Using the Draw-A-Story Drawing Test to Predict Perceived Stress, Military Life Adjustment, and Resilience

sustainability

Article Using the Draw-a-Story Drawing Test to Predict Perceived Stress, Military Life Adjustment, and Resilience

Juliet Jue 1,* and Jung-Hee Ha 2

1 Department of Art Therapy, Hanyang Cyber University, Seoul 04763, Korea 2 Graduate School of Counseling Psychology, Hanyang University, Seoul 04763, Korea; [email protected] * Correspondence: [email protected]; Tel.: +82-10-4216-0903

Abstract: In this study, we investigated how effectively a Draw-a-Story drawing test can predict the perceived stress, military life adjustment, and resilience of soldiers. A total of 276 conscripted male soldiers participated in the study. The research tools included the Perceived Stress Scale, the Military Life Adjustment Scale, the Connor–Davidson Resilience Scale (Korean version), and the Draw-a-Story drawing test. The results of the correlation and regression analyses were as follows. First, perceived stress, military life adjustment, resilience, and DAS emotional content were all mutually correlated. The DAS self-image was positively correlated only with resilience. Second, emotional content predicted soldiers’ perceived stress, military life adjustment, and resilience at significant levels. Meanwhile, our regression analysis showed that self-image did not have significant predictive power. In this paper, we discuss the implications for predictive power of our findings regarding the two measures of DAS; we also propose that DAS could serve as a tool to predict the mental states of soldiers.

Citation: Jue, J.; Ha, J.-H. Using the Keywords: perceived stress; military life adjustment; resilience; Draw-a-Story; soldiers Draw-a-Story Drawing Test to Predict Perceived Stress, Military Life Adjustment, and Resilience. Sustainability 2021, 13, 7383. 1. Introduction https://doi.org/10.3390/ Drawings express the thoughts, feelings, intentions, and experiences of the people su13137383 who draw them [1]. This projective function makes drawing assessments valuable as auxiliary tools for evaluating individuals’ minds. Although issues of reliability and validity Academic Editor: Ans Vercammen persist in measuring and interpreting results [2], researchers have frequently used drawing assessments as psychological tests [3,4]. Received: 12 May 2021 Seeking to examine the effectiveness of a drawing test with a population whose Accepted: 28 June 2021 Published: 1 July 2021 mental states need to be assessed with various methods, we chose conscripted soldiers as subjects. Although Korea is close to advanced countries in terms of economic level,

Publisher’s Note: MDPI stays neutral including personal income and industrial development, there is still a lot of room for with regard to jurisdictional claims in improvement in personal life satisfaction. Notably, Korea has not ended the war and is published maps and institutional affil- operating a conscripted military system. Thus, improving the psychological health and iations. adaptation of conscript soldiers is necessary for a sustainable society. In Korea, military service is obligatory for male adults, and an average of 300,000 men serve as military personnel a year [5]. Conscripted soldiers in the Korean army are generally between 19 and 25 years old; they live in barracks while enlisted and serve 18-month terms. Military organizations have strict rules and hierarchies, and individual freedoms are Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. limited. Conscript soldiers are, therefore, more likely to experience significant stress during This article is an open access article military service, and the physical and/or psychological difficulties of adjusting to the distributed under the terms and military environment can lead some to cause problems. Thus, evaluating and measuring conditions of the Creative Commons their psychological states can help prevent issues in advance and ensure that necessary Attribution (CC BY) license (https:// interventions are promptly performed. creativecommons.org/licenses/by/ The subjective stress experienced by soldiers while serving in the military is called 4.0/). military service stress [6]. It includes military-specific factors such as unit environment

Sustainability 2021, 13, 7383. https://doi.org/10.3390/su13137383 https://www.mdpi.com/journal/sustainability Sustainability 2021, 13, 7383 2 of 13

and interpersonal relationships, as well as external factors such as relationships with family and friends and economic problems [7]. Military service stress affects soldiers’ mental health and their adaptation to military life [7–9]. When soldiers’ stress reaches overwhelming levels, it can lead to conflict, self-destructive behaviors, and crime within the military [10–12]. Job stress can even cause soldiers to have suicidal thoughts [13]. Thus, periodically evaluating soldiers’ subjective stress levels is crucial. Adapting to military life is closely related to military service stress [9]. Higher service stress levels negatively impact soldiers’ adjustment to military life. Adaptation to military life is a major concern for conscript soldiers—an analysis of the content of telephone counseling with conscript soldiers found that 2428 soldiers, or 40.9%, were experiencing maladjustment to their units [14]. Maladjustment-related suicide among soldiers is also a regular occurrence, causing between 70 and 100 death every year [15]. Therefore, periodically evaluating soldiers’ adjustment to military life is an important means of preventing casualties. One particular psychological factor can help soldiers overcome the adversity caused by high stress levels or difficulties adapting to military life. Resilience refers to a person’s internal resources and overall ability to adapt to changes in their environments [16]. It acts as an internal protective factor that positively affects people’s lives [17,18], helping them manage stress and adapt to difficult environments [17–20]. Previous studies have tested the effects of resilience in various populations. Kim, Park, and Kwon [21] revealed that nurses with higher resilience levels burn out less. Likewise, research has shown that childcare workers with higher resilience levels experience lower levels of burnout [22]. In a similar vein, research on college students has reported that resilience has an important mediating effect, lowering their stress levels and improving their psychological well- being [23]. Meanwhile, a study of soldiers found that resilience plays a psychological modulatory effect—when army soldiers experience complex traumas that can lead to suicidal actions, resilience has a mediating effect in this process [24]. Similarly, resilience has been shown to mediate the relationships between the factors that influence adaptation to military life [25–27]. Thus, military service stress, adjustment to military life, and resilience are interrelated. Soldiers who can show resilience in military life will be able to reduce the stress they experience in the military [28]. Resilience can be developed through training [29], time, and individual effort [30]. In the case of stress, if administrators can identify soldiers’ stress before it reaches extreme levels, they might help soldiers control or alleviate it. Therefore, it is important to assess stress levels, resilience, and military life adaptation in order to improve conscript soldiers’ quality of life and realize a sustainable military environment. The purpose of this study was to determine the effectiveness of a drawing assessment as a method of evaluating and predicting soldiers’ mental states. We chose to examine Silver’s Draw-a-Story (DAS) test. This drawing test is testee-friendly because it provides stimulus drawings that it asks subjects to refer to as they draw their own pictures [1,4,31]. For this reason, the DAS is not difficult, even for those who say they do not know what to draw. The DAS has been implemented to examine a variety of people, including firefighting officials [32], subway engineers who experienced accidents on duty [33], North Korean defectors [34], and burn victims [35]. A previous study that administered the DAS to soldiers found that it can be used to effectively determine depressive status [36]. Another study found that DAS can be used to assess depression and suicidal ideation levels in soldiers [37]. Based on this theoretical background, we set out to examine how effectively the DAS test predicts conscript soldiers’ military service stress, military life adjustment, and resilience. To achieve this goal, we established the following research hypotheses.

Hypothesis 1. The DAS scales will show signiﬁcant correlations with military service stress, military life adjustment, and resilience of soldiers.

Hypothesis 2. The emotional content scale in the DAS will predict military service stress, military life adjustment, and resilience, respectively. Sustainability 2021, 13, 7383 3 of 13

Hypothesis 3. The self-image scale in the DAS will predict military service stress, military life adjustment, and resilience, respectively.

2. Methods 2.1. Participants A total of 280 Korean conscript soldiers participated in this survey. After excluding four incomplete questionnaires, we used 276 responses in our analysis. The participants were all male, their average age was 20.96 years (S.D. = 1.27, Min. = 19.0, Max. = 27.0), and their average service period was 11.19 months (S.D. = 5.48). Other demographic characteristics of the participants are presented in Table1.

Table 1. Participants’ general characteristics (N = 276).

Variable Frequency % male 276 100.0 Sex female 0 0 married 2 0.7 Marital status unmarried 274 99.3 Graduated from high school 64 23.2 Education level enrolled in college 204 73.9 Graduated from college 8 2.9 Upper class 9 3.3 Upper middle class 26 9.4 Socioeconomic status Middle class 216 78.3 Working class 20 7.2 Poor 5 1.8

2.2. Procedures and Ethical Considerations We obtained the approval of Hanyang University’s institutional review board (HYI- 18-229-1). Next, we requested research cooperation from several military units, and, after receiving approval, we conducted a survey on three units. Before conducting the survey, we described the study’s purpose to the participants and explained their rights, assuring them that their participation would be anonymous and voluntary and that they would not be penalized for not participating. After that, we explained the questionnaire response method. We provided our contact information so that participants could contact us with any inquiries related to the research. The soldiers who decided to take part in the survey then signed the consent form and started the survey. There was no time limit. After they completed the surveys, they were free to place them in the collection box.

2.3. Measures 2.3.1. The Perceived Stress Scale We used the Perceived Stress Scale developed by Hyun and Lee [6] to measure soldiers’ perceived stress levels (see AppendixA). The scale comprises 26 items rated on five-point Likert scales (1 = strongly disagree, 5 = strongly agree). The final score is the average of the response scores, and higher averages indicate higher levels of stress. Hyun and Lee demonstrated that the soldiers’ perceived stress was closely related to the stress response, thus indicating that the construct validity of this scale is appropriate. The reliability coefficient of this scale was 0.90 in Hyun and Lee’s study and 0.95 in this study.

2.3.2. The Military Life Adjustment Scale Stouffer et al. [38] originally developed the Military Life Adjustment Scale; Shin [39] reconstructed it for Korean military settings and Koo [40] later modified it. It comprises 26 items, rated on five-point Likert scales (see AppendixB). The higher the final average Sustainability 2021, 13, 7383 4 of 13

scores, the greater the soldiers’ adjustment levels. Shin proved the criterion validity by revealing that the correlation analysis between the military life adaptation sub-factors was signiﬁcant. The reliability coefﬁcient of this scale was 0.93 in Koo’s study and 0.94 in this study.

2.3.3. The Connor–Davidson Resilience Scale—Korean Version We used the Connor–Davidson Resilience Scale (Korean version) to evaluate soldiers’ resilience levels (see AppendixC). Connor and Davidson [ 41] originally developed this scale and Baek et al. [42] translated it into Korean and validated it. It consists of 25 items rated on ﬁve-point Likert scales. The higher the average scores, the better the levels of resilience. Baek et al. proved that the construct validity was appropriate through correlation analysis between this scale and the Rosenberg Self-Esteem Scale, Beck Depression Inventory, Perceived Stress Scale, and Impact of Event Scale—Revision. The researchers reported a Cronbach’s α of 0.93, and we found a Cronbach’s α of 0.95 in this study.

2.3.4. The Draw-a-Story Drawing Test Silver [31] developed the Draw-a-Story (DAS) drawing test to assess individuals’ internalized psychological problems, including depression and aggression. The tools of DAS include stimulus pictures, drawing paper, pencils, and erasers. The conditions for this test are not strict—there is no time limit and it can be conducted individually or in a group. The examiner asks a testee to draw a picture using provided stimulus drawings and to write the story. The specific implementation method is as follows (see AppendixD): the DAS provides 14 stimulus pictures, asks testees to choose two stimuli and to imagine something happening between them, and then asks them to draw a picture showing their imagined stories. Testees can add or change the original stimuli in their own drawings. The stimuli include a man with a hat, a man with glasses smoking a pipe, a boy, a woman with a bridal veil, a person with a parachute, a snake, a cat, a dinosaur, a chick, a mouse, a tree, a knife, an erupting volcano, and a castle. This art assessment is used to evaluate the emotional states of testees based on the stories and drawings they compose. Researchers can quantify testees’ responses to the DAS using the Emotional Content Scale and the Self-Image Scale. The Emotional Content Scale evaluates the emotional content expressed in a picture by assigning scores between 1 and 5. The lower the score, the more negative the content. For example, a score of 1 corresponds to a destructive relationship, a fatal danger, or a state of lethargy. A score of 2 suggests stressful or uncomfortable relationships. A score of 3 suggests ambivalence or a lack of emotional expression. A score of 4 corresponds to fortunate situations or friendly relationship expressed in a passive manner. A score of 5 corresponds to positive and active content, suggesting the individual achieves his or her goals and cares for or loves other people. The Self-Image Scale evaluates the relative weakness or strength of an individual’s self-image. It does not comprehensively evaluate a picture’s content, focusing only on the self-object identified with the person drawing the picture. In this study, we operationally defined the self-object as the subject of each testee’s written sentence. For example, if a person wrote “A chick met a rat while walking on the street,” we assumed the chick to be the self-object not the rat. Responses are rated on five-point scales: the more powerless the identified target is, the lower the score, and the higher the power, the higher the score. For example, a score of 5 applies when the identified subject has strong power, even if it is threatening or aggressive to others. Silver [4] demonstrated that the validity of the DAS test was sufficient by revealing differences in the DAS scale between those who were clinically depressed and those who were not depressed. The DAS scoring in this study was performed separately by two art therapists who had no information other than the pictures. They both had more than 7 years of experience conducting drawing tests. We calculated the degree of concordance between the individual graders by sampling 40 of the total 276 pictures, and found the correlation coefficient between them to be 0.95. Sustainability 2021, 13, 7383 5 of 13

2.4. Data Analysis We analyzed the data with IBM SPSS Statistics 23.0 as follows. First, we calculated the Cronbach’s α of each measure to examine the reliability of the questionnaires used in the study. We then calculated Pearson’s correlation coefﬁcient to evaluate the degree of agree- ment between the DAS scoring raters and computed descriptive statistics to conﬁrm the general characteristics of the study participants and the results of the questionnaire. Next, we performed a correlation analysis to examine the relationship between the drawing test and research variables. Finally, we performed a stepwise regression analysis to determine whether each scale of the DAS test predicted the research variables.

3. Results 3.1. Descriptive Statistics and Correlation Table2 presents the results of the correlation analysis and the descriptive statistics for the research variables. All variables except DAS self-image showed mutually signiﬁcant correlations. DAS self-image had signiﬁcant positive correlations with both resilience and emotional content.

Table 2. Correlation coefﬁcients and descriptive statistics for variables.

Variable 1. 2. 3. 4. 5. 1. Perceived Stress – 2. Military Life Adjustment −0.57 *** – 3. Resilience −0.40 *** 0.61 *** – 4. DAS Emotional Content −0.17 ** 0.25 *** 0.29 *** – 5. DAS Self-Image −0.10 0.10 0.19 ** 0.64 *** – Mean 2.30 3.15 3.66 2.84 3.30 Standard Deviation 0.78 0.79 0.73 1.40 1.41 ** p < 0.01, *** p < 0.001.

3.2. Regression Analysis Next, we conducted a regression analysis using the DAS emotional content as an independent variable and perceived stress, military adaptation, and resilience as dependent variables. As shown in Table3, we found that emotional content signiﬁcantly predicted both perceived stress and adjustment to military life. In the case of resilience as a dependent variable, we inserted both emotional content and self-image as independent variables based on the correlation results. We found that self-image did not have a signiﬁcant explanatory power in the regression equation. Therefore, Table2 presents the results of the regression analysis using only emotional content as a single independent variable.

Table 3. The effect of emotional content on perceived stress, military life adjustment, and resilience.

Independent Dependent R R2 F B SE β t Variable Variable Emotional Content Perceived Stress 0.17 0.03 7.89 ** −0.09 0.03 −0.17 −2.81 ** Military Life Emotional Content 0.25 0.06 17.25 *** 0.14 0.03 0.25 4.15 *** Adjustment Emotional Content Resilience 0.27 0.07 20.17 *** 0.14 0.03 0.27 4.49 *** Note. n = 276, B: unstandardized coefﬁcients, SE: standard error, β: standardized coefﬁcients, ** p < 0.01, *** p < 0.001.

3.3. Case Examples We selected two cases as examples of the DAS drawings of Korean conscript soldiers. Figure1 was created by a 21-year-old male soldier, who wrote the following story: “A cat was on the road and was frightened to see a snake.” The drawing’s emotional content score was 2, and its self-image score was 2. The soldier’s perceived stress score was 3.07, his military life adjustment score was 2.07, and his resilience score was 2.12. Sustainability 2021, 13, x FOR PEER REVIEW 6 of 13

Table 3. The effect of emotional content on perceived stress, military life adjustment, and resilience.

Independent Dependent R R2 F B SE β t Variable Variable Emotional Perceived Stress 0.17 0.03 7.89 ** −0.09 0.03 −0.17 −2.81 ** Content Emotional Military Life Ad- 0.25 0.06 17.25 *** 0.14 0.03 0.25 4.15 *** Content justment Emotional Resilience 0.27 0.07 20.17 *** 0.14 0.03 0.27 4.49 *** Content Note. n = 276, Β: unstandardized coefficients, SE: standard error, β: standardized coefficients, ** p < 0.01, *** p < 0.001.

3.3. Case Examples We selected two cases as examples of the DAS drawings of Korean conscript soldiers. Figure 1 was created by a 21-year-old male soldier, who wrote the following story: “A cat Sustainability 2021, 13, 7383 was on the road and was frightened to see a snake.” The drawing’s emotional content6 of 13 score was 2, and its self-image score was 2. The soldier’s perceived stress score was 3.07, his military life adjustment score was 2.07, and his resilience score was 2.12.

FigureFigure 1.1. DASDAS drawing:drawing: “A“A catcat waswas onon thethe roadroad andand waswas frightenedfrightened toto seesee aa snake”.snake.”

TheThe nextnext casecase isis thethe workwork ofof aa soldiersoldier whowho hadhad higherhigher stressstress levels,levels, lowerlower militarymilitary lifelife adaptationadaptation levels,levels, andand lowerlower resilienceresilience levelslevels thanthan thethe ﬁrstfirst case,case, andand thethe resultsresults ofof thethe DASDAS werewere alsoalso moremore negativenegative (see(see FigureFigure2 ).2). This This second second picture picture was was drawn drawn by by a a 22-year-old 22-year-old malemale soldier.soldier. HeHe wrotewrote thatthat aa manman wearingwearing aa parachuteparachute waswas fallingfalling intointo aa boilingboiling volcano.volcano. TheThe emotionalemotional contentcontent scorescore ofof thisthis picturepicture waswas 11 andand itsits self-imageself-image scorescore waswas alsoalso1. 1. InIn hishis sentence,sentence, thethe subjectsubject waswas “a“a personperson wearingwearing aa parachute,”parachute,” andand wewe assumedassumed thatthat hehe Sustainability 2021, 13, x FOR PEER REVIEWidentiﬁed with the person who fell into the volcano. This soldier’s perceived stress7 score of 13 identified with the person who fell into the volcano. This soldier’s perceived stress score waswas 3.23,3.23, hishis militarymilitary lifelife adjustmentadjustment scorescore waswas 1.54, 1.54, and and his his resilience resilience score score was was 1.56. 1.56.

FigureFigure 2.2. DASDAS drawing:drawing: “A“A manman wearingwearing aa parachuteparachute isis fallingfalling intointo aa boilingboiling volcano”.volcano.”

4. Discussion The purpose of this study was to determine whether the DAS drawing test could effectively predict the psychological status of 267 soldiers. We found that the emotional content scale of the DAS test significantly predicted the perceived stress, military life adjustment, and resilience of the soldiers who participated in the study. Our analysis revealed a negative relationship between emotional content and perceived stress—the more negative the content expressed in the picture, the higher the perceived stress. Considering that stress is also closely related to depression, anxiety, and physical symptoms [43,44], it is plausible that perceived stress and emotional content are strongly interrelated. The work of Byeon and Lee [36] relates directly to this study’s findings. They examined the relationship between depressive status and the DAS emotional content scale among conscripted Korean soldiers. Selecting high and low depression groups among 247 soldiers and comparing the DAS test results between the two groups, they confirmed that the group with high depression had lower scores on the emotional content scale than the group with low levels of depression. Kim and Hong [37] also investigated the relationship between depression and DAS in soldiers and found that depression was high when the emotional content scores were low. Stress may result in depression, and it is closely related to life adaptation. Specifically, several previous studies have examined the relationship between the perceived stress of soldiers and adaptation to military life [9,40,45]. In this study, we showed that higher DAS emotional content scores corresponded to better adaptation to military life, while lower DAS emotional content scores corresponded to lower adaptation levels. A low emotional content score indicates that the relationship depicted in a picture is destructive, or that the subject is frustrated, in a fatal crisis, or anxious. Soldiers may draw such pictures as symbolic representations of their current difficulties in adapting to their units. In a similar vein, a previous study found that the DAS test can predict emotional and behavioral problems in children [46]. Although the participants in this study varied in terms of age and other conditions, our findings provide additional evidence that psychological states of the people drawing the pictures are projected onto the pictures. Resilience is a psychological strength that allows people to endure adverse situations; it is a dynamic process that involves positive adaptation [27–30,47]. Our evaluation of the DAS revealed that the emotional content scale effectively predicts resilience. Previous studies examining the relationship between resilience and DAS responses have been scarce, but Choi and Jeon [48] did examine this relationship with a sample of middle-aged women. The researchers found that participants with high DAS emotional content scores had high levels of resilience; thus, their work also supports the relationship between DAS and resilience. The fact that resilience can be projected through a drawing test has practical implications in the field of military operations. In the military, soldiers inevitably experience job stress or difficulties in the barracks. However, assessing the resilience of soldiers and helping them improve their resilience can eventually improve their adaptation to military life. In fact, research has shown that professional workers with high levels of resilience assess their job stress as low and their job satisfaction as higher [49]. Therefore, one way to lower soldiers’ stress is to improve their resilience. In this process, the drawing assessment can be used as an auxiliary psychological test to evaluate soldiers’ resilience. The DAS self-image scale is used to evaluate the strength of the objects identified by the individuals who drew the pictures. In this study, we found no significant relationship between self-image and perceived stress or adjustment to military life. Although our analysis of the self-image scale showed a significant correlation between it and resilience, we ultimately excluded it from the regression analysis because it did not increase significantly when administered as an independent variable. These results have important implications in predicting whether conscript soldiers might have difficulties adjusting in the military by conducting drawing tests. In other words, it is vital to consider the whole picture to estimate the psychological state of the subject. It might be dangerous to draw a hasty conclusion from only a part of the picture. Sustainability 2021, 13, 7383 8 of 13

Self-image is a partial element compared to emotional content. Therefore, in studies analyzing the effects of self-images, we found inconsistent reporting—some studies of DAS self-images have produced significant results, but others have not. Examining the relationship between depression and the DAS self-images of conscript soldiers, Byeon and Lee [36] reported that higher levels of depression were associated with more helpless or unfortunate self-images. Other researchers have reported that the higher the DAS self- image score, the higher the psychological well-being of college students [50]. Meanwhile, adolescents who perpetrated school violence showed more of their pathological fantasies in their self-images [51]. Among subway train drivers suffering from post-traumatic stress, more negative DAS self-images were associated with more severe the post-traumatic stress [33]. Young North Korean defectors were found to have more fragile self-images [34]. In contrast, a previous study found no relationship between the DAS self-images of male juvenile delinquents and anger or physical/verbal aggression [52]. The fact that a self-image score of 5 in the self-image scale can reflect both positive and negative content likely explains why it is less effective than the emotional content scale. For example, if one draws a person who makes others happy, the self-image score is 5. However, if one draws a person threatening or attacking his or her opponent, the self-image score can also be 5. For this reason, researchers have suggested that studies should separate positively strong self-images and negatively strong self-images, which are all 5 points [52–55]. Our self-image results may have been insignificant because the 5 self-image points reflected mixed positive and negative self-image scores. There is another possible reason why the analysis result of the self-image scale was not significant: did the self-image used in the analysis truly symbolize the person’s self? In this study, we assumed that the subjects of written sentences were testees’ symbolized selves. What if the objects projected and identified with themselves were something else in the testees’ drawing? Or what if there was no such object? In such cases, the analysis result of the self-image scale would inevitably become insignificant. Therefore, defining the testees’ identified self-image will determine the applicability of this scale in the future. In this study, we analyzed using only two measures suggested by Silver [31]. However, there are other ways to analyze pictures: one can explore the degree of space usage in drawings and after providing colored media, one can examine the types and number of colors used. Although such a method is not the standard analysis method of DAS, it would be meaningful to try various analysis methods to obtain significant results. Through this study, we examined the predictive power of the Draw-a-Story test as a method to evaluate the mental health of conscript soldiers and detect potential risks, as well as their strengths, including resilience. Helping people adapt to their environment is essential and meaningful for realizing a sustainable and advanced society. The first step for adaptation is to identify one’s status accurately. Since the drawing test reveals testees’ subtle psychological states, it can provide information necessary to adapt to the environments. For the military to be sustainable, it is essential to improve its system and the environment. Furthermore, it would be indispensable to take good care of the psychological states of individual soldiers and empower them by strengthening their resilience. The Draw-a-Story test verified in this study is a tool that can improve the quality of soldiers’ life, and ultimately it could be an ingredient for creating a sustainable military culture.

5. Conclusions We conducted this study to determine whether the DAS test that Silver developed to examine depression and aggression can predict soldiers’ stress, military life adaptation, and resilience. Our findings indicate that the emotional content scale of the DAS picture test can predict such variables. The three research hypotheses established in this study were partially adopted and partially rejected as follows. The first hypothesis was that the DAS scale would correlate significantly with military service stress, military life adjustment, and resilience of soldiers. We adopted this hypothesis. The emotional content scale of the DAS Sustainability 2021, 13, 7383 9 of 13

showed significant correlations with all of the variables that we examined in the study. The second hypothesis was that the emotional content scale of the DAS would predict military service stress, military life adjustment, and resilience, respectively; we also adopted this hypothesis. Finally, we rejected the third hypothesis. Based on the regression analysis results, the self-image scale of the DAS could not predict military service stress, military life adjustment, or resilience, respectively. In summary, we found that the DAS emotional content was helpful as a tool to evaluate the psychological state of soldiers, but the DAS self-image was not. These results suggest that it is necessary to consider the overall content when using and interpreting drawing assessments rather than focusing only on a partial picture. A carefully used drawing test can act as a primary indicator for measuring the soldiers’ stress or resilience concerning military adaptation. In addition, we propose that by using picture tests to evaluate soldiers’ stress, adaptation, and resilience, practitioners can increase the likelihood of preventing problems in the military. The limitations of this study and our suggestions for future research are as follows. First, this study only considered male conscripted soldiers in their early twenties. Thus, we cannot generalize these findings to female soldiers or those in other age groups. Second, we conducted a cross-sectional survey at a specific point in time and did not track the results longitudinally. Future studies should therefore consider investigating the relationship between DAS test results and subsequent adaptation to military life or related difficulties.

Author Contributions: Data curation, J.-H.H.; formal analysis, J.J.; funding acquisition, J.-H.H.; investigation, J.-H.H.; methodology, J.J.; project administration, J.-H.H.; visualization, J.J.; writing— original draft, J.J. All authors have read and agreed to the published version of the manuscript. Funding: This research was funded by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2018RIA5A7025522). Data Availability Statement: The data presented in this study are available on request from the corresponding author. The data are not publicly available due to their containing information that could compromise the privacy of research participants. Conﬂicts of Interest: The authors declare no conﬂict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Appendix A. The Perceived Stress Scale Please read each of the following questions and choose from 1 to 5 points that best represent your thoughts. (1 = strongly disagree, 5 = strongly agree) 1. I get stressed because of the inconvenience of facilities (e.g., toilet, bathroom). 2. I get stressed because of the lack of leisure life. 3. I get stressed because meals are poor. 4. I get stressed because the quality of supplies is not as good as expected. 5. I get stressed because my sleeping place is narrow and uncomfortable. 6. I get stressed because I don’t have any feedback for my work. 7. I get stressed because what I have to do now doesn’t make sense. 8. I get stressed because the life around me is confusing. 9. I get stressed when I have to do something contrary to my beliefs. 10. I get stressed because I don’t know what to do. 11. I get stressed because of the rude words and behaviors of people around me. 12. I get stressed because of conﬂicts with people around me. 13. I get stressed because I don’t have as much privacy as needed. 14. I get stressed because of unfair demands from people around me. 15. I get stressed because of excessive work. 16. I get stressed because the assigned task doesn’t ﬁt to my aptitude. 17. I get stressed because I lack the skills and experiences to do my job. Sustainability 2021, 13, 7383 10 of 13

18. I get stressed because of the conﬂict over following instructions. 19. I get stressed because of the risk of accidents at work. 20. I get stressed because the work orders given to me are not clear. 21. I get stressed because my daily work is boring and unchanged. 22. I get stressed because my personal time (e.g., after work hours) is not guaranteed. 23. I get stressed because vacations or overnight stays are unreasonably carried out. 24. I get stressed because of my family problems. 25. I get stressed because of my lover. 26. I get stressed because I am anxious about the future after my release.

Appendix B. The Military Life Adjustment Scale Please read each of the following questions and choose from 1 to 5 points that best represent your thoughts and feelings. (1 = strongly disagree, 5 = strongly agree) 1. In general, daily life in the unit is cheerful. 2. I try to spend my free time in the military for my personal development. 3. My physical health is very good. a. In battle, I want to fight for my country as a combatant rather than an administrative soldier. 4. If the country is in crisis, I will extend my service period. 5. When a battle occurs, I will go to the battlefield immediately. 6. If a war breaks out, I want to go to a unit on the front line. 7. My current position is very satisfactory compared to other positions. 8. If I were given the opportunity to change my position, I would not change it. 9. My job in the military is very valuable. 10. In general, there are many opportunities to demonstrate my abilities in the military. 11. I think my position is very important for the military to carry out its combat mission. 12. I am doing my best in the military service. 13. Our unit’s training and military conditions are very good. 14. My job in the military is interesting. 15. I think the military is very good in all respects these days. 16. Our unit’s administration (e.g., reward, vacation, overnight stay, outing) is fair. 17. Work, training, and office hours in the military are meaningful. 18. In terms of mission performance, the levels of our unit’s non-commissioned officers are excellent. 19. The officers keep what they once promised their subordinates to the end. 20. I have a lot of non-commissioned officers whom I want to be together in battle. 21. All officers in our unit care about their subordinates. 22. I think the current system of promotion in the order of seniority is a very good system. 23. Even when I receive an unfair order or instruction from my boss, I am not bothered. 24. I believe the military is doing its best for soldiers’ welfare. 25. I will have a good impression of the military when I am discharged.

Appendix C. The Connor–Davidson Resilience Scale Looking back over the past one month, and please choose from 1 to 5 points that best represent how you think or feel. (1 = strongly disagree, 5 = strongly agree) 1. I am able to adapt to change. 2. I have close and secure relationships. 3. Sometimes fate or God can help. 4. I can deal with whatever comes. 5. Past success gives me conﬁdence for new challenges. 6. I see the humorous side of things. 7. Coping with stress can strengthen me. 8. I tend to bounce back after illness or hardship. Sustainability 2021, 13, 7383 11 of 13

9. Things happen for a reason. 10. I give my best effort no matter what. 11. I can achieve my goals despite obstacles. 12. When things look hopeless, I don’t give up. 13. I know where to turn for help. 14. Under pressure, I can stay focused. 15. I prefer to take the lead in problem solving. 16. I am not easily discouraged by failure. 17. I think of myself as a strong person. 18. I can make unpopular or difﬁcult decisions. 19. I can handle unpleasant feelings. 20. Sometimes I have to act on a hunch. 21. I have a strong sense of purpose. 22. I am in control of my life. 23. I like challenges. 24. I work to attain my goals. 25. I have pride in my achievements.

Appendix D. The Draw-a-Story Drawing Test Instruction: The stimulus pictures provided show pictures of people, animals, places, and objects. Choose two of these and imagine the story of what is going on between them. Now draw your story. You can change parts of the stimulus picture or add your ideas when you draw. When you have ﬁnished drawing, please write your story in the blank space.

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