高功能孤独症儿童的统合型房树人绘画测验特征

Characteristic of the synthetic house-tree-person test in children with high-functioning autism

目的:探讨高功能孤独症儿童的统合型房树人(S-HTP)绘画测验特征及其社会性发展。方法:对符合美国精神障碍诊断与统计手册第4版(Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,DSM-Ⅳ)的35例高功能孤独症儿童和年龄、性别、智商相匹配的70例正常对照儿童进行S-HTP绘画测验,分析高功能孤独症儿童S-HTP绘画测验特征(整体评价15个项目、房屋评价9个项目、树木评价5个项目和人物评价14个项目)。结果:在S-HTP绘画测验中,高功能孤独症儿童绘画特征与正常儿童存在明显差异。在主要反映社交互动水平的整体评价中有8个项目存在差异,如孤独症患儿绘画的画面统合性强的比例明显低于正常儿童[5.7%(2/35)vs.67.1%(47/70),P<0.05];在主要反映家庭关系的房屋评价中的有4个项目存在差异,如孤独症儿童绘画中人只在房屋外面的比例明显高于正常儿童[100%(35/35)vs.85.7%(60/70),P<0.05];在主要反映无意识的自我形象的树木评价中有4个项目存在差异,如孤独症儿童树木简化的比例明显高于正常儿童[73.5%(25/35)vs.24.3%(17/70),P<0.05];在主要反映有意识的自我形象和人际关系的人物评价中有8个项目存在差异,如孤独症儿童绘画人物数目2人以上的比例明显低于正常儿童[20.0%(7/35)vs.68.6%(48/70),P<0.05]。结论:高功能孤独症儿童统合型房树人绘画测验绘画特征反映出其社会性发展落后于正常同龄儿童,主要表现在社交互动、人际关系、自我概念和家庭关系方面。

Objective：To explore the characteristic of the synthetic house-tree-person （S-HTP） test in chil- dren with high-functioning autism. Methods： Totally 35 children with high-functioning autism （HFA） and 70 nor- mal children matched for age, gender and nonverbal Intelligence Quotient（IQ） were enrolled and completed the S- HTP test. Four elements of the drawings were assessed, including the whole evaluation items（ 15 items）, the house i- tems（9 items）, the tree items （5 items）and the person items（ 14 items）. Results： There were significant differencesbetween the HFA children and normal controls on some items of drawings. There were 8 different items in whole e- valuation items which reflect participants＇social interaction, for example, the proportion of integrated drawings in the autism children were lower than that of the normal controls [ 5.7 % （2/35） vs. 67. 1% （47/70）, P 〈 0. 05 ]. There were 4 different items in house items which reflect participants＇family relationships, for example, the autism children were more likely to draw the person outside the house in their drawings [ 100% （35/35） vs. 85.7% （60/70）, P 〈 0. 05]. There were 4 different items in tree items which reflect participants＂ unconscious self-concept, for example, the drawings of the autism children tend to appear simplified trees [73.5% （25/35） vs. 24. 3% （17/70）, P 〈 0. 05 ]. There were 8 different items in person items which reflect participants＂ conscious self-concept and interper- sonal relationship, for example, the proportion of pictures which appeared more than two person in autism group was lower then that of the normal controls [20.0% （7/35） vs. 68.6% （48/70）, P 〈0.05]. Conclusion： The synthetic house-tree-person drawing could reflect the defects of the social interaction in the HFA, consisting of four aspects of social interaction, interpersonal relationship, self-concept and family relationships.