Self-figure drawings in women with anorexia; bulimia; overweight; and normal weight: A possible tool for assessment

Eating disorders (ED) are an increasing problem in children and young adolescents. This paper examines the use of self-figure drawing in the assessment of eating disorders. We combined the use of self-figure drawing as a short and non-intrusive tool with the administration of previously validated questionnaires (EAT-26 and the BSQ). Seventy-six women (thirty-six were diagnosed as having eating disorders according to DSM-IV criteria, either anorexia nervosa or bulimia nervosa, 20 were overweight, 20 had no eating disorders and were of normal weight) were recruited for this study. Objective and quantifiable methods of assessment in analysis of the self-figure drawing were used. The results indicated that self-figure drawing scores were clearly differentiated among groups. The results also indicated significantly high correlation between the self-figure drawing and the two validated psychometric assessments of eating disorders. The findings’ implications and possible interpretations are discussed. Findings indicate that using self-figure drawing as a tool to assess ED or a tendency to develop ED would be valuable for practitioners.

Research highlights▶ The current study investigated whether ED manifests in self-figure drawings of outpatient women diagnosed with AN or BN. As hypothesized, positive correlations were found between the psychometric assessments and four indicators in the DAP test. ▶ Indicators of the DAP test were found to differentiate particularly between those who met (anorexia and bulimia) vs. those who did not meet the (overweight and normal) criteria of ED. ▶ Self-report instruments are often used to verify the ED diagnosis in patients already under observation for ED. Completing these self-report questionnaires requires the patient's cooperation at a period when he or she often attempts to conceal the eating problem. Our goal is to examine whether the Draw-A-Person (DAP) test developed by Machover (1949) might serves as an effective screening tool in assisting practitioners in detecting young adult women at risk for ED but not yet diagnosed and not yet undergoing an ED specific evaluation. ▶ In this paper we applied objective and quantifiable methods of assessment in analysis of the self-figure drawing. We found that using very strict criteria on specific indicators enhance inter raters’ reliability. This finding suggests that the reliability score reported in previous studies had less or nothing to do with the specific illustrations of the indicators which led to more subjectivity. ▶ Our findings suggest that using the self-figure drawing as a tool to assess ED or a tendency to develop an ED would be valuable for practitioners in general and art therapists, in particular.