Analysis of the Relationship Between Intelligence, Sensory Processing

Sensitivity and the Digital Tree Drawing Test: A Feasibility Study

Johanna Emelie Heger

1,2

, Dorothea Isselstein-Mohr

, Sebastian Unger

and Thomas Ostermann

Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany

ENergietankstelle, Hattingen, Germany

Keywords: Digitalization, Attitudes, Questionnaires, Personality Assessment, Software Validation.

Abstract: The personality trait of intelligence has a research history rich in psychometric tradition, whereas sensory

processing sensitivity is a young construct, which in its conceptualization shows similarities with other

psychological and psychopathological concepts such as introversion, autism spectrum disorder, but also

various giftedness concepts. The digital tree drawing test recently achieved good results in the diagnostics of

cognitive performance losses in adults. The present study investigates whether the characteristics of

intelligence and sensitivity are related and can be mapped in a second step using the digital tree test in the

drawing process. For this purpose, 19 children and adolescents with existing intelligence and sensitivity

diagnoses underwent the digital tree test. The results were evaluated using correlation analyses. Hardly any

significant correlations were found between intelligence and sensitivity. Contrary to the previous assumption,

the correlations found were negative. Drawing parameters, on the other hand, showed clear correlations with

both traits, but here primarily with the sensitivity facets, so that drawing process variables could be identified

which appear to be relevant for the personality traits. Future research could investigate in greater depth the

direction and predictive value of these correlations in order to expand the diagnostic repertoire of

psychological practitioners using the digital tree drawing test.

1 INTRODUCTION

Sensitivity is generally understood as a sensitivity in

one's own experience of feelings and in dealing with

other people. Early descriptions of the characteristic

go back to the psychoanalyst Carl Gustav Jung (1875-

1961), who wrote about sensitivity and introversion

in his typology of characters (Jung, 1913). The

developmental psychologist Jerome Kagan and its

team also contributed the first indications of the

characteristics of high sensitivity: they found, for

example, that a certain percentage of babies appear to

be more open to stimuli than the rest (Kagan et al.,

1994). After following his participants for many

years, he found that these more open babies develop

into more “inhibited” children and adolescents. They

are more cautious, reserved and deliberate (Kagan et

al., 1994), which is reminiscent of today's

descriptions of highly sensitive people, or HSP for

short (Aron & Aron, 1997).

https://orcid.org/0009-0000-6251-2923

https://orcid.org/0000-0003-2695-0701

It is only in recent years that this temperamental

trait has become the focus of scientific research

alongside social discourse, which is reflected in a

rapid increase in publications. Leading researchers in

the field of sensitivity predominantly use the term

sensory processing sensitivity (SPS) in their studies,

which highlights the connection between sensitivity

and the underlying processing (Greven et al., 2019).

This makes SPS, alongside differential susceptibility

(Belsky & Pluess, 2009) and biological context

sensitivity (Ellis & Boyce, 2011), one of the theories

of environmental sensitivity, an umbrella term for the

perception and processing of environmental stimuli

and the individual characteristics of these abilities

(Pluess, 2015). According to Jagiellowicz et al.

(2016), highly sensitive people are characterized by

deeper stimulus processing and attention to detail, a

tendency to overstimulation and emotional reactivity.

Twin studies have shown a genetic variance

explanation of 47%, which means that almost half of

Heger, J. E., Isselstein-Mohr, D., Unger, S. and Ostermann, T.

Analysis of the Relationship Between Intelligence, Sensory Processing Sensitivity and the Digital Tree Drawing Test: A Feasibility Study.

DOI: 10.5220/0013152400003911

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 18th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2025) - Volume 2: HEALTHINF, pages 515-522

ISBN: 978-989-758-731-3; ISSN: 2184-4305

515

the inter-individual sensitivity differences can be

explained genetically and the other half by common

and different environmental influences and the

measurement error, answering the question of

etiology (Assary et al., 2021).

A study examining brain activity found that

people with a high SPS had slower reaction times

(Jagiellowicz et al., 2011). Brain regions associated

with visual processing and attention were

significantly more activated in these individuals, so

that more subtle stimuli and changes could be

perceived.

Another fMRI study found connections between

SPS and attention, empathy, action planning and

situational awareness through altered activity in the

insula, which is responsible for the integration of

sensory stimuli and consciousness, and the medial

temporal gyrus, which is associated with the

recognition of faces (Acevedo et al., 2014).

A connection was also found with the premotor

cortex, where the mirror neurons are located, which

are responsible for recognizing the emotions of other

people, thus enabling empathy (Greven et al., 2019).

A recent study also showed that SPS is associated

with increased resting-state connectivity (Acevedo et

al., 2021). Another finding by Aron et al. (2010) was,

that SPS acts as a moderator for cultural differences

in the processing of visual-spatial tasks and that

people with high SPS therefore show fewer problems

in solving non-culturally congruent tasks.

While SPS was initially conceptualized as a

unidimensional construct, we now know about its

three-dimensional structure: Aesthetic Sensitivity,

AES for short, describes openness and appreciation

for aesthetic and positive stimuli. The Low Sensory

Threshold, LST for short, stands for the perception of

subliminal and detailed stimuli and the associated

attention to things that other people do not notice.

Ease of Excitation, or EOE for short, refers to rapid

overstimulation by extra- and intrapersonal stimuli

and thus relates to the intensity of perception (Pluess

et al., 2018; Smolewska et al., 2006).

Although sensitivity is a continuous trait, people

can be divided into sensitivity groups, where the less

sensitive make up about 20-25%, the moderately

sensitive about 41-47% and the highly sensitive about

20-35% (Lionetti et al., 2018). As a disjunctive

personality trait, high sensitivity is not pathological;

neither high nor low sensitivity are problematic on

their own. However, in combination with negative

events and environments, the risk of mental illness

like depression or anxiety and unfavorable

developmental trajectories increases, which

underlines the importance of correctly identifying

highly sensitive individuals and conducting in-depth

research into the personality trait (Greven et al., 2019;

Krampe & van Randenborgh, 2023).

Intelligence is often conceptualized as a more

cognitive trait, with aspects such as short- and long-

term memory or fluid and crystallized intelligence as

in the Cattell-Horn-Carroll theory or CHC theory for

short (Schneider & McGrew, 2012). However, there

are also more comprehensive concepts that describe

intelligence more broadly and include factors such as

social behavior (Heller, 2013) or creativity (Renzulli,

2011). Therefore, intelligence is considered a

personality trait and, according to Wechsler's (1940)

definition, it describes a general competence to deal

constructively with one's environment. Due to aspects

of SPS that overlap with the different facets of

intelligence, a possible link between both traits is

obvious. However, the number of studies on a

possible connection between SPS, i.e. high

sensitivity, and giftedness has been sparse to date,

although there are also studies on related sensitivity

terms that overlap with SPS in their definition

(Gallagher, 2022; Samsen-Bronsveld et al., 2024;

Winkler & Voight, 2016).

The tree drawing test was originally developed as

a projective method for determining past traumas by

unraveling the unconsious aspects of the psyche, but

it is also established in giving insights on one's

developmental stage by displaying cognitive and

emotional competences (Koch, 2008). Although it is

primarily applied by interpreting the drawing as a

whole, the digitized version focuses on the drawing

process rather than the finished image and has proven

itself in the field of Alzheimer's and dementia

diagnostics as well as the determination of cognitive

impairments (Faundez-Zanuy et al., 2014; Robens,

Heymann, et al., 2019).

In the present study the digital tree drawing test is

used for assessing the cognitive strengths of young

people. The basic idea is that the mechanisms of the

drawing process, which indicate cognitive

impairments, have elementary connections to

cognitive and perceptual abilities, which could

therefore also be evident on the other side of the

spectrum, i.e. higher sensitivity.

Based on these considerations, we hypothesize

that intelligence and sensitivity can be mapped

individually via the drawing process in the digital tree

drawing test. The digital tree drawing test therefore

represents a non-verbal test procedure for

determining intelligence and sensitivity that

complements psychometric procedures.

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2 MATERIAL AND METHODS

2.1 Recruitment and Setting

Participants were recruited from the

ENergietankstelle Hattingen or the Institut

AMBITION. Both are psychotherapeutic care

facilities for children, adolescents and adults and a

psychological testing center that focuses on people

with high sensitivity and people with giftedness.

The prerequisites for participation in the study

were the existence of an intelligence assessment and

a completed sensitivity assessment. The test batteries

used to determine intelligence were almost all from

the Wechsler test family.

The study took place on the premises of the

practices. These are familiar to the participants and

act as a safe place for them, where they can feel

comfortable. The test administrator and the test

subject were present during the test.

2.2 Assessment Methods

The tree drawings were made on a Microsoft Surface

Pro 3 tablet. The tablet has a 64-bit Windows 8.1 Pro

operating system, a 1.7 GHz Intel Core i7-4650U

dual-core processor with a maximum CPU frequency

of 3.3 GHz, 8 GB of RAM and a resolution of 2160 x

1440 pixels. To draw on the tablet, a pressure-

sensitive digital pen with 4096 pressure sensitivity

levels was used (Figure 1).

Figure 1: Microsoft Surface for the digital Tree Drawing

Task taken from (Robens & Ostermann, 2020).

After familiarizing themselves with the tablet

participants were asked to draw a tree of their choice.

In total, no test took more than 30 minutes.

The intelligence and sensitivity values of the

participants had already been collected in advance,

independently of the present study, using the

Wechsler Intelligence Scale for Children - Fifth

Edition (WISC-V) by Petermann (2017) or previous

versions and the short version of the Highly Sensitive

Child Scale (HSC) by Pluess et al. (2018). Although

sensitivity is a normally distributed and continuous

characteristic, it can be divided into three sensitivity

groups: HSC-values lower than 3.8 indicate lower

sensitivity, values between 3.8 and 4.7 point towards

a moderate sensitivity and values higher than 4.7

indicate high sensitivity.

2.3 Digital Tree Drawing Variables

From the digital tree drawing process, the following

16 variables were extracted:

 Total time (s)

 Drawing time (s)

 Not drawing (%)

 Pen pressure

 Pressure-velocity relation

 Color changes

 Color count

 Strokes per minute

 Line width changes

 Line widths

 PenUp count

 PenUp (%)

 PenUp drawing relation

 PenUp line length

 Mean velocity

 Volatile motion

2.4 Statistical Procedures

Data was first summarized using descriptive statistics.

For this purpose, mean values and standard deviations,

minimum, maximum and medians were calculated for

metrical variables and percentages for nominal

variables. All analyses were subdivided into highly

sensitive and low-moderate sensitive individuals.

To test the hypothesis mentioned at the end of

Chapter 1, Pearson's correlation coefficient were

calculated to determine whether sensitivity values

were associated with drawing characteristics. For this

purpose, the sample was considered as a whole and

not subdivided into groups. All analyses were carried

out using SPSS for Windows Version 28.

3 RESULTS

3.1 Sample

The study sample comprises 19 children and

adolescents (11 females and 8 males) aged between 7

Analysis of the Relationship Between Intelligence, Sensory Processing Sensitivity and the Digital Tree Drawing Test: A Feasibility Study

517

and 18 (mean age: 12.5 ± 2.2 years) with a mean IQ

of 124.05 ± 9.41. The sample includes three less

sensitive people (all males) with HSC values < 3.8,

eight moderately sensitive people (all females) with

values between 3.8 and 4.7 and eight highly sensitive

people (3 females and 5 males) with sensitivity values

> 4.7. Table 1 compares the highly sensitive people

with the low and moderately sensitive people and lists

further sociopsychological data on the participants.

Table 1: Sociopsychological data of the total sample

(Abbrev: SPS: Sensory Processing Sensitivity; EOE: Ease

of Excitation; LST: Low Sensory Threshold; AES:

Aesthetic Sensitivity).

High SPS Low/Mod.

SPS

Total

Gender

Male

Female

5 (62.5 %)

3 (37.5 %)

3 (27.3 %)

8 (72.7 %)

8 (42.1 %)

11 (57.9 %)

Age (yrs)

M ± SD

Median

12.3 ± 1.6

12.5

12.6 ± 2.7

12.5 ± 2.2

M ± SD

Median

124.1 ± 8.2

125

124.0 ± 10.6

125

124.1 ± 9.4

125

SPS-Total

M ± SD

Median

5.7 ± 0.58

5.5

3.98 ± 0.46

4.08

4.70 ± 1.01

4.5

SPS-EOE

M ± SD

Median

5.7 ± 0.65

5.6

3.91 ± 0.94

4.66 ± 1.22

SPS-LST

M ± SD

Median

5.65 ± 0.77

5.46

2.61 ± 0.88

2.83

3.89 ± 1.74

3.33

SPS-AES

M ± SD

Median

5.71 ± 0.64

5.62

5.15 ± 0.7

5.5

5.39 ± 0.72

5.5

3.2 Key Results

Table 2 shows the features extracted from the digital

tree drawing test. Once again, the highly sensitive

people are compared with the low and moderately

sensitive people. As can be clearly seen, there are

significant differences between the two groups in

terms of digital tree drawing values. This becomes

also evident in the correlation analysis, of which the

Pearson correlation values are shown in Table 3.

As can be seen in Table 3, the total HSC score

(SPS) correlated significantly positively with the

pressure-velocity relation (r = .461, p < 0.05), the line

width changes (r = .461, p < 0.05) and the PenUp

percentage (r = 489, p < 0.05) and highly

significantly negatively with the jumpy character

movements (r = -.634, p < 0.01).

Table 2: Features extracted from the digital tree drawing

test. Data is given in Mean ± SD.

High SPS Low/Mod.

SPS

Total

Total time (s) 649.58

± 238.70

500.88

± 294.01

563.50

± 275.45

Drawing time (s) 265.21

± 144.49

250.83

± 107.22

256.89

± 120.66

Not drawing (%) 0.58

± 0.18

0.42

± 0.18

0.49

± 0.19

Pen pressure 0.25

± 0.09

0.25

± 0.09

0.25

± 0.09

Pressure-velocity

relation

2.08

± 1.01

1.35

± 0.68

1.66

± 0.88

Color changes 18.88

± 7.51

15.18

± 17.94

16.74

± 14.294

Color count 5.5

± 1.85

5.36

± 2.91

5.42

± 2.45

Strokes per

minute

46.31

± 23.65

31.34

± 36.93

37.65

± 32.14

Line width

changes

9.13

± 10.629

6.82

± 4.35

7.79

± 7.47

Line widths 2.75

± 0.46

2.55

± 0.68

2.63

± 0.59

PenUp count 476.88

± 249.01

328.55

± 544.65

391.00

± 441.11

PenUp (%) 0.30

± 0.10

0.21

± 0.13

0.25

± 0.12

PenUp-drawing

relation

0.99

± 0.75

0.49

± 0.50

0.70

± 0.65

PenUp line

length

26702.86

± 16833.60

20906.44

± 39381.20

23347.03

± 31312.04

Mean velocity 8.25

± 5.18

10.53

± 5.73

9.57

± 5.48

Volatile motion 69.18

± 29.88

103.07

± 49.98

88.80

± 45.06

The EOE facet shows a positive correlation with

the pressure-velocity relationship (r = .532, p < 0.05),

a negative correlation with the average velocity (r = -

.556, p < 0.05) and a highly significant negative

correlation with the abrupt drawing movement (r = -

.663, p < 0.01).

The LST shows positive correlations with the Not

Drawing percentage (r = .533, p < 0.05), with the

PenUp percentage (r = .535, p < 0.05) and with the

PenUp-drawing relation (r = .526, p < 0.05), as well

as a negative correlation with the volatile motion

(r = -.544, p < 0.05).

Although, some variables of the digital tree

drawing test correlated with at least one of the HCS

scales, the AES sensitivity facet was the only one that

showed no significant correlations.

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Table 3: Correlations between the digital tree drawing test

and the HCS-Scales (**: The correlation is significant at the

0.01 level; *: The correlation is significant at the 0.05 level).

SPS EOE LST AES

Total time (s) .304 .128 .361 .301

Drawing time (s) .026 -.038 -.013 .170

Not drawing (%) .431 .315 .533* .169

Pen pressure -.155 -.038 -.222 -.224

Pressure-velocity

Relation

.461* .532* .415 .069

Color changes .099 -.049 .125 .242

Color count -.043 -.024 -.061 -.045

Strokes per

minute

.245 .304 .282 -.096

Line width

changes

.461* .387 .387 .406

Line widths .258 .339 .215 -.003

PenUp count .194 .170 .262 -.003

PenUp (%) .489* .419 .535* .229

PenUp-drawing

elation

.421 .313 .526* .146

PenUp line

length

.094 .064 .186 -.095

Mean velocity -.442 -.556* -.292 -.187

Volatile motion -.634** -.663** -.544** -.308

4 DISCUSSION

4.1 Key Findings

The correlation analyses of the sensitivity and

drawing values presented in this pilot study revealed

a large number of significant or highly significant

correlations.

Firstly, the overall sensitivity was positively

related to the pressure/speed ratio, the number of

stroke width changes and the percentage of time the

digital pen is held in the air instead of being used for

drawing. There is a significant negative association

with erratic drawing movements. This coherently

underpins the picture of sensitivity, according to

which more sensitive people also pay attention to

small differences and tend to proceed deliberately and

carefully instead of acting impulsively or

spontaneously (Aron, 1996; Aron et al., 2012).

Secondly, the EOE subscale also correlated

positively with the pressure-speed relationship, was

strongly negatively related to the average drawing

velocity and the abrupt drawing movements and thus

supports the impression that people with higher

sensitivity appear to draw more cautiously, more

nuanced and more slowly or, conversely, appear to be

more sensitive with a more cautious drawing style.

And thirdly, the LST sensitivity factor is

positively associated with the percentage of time not

drawing and the time the pen is held over the tablet

and negatively associated with erratic drawing

movements. This again suggests that increased

sensitivity, in this case in the area of a low sensory

threshold, is associated with a more careful drawing

style.

Future studies with higher sample size of that

people with higher sensitivity could also include

analyses to differentiate between different levels of

sensitivity which have only been rudimentarily

carried out here (Robens, Ostermann, et al. 2019;

Unger, Bayram, et al. 2024). This could open up new

and exciting fields of research, particularly in this

area.

4.2 Limitations

From a methodological perspective, limitations of the

present study can be identified. For example, there is

a clear limitation in the sample size. Although a test

subject group of 19 participants can indicate an initial

direction and appears adequate for a small research

project, a bigger sample size should be examined in

order to achieve truly robust results.

Since most of the participants are clients of a

psychotherapeutic practice with a focus on working

with gifted children and adolescents, almost all of

them have an above-average intelligence quotient.

This means that the group is very homogeneous in

terms of the characteristic of intellectual giftedness

and correlations with other variables such as

sensitivity or the sign parameters are difficult to

identify.

With respect to the correlation analyses, it is

important to note, that the results can be interpreted

in both directions, as correlation analyses only show

whether an association exist but not from which of the

variables it originates. When analyzing the drawing

variables with the personality traits, it nevertheless is

more likely that personality traits influence the

drawing process and not vice versa. However, this has

to be taken into account in future research.

Analysis of the Relationship Between Intelligence, Sensory Processing Sensitivity and the Digital Tree Drawing Test: A Feasibility Study

519

5 CONCLUSION

Various research findings in recent years show, on the

one hand, that the personality trait of intelligence is

constantly being evaluated and adapted to current

scientific findings (McGrew, 2009) and, on the other

hand, that alternative, not purely cognitive

conceptualizations of intelligence and giftedness are

increasingly gaining acceptance in society and in

science (Renzulli, 2011, 2012). In its conception,

sensory processing sensitivity includes, among other

things, an increased perception of detail, attention to

subliminal stimuli and a pronounced responsiveness

to aesthetics (Pluess et al., 2018).

Due to partially overlapping and matching

conceptualizations of both characteristics, there is

reason to assume a positive correlation between the

two characteristics, according to which one could act

as a predictor for the other (De Gucht et al., 2023).

This study investigated this possible correlation.

Unfortunately, a reliable correlation between these

characteristics could not be confirmed, as the group

was too homogeneous in terms of intelligence. In a

second step, it was examined whether these

characteristics can be mapped independently of each

other using the digital tree test and expressed in

character variables. This worked well for cognitive

impairment and psychiatric disorders in older people

in other studies (Robens, Heymann, et al., 2019).

Despite these limitations, the participants in this

study reported good experiences with drawing on the

tablet, which speaks for the practicability and user-

friendly implementation of the digital tree drawing

test. In addition, the added value of this research

project lies in the approach to a thematically still quite

unexplored area. As the scoping review on digital

drawings tools (Unger, Robens, et al., 2024) points

out, there is no previous work that has investigated

both personality traits, i.e. aptitude and sensitivity, in

relation to the digital tree drawing test. It has even

been found that children and adolescents are

generally neglected in the assessment of mental

conditions and efforts in this direction, for example,

cover only the examination of the intuitive operation

of a stylus (Wu et al., 2018). To all appearances, the

digital tree drawing test has so far been used primarily

in the area of cognitive disorders and psychiatric

illnesses, but not in younger groups of people with

more pronounced abilities. Sensory processing

sensitivity, on the other hand, is still a young

construct with a great need for research in order to

minimize the risk of developing mental illnesses by

finding adequate medical and societal understanding

and handling. The present study therefore represents

a first attempt to examine these different

characteristics and processes in conjunction with each

other in a young group of participants. This is

important because different diagnostic tools are

necessary for a multi-layered and individually

accurate diagnosis and working with children and

adolescents, who usually have less developed

linguistic and reflexive skills than adults, poses

particular challenges in this respect.

If it turns out that the tree test is a good tool, not

only in terms of its projective qualities but also as a

process-oriented means of testing high sensitivity,

this would represent a significant gain for practicing

diagnosticians.

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