{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:30:18Z","timestamp":1792524618641,"version":"4.5.0"},"reference-count":78,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Reality shows us that situations of mistreatment and sexual abuse in childhood are still seldom visible, despite their high prevalence around the world. It is essential to detect and address them, especially among children in situations of dire risk or neglect. The purpose of this study is to determine if graphic emotional indicators are expressed in the drawings of the projective Draw-a-Person (D.A.P) test, made by children in situations of dire risk or neglect. The sample is made up of 34 children, between the ages of 5 and 11 (17 girls and 17 boys), attended by Specialised Child and Adolescent Care Services of the Barcelona Town Hall (Spain). The drawings were coded quantitatively. The results indicated that most of the drawings show a frequency of graphic emotional indicators, as well as graphic indicators common to experiences of mistreatment and\/or abuse, which confirm the existence of emotional problems. However, no significant differences based on gender and age were found, except for one indicator of sexual abuse (body omitted\/distorted), which is significantly more common in the boys. Results also revealed that the drawings of human figure enable the children to express their experiences of traumatic situations which are difficult to verbalize. These findings have important implications for professionals, as the use of this projective technique can help to early identification and design treatment strategies in situations of mistreatment and\/or abuse in children and their families.<\/jats:p>","DOI":"10.3389\/fpsyg.2023.1002864","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T15:51:11Z","timestamp":1677081071000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Children\u2019s drawings as a projective tool to explore and prevent experiences of mistreatment and\/or sexual abuse"],"prefix":"10.3389","volume":"14","author":[{"given":"Elisabeth","family":"Ball\u00fas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma Carmen","family":"Comelles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma Teresa","family":"Pasto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Benedico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1177\/1524838012440339","article-title":"Can projective drawings detect if a child experienced sexual or physical abuse? A systematic review of the controlled research","volume":"13","author":"Allen","year":"2012","journal-title":"Trauma Violence Abuse"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"114","DOI":"10.3389\/fpsyg.2020.562972","article-title":"Dissociation as depicted in the traumatic event drawings of child sexual abuse survivors: A preliminary study","volume":"34","author":"Amir","year":"2007","journal-title":"Arts Psychother."},{"key":"ref4","volume-title":"Evaluaci\u00f3n en psicolog\u00eda cl\u00ednica II","author":"Avila","year":"1997"},{"key":"ref5","first-page":"69","article-title":"Adopci\u00f3n y t\u00e9cnicas proyectivas: estudio comparativo con el test del dibujo del animal (LADS)","volume":"35","author":"Ball\u00fas","year":"2020","journal-title":"Revista de psicopatolog\u00eda y Salud Mental del ni\u00f1o y adolescente"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1177\/0020872819878484","article-title":"Attachment representations in international adolescent adoptees in Spain, over eight to seventeen years of placement","volume":"62","author":"Ball\u00fas","year":"","journal-title":"Int. Soc. Work."},{"key":"ref7","first-page":"48","article-title":"Test del Dibujo de un Animal, evaluaci\u00f3n normativa: distribuci\u00f3n de frecuencias","volume":"27","author":"Barbosa","year":"2014","journal-title":"Revista de la Sociedad Espa\u00f1ola del Rorschach y M\u00e9todos Proyectivos"},{"key":"ref01","first-page":"57","article-title":"Test del Dibujo de un Animal, evaluaci\u00f3n formal: distribuci\u00f3n de Variables expresivas","volume":"28","author":"Barbosa","year":"2015","journal-title":"Revista de la Sociedad Espa\u00f1ola del Rorschach y M\u00e9todos Proyectivos"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1027\/1192-5604\/a000113","article-title":"Attachment picture story (APS): adaptation and validation of the projective Patte noire test to evaluate attachment in adolescence","volume":"40","author":"Ball\u00fas","year":"","journal-title":"Rosrschachiana"},{"key":"ref9","first-page":"8","article-title":"Estudio exploratorio de dibujos de ni\u00f1os en duelo","volume":"14","author":"Ball\u00fas","year":"2007","journal-title":"Medicina Paliativa"},{"key":"ref10","volume-title":"Entrevista Apego Adulto","year":"2010"},{"key":"ref11","volume-title":"Test de apercepci\u00f3n infantil (CAT)","author":"Bellak","year":"1979"},{"key":"ref12","volume-title":"CUIDA. Cuestionario para la Evaluaci\u00f3n de Adoptantes, Cuidadores, Tutores y Mediadores","author":"Bermejo","year":"2014"},{"key":"ref14","volume-title":"Manual y gu\u00eda de interpretaci\u00f3n de la t\u00e9cnica de dibujo proyectivo","author":"Buck","year":"1995"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1177\/1359104502007002006","article-title":"Attention deficit hyperactivity disorder is associated with attachment insecurity","volume":"7","author":"Clarke","year":"2002","journal-title":"Clin. Child Psychol. Psychiatry"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/s0197-4556(99)00013-1","article-title":"Draw and tell: drawings within the context of child sexual abuse investigations","volume":"26","author":"Cohen-Liebman","year":"1999","journal-title":"Arts Psychother."},{"key":"ref17","volume-title":"Abuso y maltrato infantil. Indicadores en \u201cPersona bajo la lluvia\u201d","author":"Colombo","year":"2004"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1080\/10538712.2015.1057666","article-title":"Body-related emotions in posttraumatic stress disorder following childhood sexual abuse","volume":"24","author":"Dyer","year":"2015","journal-title":"J. Child Sex. Abus."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1111\/j.1540-4560.2006.00487.x","article-title":"Ethnicity, culture, and child maltreatment","volume":"62","author":"Elliott","year":"2006","journal-title":"J. Soc. Issues"},{"key":"ref20","doi-asserted-by":"crossref","DOI":"10.4135\/9781452229201","volume-title":"Understanding and assessing child sexual maltreatment","author":"Faller","year":"2003"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"34","DOI":"10.3390\/socsci4010034","article-title":"Forty years of forensic interviewing of children suspected of sexual abuse, 1974\u20132014: historical benchmarks","volume":"4","author":"Faller","year":"2014","journal-title":"Soc. Sci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"104285","DOI":"10.1016\/j.chiabu.2019.104285","article-title":"The child sexual abuse disclosure controversy: new perspectives on an abiding problem","volume":"99","author":"Faller","year":"2020","journal-title":"Child Abuse Negl."},{"key":"ref23","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1080\/00223980.1939.9917671","article-title":"Projective methods for the study of personality","volume":"8","author":"Frank","year":"1939","journal-title":"J. Psychol."},{"key":"ref24","volume-title":"Interacci\u00f3n y proyecto familiar: evaluaci\u00f3n individual, di\u00e1dica y grupal por medio del test de la familia kin\u00e9tica actual y prospectiva","author":"Frank de Verthelyi","year":"1985"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s40653-017-0182-8","article-title":"Does the type of abuse matter? Study on the quality of child attachment narratives in a sample of abused children","volume":"11","author":"Fresno","year":"2018","journal-title":"J. Child Adol. Trauma"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1080\/07421656.2018.1459103","article-title":"Adolescents\u2019 rejection sensitivity as manifested in their self-drawings","volume":"35","author":"Goldner","year":"2018","journal-title":"Art Ther."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"101877","DOI":"10.1016\/j.aip.2021.101877","article-title":"Fragmentation of the self: characteristics of sexual assault and implications in self-drawing","volume":"77","author":"Goldner","year":"2021","journal-title":"Arts Psychother."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"562972","DOI":"10.3389\/fpsyg.2020.562972","article-title":"Perceptions of child abuse as manifested in drawings and narratives by children and adolescents","volume":"11","author":"Goldner","year":"2021","journal-title":"Front. Psychol."},{"key":"ref29","volume-title":"Test proyectivos gr\u00e1ficos","author":"Hammer","year":"1978"},{"key":"ref30","doi-asserted-by":"crossref","DOI":"10.4324\/9780203110171","volume-title":"Drawings in assessment and psychotherapy: Research and applications","author":"Handler","year":"2013"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1177\/1079063219858144","article-title":"Child sexual abuse in organizational settings: A research framework to advance policy and practice","volume":"31","author":"Harris","year":"2019","journal-title":"Sex. Abus."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.aip.2012.11.003","article-title":"Self-mutilation as expressed in self-figure drawings in adolescent sexual abuse survivors","volume":"40","author":"Jacobs-Kayam","year":"2013","journal-title":"Arts Psychother."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1016\/j.chiabu.2014.01.003","article-title":"The effect of drawing on children\u2019s experiences of investigations following alleged child abuse","volume":"38","author":"Katz","year":"2014","journal-title":"Child Abuse Negl."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1001\/archpsyc.57.10.953","article-title":"Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis","volume":"57","author":"Kendler","year":"2000","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1016\/S0272-7358(99)00022-7","article-title":"Racial, ethnic, and cultural factors of childhood sexual abuse: A selected review of the literature","volume":"20","author":"Kenny","year":"2000","journal-title":"Clin. Psychol. Rev."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1080\/15325024.2018.1549191","article-title":"Sexual abuse detection through drawing workshop: e-learning contribution","volume":"24","author":"Kissos","year":"2019","journal-title":"J. Loss Trauma"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"104755","DOI":"10.1016\/j.chiabu.2020.104755","article-title":"Can artificial intelligence achieve human-level performance? A pilot study of childhood sexual abuse detection in self-figure drawings","volume":"109","author":"Kissos","year":"2020","journal-title":"Child Abuse Negl."},{"key":"ref38","volume-title":"El dibujo de la figura humana en ni\u00f1os: evaluaci\u00f3n psicol\u00f3gica","author":"Koppitz","year":"1968"},{"key":"ref39","year":""},{"key":"ref40","first-page":"106","article-title":"The use of the Machover draw-a-person test in detecting adult survivors of sexual abuse: A pilot study","volume":"37","author":"Lev-Wiesel","year":"1999","journal-title":"Am. J. Art Ther."},{"key":"ref41","article-title":"Use of creative art therapies in prevention, screening and treatment of child sexual abuse: introduction to the special issue","author":"Lev-Wiesel","year":"2021","journal-title":"J. Child Sex. Abus."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1037\/1076-8971.11.1.194","article-title":"Disclosure of child sexual abuse: what does the research tell us about the ways that children tell?","volume":"11","author":"London","year":"2005","journal-title":"Psychol. Public Policy Law"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1080\/09658210701725732","article-title":"Review of the contemporary literature on how children report sexual abuse to others: findings, methodological issues, and implications for forensic interviewers","volume":"16","author":"London","year":"2008","journal-title":"Memory"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1080\/08853126.1953.10380466","article-title":"Human figure drawings of children","volume":"17","author":"Machover","year":"1953","journal-title":"J. Proj. Tech."},{"key":"ref45","first-page":"237","article-title":"El diagn\u00f3stico infantil desde la expresi\u00f3n gr\u00e1fica: el test de Dos Figuras Humanas (T2F)","volume":"20","author":"Maganto","year":"","journal-title":"Cl\u00ednica y Salud"},{"key":"ref46","volume-title":"Test de dibujo de dos figuras humanas (T2F)","author":"Maganto","year":""},{"key":"ref47","first-page":"73","article-title":"Indicadores emocionales complementarios para la evaluaci\u00f3n emocional del Test del dibujo de dos figuras humanas (T2F)","volume":"1","author":"Maganto","year":"2011","journal-title":"Revista Iberoamericana de Diagn\u00f3stico y Evaluaci\u00f3n-e Avalia\u00e7\u00e3o Psicol\u00f3gica"},{"key":"ref48","first-page":"11","article-title":"Las consecuencias neurobiol\u00f3gicas del maltrato infantil y su impacto en la funcionalidad del eje HHA","volume":"34","author":"Marques-Feixa","year":"2020","journal-title":"Psicopatolog\u00eda y salud mental"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.13129\/2282-1619\/mjcp-3025","article-title":"A narrative review on clinical and research applications of the Mirror paradigm: body image, psychopathology, and attachment. Mediterranean","volume":"9","author":"Muzi","year":"2021","journal-title":"J. Clin. Psychol."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0022-4405(91)90011-f","article-title":"Confirmatory factor analysis of planning, attention, simultaneous, and successive cognitive processing tasks","volume":"29","author":"Naglieri","year":"1991","journal-title":"J. Sch. Psychol."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"22","DOI":"10.2471\/blt.08.060061","article-title":"Multiple types of child maltreatment and adolescent mental health in Viet Nam","volume":"88","author":"Nguyen","year":"2010","journal-title":"Bull. World Health Organ."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"15","DOI":"10.5723\/csac.2017.7.1.015","article-title":"Childhood emotional, physical, and sexual abuse and associations with mental health and health-risk behaviors among university students in the Association of Southeast Asian Nations (ASEAN)","volume":"7","author":"Nguyen","year":"2017","journal-title":"Child Stud. Asia-Pacific Contexts"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"1001349","DOI":"10.1371\/journal.pmed.1001349","article-title":"The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis","volume":"9","author":"Norman","year":"2012","journal-title":"PLoS Med."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1080\/14616734.2021.1991664","article-title":"Can the family drawing be a useful tool for assessing attachment representations in children? A systematic review and meta-analysis","volume":"24","author":"Pace","year":"","journal-title":"Attach Hum. Dev."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"105640","DOI":"10.1016\/j.chiabu.2022.105640","article-title":"The adverse childhood experiences\u2013international questionnaire (ACE-IQ) in community samples around the world: A systematic review (part I)","volume":"129","author":"Pace","year":"","journal-title":"Child Abuse Negl."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"980129","DOI":"10.3389\/fpsyg.2022.980129","article-title":"Family drawing for assessing attachment in children: weaknesses and strengths","volume":"13","author":"Pace","year":"","journal-title":"Front. Psychol."},{"key":"ref57","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1080\/14330237.2016.1163899","article-title":"Childhood physical and sexual abuse, and adult health risk behaviours among university students from 24 countries in Africa, the Americas and Asia","volume":"26","author":"Peltzer","year":"2016","journal-title":"J. Psychol. Afr."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.reml.2012.10.002","article-title":"Enfoque multidisciplinar de la exploraci\u00f3n del abuso sexual infantil","volume":"39","author":"Pereda","year":"2013","journal-title":"Revista Espa\u00f1ola de Medicina Legal"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.cpr.2009.02.007","article-title":"The prevalence of child sexual abuse in community and student samples: A meta-analysis","volume":"29","author":"Pereda","year":"2009","journal-title":"Clin. Psychol. Rev."},{"key":"ref60","volume-title":"Psicolog\u00eda del ni\u00f1o","author":"Piaget","year":"1920"},{"key":"ref61","volume-title":"Psicodiagn\u00f3stico diferencial con test gr\u00e1ficos","author":"Pont","year":"2012"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1097\/00004583-200303000-00006","article-title":"Ten-year research update review: child sexual abuse","volume":"42","author":"Putnam","year":"2003","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref63","volume-title":"Test de matrices progresivas","author":"Raven","year":"1995"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/inm.12369","article-title":"Do adult mental health services identify child abuse and neglect? A systematic review","volume":"27","author":"Read","year":"2017","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref66","first-page":"63","article-title":"Particularidades de los dibujos de ni\u00f1os que han sufrido un abuso sexual","volume":"12","author":"Royer","year":"1999","journal-title":"Revista de la Sociedad Espa\u00f1ola del Rorschach y M\u00e9todos Proyectivos"},{"key":"ref67","volume-title":"Els abusos sexuals a nens i nenes i errors del sistema","year":"2017"},{"key":"ref68","volume-title":"Image and appearance of the human body","author":"Schilder","year":"1935"},{"key":"ref69","volume-title":"Las T\u00e9cnicas Proyectivas y el proceso psicodiagn\u00f3stico","author":"Siquier de Ocampo","year":"1987"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1002\/car.2353","article-title":"The prevalence of child maltreatment across the globe: review of a series of meta-analyses","volume":"24","author":"Stoltenborgh","year":"2014","journal-title":"Child Abuse Rev."},{"key":"ref71","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1177\/1077559511403920","article-title":"A global perspective on child sexual abuse: meta-analysis of prevalence around the world","volume":"16","author":"Stoltenborgh","year":"2011","journal-title":"Child Maltreat."},{"key":"ref72","doi-asserted-by":"publisher","first-page":"12070957","DOI":"10.1176\/appi.ajp.2013.12070957","article-title":"Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and Neurobiologically distinct subtypes","volume":"170","author":"Teicher","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref73","first-page":"9","article-title":"Presentaci\u00f3n monogr\u00e1fico Abuso Sexual Infantil","volume":"34","author":"Tello","year":"2020","journal-title":"Psicopatolog\u00eda y salud mental"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1027\/1192-5604\/a000095","article-title":"Cultural differences in the emotional indicators of the two-people drawing test","volume":"38","author":"Tuset","year":"2017","journal-title":"Rorschachiana"},{"key":"ref75","volume-title":"HTP y Dibujo una persona como medida de abuso sexual en ni\u00f1os: sistema de puntuaci\u00f3n cuantitativa","author":"Van Hutton","year":"1994"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1093\/schbul\/sbs050","article-title":"Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective-and cross-sectional cohort studies","volume":"38","author":"Varese","year":"2012","journal-title":"Schizophr. Bull."},{"key":"ref77","first-page":"51","article-title":"Las adversidades en la infancia incrementan el riesgo de psicosis: meta-an\u00e1lisis de estudios paciente-control, prospectivos y de corte transversal de cohorte","volume":"21","author":"Varese","year":"2013","journal-title":"Revista de Psicopatolog\u00eda y Salud Mental del Ni\u00f1o y del Adolescente"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.chiabu.2018.08.013","article-title":"Identifying maltreatment subgroups with patterns of maltreatment subtype and chronicity: A latent class analysis approach","volume":"87","author":"Warmingham","year":"2019","journal-title":"Child Abuse Negl."},{"key":"ref79","volume-title":"Silent screams and hidden cries: An interpretation of artwork by children from violent homes","author":"Wohl","year":"1985"},{"key":"ref80","volume-title":"GLOBAL PLAN OF ACTION to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children","year":"2016"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1002864\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T15:51:37Z","timestamp":1677081097000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1002864\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,22]]},"references-count":78,"alternative-id":["10.3389\/fpsyg.2023.1002864"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2023.1002864","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,22]]},"article-number":"1002864"}}