1
Introduction
PROBLEMS OF AGGRESSION
Aggressive incidents occur frequently in schools, and although some schools address them effectively, others are overwhelmed with responsibilities and potentially violent students may be overlooked. Although teachers have reported that bullies victimize only about 15% of their students, students tend to disagree. MacNeil (2002) cites studies that found 50% of students had been bullied, 65% had witnessed bullying, and students in urban, suburban, and rural schools reported similar rates.
Violent behavior seems to be increasing. The number of seriously injured children nearly quadrupled from 1986 to 1993 (Bok, 1998). Other children had inflicted a substantial proportion of their injuries, and homicide has become the second leading cause of death for Americans aged 15 to 45.
The prevention of violence has become a priority in schools throughout the country, but whereas preventive programs focus on students with histories of violent behavior, quiet but angry students may be overlooked, as noted by Dr. Pfeiffer, who wrote the foreword to this book. She was reminded of the recent stabbing and death of a 14-year-old honor student by another honor student in the school her children attended.
PROBLEMS OF DEPRESSION
Suicide is among the leading causes of death among children and adolescents ages 10 to 19, and ranks third among adolescents, exceeded only by homicides and accidents (Goldston, 2003). A study of 100 consecutive suicides by children found that a majority had manifested antisocial behavior (Shafer & Fisher, 1981), suggesting that the expression of aggressive feelings is not likely to deter a child from suicide. Pfeffer (1986) observed that suicidal children can be distinguished from nonsuicidal children by feelings of hopelessness, depression, and the wish to die. Some children mask depression with antisocial behavior, expressing fantasies of violence, explosions, annihilation, and death with bad outcomes for principal subjects (McKnew, Cytryn, & Yahries, 1983).
Studies of major depressive disorders among students have found that they show an increased risk for homicidal as well as suicidal ideation (Connor, 2002). Connor also notes that depressed children and adolescents do not suppress their anger, unlike depressed adults who tend to suppress angry feelings.
Three major patterns of depression were cited by Beck, Rush, Shaw, and Emory (1979): negative views of self, negative views of the future, and a tendency to interpret oneās experiences in a negative way. These patterns appear frequently in responses to a drawing task that illustrate the chapters that follow.
OBJECTIVES AND PROCEDURES
The aim of this book is to provide a technique for identifying children and adolescents who may harm others or themselves. The book builds on previous studies that found responses to the drawing task
useful as a first step in identifying children and adolescents at risk for aggression and depression.
Chapter 2 presents background literature about the nature of aggression and depression observed by clinicians and other specialists. It also discusses the role of art in cognition, assessment, and treatment, as well as its clinical and educational implications. Chapter 3 reviews Draw-A-Story (DAS) and the Silver Drawing Test (SDT), the assessments used in the studies reported here, and chapter 4 reviews the pilot study and questions it raised leading to the current studies presented in Part Two.
Part Two begins with the three rating scales used to assess responses to the drawing task (chapter 5). The scales assess Emotional Content, Self-Images, and the Use of Humor, and each is a continuum ranging from strongly negative, scored 1 point, to strongly positive, scored 5 points. Chapter 6 presents scored responses to the drawing task by each child or adolescent in the aggressive group, together with histories of their behaviors. Chapter 7 presents the differences found between this group of aggressive students and a control group of nonaggressive students. It also examines subgroups that emerged as well as individual case histories. Chapter 8 discusses the changes and consistencies that emerged in the emotional states of aggressive and/or depressed students after intervals of time. Chapter 9 presents a study of cultural differences and similarities observed in responses to the DAS task by Russian children, adolescents, and adults with histories of violent behavior.
Part Three concludes the book with summaries of the findings, including gender and cultural differences and similarities. It also discusses their clinical and educational implications and offers suggestions for further investigation.
2
Previous Studies of Aggression, Depression, and the Role of Art
AGGRESSION
Lorenz (1963) defines aggression as an instinct, the fighting instinct directed against members of the same species by animals as well as people. He notes the happy expression of a dog about to catch a hunted rabbit, and that hunting is a pleasurable sport for some human beings as well. Depending on circumstances, aggression may be appropriate or inappropriate.
Connor (2002) defines inappropriate aggression as maladaptive and dysfunctional, an angry reaction to real or perceived danger, and it may include depression. Some depressed children are angrier than normal children, and unlike adults, do not appear sad, or suppress anger, as noted in chapter 1. He defines appropriate aggression as adaptive, its social values changing as societies change, and suggests that there is a continuum from appropriate to inappropriate aggression. Children and adolescents may show either or both forms, as well as no aggressive behavior.
Connor (2002) also suggests that there are four subtypes of aggressive behavior: defensive, offensive, relational, and harmful to oneself. Defensive aggression is an angry reaction to real or perceived danger, and arises in response to threats or frustration. It produces intense arousal and is hypervigilant and impulsive. Studies have found that it is associated with peer rejection and exposure to violence. Rather than benefit the aggressor, its intent is to defend against threat, and to harm the source of frustration. It may include depression, social withdrawal, anxiety, fear, or confrontations with others, such as fighting or defying authority. Inappropriate aggressors tend to misinterpret and overreact, blame others, and expose themselves to danger. Their aggressiveness emerges earlier in life, and may result from abuse, harsh parental discipline, or family instability.
Offensive aggression is characterized by unprovoked attacks with intent to benefit the aggressor. It is motivated by reward, such as dominance, territory, food, or the acquisition of objects. It tends to arouse little emotion and is reinforced by success and by social role models. Studies have found correlations of aggression with positive expectations and social dominance. Offensive aggressors tend to be callous and unable to empathize. They gang up on victims and use force to have their way. They also tend to hide their aggressiveness and protect themselves from injury. Connor (2002) defines relational aggression as harming a victimās relations with others. Aggression that is harmful to oneself is suicidal ideation.
Fischer and Watson (2002) have identified two characteristics that predict the development of physical violence toward others: harsh physical punishment in the family and inhibited temperament of the child. They distinguish between shyness and inhibited temperament, and suggest two factors that predict aggressiveness in children with inhibited temperaments: fearfulness in general and low self-esteem. Inhibited temperament may appear in infancy as well as in isolated and alienated youth, and includes high emotional reactivity. They also suggest that negative self-representation may predict later aggression and violence. They are conducting a longitudinal study of aggressive behavior, tracing the antecedents of teenage aggression that ranges from hostile behavior to physical violence, and have tracked 440 children for 8 years. Trained interviewers go into participantsā homes and conduct a series of 2-hour interviews with the children studied as well as their mothers.
Other investigators have found that punitive reactions to youth violence and aggression have had poor results (Christle, Jolivette, & Nelson, 2000). Effective school programs have used preventive strategies instead of waiting for aggressive behaviors to occur and then reacting (Skiba & Peterson, 2000).
DEPRESSION
The American Psychiatric Association includes recurrent thoughts of death and suicidal ideation among the symptoms of depressive disorders (Diagnostic Criteria from DSM-IV). As cited in chapter 1 of this volume, several clinicians have observed that negative views of events and oneself are characteristic of depression and that depression can be masked by antisocial behavior. Depression has been found even in young children. In a study of self-reported symptoms Edelsohn, Iaglongo, Wertheimer-Larrson, Crockett, and Kellams (1992) observed that first graders in the highest quartile level of depression remained in the upper quartile at retest. The depressive symptoms they reported were characteristic of adult depression, suggesting that reliable and valid assessment even of young children is possible.
Some children become depressed because they tend to be snubbed or ridiculed by peers. The theory of group socialization of development (Harris, 1995) proposes that powerful emotions are generated by intergroup relationships. Regardless of nationality, childrenās peer groups create their own culture. Status hierarchies within the group, such as differences in dominance or social power, may have lasting effects on personality. If a childās behavior does not conform to the groupās norms, he or she risks rejection. For example, shy, inhibited behavior is generally acceptable for girls, but not for boys. In most large high schools, adolescents have historically sorted themselves into groups such as the ājocks,ā the ābrains,ā the āburnouts,ā and so on. Students who are victimized or rejected by their peers have low status on the popularity hierarchy. Differences in social skills tend to widen over time, and high or low status in the peer group may have effects that persist into adulthood, even though peer groups are less important to adults.
The authors cited above did not refer to behaviors such as drawing, but neuroscientists and art therapists have observed the role art can play in understanding cognitive processes and assessing emotional disturbances.
THE ROLE OF ART
The visual arts tend to be peripheral in our schools, as though they were irrelevant to the cognitive demands of other subjects in the curriculum. Recently, however, scientists have found similarities between studio art experiences and the function of the human brain.
Observations by Neuroscientists and Other Scientists
According to Zeki (1999, 2001), the preeminent function of the visual brain is to acquire knowledge about the world, and the brain acquires this knowledge by selecting what is essential and discarding much that is superfluous. The brain is less concerned with particular objects than with generalizing from them in order to obtain knowledge about categories, the constant, essential features of objects or situations. Neurons in the brainās visual pathways search for con-stancies in order to solve perceptual problems, just as artists search for the constant, essential features of objects, faces, landscapes, situations, or ideas. Zeki concludes that āin large measure, the function of art and the function of the visual brain are one and the sameā (1999, p. 1).
Another neuroscientist, Ramachandram (2001), proposes that neural mechanisms and universal laws underlie art experiences, ācapturing the very essence of something in order to evoke a specific emotion or mood in the viewerās brain.ā The universals cut across cultures, and help explain the effectiveness of an outline drawing. For example, many different brain cells respond to a particular face, each cell responding to a different view of the face. At a subsequent stage, however, a new type of brain cell, a master cell, re...
