The Adult Attachment Projective Picture System: a pilot study of inter-rater reliability and face validity with adults with intellectual disabilities

Date05 March 2018
DOIhttps://doi.org/10.1108/AMHID-11-2017-0036
Published date05 March 2018
Pages57-66
AuthorDeanna Gallichan,Carol George
The Adult Attachment Projective Picture
System: a pilot study of inter-rater
reliability and face validity with adults with
intellectual disabilities
Deanna Gallichan and Carol George
Abstract
Purpose The purpose of this paper is to assess whether the Adult Attachment Projective (AAP) Picture
System is a reliable and face valid measure of internal working models of attachment in adults with intellectual
disabilities (ID).
Design/methodology/approach The AAPs of 20 adults with ID were coded blind by two
reliable judges and classified into one of four groups: secure, dismissing, preoccupied, or unresolved.
Inter-rater reliability was calculated using κ. Six participants repeated the assessment for test-retest
reliability. Two independent experts rated ten cases on the links between the AAP analysis and the
clinical history.
Findings There was significant agreement between AAP judges, κ¼0.677, po0.001. Five out of six
participants showed stability in their classifications over time. The majority of expert ratings were
goodor excellent. There was a significant inter-class correlation between raters suggesting good
agreement between them r ¼0.51 (po0.05). The ratersfeedback suggested that the AAP had goo d
clinical utility.
Research limitations/implications The inter-rater reliability, stability, face validity, and clinical utility of the
AAP in this population is promising. Further examination of these findings with a larger sample of individuals
with ID is needed.
Originality/value This is the first study attempting to investigate the reliability and validity of the AAP in
this population.
Keywords Attachment, Assessment, Intellectual disabilities, Relationships, AAP, Internal working models
Paper type Research paper
Introduction
This paper addresses the assessment of mental representations of attachment in adults with
intellectual disabilities (ID) . Bowlby (1969/1982, 1973, 1980) propose d that the early
development of relationships with caregivers (i.e. attachment relationships) were key to
emotional development and to psychological health in adulthood. Attachment experiences were
thought to influence peoples patterns of thinking about relationships and their sense of
themselves as worthy of care. Termed internal working models, Bowlby considered these
attachment representations to operate outside of conscious awareness. Bowlbys proposals
have been substantiated by over 40 years of basic and clinical research in children and adults
(Cassidy and Shaver, 2016).
Over the past few decades, the field of ID has increasingly acknowledged the importance of
peoples internal worlds (Webb, 2014). Further, there is growing interest in the application of
attachment theory to clinical problems (Fletcher et al., 2016). Despite this interest, there is no
measure of internal working models of attachment that has been shown to be reliable or valid for
Received 3 November 2017
Revised 21 January 2018
Accepted 13 February 2018
The authors would like to thank:
Dr Judith McBrien, who made it
possible for the first author to be
trained in the AAP; Dr Malcolm
West who co-facilitated the AAP
seminar; several assistants who
supported the research: Roberta
Bowie, Louise Sheppard, Sarah
Parker and Sophie Bishop; Dr
John Wright and Dr Helen Fletcher
who generously gave up their time
to be experts 1 and 2,
respectively; two anonymous
reviewers who commented on an
earlier version of this manuscript;
and most importantly, to all of the
people with intellectual disabilities
who generously gave up their time
to participate in the study.
Deanna Gallichan is a
Consultant Clinical
Psychologist at Community
Learning Disabilities Team,
Livewell Southwest CIC,
Plymouth, UK.
Carol George is a Professor of
Psychology at Department of
Psychology, Mills College,
Oakland, California, USA.
DOI 10.1108/AMHID-11-2017-0036 VOL. 12 NO. 2 2018, pp.57-66, © Emerald Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE57

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT