title: The Manchester Color Wheel: validation in secondary school pupils.
abstract: BACKGROUND
  As part of our research programme into facilitating improved ways of communicating with patients, especially about more sensitive clinical issues, we have been investigating whether there are any non-verbal methods that might aid this process. One such approach is to ask patients to choose a color in response to a particular question, for instance about health or psychological status, and for this purpose we developed the Manchester Color Wheel (MCW). This instrument consists of positive, neutral and negative colors and its validation in normal adults and those with anxiety or depression showed that it is responsive to change and reproducible. It also has the capacity to identify a positive frame of mind. We concluded that it might be a particularly useful instrument in adolescents and therefore this study aimed to validate it in a secondary school.
  
  
  METHODS
  620 pupils (aged 11-17 years, mean age 14.0 years, 298 (48.1%) males, 322 (51.9%) females) at Sale Grammar School in Greater Manchester were asked to relate their mood to a MCW color and also complete the Hospital Anxiety Depression (HAD) questionnaire. To give these pupils an experience in science, 197 were divided into four subgroups for an 'experiment' to ascertain whether, compared to controls, a change in mood color choice could be induced by participation in sport, music or art activities.
  
  
  RESULTS
  Although mood color and HAD depression score are unlikely to be measuring exactly the same psychological state, a negative mood color was chosen by 62.5% of HAD depressed compared to only 14.5% of HAD normal pupils (p < 0.001). In contrast, a positive mood color was chosen by 48.9% of normal and only 18.8% of depressed pupils (p < 0.001). In the 'experiment', compared to controls, all activities resulted in an increased choice of positive mood colors which reached significance for sport and music.
  
  
  CONCLUSIONS
  This study confirms the potential utility of the MCW to rapidly and easily assess a variety of health issues in large populations, including adolescents. Some of our results should also be of interest to educationalists.
authors.affiliation: Department of Medical Illustration, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
authors.forename: Helen R
authors.initials: HR
authors.lastname: Carruthers
authors.forename: Linda
authors.initials: L
authors.lastname: Magee
authors.forename: Susan
authors.initials: S
authors.lastname: Osborne
authors.forename: Linda K
authors.initials: LK
authors.lastname: Hall
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Whorwell
mesh_terms: D000293:Adolescent; D000339:Affect; D001007:Anxiety / Q000175:diagnosis*; D002648:Child; D003116:Color; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009146:Music / Q000523:psychology; D011369:Professional-Patient Relations; D011581:Psychological Tests / Q000592:standards*; D012613:Sculpture / Q000523:psychology; D013177:Sports / Q000523:psychology; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires / Q000592:standards; D006113:United Kingdom