460 J. E.

ORME

RESULTS the average schizophrenic seeking psychiatric

In the total group of 1131 patients, only 16 Ss
gave alphabetical reaponsea, namely 13 schizo-
hrenics 1 manic, 1neurotic and 1senile dement.
Fhree of 170 male schizophrenics, and 10 of 114
female schizophrenics gave alphabetical re-
s onsea. The corrected Chi Squares (all d. f. =
17 of alphabetical res onders were 24.46 for
schizo hrenics vs. all otgers ( p = .01), nonsignif-
icant for overall males vs. females, and 5.60 for
female schizophrenics vs. male schizophrenics
(p = ,05).
Takmg Vocabulary as the most stable measure
of intellectual level, the 16 a1 habetical respond-
ers were compared with 16 & matched for age,
sex and diagnosis. Using the Mill Hill Vocabu-
lary Scale and its scoring grades(*), the alpha-
betical group were significantly more intelligent
(2with 1df was 5.64, p = .05). This is probably
related to the further finding that they were
more responsive, giving a range from 16-102, as
opposed to the matched groups 7-53. A com-
bmed median test gives a corrected r2 (d. f. 1) of
10.12 ( p = 0.01).
Nine of the responders were in the 31-40 age
group, 4 being older. They are clearly older than
help. Five of the 13 schizophrenics were diag-
nosed paranoid schizophrenia.
CONCLUSIONS
This study therefore c o n k the rarity of the
alphabetical r onse, even in severe pathology,
and its virt8 restriction to schizophrenia.
Schizo hrenics who give alphabetical res OD-
are olfer, more responsive and more integgent.
Possibly the alphabetical response plays a role in
Rorschach performance analogous to that of
paranoid ideation in behavior, both being an at-
tempted defense a ainst ego threatening forces.
No obvious rationafe presents itaelf to explain the
increased incidence in female schizophrenics.
REFERENCES
1. O m , J. E. The Rorschach sex res onse in a
psychiatric population. J. din. ~SycRol.,
1962,
18, 303.
2. PHI LIPS^ L. and Smm, J. G. Rorschach
interpretation: advanced technique. New York:
Grune and Stratton, 1953.
3. RAVEN,J. C. The Mill Hill Vocabulary
Scale. Revised edition, London: H. K. Lewis,
1958.

T H E RELATIONSHIP BETWEEN KNEE AND ARM JOINTS ON

HUMAN FIGURE DRAWINGS AND PARANOID TRENDS
ROBERT W. WILDMAN
Milkdgeville (Ga.) Stute Hospital
PROBLEM
Some years ago a colleague’ pointed out that there was a connection between
paranoid symptomatology and the drawing in of joints on arms and legs on human
figure drawings. Buck(’) states that emphasis upon knees suggests the presence of
homosexual tendencies. Over a period of time, this investigator was impressed with
the frequent connection between these two variables. This study was designed to
determine the validity of this hypothesis.
METHOD
Files on patients in the psychology department were consulted and 30 patients
were selected who had completed the H T P and who had drawn knee or arm joints
on the figure drawings. Thirty additional patients were selected from the files who
had completed the HTP and who had not drawn joints on the figure drawings. It
was concluded that joints had been drawn if there was a circle or line in the knee or
arm area.
The folder on each patient was then obtained from the record room. These
records typically contain a social history, mental exams, medical data, etc. A psy-
chology technician went through each folder thoroughly and jotted down every
statement about the patient that indicated paranoid trends. Examples: “Sus-
picious, jealous, says wife tried to poison food, turned against others, people throw
atomic powder out of car at him, Indians poisoned him while fishing on Chatta-
hoochee, some one dopes him up all the time, etc.”
Four psychologists were asked to rate each one of the patients from the des-
criptive comments concerning paranoid trends and to rate them one, three, or five
‘James B. Morris,Anclote Manor, Tarpon Springs, Florida.
RELATIONSHIP BETWEEN K N E E AND ARM JOINTS ON H U M A N FIGURE DRAWINGS 461

depending upon the amount of paranoid pathology present. A patient was given a
score of 1 if little or no paranoid symptomatology existed, and 3 if moderate, and
5 if very high. Because of unreliability of psychiatric diagnoses, it was decided to
use descriptive statements about the patients derived from the case history.
RESULTS
The reliability of ratings between judges was .80 or 73.00% agreement. The
experimental group (joints on drawings) and the control group (no joints on draw-
ings) each had seven patients out of the 60 with a moderate degree of paranoid
symptomatology. This classification was excluded and the two extremes, high and
low, were emphasized in tabulating the results. The experimental group had 16
patients that were rated high on paranoid tendencies and the control group only 8.
The experimental group had 7 rated low in paranoid pathology and the control
group 15. The Chi square derived from this data was significant beyond the .025
level.
DISCUSSION
It is apparent that patients who have a high degree of paranoid symtomatology
draw joints on the figure drawings twice as often as those who do not have prominent
paranoid tendencies. The drawing of joints cannot be considered pathognomonic be-
cause it does not always occur among patients with paranoid trends. It is a significant
sign, when present, and perhaps it is even more significant than this data would
indicate because some of the patients who drew joints and were not described as
being very paranoid, might have been evasive and hiding some of their true symp-
tomatology or were in a pre-paranoid stage.
It is a good clinical sign to note, but it is difficult to explain why this con-
nection exists. Perhaps, people who are paranoid are generally sensitive about them-
selves and others and this generalizes to the body image and therefore accounts for a
greater amount of anatomical detail. The compulsiveness, rigidity, and higher in-
telligence in the paranoid may also account for a strong tendency not to leave the
finer parts of the drawing out. Possibly, the anticipated aggressiveness of others
might cause an individual to be particularly aware of how arms and legs can react
violently by way of swinging upon a joint. Of course, all this is strictly speculation.
There are probably several other variables on human figure drawings that indicate
paranoid trends also. It is likely that by combining three or four signs (profile, etc.)
that perhaps a large percentage of paranoids would be disclosed by these indicators
alone.
SUMMARY
I t was hypothesized that there was a strong connection between paranoid
tendencies and the drawing of joints on human figure drawings. Thirty patients who
had drawn joints on the HTP were selected for the experimental group and thirty
who had not drawn joints were selected for the control group. Descriptive phrases
about the patients found in the case history were used to determine the actual
degree of paranoid pathology. Four staff psychologists rated this material as low,
medium, or high. The reliability between judges was .80 or an agreement of 73 per-
cent.
More than twice as many patients who had drawn joints were rated as being
high in paranoid trends as those who were rated low. In the control group, almost
twice as many patients were rated low in paranoid trends as compared to high. The
Chi square derived from the data was significant beyond the .025 level. Ahhough
this indicator is not pathognomonic, when found it is highly suggestive of paranoid
trends and worth investigating. Hypotheses were given as to why this connection is
found, but the real reasons are not known.
REFERENCES
1. JOLLES I. A catalogue for the Qualitative interpretation for the H-T-P. Beverly Bib, Calif.:
Weatern hychological Servicea, 1952.