Purpose

1. The Development of a Computerized Scoring System for Kinetic House-Tree-Person Drawing Test 1Ay-Woan Pan, 2 Tsyr-Jang Chen, 3 Chih-Ying Li, 3 Yun-Ling Chen 1National Taiwan University, Department of Occupational Therapy; National Taiwan University Hospital, Department of Psychiatry; Fu-Jen University, Department of Occupational Therapy 2LungHwa University of Science and Technology, Department of Mechanical Engineering 3National Taiwan University, Department of Occupational Therapy Purpose Kinetic-House-Tree-Persondrawing test (KHTP) was used frequently by occupational therapists who work in mental health area in the past and today in Taiwan. However, KHTP was criticized of its lack of psychometric qualities and theoretical basis and became a controversial issue in clinical application. The purpose of thisstudy is to develop a scoring system for KHTP and conduct preliminary study of psychometric qualities of KHTP. Table 2. Demography of the Clients Table 1. 35 Items of Depression and Anxiety Table 4. Rasch Measure of 35 Items Methods We identified a group of depression and anxiety characteristics based on literature review and manual for 35 items(Table1). Each item was scored if certain characterizes was displayed (score of 1).Score of 35 means a greatest degree of depression and anxiety of the drawer. The scoring system was programmed into the computer using VB software (Figure1). 165 subjects (mean age=20.3, SD=2.5) were instructed to draw a KHTP, and completed assessment of BAI, BDI-II, WHOQOL-BREF, NTUHSC, BHS (Table2). 44 subjects completed KHTP again 2 weeks later. Two raters scored all drawings blinded. Rasch analysis was used to analyze if 35 items fit the model. Concurrent validity was tested comparing score of KHTP with BDI, BAI, NTUHSC, BHS and WHOQOL. Table 3. Kappa Value of Test-retest Results The results showed that the Cronbach α of the scale is .90. Thirty-eight percent of the kappa value of the test retest reliability of the scale exceeds .40(Table3). The inter-rater reliability, however, were lower than expected as ICC=.57. All 35 items fit the Rasch measurement model well representing a continuum of degree of depression or anxiety(Table4). The Spearman correlation coefficients of the KHTP with BDI-II. BAI, BHS, WHOQOL, and NTUHSC were significant(Table5). Table 5. Spearman Correlation Coefficients Discussion This study demonstrated that the KHTP quantitative scoring system had acceptable construct validity and internal consistency. We suggested that KHTP and the scoring system can be applied in those people who are difficult to be interviewed or unwilling to express verbally. In the future, it can be applied in patients with mental illness for different age group to examine its applicability and predictive validity. Figure1. Computerized Scoring System Example 1. Discontinuous Lines & Texture (Item 2) Example 2. Thin Trunk of the Tree (Item 34) Example 3. Obvious Reticular Roof (Item 27) Acknowledgement The study was supported and funded by National Science Council of Taiwan (NSC 95-2516-S-002-007) & Department of Health (DOH-TD-M-113-047)