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Tree Imagery in Drawing Tests for Screening Mental Disorders: A Systematic Review and Meta‐Analysis.

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Title: Tree Imagery in Drawing Tests for Screening Mental Disorders: A Systematic Review and Meta‐Analysis.
Authors: Guo, Huibing (AUTHOR), Feng, Bin (AUTHOR), Liu, Tiantian (AUTHOR), Zhao, Ruopeng (AUTHOR), Fan, Huiyong (AUTHOR), Dong, Zaiquan (AUTHOR), Gong, Qiyong (AUTHOR), Chen, Taolin (AUTHOR), Manthey, Marie Kristin (AUTHOR)
Source: Depression & Anxiety (1091-4269). 7/11/2026, Vol. 2026, p1-10. 10p.
Subjects: Projective techniques, Evidence synthesis, Research methodology, Medical screening, Drawing instruments, Trees in art, Mental illness
Abstract: Although tree imagery in projective drawing tests is a promising nonverbal tool for screening mental disorders, its clinical utility remains constrained by inconsistent predictor selection. To address this gap, the present systematic review and meta‐analysis synthesizes the characteristics of tree imagery linked to mental disorders and evaluates their predictive efficacy. Following the PRISMA guidelines, we analyzed 42 studies involving 8552 participants from English and Chinese databases published between 1948 and 2024. The results showed that 24 specific characteristics significantly predicted mental disorders (p < 0.05), which were classified into five distinct categories: blackened out (e.g., blackened tree, odds ratio [OR] = 2.01), scribbled lines (e.g., weak lines, OR = 2.82), oddly shaped (e.g., flattened crown, OR = 3.10), no vitality (e.g., very small tree, OR = 3.93), and overly simple (e.g., simplified drawing, OR = 7.07). Furthermore, subgroup analyses indicated that features such as "blackened tree" (OR = 1.71), "no motion" (OR = 3.34), and "excessive separation" (OR = 2.77) were significantly associated with affective disorders, whereas the presence of "roots" (OR = 4.89) was uniquely associated with the thought‐disorder subgroup. Ultimately, tree imagery may offer a valuable nonverbal, adjunctive approach to screening for mental disorders, offering several statistically supported indicators that may effectively complement traditional assessment tools. [ABSTRACT FROM AUTHOR]
Copyright of Depression & Anxiety (1091-4269) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Tree Imagery in Drawing Tests for Screening Mental Disorders: A Systematic Review and Meta‐Analysis.
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  Data: Although tree imagery in projective drawing tests is a promising nonverbal tool for screening mental disorders, its clinical utility remains constrained by inconsistent predictor selection. To address this gap, the present systematic review and meta‐analysis synthesizes the characteristics of tree imagery linked to mental disorders and evaluates their predictive efficacy. Following the PRISMA guidelines, we analyzed 42 studies involving 8552 participants from English and Chinese databases published between 1948 and 2024. The results showed that 24 specific characteristics significantly predicted mental disorders (p &lt; 0.05), which were classified into five distinct categories: blackened out (e.g., blackened tree, odds ratio [OR] = 2.01), scribbled lines (e.g., weak lines, OR = 2.82), oddly shaped (e.g., flattened crown, OR = 3.10), no vitality (e.g., very small tree, OR = 3.93), and overly simple (e.g., simplified drawing, OR = 7.07). Furthermore, subgroup analyses indicated that features such as &quot;blackened tree&quot; (OR = 1.71), &quot;no motion&quot; (OR = 3.34), and &quot;excessive separation&quot; (OR = 2.77) were significantly associated with affective disorders, whereas the presence of &quot;roots&quot; (OR = 4.89) was uniquely associated with the thought‐disorder subgroup. Ultimately, tree imagery may offer a valuable nonverbal, adjunctive approach to screening for mental disorders, offering several statistically supported indicators that may effectively complement traditional assessment tools. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Depression &amp; Anxiety (1091-4269) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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    Identifiers:
      – Type: doi
        Value: 10.1155/da/9571222
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 10
        StartPage: 1
    Subjects:
      – SubjectFull: Projective techniques
        Type: general
      – SubjectFull: Evidence synthesis
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Medical screening
        Type: general
      – SubjectFull: Drawing instruments
        Type: general
      – SubjectFull: Trees in art
        Type: general
      – SubjectFull: Mental illness
        Type: general
    Titles:
      – TitleFull: Tree Imagery in Drawing Tests for Screening Mental Disorders: A Systematic Review and Meta‐Analysis.
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              Text: 7/11/2026
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              Y: 2026
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