有躯体化症状的小学生的房树人绘画测验特征

Drawing characteristics of somatization tendency children in house-tree-person test

目的:探索躯体化倾向小学生的房树人绘画测验特征,并探讨绘画测验特征对躯体化的预测指标。方法:对北京市某小学296名三、四年级学生进行儿童躯体化量表(CSI)和Achenbach儿童行为量表(躯体化分量表)的调查和"房-树-人"团体绘画测验,筛选出符合躯体化标准倾向(CSI≥17和儿童行为量表躯体化得分男孩>7,女孩>9)的学生37例,与133名年龄匹配的正常儿童(CSI和儿童行为量表躯体化得分≤平均分)进行对照分析和回归分析,分析有躯体化倾向的儿童的绘画测验特征。结果:躯体化组儿童与正常组儿童在12种绘画特征出现频率的差异有统计学意义,如躯体化组中强调配件出现频率高于正常组[18.9%(7/37)vs.0.0%(0/75),P<0.05];儿童躯体化量表的胃肠道症状(如没画窗户,r=0.16,P<0.05)、疼痛虚弱症状(如强调配件,r=0.37,P<0.01)、心血管及其他症状(如圆衣领,r=0.23,P<0.01)、假神经症状(如强调配件,r=0.24,P<0.01)条目的得分与部分绘画特征出现频率呈正相关;具有没画窗户(OR=24.04),画在纸最下部(OR=11.20),圆衣领(OR=16.36),强调纽扣(OR=6.00),强调配件(OR=43.93),胳膊不同粗细(OR=5.22)绘画特征的小学生更容易出现躯体化症状。结论:"房-树-人"绘画测验中没画窗户、画在纸最下部、圆衣领、强调纽扣、强调配件、胳膊不同粗细6项绘画特征可能与小学生的躯体化症状相关。

Objective： To investigate the house-tree-person（ HTP） test characteristics in pupils with somatization tendency and discuss the predictive indicators of the HTP characteristics on somatization tendency. Methods：Totally 296 pupils in Beijing w ere assessed w ith the Children ＇ s Somatization Inventory（ CSI）, Child Behavior Checklist（ CBCL,body parts） and the HTP group draw ing tests. Among them,37 cases meeting the somatization criteria（ CSI score ≥17,and boy＇ s CBCL body score 7,girl＇ s CBCL body score 9） w ere selected. Meanw hile,133 normal pupils（ CSI score and CBCL body score ≤ average score） w ere selected as the controls. The HTP draw ing test characteristics w ere compared betw een the tw o groups. Results： There w ere significant differences betw een the ones w ith somatization tendency and the normal children in 12 HTP draw ing characteristics. For instance,the emphasizing accessories occurred more frequently in the somatization group than in the normal children [18. 9%（ 7 /37） vs. 0. 0%（ 0 /75）,P〈0. 05]. The gastrointestinal symptom（ r = 0. 16,P〈0. 05）,the w eak pain symptom（ such as emphasizing on accessories,r = 0. 37,P〈0. 01）,the cardiovascular and other symptoms（ such as round collar,r = 0. 23,P〈0. 01） as w ell as the false neurological symptoms score（ such as emphasizing on accessories,r= 0. 24,P〈0. 01） w ere highly associated w ith part of the HTP draw ing characteristics. Pupils w ith the draw ing characteristics of no w indow s（ OR = 24. 04）,painting on the low ermost（ OR = 11. 20）,round collar（ OR = 3. 23）,stressing button（ OR = 6. 00）, emphasizing accessories（ OR = 43. 93）, arms of different thickness（ OR = 5. 22）,w ere easier to get the somatization symptom. Conclusion： It suggests that six draw ing characteristics such as no w indow s,painting on the low ermost, round collar, stressing button, emphasizing accessories and arms of different thickness in HTP test may be related to pupils＇ somatization symptoms.