DRAW-A-PERSON AND KINETIC FAMILY DRAWING 367 Table DSM-III-R Diagnoses by Clinical Group Mood disorders Anxiety disorders Mood and anxiety disorders Dysthymic xiety disorder(1) Anxiety disorder paration anxiety (2 anxiety (2) ysthy mic disorder/overanxious disorder/separation anxiety () separation anxiety(I) Overanxious disorder/dysthymic disorder(I Overanxious disorder/depressive disorder N.O.S. (1) Overanxiousdisorder/separation anxiety/depressive disorder NOS(3) Note, Numbers in parentheses indicate the number of cases of the disorder in the clinical group. DSM- III-R= Diagnostic and Statistical Manualof Mental Disorders(3rded, rev American Psychiatric Assoc tion, 1987); N.O.S. not otherwise specifi of children who participated in a larger school-based study of child- was devised by Reynolds and Richmond 1985)and is a 37-item self-re- hood depression and anxiety. The majority (86%)were white, 6% were port measure designed to assess the level and nature of anxiety in Black, 4% were Hispanic, and 3% were from other racial groups. All of children and adolescents from 6 to 19 years of age. The choices are Yes the children were in regular education. They ranged in age from 9 to and No, with Yes indicating that a statement is descriptive of the childs 1444 years old, with an overall mean age of 1 14 years. through tl feelings or actions. the yes responses are sun procedures described below, children were included as part of the clin- score. High scores indicate a high level of anxiety. The RCMAS is ical sample if they received a DSM-11l-R diagnosis based on the K- reported to have high internal consistency (=77-88)across a variety SADS interview of a mood disorder(n=12; 9 girls and 3 boys), anxiety of ages and populations and adequate test-retest reliability (ru=68) disorder(n=11; 10 girls and 1 boy), or mood and anxiety disorder over a 9-month period( Reynolds richmond 1985). s), and completed all est(S Schedule for Affective Disorders and Schizophrenia for School-Age not included due to their absence on the day the drawings were col- hildren(K-SADS). This interview schedule appropriate for clinical lected). Specific DSM-III-R diagnoses are indicated by group in Ta- or research assessments, was developed by Puig-Antich& Ryan(1986) ble 1. The process of assigning diagnoses and resulting reliability data This is a semistructured interview that measures depression as well asa are presented under Procedures. For the control group, 13 children(9 number of additional DSM-III(American Psychiatric Association, girls and 4 boys)were selected who had completed all measures of 1980)and DSM-III-R diagnostic categories. The K-SADS can be interest, did not receive a DSM-III-R diagnosis or elevated scores on used with children ages 6 to 16 and yields a rating of the presence, he screening measures, and reported little sy mptomatology on the absence, and severity of symptomatology. The mood and anxiety dis- K-SADS. Mean scores by group on all measures used to screen the orders sections of the Present Episode format of the fourth edition of Revised Children's Manifest Anxiety Scale(RCMAS), and the Sched- demonstrated high diagnostic reliability for mood (Ambrosini, Metz, ule for Affective Disorders and Schizophrenia for School-Age Children Prabucki, Lee, 1989: Kendall, Stark, Adam, 1990; Last& Strauss, 1990; Mitchell, McCauley, Burke, Calderon, Schloredt, 1989)and anxiety(Last Strauss, 1990)disorders. In addition, sufficient inter nal consistency(Ambrosini et al 1989)and test-retest reliabil (Apter, Orvaschel, Laseg, Moses, Tyano, 1989) have been reported Childrens Depression Inventory (CDI). This inventory was devel- Ambrosini and colleagues conclude that the achievement of high diag oped by Kovacs(1983)on the basis of the Beck Depression Inventory nostic, scale, and symptom reliability support the K-SADS as a rel monly used self-report measure of depression for children 7-17 years Coopersmith Self-Esteem Inventory(CSEI). This inventory was de- of age. The CDI consists of 27 items designed to assess the presence veloped by Coopersmith and measures an individual's personalevalua and severity of the overt symptoms of depression over the 2 weeks prior tion of self-worth Form B(Coopersmith, 1975)includes 25 short state to the assessment. a three-alternative choice format is used. the ments of both a positive and negative valence that the child rates as like hoices are scored from 0-2, with total scores of 19 or greater consid- me or unlike me. The items are keyed so that a high score reflects red to be indicative of a significant level of depression(Kovacs, 1983). positive self-esteem. The CSEI Form B has demonstrated adequate The CDi is reported to have high internal consistency with normal( test-retest and internal consistency reliability (.-81; Reynolds, an- 94)and emotionally disturbed (= 80)fifth-and sixth-grade students denson, Bartell, 1985). Saylor, Finch, Spirito, Bennett, 1984). In addition, acceptable test- Self-Report Measure of Family Functioning(SRMFF). This inven retest reliability (u=.77)over a 3-week period has been reported tory was developed by Bloom(1985 ) It consists of 75 items that were (Smucker, Craighead, Craighead, Green, 1986) selected from the Family Environment Scale(Moos Moos, 198 1) Revised childrens Manifest Anxiety Scale(RCMAS). This inventory Family-Concept Q-Sort(Van Der Veen, 1965), Family AdaptabilityDRAW-A-PERSON AND KINETIC FAMILY DRAWING 367 Table 1 DSM-III-R Diagnoses by Clinical Group Mood disorders (n=12) Anxiety disorders Mood and anxiety disorders (n=16) Major depression (3) Dysthymic disorder (4) Depressive disorder N.O.S. (5) Generalized anxiety disorder (1) Anxiety disorder N.O.S. (10) Major depression/overanxious disorder (3) Dysthymic disorder/generalized anxiety disorder (1) Depressive disorder N.O.S./separation anxiety (2) Depressive disorder N.O.S./anxiety disorder N.O.S. (1) Major depression/overanxious disorder/separation anxiety (2) Dysthymic disorder/overanxious disorder/separation anxiety (1) Dysthymic disorder/generalized anxiety disorder/ separation anxiety (1) Overanxious disorder/dysthymic disorder (1) Overanxious disorder/depressive disorder N.O.S. (1) Overanxiousdisorder/separationanxiety/depressive disorder N.O.S. (3) Note. Numbers in parentheses indicate the number of cases of the disorder in the clinical group. DSM￾III-R = Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Associa￾tion, 1987); N.O.S. = not otherwise specified. of children who participated in a larger school-based study of child￾hood depression and anxiety. The majority (86%) were White, 6% were Black, 4% were Hispanic, and 3% were from other racial groups. All of the children were in regular education. They ranged in age from 9'/2 to 14V4 years old, with an overall mean age of 1 PA years. Through the procedures described below, children were included as part of the clin￾ical sample if they received a DSM-III-R diagnosis based on the K￾SADS interview of a mood disorder (n = 12; 9 girls and 3 boys), anxiety disorder (n = 11; 10 girls and 1 boy), or mood and anxiety disorder (n = 16; 13 girls and 3 boys), and completed all measures of interest (5 were not included due to their absence on the day the drawings were col￾lected). Specific DSM-III-R diagnoses are indicated by group in Ta￾ble 1. The process of assigning diagnoses and resulting reliability data are presented under Procedures. For the control group, 13 children (9 girls and 4 boys) were selected who had completed all measures of interest, did not receive a DSM-III-R diagnosis or elevated scores on the screening measures, and reported little symptomatology on the K-SADS. Mean scores by group on all measures used to screen the participants, that is, the Children's Depression Inventory (GDI), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Sched￾ule for Affective Disorders and Schizophrenia for School-Age Children (KSADS), described below) are reported in Table 2. Instrumentation Children's Depression Inventory (CDI). This inventory was devel￾oped by Kovacs (1983) on the basis of the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961). It is the most com￾monly used self-report measure of depression for children 7-17 years of age. The CDI consists of 27 items designed to assess the presence and severity of the overt symptoms of depression over the 2 weeks prior to the assessment. A three-alternative choice format is used. The choices are scored from 0-2, with total scores of 19 or greater consid￾ered to be indicative of a significant level of depression (Kovacs, 1983). The CDI is reported to have high internal consistency with normal (ra = .94) and emotionally disturbed (/•„ = .80) fifth- and sixth-grade students (Saylor, Finch, Spirito, & Bennett, 1984). In addition, acceptable test￾retest reliability (ru = .77) over a 3-week period has been reported (Smucker, Craighead, Craighead, & Green, 1986). Revised Children's Manifest Anxiety Scale (RCMAS). This inventory was devised by Reynolds and Richmond (1985) and is a 37-item self-re￾port measure designed to assess the level and nature of anxiety in children and adolescents from 6 to 19 years of age. The choices are Yes and No, with Yes indicating that a statement is descriptive of the child's feelings or actions. The Yes responses are summed for a total anxiety score. High scores indicate a high level of anxiety. The RCMAS is reported to have high internal consistency (ra = J7-.88) across a variety of ages and populations and adequate test-retest reliability (rtl = .68) over a 9-month period (Reynolds & Richmond, 1985). Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This interview schedule, appropriate for clinical or research assessments, was developed by Puig-Antich & Ryan (1986). This is a semistructured interview that measures depression as well as a number of additional DSM-III (American Psychiatric Association, 1980) and DSM-III-R diagnostic categories. The K-SADS can be used with children ages 6 to 16 and yields a rating of the presence, absence, and severity of symptomatology. The mood and anxiety dis￾orders sections of the Present Episode format of the fourth edition of the interview were used in the current investigation. The K-SADS has demonstrated high diagnostic reliability for mood (Ambrosini, Metz, Prabucki, & Lee, 1989; Kendall, Stark, & Adam, 1990; Last & Strauss, 1990; Mitchell, McCauley, Burke, Calderon, & Schloredt, 1989) and anxiety (Last & Strauss, 1990) disorders. In addition, sufficient inter￾nal consistency (Ambrosini et al., 1989) and test-retest reliability (Apter, Orvaschel, Laseg, Moses, & Tyano, 1989) have been reported. Ambrosini and colleagues conclude that the achievement of high diag￾nostic, scale, and symptom reliability support the K-SADS as a reli￾able diagnostic tool for use with children. Coopersmith Self-Esteem Inventory (CSEI). This inventory was de￾veloped by Coopersmith and measures an individual's personal evalua￾tion of self-worth. Form B (Coopersmith, 1975) includes 25 short state￾ments of both a positive and negative valence that the child rates as like me or unlike me. The items are keyed so that a high score reflects positive self-esteem. The CSEI Form B has demonstrated adequate test-retest and internal consistency reliability (ra = .81; Reynolds, An￾derson, & Bartell, 1985). Self-Report Measure of Family Functioning (SRMFF). This inven￾tory was developed by Bloom (1985). It consists of 75 items that were selected from the Family Environment Scale (Moos & Moos, 1981), Family-Concept Q-Sort (Van Der Veen, 1965), Family Adaptability