Human Figure

Drawing Test
Flores, Rio, Santos, Sazon
 INTRODUCTION
The drawing that a patient makes of a human figure represents the self in the
environment.
The analysis of human figure drawings is widely used as a qualitative clinical
assessment technique.
Projective- analytic theory is based on the assumption that deep and often
unconscious feelings and motives may be accessed through various means of
self-expression (Machover, 1949).
The drawing of a human figure was seen by Machover as an ideal vehicle for
that self-expression.
Human figure drawings have been interpreted on the basis of variations.
General Descriptions
Human Figure Drawing Test (HFDT) is designed to enhance rather than to replace the
time-honored projective-analytic aspect of human figure drawing analysis.
The unique contribution of the HFDT is the application of empirical data to assist in
qualitative analysis.
The HFDT is designed to provide an objective approach based on a traditionally
projective clinical assessment.
In developing the HFDT, the authors confirmed those standards by evaluating human
figure drawings made by members of a psychiatric hospital staff and comparing
them with drawings made by patients.
. With the standards for normality of drawings confirmed, 74 variations from those
standards were identified.
The HFDT is based on a traditional projective drawing technique designed to support
both quantitative and qualitative clinical interpretation of human figure drawings.
General Descriptions
The drawings are then evaluated to generate clinical interpretive
hypotheses, and the same-sex drawing is scored to obtain an estimate of
the individual's level of cognitive functioning.
Scaled scores, including an overall Impairment score, Distortion and
Simplification scores, and an Organic Factors Index are provided along
with easy access to both quantitative and qualitative interpretive support.
A Scoring Sheet, a Score Summary Sheet, an Interpretation Guide, and a
Profile Sheet are all contained in the HFDT AutoScoreTM Form (WPS
Catalog No. W286B).
The AutoScoreTM Form's Interpretation Guide is a convenient feature for
both new and experienced users, allowing immediate reference to
common interpretive concepts for each scored drawing feature.
 Purposes and Clinical Applications

Human figure drawing has a place in several areas of clinical activity.

For diagnostic purposes, the HFDT provides information that, when linked with other
interview and assessment tools, can reveal an individual's general conflicts and
concerns.
In ongoing therapy, projective drawings can reflect overall changes in an individual's
psychological state.
HFDT allows the clinician to compare an individual's drawing to the drawings of
people in nonclinical settings as well as to the drawings of psychiatric patients
diagnosed.
As with any clinical interpretative system, this one should be used with caution.
The HFDT is most suitable for use with indiViduals over 15 years of age.
 Purposes and Clinical Applications

The engaging nature of the drawing task makes it especially well suited for use in
any situation where direct verbal communication about conflictual material is
unlikely because of obstacles to motivation or verbal ability.
Users of the HFDT should have training and supervised experience with
individually administered clinical instruments.
Qualitative Evaluation
It is necessary to evaluate the drawings and the
client's behavior during the drawing session in terms
of how they may reflect the psychological and
environmental pressures impinging upon the client.
 Administration

Takes 5-10 minutes to administer

The client should be seated at a table in a
comfortable position for drawing.
The area where the drawings are to be taken
should be quiet and free from distractions.

Scoring
Copy the client's
identifying
information from the
Drawing Form to the
identical spaces
provided at the top of
the Profile Sheet of
the AutoScoreTM
Form

 Scoring
Then turn the AutoScoreTM Form
over so that the Scoring Sheet is
showing. Using the criteria
presented in the concluding section
of this chapter, "Scoring Criteria and
Illustrated Examples," mark the box
beside each of the 74 features that
is present in the drawing. Use a
hard-tipped pen and enough
pressure to transfer your marks
through the AutoScoreTM Form's
carbon paper. Use the rulers
provided along the edges of the
Scoring Sheet to evaluate features
that require measurement.

Scoring
Once you have finished
with the Scoring Sheet,
tear off the perforated
strip along the bottom of
the AutoScore TM Form
and discard the
carbonized tissue. Your
scoring marks have been
transferred to the Score
Summary Sheet and to the
Interpretation Guide

 Scoring
Count all the marked boxes on the Score
Summary Sheet, and enter that number in
the space labeled *Impairment Raw Score" T
o determine the Distortion raw score. count
all the marked boxes that are labeled "D."
and enter that number in the space labeled
"Distortion Raw Score.”
Next. count all the marked boxes that are
labeled and enter that number in the space
labeled "Simplification Raw Score." Subtract
the Simplification raw score from the
Distortion raw score to determine the
Organic Factors Index. and enter the result
in the appropriate space. These scores can
now be transferred to the Profile Sheet and
plotted on the profile graph

 Scoring
The intersection of the Distortion and Simplification raw scores
should be plotted on the separate graph on the right side of the
Profile Sheet, using the following instructions:
1. Find the Simplification raw score on the horizontal axis of the
graph. In the example shown in profile sheet, the Simplification
raw score is 2.
2. Follow the vertical line that corresponds to the Simplification
raw score upwards until you reach the horizontal line that
crosses the vertical axis of the graph at the point corresponding
to the Distortion raw score. (In the example shown in the profile
sheet, the Distortion raw score is 4.)
3. Draw an X on the graph at the intersection of these two lines

Test Materials
HFDT Drawing Form
Pencil No. 2
HFDT AutoScore Form

Procedure
Fill in the identifying information on the first
page of the Drawing form.
Fold the form, wherein the identifying
information is inside then present one of the
blank sides of the form to the testtaker.
Ask the client to draw a person.
After the testtaker completes his/her
drawing, ask him/her to flip the paper and
draw another person with the opposite sex
from the first drawing
Procedure Cont.
If the testtaker attempts to draw a stick figure,
ask him/her to draw a regular, whole person,
instead.
Tester should have a clear view of the page while
the testtaker is drawing, so that the tester can
note the sequence and details of the drawing and
observe the testtaker during the session.
Record the observations in the first page of the
Drawing form. These informations will help in the
qualitative evaluation of the drawings.
 Item Interpretation
Size
1. Small Size: Anxiety and depressive tendencies have been associated with small drawings.
Other personaliy characteristics associated with small drawings have included withdrawal
tendencies; feelings of inferiority, smallness, and inadequacy; paranoia; regression; vegetative
states; low energy levels; and "shrunken ego" states.
2. Large Size: Large drawings have been associated with positive mood, ascendancy, and high
self-esteem. High "fantasy self-esteem," grandiosity, euphoria, and other manic features have
also been associated with large drawings. Large drawings may also indicate aggression.
3. Larger, Dominant Female: When drawn by males, larger, dominant female figures have been
associated with a problematic relationship with the mother and with passivity, inadequacy,
submissiveness, and related psychosexual disturbances. Larger, dom been found in the drawing
abusers. Problematic mater culine strivings have been female figures drawn by female subjects.
4. Larger, Dominant Male: Interpretative assumptions about larger, dominant male figures
drawn by male subjects have included possible depression, self-inflation, and belittling attitudes
toward females. When drawn by female subjects, larger, dominant male figures have been
interpreted as self-depreciating.
 Item Interpretation
Placement
5. Top Placement: Top placement is associated with optimism. Other interpretations have
included a sense of being up in the air with no sound foundation; striving for unattainable goals;
seeking satisfaction in fantasy; aloofness; inaccessibility; and high aspirations, with a low energy
level and difficulty attaining goals.
6. Bottom Placement: Bottom placement has been associated with depression, insecurity,
inadequacy, and concrete thinking. Some clinicians have reported that bottom placement may
also reflect a calm and stable personality.
7. Left Placement: Left placement is related to uncertainty, apprehensiveness, and self-
orientation. An emotional focus and general concern with past events is suggested.
8. Right Placement: Right placement indicates orientation to the environment, as opposed to
self-orientation. Right placement has also been associated with orientation toward or concern
with future events, and it can be an indication of intellectualization and self-control as well as
stability.
 Item Interpretation
Spontaneity
9. Arms Folded: Arms are related to social adapta tion. Folded arms have been thought to reflect
suspiciousness, hostility, rejection of the world, and rigid impulse controls.
10. Arms Pressed to Body: Arms pressed to the body have been consistently associated with
impairment of spontaneity, and with rigidity and inhibition.
Children and Adolescents: In drawings by children or adolescents that show the figure's arms
pressed to the body, this characteristic has been associated with conflict between the self and the
environment.
11. Legs Pressed Together: Figures drawn with the legs pressed together have been associated
with sexual inhibition or sexual disturbance.
Children and Adolescents: This characteristic has been associated with personal and social
disturbance when found in the drawings of children or adolescents.
12. Hands Behind Back: Evasiveness has been asso ciated with the placement of the figure's
hands behind its back. However, artistic sophistication has also been suggested as an alternative
interpretation in some cases.
 Item Interpretation
Proportion
13. Gross Disproportion: Gross disproportion has been considered a sign of severe disturbance related to
very poor reality contact or an organic condition, such as that produced by alcoholism,
psychosis, or mental retardation.
14. Extreme Asymmetry: Severe anxiety and histrionic childishness have been reported as relating to extreme
asymmetry. Extreme asymmetry may also reflect a sense of body awkwardness, incoordination, general
physical inadequacy, confusion of lateral dominance or impulse disturbance.
15. Thin, Wasted, or Ribbonlike Arms: In drawings. of figures with thin, wasted, or ribbonlike arms, this feature
is attributed to feelings of futility and a lack of achievement. A frequent interpretation of arms depicted this
way is that they suggest physical or psychological vulnerability or o ganic conditions. The possibility of an
organic condition or of deterioration related to alcoholism should also be seriously considered in cases where
this drawing feature is present.
16. Thin, Wasted, or Ribbonlike Legs: Thin, wasted, or ribbonlike legs are often found in the same drawings in
which thin, wasted, or ribbonlike arms are drawn, and the same recommendation is made rule out organic
conditions. Legs drawn this way might be interpreted as an expression of decline or deficit, of involutional,
senile, or organic condition, or of deterioration related to alcoholism.
 Item Interpretation
Aesthetic Appearance
17. Stick Figure: The least extreme interpretations of stick figure drawings have included possible
agitated depression, evasiveness, rigidity, psychopathy, and insecur ty. However, stick figures are often
drawn by subjects with organic conditions or mental retardation. Individuals who draw stick figures
are frequently found to be experiencing severe cognitive impairment.
18. Blank Outline (Void of Features): Outlined figures with no facial features have been associated
with shallow emotionality, lack of insight, poor reasoning ability, psychosis, organic conditions, and
mental retardation. Blank figures are commonly drawn by subjects with major depression, manic-
phase psychosis, paranoid schizophrenia, organic mental disorders, and mental retardation. They are
also often drawn by subjects with the diagnosis of chronic, undifferentiated schizophrenia.
19. Primitive Appearance: Major disorders have been associated with primitive drawings. In particular,
hysterical conditions, regression, psychosis, mental retardation, and organicity are thought to be
suggested by such drawings. This drawing feature may also be interpreted as an indicator of
regression or of severe cognitive impairment.
 Item Interpretation
Aesthetic Appearance
20. Bizarre Drawing: Other than those observed in a college population, bizarre drawings have been
associated with psychosis or alienation. Bizarre drawings are very rarely drawn by non-college,
nonclinical adult individuals.
21. Bizarre Hair: There are no specific references to bizarre hair in the literature, although it is
assumed that the same references cited for bizarre drawings would apply. Bizarre hair was most
often drawn by those subjects in the HFDT standardization sample who had diagnoses of
schizophrenia, but also occasionally by patients with other diagnoses.
22. Disheveled Hair: Disheveled hair has been associated with sexual concerns, sexual impulsivity,
and thought disorder.
23. Teeth Showing: Most often, teeth have been considered a sign of oral or general
aggressiveness. In addition, sarcasm, superciliousness, and compensation for weakness have been
inferred from the presence of this drawing feature. Although the drawing of teeth is usually very
rare, it has been found in the drawings of subjects with a variety of diagnoses.
 Item Interpretation
Aesthetic Appearance
24. Spiked Fingers: Like teeth, spiked fingers have been associated with aggressiveness, but
without the assumption of oral involvement.
25. Petal-like Fingers: Poor manual skills, infantility and organic conditions have been associated
with petal-like fingers. Such fingers are found in the drawings of subjects across the spectrum of
diagnostic groups, and are often drawn by lower-functioning individuals.
26. Internal Organs Shown: Associated with somatic delusions and concern with internal pathology,
the drawing of internal organs is very rare and typically indicates extreme pathology. Individuals
with medical conditions may draw figures with internal organs shown.
27. Disconnected Body Parts: Disconnected parts have been seen as an indication of mental
deficiency or organicity.
28. Geometric Shapes for Body Parts: The traditional interpretation of drawings in which body
parts are depicted by geometric shapes is that this drawing feature indicates organic or severe
psychotic conditions. In the HFDT standardization sample, geometric shapes were drawn by
patients with a variety of psychiatric disorders, but primarily by patients with mental retardation.
 Item Interpretation
Aesthetic Appearance
29. Confused Profile/Full Face: Confused profile/full face drawings were found infrequently in the
HFDT standardization sample. Other researchers have observed such confusion of facial features in
drawings by individuals with organic or psychotic conditions.
30. Unequal Arms (Size or Length): Unequal arms are found frequently in the drawings of severely
impaired subjects, suggesting that unequal arms may be associated with the problems of spatial
orientation commonly experienced by individuals with organic conditions or cognitive
disorganization. Their presence in a drawing has been attributed to confusion of lateral dominance
and has also been associated with organicity.
 Item Interpretation
Line Quality
31. Light Lines: Light lines have been attributed to generalized anxiety and/or depression related to
feelings of inadequacy, insecurity, timidity, and poor self-concept.
32. Heavy Lines: Generally, heavy lines have been associated with an excited, apprehensive, or
tense emotional state with high energy output. They may also indicate mood volatility.
33. Reinforced Lines: Reinforced lines suggest defense mechanisms as protection from
depersonalization, conflict, and withdrawal-related fears. They also suggest feelings of extreme
vulnerability.
34. Tremulous Lines: Strongly suggestive of an organic-related condition often associated with
neuromuscular degeneration, tremulous lines have been found in the drawings of alcoholic subjects
with organic conditions. Schizoid individuals also sometimes produce drawings with tremulous lines.
35. Sketched: Sketched figures were scored most frequently for higher functioning and nonclinical
subjects in the HFDT standardization sample. Sketching has been associated with anxiety,
uncertainty, insecurity, timidity, meticulousness, and an inability to be definite. (Note: Item 35-A is
scored for sketched figures. When Item 35-A is not scored, Item 35-B is scored only for the
purpose of calculating the client's Distortion raw score.)
 Item Interpretation
36. Opposite Sex Drawn First: Drawing the opposite sex first has been
associated with either a very strong emo- tional attachment to a member
of the opposite gender, a sex- ual identity problem in males, or
aggressiveness in females. It occurs in drawings by individuals in all
diagnostic categories.
37. Genderless: Suggestive of a condition of cognitive and emotional
regression and may denote sexual conflicts or denial of sexual issues.
38. Effeminate Male Drawn by Male: Indicator of sexual maladjustment or
effeminate personality characteristics. Typical in male college students.
39. Masculine Female Drawn by Female: Identification with a strong male
figure or to limited heterosexual contacts.
 Item Interpretation
AGE:
40. Childlike: Childlike figures drawn by adults have been
associated with hysterical qualities, regressed states,
repression, fixed emotional states, and dependency.

41. Developmentally Indistinguishable: These figures

suggest withdrawn and regressed emotional states and/or
mental retardation.
 Item Interpretation
WAIST:
42. Waist Not Indicated: Figures lacking an indication of
the waist were primitive and drawn by regressed or
severely dysfunctional objects.

43. Elaborate Belt or Other Waist Emphasis: Waist

emphasis is viewed as the conversion of covert tension to
aesthetic interests or self-display, the expression of the
conflict in sexual drives.
 Item Interpretation
CLOTHING:
44. Partially Clothed: Figures that are partially clothed betray body
narcissism and self-absorbed fantasy as opposed to social
interaction.
45. Naked without Genitalia: Suggests graphmotor difficulties or
inattention to detail that may be associated with denial, sexual
conflict, and developmental delay.
46. Genitalia Shown or Strongly Indicated: Sexual overconcern or
maladjustment.
 Item Interpretation
EYES, EARS, and NOSE:
47. Pupils Omitted: Associated with immaturity, egocentricity,
regression, reluctance to accept visual stimuli, and guilt for
voyeuristic tendencies.

48. Large Ears: Deafness, possible hallucinations, and possible

reactions to criticism- from mild to paranoid reactions.

49. Nostrils Showing: Associated with aggressive tendencies or

excessive control of those tendencies. Asthmatic conditions
can also be associated.
 Item Interpretation
FEET
50. Long feet: Sexual aberrations, concern over male virility, security
needs, and strivings for independence.
51: Pointed feet: Instrument for attack. Sign of repressed hostility.
52. Boots on Feet: Need for autonomy and concern over sexual virility.
53. Bare feet on Clothed figure: Aggressive tendencies
54. Chicken feet: Typically drawn by severely cognitively impaired,
organically impaired alcohol abusers, and most frequently on mentally
retarded subjects.
 Item Interpretation
OMISSIONS
55. Head Omitted: Common drawings of subjects with organic conditions.
56. Hair Omitted: Feelings of sexual inadequacy.
57. Eyes Omitted: General ineffectiveness, voyeurism, and visual hallucinations.
58. Nose Omitted: Sexual implications are assumed; regressed, organic, and
mentally retarded subjects
59. Mouth Omitted: Asthmatic conditions, sadistic tendencies, and guilt relating
to oral aggression. Feelings of rejection, needs for attendtion, dependency
concerns, guilt feelings and depression.
 Item Interpretation
60. Neck Omitted: Intellect to excessive influences by the body drives, leaving subject with
insufficient impulse controls; Regression, mental deficiency
61. Shoulders Omitted: Inferiority feelings and organicity
62. Trunk Omitted: Regression, poor body image, mental retardation, rejection of physical
impulses, denial of body drives.
63. Arms Omitted: Severe guilt feelings, active withdrawal from other people, refusal to deal with
the outside world, depression, feelings of rejection, psychosis, mental retardation.
64. Hands Omitted: Lack of confidence and feelings of inadequacy
65. Fingers Omitted: Interpersonal inadequacy
66. Legs Omitted: Depression, withdrawal, dependency, constricted mobility
67. Feet Omitted: Sexual disturbance. depression, withdrawal, crippling lack of autonomy
 Item Interpretation
68. Shading (Aside from hair): Sign of anxiety; When used in three-dimensional quality, sign of
intelligence
69. Stereotyped (Clown, cowboy, hippie): Fantasy projections of self, with the self-projection being
either self-aggrandizing or self-depreciating.
70. Profile figure: Evasiveness, paranoia, and oppositional tendencies; Maturity, sophistication, and
intelligence
71. Profile Head on Front figure: Frustration, social uneasiness, possible guilt in social relations, and
dishonesty
72. Clenched fists: Belligerence, rebelliousness, hostility
73. Additional of Extraneous Objects: Sign of obsessive or narcissistic tendencies; can also be
interpreted as expansiveness or manic tendencies
74. Transparencies: Lapse in judgement, voyeuristic tendencies, or signify poor reality contact
 Interrater Reliability
Interrater reliability was assessed by two different studies. In
both studies, drawings were scored on the presence (item
score = 1) or absence (item score = 0) of each of the 74 clinical
items. Scores for the items were summed to obtain an
Impairment score, and then an assignment of Impairment level-
-mild, moderate, or severe--was made for each drawing.
Drawings with an impairment score of 6 or less were classified
as mild, drawings with an impairment score between 6 and 13
were classified as moderate, and drawings with an impairment
score of 13 or more were classified as severe.
Interrater Reliability
First study = 80 drawings; 10 from normal subjects, 10 from
random 7 clinical groups
Two inexperienced raters were asked to score the drawings
based on the instructions on the manual.
Scores were compared to scores given by psychologists
Item agreement 92% and 90%
Impairment level 86% and 65%
Cohen’s Kappa is .77 and .42
Substantial and Moderate agreement respectively
Interrater Reliability
Second study = 2 psychology classes; 28 graduate class
students, 42 undergraduate class students
Each student was asked to score one drawing with
instructions from the manual presented on a screen and
read aloud
Raters’ score were compared to scoring done by observing
psychologists
Item Agreements of 90% and 86%
impairment level agreement was 75% and tp%
Cohen’s Kappa of .57 and .23
 VALIDITY
Overall Impairment Score = Two Way Analysis of Covariance

Distortion and Simplification Scales = Analysis of the interim

correlations

Organic Factors Index

Discriminant Validity
 Thank
you and
God bless
us all! :3