in the different tribes of Native Americans as compared to white children, among Maori children in New Zealand, among Tallensi children, among Turkish children and between Japanese and U.K. children (Cox, Koyasu, Hiranuma, and Perara, 2001; Cox, 1993). Contrary to the mentioned studies, Yama (1990) found that global characteristics of the drawings of his Vietnamese sample suggests that some aspect of personality does not depend of culture, that is, there are aspects of the drawings that reflects something within the respondents that goes beyond differences in language and culture. Given the ease in its administration and the simplicity of its instructions, the human figure drawing may be suitable, especially for cultures that do not speak or are not fluent in English, and where translation of other verbal tests may result in breakdown in communication (Dans-Lopez & Tarroja, 2010; Gustafson & Waehler, 1992; Yama, 1990). Empirical studies on human figure drawings in the context of Filipino adult experiences are scant. There are only few, if any at all, that studied human figure drawings among Filipinos with lower socio-economic status and lower educational attainment. As such, empirical studies using the human figure drawing test within the Filipino context and related to adjustment experiences may prove useful for psychologists in the field of assessment of individuals in the same economic status, such as those applying to be OFWs. ADJUSTMENT FACTORS ON HFDT 5
The purpose of this study is to discover the relationship between adjustment factors (intrusive thoughts, avoidance, failure to adapt, depression and anxiety) and the characteristics (quality, bizarreness and specific indicators) of the human figure drawings of lower SES Filipinos. Method The sites of this study were a military camp in Quezon City, a bus station in Recto, Manila, a bus station in Angeles, Pampanga, and a professional school in Makati. Participants of this were a heterogeneous mixture of respondents from those different sites. Among the 65 participants, 72.3% were male, 76.9% were married, 40% were able to enter college, 63.1% were bus company workers, and 38.9% had a monthly family income of P5,001 to P10,000. Table 1 Sociodemographic Characteristics of Respondents (n=65) Valid Percent Gender Male Female
72.3 24.6 Civil Status Single Married Widower/Widow Separated
13.8 76.9 4.6 1.5 Occupation Bus Company Armed Forces - Reserved Household Helpers Security Guards
8.8 9.6 23.5 10.3
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Educational Attainment Elementary High School College Vocational
13.8 35.4 4.0 7.7 Monthly Family Income P1,000 to P5,000 P5,001 to P10,000 P10,001 to P15,000 P15,001 to P20,000 P20,001 to P30,000 More than P30,000
22.2 38.9 22.2 11.1 5.6 0.0
The study was comprised of a questionnaire about demographics, a questionnaire on Mga Reaksyon sa Stress o Problema, a Draw-a-Person sheet, and a consent form. The Mga Reaksyon sa Stress o Problema questionnaire was composed of 21 items that were rated using a five point Likert scale ranging from 1 hindi (never) to 5 parati (always). Participants were also asked questions about gender, educational attainment, marital status and children, and household income. The sheet for the draw-a-person instructed participants to draw a whole person specifying not to draw a stick to the best of their ability. The reliability of the factors for Mga Reaksyon sa Stress o Problema were established where the items for intrusive thoughts had Cronbachs = .82; items for avoidance had Cronbachs = .70; items for failure to adapt had Cronbachs = .67; items for depression had Cronbachs = .60; and items for anxiety had Cronbachs =.68. Data collection occurred between the November 30, 2013 and the January 7, 2014. Researchers went to the location sites previously stated. Participants were purposively selected, for example, bus drivers and conductors arriving in the bus terminal were invited to take a survey in the dispatchers office where it is conducive to take the survey. They were told that the survey ADJUSTMENT FACTORS ON HFDT 7
will not have any effect on their jobs. After each participant finished, they were given a small food token. Researchers used an HFDT Microsoft Excel template to rate the characteristics of each drawing. After which, the researchers had brownbag sessions where they discussed and reconciled the differences in their ratings of respondents drawings. The answers to the demographics and the Mga Reaksyon sa Stress o Problema questionnaire were encoded in SPSS together with the ratings for global characteristics quality and bizarreness and the sum of the indicators. Data were cleaned and analyzed using descriptive and correlational statistics (Pearsons R) as well as t-test and One-way ANOVA. Results
Interrater reliability for global quality (0.68), bizarreness (0.67) and specific indicators (0.79) were within acceptable ranges. The mean score for Quality is M = 2.67 (SD = .89), for Bizarreness M = 2.64 (SD = .88), and for Specific Indicators M = 8.46 (SD = 4.75). No significant correlations were found among all adjustment factors and quality, bizarreness and specific indicators. There were also no significant differences between males and females as well as those who have and do not have children for all variables. Likewise, one-way ANOVA revealed no significant difference across Civil Status for all variables. However, there were significant differences across educational attainment for depression (F (3,59) = 5.57, p<0.05, and anxiety (F (3,59) = 3.41, p< 0.05). Those who had only elementary education had higher mean scores for depression (M = 1.91, SD = .47) and they were also more anxious (M = 2.36 SD = .92) than all the other respondents who had higher educational ADJUSTMENT FACTORS ON HFDT 8
attainment. There were no significant differences for quality, bizarreness and specific indicators across educational attainment. Likewise, a one-way ANOVA was conducted to determine whether there were significant differences for quality, bizarreness, specific indicators and adjustment factors across family income. There were significant differences for quality (F (4,54) = 5.01, p< 0.05), bizarreness (F (4,54) = 5.38, p< 0.05) and anxiety(F (4,54) = 3.22, p< 0.05). Counterintuitively, those who had a monthly family income of 1,000 to 5,000 had better quality (M = 3.38, SD = .64) and less bizarre drawings (M = 3.40, SD = .67) despite being more anxious (M = 2.36, SD = .76) than the rest of the respondents. We hypothesized that the non-significance of the correlation between the adjustment factors and the HFDT indicators could be due to the heterogeneity of our sample. Hence, we decided to analyze only the respondents from the bus line company (n = 41), making our sample a relatively homogenous population (e.g. they come from the same working environment). Among bus company workers, quality of drawings was weakly and negatively correlated with depression such that those who were more depressed had lower quality of drawings (r = -.33, p < 0.05). It was also found that bizarreness was inversely and weakly correlated with intrusive thoughts (r = -.33, p < 0.05) and depression (r = -.32, p < 0.05); those who had more bizarre drawings tend to have more intrusive thoughts and were more depressed (Table 2). There were also differences for quality (F (4,31) = 4.71, p< 0.05) and bizarreness (F (4,31) = 4.66, p<0.05) across monthly family income levels. Again, respondents who had an income of 1,000 to 5,000 had higher quality (M = 3.54, SD = .75) and less bizarre drawings (M = 3.58, SD = .81). ADJUSTMENT FACTORS ON HFDT 9
Table 2 Pearsons Product Moment Correlations among Bus Company Workers (n = 41) Intrusive Thoughts Depression Quality -.28 -.33* Bizarreness -.33* -.32* * Significant at = 0.05
Discussion Educational Attainment and Depression Poor psychological health is among the leading chronic health problems worldwide with depression-related symptoms being the most prevalent. Comparing the results of those who reached High school and those who took vocational courses, scores on the depression scale were higher among those who reached high school. Furthermore, those who only reached Elementary were more depressed and anxious than the rest. This is concurrent with the findings A public health survey by Lindstrom, et.al in Scandinavia (2006) wherein they conducted across Scandinavia, revealed that respondents who have low education have higher tendencies of poor psychological health. This may be attributed to the fact that those who only reached elementary have narrower opportunities to land on a decent paying job. They also mentioned that based on the Swedish Public Health Report, people who experience economic stress is more prone to mental illness than the others. (Lindstrm, Moghaddassi,& Merlo, 2006). Family Income In the study of Dans-Lopez and Tarroja (2010), respondents with only high school or elementary education had poorer quality and more bizarre drawings. It was mentioned that those ADJUSTMENT FACTORS ON HFDT 10
with high school and elementary education mostly belonged to lower income groups. This finding seems to be inconsistent with the results of our present study which shows the opposite. As in previous studies conducted elsewhere, the idea is that people who has lower family income suffer from economic stress, thereby poorer psychological health, leading to poorer quality and more bizarre drawings in the HFDT. In contrast however, our study found that those who have lower family income actually have better quality of drawings hence it could be inferred that they are more psychologically healthy. What could have been the mediating variables that may have led more anxious and more depressed Filipinos who come from lower-income brackets in our study to be more psychologically healthy as evidenced by their HFDT? One hypothesis is that the strong spirituality and prayerfulness of Filipinos acted as a mediating variable a buffer that improved psychological health despite them suffering from depression and anxiety. For example, as the researchers were talking to one respondent who earns less than P400.00 a day, he fervently said that despite all of this sufferings, we should stay strong be and dedicate all our efforts and sufferings to God. Indeed, in a study of Pargament et al (2005), prayer coping was shown to promote physical and mental health. Religious coping as a multidimensional construct has been related to physical health, psychological well-being, health behaviors, and feelings of efficacy (Harrison, Koenig, Hays, Eme-Akwari, & Pargament, 2001). Faith may offer motivation, a source of value and significance and coping. Prayer coping is meant more than a ritual because it indicates the intention of survival. Filipinos in our study may be using religiosity coping as their mechanism as they face economic stressors. Adjusting preferences and goals in line with experienced constraints and limitations or also known as adaptive coping can also explain the obtained results. Adaptive coping has been ADJUSTMENT FACTORS ON HFDT 11
described as appropriate for a good psychological adjustment to the unchangeable (Brandstdter, & Rothermund, 2002). Within this coping strategy, acceptance is considered a key variable. When people in the low socio economic status accept their situation, it is assumed that they will adjust their life goals towards more achievable goals by integrating this difficult life event (Poppe, et.al, 2013). The findings of our study provides a counterevidence to the stereotype that people from the lower income brackets tend to be psychologically unhealthy succumbing to the stressors of daily life. Instead we add to the literature on positive psychology, specifically on resilience defined as the flexibility in responding to changing situational demands, and the ability to bounce back from negative emotional experiences (Block & Block, 1980). We suggest that the economic constraints of the lower income Filipino respondents have actually made them psychologically-fit resilient individuals who experience positive emotions even in the midst of stressful events and are able to rebound successfully despite adversity. We conclude that lower income Filipinos are capable of understanding the benefits associated with positive emotions and using this knowledge to their advantage when coping with negative emotional stress or events (Tugade & Fredrickson, 2002). Limitations and Recommendations There were several limitations associated with this study. The study was designed with reading level as a primary consideration, but we found that there were individuals who were guided in answering the questionnaire because they do not know how to read. The test administration was different with them because the researchers have to read the whole questionnaire. Hence, the researchers might have also affected the way the respondents answered the questions. ADJUSTMENT FACTORS ON HFDT 12
Another factor will be the testing conditions. Since there are different populations, testing conditions were not consistent. The researchers suggests that for future studies use a homogenous population and similar settings be used as much as possible. Findings from this present study highlight different results from majority of the studies conducted on HFDT. Future studies may benefit in increasing the sample size so that it can be more representative of the low SES group. We also suggest the examination of religiosity and spirituality as a mediating variable between demographic variables, adjustment factors and HFDT indicators.
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