Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-22T18:28:23.094Z Has data issue: false hasContentIssue false

Kinematic measures of brain drawings are associated with illness perceptions in people with stroke

Published online by Cambridge University Press:  10 May 2016

Katharina Grünich
Affiliation:
Department of Clinical Psychology, Philipps University of Marburg, Marburg, Germany
Vanessa Garcia-Hoyos
Affiliation:
Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
Cathy Stinear
Affiliation:
Department of Medicine, University of Auckland, Auckland, New Zealand
Suzanne Ackerley
Affiliation:
Department of Medicine, University of Auckland, Auckland, New Zealand
Jitske Tiemensma
Affiliation:
Department of Psychological Sciences, University of California Merced, Merced, California, USA
Elizabeth Broadbent*
Affiliation:
Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
*
Correspondence should be addressed to: Dr. Elizabeth Broadbent, Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand. Phone: +64 9 373 7599; Fax: +86756 Facsimile: 64 9 373 7013. Email: [email protected].
Get access

Abstract

Background:

Previous research has shown that measuring the size and content of patients’ drawings of their illness can reveal their perceptions and predict recovery. This study aimed to assess the usefulness of analyzing kinematic features of drawings.

Methods:

A pilot observational study was conducted with 15 patients who had been hospitalized with a stroke 8 to 11 months previously. They were asked to draw a picture of what they thought had happened to their brain and describe the drawing using an electronic inking pen and digitizing tablet. Analysis of kinematic data (time to draw/write, drawing/writing speed, and pen pressure) was conducted using MovAlyzeR® software. Evaluations of physical functioning, quality of life, illness perceptions, and emotional well-being were administered, and correlations with kinematic measures assessed.

Results:

Stronger pen pressure was associated with perceptions of greater control over the stroke. Faster drawing was correlated with greater worry about a recurrent stroke and the perception that the effects of the stroke would last longer. Needing more time to write was associated with perceptions of fewer consequences of the stroke. No associations between kinematic measures and indicators of stroke severity, physical, or emotional well-being were shown.

Conclusions:

Kinematic measures of stroke patients’ drawings of their brain and comments were associated with illness perceptions and not measures of physical or emotional health status. The addition of kinematic analysis may add further utility to the assessment of patients’ drawings of their illness. More studies need to be performed with larger sample sizes and other patient groups.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adunsky, A., Fleissing, Y., Levenkrohn, S., Arad, M. and Noy, S. (2002). Clock drawing task, mini-mental state examination and cognitive-functional independence measure: relation to functional outcome of stroke patients. Archives of Gerontology and Geriatrics, 35, 2, 153160, http://dx.doi.org/10.1016/S0167-4943(02)00018-3.Google Scholar
Andrews, K., Brocklehurst, J. and Richards, B. (1980). The prognostic value of picture drawings by stroke patients. Rheumatology, 19, 180188. doi:10.1093/rheumatology/19.3.180.Google Scholar
Banks, J. L. and Marotta, C. A. (2007). Outcomes validity and reliability of the modified rankin scale: implications for stroke clinical trials: a literature review and synthesis, Stroke, 38, 10911096.Google Scholar
Broadbent, E. Ellis, C. J., Gamble, G. and Petrie, K. J. (2006a). Changes in patient drawings of the heart identify slow recovery following myocardial infarction. Psychosomatic Medicine, 68, 190913 Google Scholar
Broadbent, E., Petrie, K. J., Ellis, C. J., Ying, J. and Gamble, G. (2004). A picture of health - myocardial infarction patients’ drawings of their hearts and subsequent disability: a longitudinal study. Journal of Psychosomatic Research, 57, 583587.Google Scholar
Broadbent, E., Petrie, K. J., Main, J. and Weinman, J. (2006b). The brief illness perception questionnaire. Journal of Psychosomatic Research, 60, 631637. doi:10.1016/j.jpsychores.2005.10.020.Google Scholar
Broadbent, E., Wilkes, C., Koschwanez, H., Norton, S., Weinman, J. and Petrie, K. J. (2015). A systematic review of the brief IPQ. Psychology & Health, 11, 1361–85. doi:10.1080/08870446.2015.1070851.Google Scholar
Brott, T. et al. (1989). Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 20, 864870. doi: 10.1161/01.STR.20.7.864.Google Scholar
Caligiuri, M. P., Teulings, H. L., Dean, C. E. and Lohr, J. B. (2015). A quantitative measure of handwriting dysfluency for assessing tardive dyskinesia. Journal of Clinical Psychopharmacology, 35, 168174.Google Scholar
Duncan, P. W., Bode, R. K., Lai, S. M. and Perera, S. (2003). Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale. Physical Medicine and Rehabilitation, 84, 950963. doi:10.1161/01.STR.30.10.2131.Google Scholar
Duncan, P. W., Min Lai, S., Tyler, D., Perera, S., Reker, D. M. and Studenski, S. (2002). Evaluation of proxy responses to the stroke impact scale. Stroke, 33, 25932599.Google Scholar
Friedman, P. J. (1991). Clock drawing in acute stroke. Age and Ageing, 20, 140145. doi: 10.1093/ageing/20.2.140.Google Scholar
Heinik, J., Werner, P., Dekel, T., Gurevitz, I. and Rosenblum, S. (2010). Computerized kinematic analysis of the clock drawing task in elderly people with mild major depressive disorder: an exploratory study. International Psychogeriatrics, 22, 479488. doi: 10.1017/S1041610209991360.Google Scholar
Hoogerwerf, M. A., Ninaber, M. K., Willems, L. N. A. and Kaptein, A. A. (2012). “Feelings are facts”: illness perceptions in patients with lung cancer. Respiratory Medicine, 106, 11701176.Google Scholar
Jones, A. S. K., Ellis, C. J., Nash, M., Stanfield, B. and Broadbent, E. (2015). Using animation to improve recovery from acute coronary syndrome: a randomized trial. Annals of Behavioral Medicine. doi. org/10.1007/s12160-015-9736-x.Google Scholar
Kaptein, A. A. and Broadbent, E. (2007). Illness cognition assessment. In Ayers, A. B. S., McManus, C., Newman, S., Wallston, K., Weinman, J. and West, R. (eds.), Cambridge Handbook of Psychology, Health & Medicine (2nd ed., pp. 268272). Cambridge: Cambridge University Press.Google Scholar
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613. doi.org/10.1046/j.1525-1497.2001.016009606.x.Google Scholar
Leventhal, H., Nerenz, D. R. and Steele, D. S. (1984). Illness representations and coping with health threats. In Baum, A. and Singer, J. E. (eds.), Handbook of Psychology and Health (Vol. IV, pp. 221252). New York: Erlbaum.Google Scholar
Niedenthal, P. M. (2007). Embodying emotion. Science, 316, 10021005. doi: 10.1126/science.1136930.Google Scholar
O'Carroll, R. E., Chambers, J. A., Dennis, M., Sudlow, C. and Johnston, M. (2013). Improving adherence to medication in stroke survivors: a pilot randomised controlled trial. Annals of Behavioral Medicine, 46, 358368.Google Scholar
Rankin, J. (1957). Cerebral vascular accidents in patients over the age of 60. II. Prognosis. Scottish Medical Journal, 2, 200215.CrossRefGoogle ScholarPubMed
Teulings, H.-L. and Caligiuri, M. P. (1997). NeuroScript LLC. Retrieved from http://www.neuroscript.net.Google Scholar
van Leeuwen, B. M., Herruer, J. M., Putter, H., van der Mey, A. G. and Kaptein, A. A. (2015). The art of perception: Patients drawing their vestibular schwannoma. The Laryngoscope, 125, 26602667.Google Scholar
Vass, Z. (2012). A psychological interpretation of drawings and paintings. The SSCA Method: A Systems Analysis approach. Budapest: Alexandra Publishing.Google Scholar
Werner, P., Rosenblum, S., Bar-On, G., Heinik, J. and Korczyn, A. (2006). Handwriting process variables discriminating mild Alzheimer's Disease and mild cognitive impairment. Journal of Gerontology: Psychological Sciences, 61, (B), 228236. doi:10.1093/geronb/61.4.P228.Google Scholar