Body drawings as an assessment tool in somatoform disorder

Abstract

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, α = 0.76) and basic elements (factor 2, α = 0.73). Both factors correlated with the art therapists’ rating (Spearman’s ρ = −0.53 and ρ = −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.