February 10. 2010 DDS

Here are my ideas about the article I just read about the DDS, or Diagnotstic Drawing Series by Fowler, J.P., and Ardon. It's calleid Diagnostic Drawing Series and Dissociative Disorders: A Dutch Study.

The DDS is one of the most widely researched diagnostic instruments available to Art Therapists.

The DDS

is not based on an interpretation of the content of

drawings but on an empirical correlation between

graphic characteristics and psychopathology." Fowler, J.P. & Arlen, 2002)

That's an important thing to know for those who do not know much about art therapy.

This study was done in several dutch mental health clinincs, using patients diagnosed with DED or DDNPS, or others described as having dissassociative symptoms.

Administering the DDS on admittance to the

clinic, we observed that patients with DID or DDNOS

were producing drawings with a very similar graphic

profile to the profile described in American studies

(

Mills & Cohen, 1993

) and different to the profiles

of patients with other disorders. The allocation of patients

to a graphic profile is based on which graphic

characteristics are found in the individual drawings

in a series and on differences between the three

drawings in a series. This is a clinical decision based

on research findings, training, and individual rater’s

experience ." (Fowler, J.P. & Arlen, 2002)

Three major research questions were brought about because of the reliability and validity were found to be rather unsure.

Also used in this study was the SCID-D during an interview portion of the study.

The DDS requires that patients produce three drawings out of standardized materials. A rating guide and drawing analysis forms are used to rate the drawings. Note that

Rating the different items is only the first phase in

deciding in which graphic profile an individual DDS

should be placed. A fairly complex decision process is

then used to eliminate membership of various known

graphic profiles by comparing both the ratings of the

individual drawings, and the differences between the

three drawings in a series, with what is expected from

the graphic profile. (Fowler, J.P. &Arlen 2002)

The results were than on average there is an agreement of 82.7% among 3 raters across 23 DAF items.

The agreement between the Multiple Correspondence

Analysis categorization and the clinical

diagnosis was actually better than the agreement obtained

by the two least experienced raters" (Fowler, J.P. & Arlen, 2002)

Inter-rater reliability here is found to be insufficient, as things are seen differently by different people. Also some rate intuitively, which does not work as well in an empiracal study.

This was a very interesting article in pointing outhe discrepencies betw een raters. It is nice to know that there is a correspondence between art therapy and the DDS in helping to find a diagnosis for a dissociative disorder.