Haitian children’s resilience and vulnerability assessed with house–tree–person (HTP) drawings.

Abstract

House-Tree-Person (HTP) Test drawings by children (N ϭ 131; age range 6 -15) in Haiti were studied statistically to assess for resilience and vulnerability post-2010 Haiti earthquake. Consistent with ecological theory, item contents indicated that resilience was derived from systems of home life and familial relationships, reflections on self-other interactions, interpersonal relationships, and connectedness with the environment, and that vulnerability was derived from living without external systemic support, placing a child at risk for an intrapersonal life of negative representation of self, self-in-relation to others, and personal-social attitudes. A pilot qualitative study developed item criteria with themes of resilience and vulnerability. While exploratory analyses of the scoring system led to the formation of resilience (RES) and Vulnerability (VUL) items (31 items) that were scored as present or not present (1 or 0) in the sample's drawings. For the study, several raters scored the same participant's 3 drawings, which showed fair interrater reliability through ICCs, moderate Cronbach's alphas, and a strong negative correlation between RES and VUL. A multivariate regression analysis for RES and VUL showed differences by age and sex, as well as trends in RES and VUL across time for participant locations that were impacted differently by postearthquake conditions. Over 50% of participants had significantly different RES and VUL scores that were not due to measurement error, suggesting differential individual profiles. The majority had higher RES scores and a few had significantly higher VUL scores, showing that resilience was the cultural norm for Haitian children. It is recommended that vulnerable Haitian children would benefit from strength-based resilience counseling for trauma. An innovative study applied the controversial HTP tool in a way that has not been done before to assess Haitian children who are exposed to continuous trauma. The study is important by virtue of examining over time the applicability and scope of the nonverbal HTP test to assess for adaptation and maladaptation in a non-English speaking and socioculturally different community in the Caribbean.

Haitian Children’s Disaster Trauma: Validation of Pictorial Assessment of Resilience and Vulnerability

“…The international drawing studies have been clinical and interpretive in their approach, and their usefulness for clinicians needs recognition. The authors' present study, on the other hand, followed their previous study of the HTP test (Roysircar et al, 2017) with children from the same communities in Haiti, studied both adjustment and maladjustment of Haitian children, and statistically examined the HTP indices of Resilience and Vulnerability.…”

“…The scoring of the adapted HTP accounted for the impact of trauma on Haitian resilience and vulnerability (Roysircar et al, 2017). Two types of impact were expected, one positive and the other negative, on the basis of the literature on contextual trauma (APA, 2017;Clauss-Ehlers, 2008;Harvey, 2007;Roysircar, 2013a;Roysircar et al, 2013, Roysircar et al, 2017; the cultural strength of religion and/or spirituality in people of the African diaspora (Aten et al, 2014;O'Grady et al, 2012;Orton & O'Grady, 2016;Roysircar, 2013a;Schwartz, 2012;Thompson, 2018); ancestral trauma and resilience of Africans (Hargrow, 2013;Leary, 2005); Haitian mental health concerns (James, Noel, Favorite, & Jean, 2012;Nicolas, DeSilva, Grey, & Gonzalez-Eastep, 2006;Roysircar, 2013a;Roysircar et al, 2017); and the history of colonization, dictatorships, police brutality, and governmental neglect in Haiti (Farmer, 2004(Farmer, , 2011World Bank, 2014). Two of the authors (Roysircar and Thompson) are familiar with the Port-au-Prince surrounding areas damaged by the 2010 earthquake because of their mental health services in an NGO primary care clinic since the 2010 earthquake (Bowman & Roysircar, 2011;Roysircar, 2013a;Roysircar, Pignatiello, Lanza, & Irigoyen, 2015).…”

“…While trauma is a universal experience, the cultural context in which traumatic events unfold is an important consideration. People's interpretation of and response to trauma may be shaped by societal norms about individualism versus communalism, religion and spirituality, social roles, gender, class, race, age, and overarching cultural values (American Psychological Association [APA], 2017;Clauss-Ehlers, 2008;Roysircar, 2013a;Roysircar, Colvin, Afolayan, Thompson, & Robertson, 2017;Roysircar, Podkova, & Pignatiello, 2013). Resilience is one aspect of the child trauma response that refers to the "process, capacity or outcome of successful adaptation despite challenges or threatening circumstances .…”

Counseling Psychology and the Amelioration of Oppression: Translating Our Knowledge Into Action

“…These include governmental neglect, political persecution, unemployment and poverty, continuous contextual traumas (cf. Roysircar, Colvin, Afolayan, Thompson, & Robertson, 2017), subjugation of girls and women (cf. Horne, Maroney, Nel, Chaparro, & Manalastas, in press), disparities in power, social inequalities, and structural violence (Norsworthy & Buranajaroenkij, 2011), and war and conflict on both local and global scales.…”

Association of Synthetic House-Tree-Person Drawing Test and Depression in Cancer Patients

“…In 1979, Mikami [11] developed the S-HTP drawing test, of which characteristic is the house, tree, and person which are drawn on the same sheet of paper and assessed together in relation to each other. Currently, there are many types of research using S-HTP drawing test to assess psychological functioning such as children's resilience and vulnerability in Haitian [12] and anxiety in cancer patients [13]. However, studies on S-HTP drawing test and depression are rarely found in cancer patients.…”