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).
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.
There was significant agreement between AAP judges, κ=0.677, p<0.001. Five out of six participants showed stability in their classifications over time. The majority of expert ratings were “good” or “excellent”. There was a significant inter-class correlation between raters suggesting good agreement between them r=0.51 (p<0.05). The raters’ feedback suggested that the AAP had good clinical utility.
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.
This is the first study attempting to investigate the reliability and validity of the AAP in this population.
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.
Gallichan, D. and George, C. (2018), "The Adult Attachment Projective Picture System: a pilot study of inter-rater reliability and face validity with adults with intellectual disabilities", Advances in Mental Health and Intellectual Disabilities, Vol. 12 No. 2, pp. 57-66. https://doi.org/10.1108/AMHID-11-2017-0036Download as .RIS
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