Picturing disturbed body experience:A comparison of body drawings in persons with somatoform disorder and a general population sample

People with somatic symptom disorder or somatoform disorder are considered to have a troubled relationship to their body that is hard to assess with self-report questionnaires alone. To examine the potential value of own-body drawings as an assessment tool, objective features of drawings from 179 patients referred to treatment for somatoform disorder, were compared to those of 173 age-and-sex matched persons from the general population. While two factors had been found in the somatoform disorder sample, in the general population only the factor that reflected 'details' in own-body drawings was replicated. The two samples did not score differently on this factor. The general population sample showed a less strong association between objective body drawings scores on this 'details' factor and self-reported scores of body experience than the somatoform disorder sample. Moreover, the phenomenological contents of the drawings were more oriented towards health or appearance than the mostly mixed or unclear orientation of persons with somatoform disorder. Because the objective scoring of body drawings did not differ between groups while the contents of body drawings appeared to differ, the results suggest that this objective scoring of body drawings is not appropriate to distinguish people with and without somatoform disorder

Body drawings as an assessment tool in somatoform disorder

As part of the assessment of somatoform disorder, body drawings may provide complementary information to augment self-report questionnaires. This study examined the psychometric quality of observer ratings of objective characteristics of 180 own body drawings made by persons referred to treatment for somatoform disorder and 67 post-treatment drawings. Physical features of the drawings such as eyes, hands, size and angle of perception, were scored. These observer ratings were correlated with participants' responses on the Dresden Body Image Questionnaire (DBIQ-35) and with a single assessment by art therapists of the clients' relationships to their bodies. Changes in the observer ratings before and after therapy were evaluated. Inter-rater reliability was adequate to excellent for ten observer ratings and the art therapist ratings. Categorical principal components analysis of observer ratings indicated a 2-factor structure comprising details (factor 1, alpha = 0.76) and basic elements (factor 2, alpha = 0.73). Both factors correlated with the art therapists' rating (Spearman's rho = -0.53 and rho = -0.36) but not with DBIQ-35 scales. Factor scores improved after therapy. Assessment of objective characteristics of body drawings in clients with somatoform disorder indicates reliability, sensitivity to change and initial validity. These assessments may help to improve evaluation of client characteristics and treatment effectiveness

Figural representation of the hierarchical structure of components of body-relatedness according to patients and their therapists.

<p>Figural representation of the hierarchical structure of components of body-relatedness according to patients and their therapists.</p

Mean scores (standard deviation) of importance of the clusters.

<p>Mean scores (standard deviation) of importance of the clusters.</p