Case Control Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Sep 22, 2016; 6(3): 329-338
Published online Sep 22, 2016. doi: 10.5498/wjp.v6.i3.329
Self-worth and psychological adjustment of obese children: An analysis through the Draw-A-Person
Giuseppe Scimeca, Amelia Alborghetti, Antonio Bruno, Giulia Maria Troili, Gianluca Pandolfo, Maria Rosaria Anna Muscatello, Rocco Antonio Zoccali
Giuseppe Scimeca, Antonio Bruno, Giulia Maria Troili, Gianluca Pandolfo, Maria Rosaria Anna Muscatello, Rocco Antonio Zoccali, Psychiatric Unit, Department of Biomedical, Dental Sciences and Morpho-functional Imaging, University of Messina, 98125 Messina, Italy
Amelia Alborghetti, “Don Carlo Gnocchi” Foundation, 00135 Rome, Italy
Author contributions: Scimeca G designed the study and contributed to the manuscript writing and final revision; Alborghetti A performed the majority of experiments and contributed to the writing of the manuscript; Bruno A performed data analysis and contributed to the writing of the manuscript; Troili GM contributed to the literature search and writing of the manuscript; Pandolfo G performed part of experiments and contributed to the writing of the manuscript; Muscatello MRA contributed to the literature search, manuscript writing, and final revision; Zoccali RA contributed to the study idea, manuscript writing and final revision of the article.
Institutional review board statement: The protocol has been approved by the ethics committee of the University of Messina and by the participating school districts.
Informed consent statement: All subjects and their parents provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no proprietary, financial, professional or other personal interest of any nature in any product, service or company.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonio Bruno, MD, PhD, Psychiatric Unit, Department of Biomedical, Dental Sciences and Morpho-functional Imaging, University of Messina, Via Consolare Valeria n. 1, 98125 Messina, Italy. antonio.bruno@unime.it
Telephone: +39-090-2212092 Fax: +39-090-695136
Received: March 31, 2016
Peer-review started: March 31, 2016
First decision: May 17, 2016
Revised: July 28, 2016
Accepted: August 17, 2016
Article in press: August 19, 2016
Published online: September 22, 2016
Processing time: 172 Days and 12.7 Hours
Abstract
AIM

To investigate psychopathological correlates of child obesity via the Draw-A-Person test (DAP).

METHODS

The participants were 50 children with a mean age of 9.74 years. Body mass index (BMI) was used as a measure of body fat. Children were divided into normal (n = 17), overweight (n = 14) and obese (n = 19). Two qualitative methods of scoring the DAP based on an integrative approach were used to assess self-concept (ESW) and overall level of children’s adjustment (EAC). A procedure for judging interpretative skills of clinicians was implemented before they evaluated children’s drawings.

RESULTS

As predicted by our hypothesis, BMI was negatively correlated with ESW, r (50) = -0.29, P < 0.05, but not with EAC, r (50) = - 0.08, P = ns. To evaluate the effect of gender, Pearson correlations were re-computed regrouping the sample accordingly: BMI and EAC reached a significant negative correlation in female subjects, r (24) = -0.36, P < 0.05, and a positive correlation in male subjects, r (26) = 0.37, P = < 0.05; negative correlation between BMI and ESW became stronger in females, r (24) = -0.51, P < 0.01 but not in males, whose correlation disappeared resulting not-significant, r (26) = -0.06, P = ns. No effect of age was found. Results indicate that obesity has a negative correlation exclusively on overall adjustment and self-concept in female children.

CONCLUSION

It was concluded that there is a negative bias toward females that reveals how the stigma of obesity is widespread in Western society.

Keywords: Obesity; Draw a person; Draw-A-Person test; Projective techniques; Psychopathology

Core tip: This study was executed to investigate psychopathological correlates of child obesity via the Draw-A-Person test (DAP). A new procedure for using the DAP was suggested. Results indicate that obesity has a negative correlation exclusively on overall adjustment and self-concept in female children. It is consequently concluded that there is a negative bias toward females that reveals how the stigma of obesity is widespread in Western society. The “intuitive reading” of figure drawings can be considered a valid tool of assessment, even though interpreters’ skills should always be assessed before executing each single studies in order to guarantee sound methodological praxis.