Uncovering the Mental World of Children: Attachment Quality, Mental State Talk, and Children’s Drawings

ABSTRACT

The present study utilized archival data to uncover trends associated with children’s drawings, attachment quality, and mental state talk (MST). Two samples of 5–12-year-old children and their caregivers were recruited: one child sample from a public elementary school (n = 54), and the other from consecutive admissions to a child psychiatric inpatient unit (n = 45). Children completed drawings of family, primary caregiver, and self. Drawings were coded using the Formal Elements (FE) and Content rating scales designed to identify selective content and organizational qualities. Attachment quality and MST were obtained using the Attachment Story Completion Task and Children’s Apperception Test. Consistent with the first hypothesis, attachment quality demonstrated a marginally significant positive relationship with Content scores of inpatient children’s family drawings. Consistent with the second hypothesis, attachment quality demonstrated a significant positive relationship with MST in both samples. Consistent with the third hypothesis, MST demonstrated a significant positive relationship with Content scores of nonpatient children’s caregiver drawings, FE scores of nonpatient children’s family drawings, and both Content and FE scores of inpatient children’s family drawings. Drawings hold promise as tools to access children’s internal working models and mental states. Clinical implications are discussed.

Acknowledgments

The authors wish to acknowledge the following persons for their assistance with coding for this study: Alisa Barsch, Sorrel Johnson, Jenae Richardson, Emily Rispoli, Rachel Ross, Alexandra Tannenbaum, Adama Toure, Theresa Whelan, and Andrea Youniss. The authors acknowledge the guidance and insights of Dr. Valeda Dent in helping to formulate this study. The authors also gratefully acknowledge the cooperation of the children and caregivers who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Due to patient confidentiality issues, the data will not be made available.

Additional information

Funding

This work was supported by the International Psychoanalytical Association Research Advisory Board; Long Island University; Contemporary Freudian Society.

Notes on contributors

Holly Rosen

Holly Rosen, Psy.D., is a postdoctoral fellow at Psychiatry Associates Faculty Group Practice within NYU Langone Medical Center. She received her doctorate degree in Clinical Psychology at Long Island University Post Campus in Brookville, NY in 2023. She completed her predoctoral internship at VA New York Harbor Health Care: Brooklyn Campus. Prior to that, she received outpatient training at Montefiore Medical Center and inpatient training at New York Presbyterian Hospital. Throughout her clinical training, she served as a counselor at Options for Community Living, a transitional living facility for individuals with mental illness and substance abuse disorders. Dr. Rosen is interested in attachment patterns, personality models, and trauma. She served as an instructor for courses about attachment theory and the Enneagram personality model for the Educational Studies Splash Program at Clark University as well as the Spark Program at the Massachusetts Institute of Technology.

Geoff Goodman

Geoff Goodman, Ph.D., A.B.P.P., F.I.P.A., is Professor of Psychiatry and Behavioral Sciences in the Emory School of Medicine and Associate Professor of Psychology and Spiritual Care in the Candler School of Theology, Atlanta, GA. He is also Director of New Psychodynamic Programs and Research and Director of the Psychodynamic Research Lab in the Emory University Psychoanalytic Institute (EUPI) and Coordinator of the Society and Personality Concentration in the Candler School of Theology. From 1999 to 2022, Dr. Goodman was Associate Professor of Psychology in the Long Island University (LIU) Clinical Psychology Doctoral Program, New York. He is also a licensed clinical and certified school psychologist with 31 years of experience in private practice in New York and Georgia, treating children and adolescents as well as adults. He is certified in both Clinical Psychology and Psychoanalysis by the American Board of Professional Psychology (ABPP) and is certified as both an adult and a child and adolescent psychoanalyst and Fellow of the International Psychoanalytical Association (FIPA). In 2013, Dr. Goodman was awarded the J. William Fulbright Foreign Scholarship by the US Department of State and spent eight months in 2014 establishing and evaluating a play-based intervention program in two rural village libraries in Uganda.

Donna Tuman

Donna Tuman, Ed.D., recently retired in 2023, was an associate professor at Long Island University Post, where she was chairperson of the Art Department and director of the Art Education Program. From 2003-2009, Dr. Tuman served as president of the University Council for Art Education, a higher education organization working for arts advocacy, and policy change in the schools. She practiced in both public schools and museums while pursuing an Ed.D. in art education from Teachers College, Columbia University. Her research interests include art teacher education, museum-based teacher training, arts advocacy and gender differences in artistic development of children. Her work has been published in Visual Arts Research, Gender Issues in Art Education, Studies in Art Education and The Journal of Aesthetic Education. Her specialties include Art Education, Art Museum Education, Arts Leadership, and Gender Issues in Visual Arts.

Deborah Ohm

Deborah Ohm, Psy.D., earned her doctorate degree in Clinical Psychology at Long Island University Post Campus in 2016. She began working as a clinical psychologist for Columbia Health in 2021. The majority of her clinical training has been in inpatient and outpatient hospital settings and community mental health clinics. Prior to Columbia Health, she was a supervising psychologist at the Mount Sinai Adolescent Health Center, where she helped coordinate the Dialectical Behavior Therapy (DBT) Program for adolescents, young adults, and their families. Dr. Ohm has extensive training and expertise in treating individuals with a wide range of difficulties, including trauma, depression, anxiety, suicidality, intentional self-injury, struggles with identity and sense of self, and difficulties with relationships and family conflict.