The role of defensive exclusion (Deactivation and Segregated Systems) in the development of early... more The role of defensive exclusion (Deactivation and Segregated Systems) in the development of early relationships and related to subsequent manifestations of symptoms of eating disorders was assessed using the Adult Attachment Projective Picture System (AAP). Fifty-one DSM-IV diagnosed women with anorexia participated in the study. Anorexic patients were primarily classified as dismissing or unresolved. Quantitative and qualitative analyses of defensive exclusion were carried out. Results showed potential benefits of using the AAP defense exclusion coding system, in addition to the main attachment classifications, in order to better understand the developmental issues involved in anorexia. Discussion concerned the processes, such as pathological mourning, that may underlie the associations between dismissing and unresolved attachment and anorexia. Implications for developmental research and clinical nosology are discussed.
Zeitschrift für psychosomatische Medizin und Psychotherapie, 2007
In this study we investigated for the first time the facial activity of patients with Borderline ... more In this study we investigated for the first time the facial activity of patients with Borderline Personality Disorder (BPD) compared to healthy controls during the Adult Attachment Projective (AAP). The AAP is a valid interview measure for assessing adult attachment representation. The attachment system is activated by eight attachment-related pictures. The subjects are asked to tell a story about each picture. The affective facial behavior during the AAP interview in 15 female patients with BPD and 14 healthy women was coded using EMFACS. Affective facial behavior was compared between diagnostic and attachment groups (resolved versus unresolved trauma). As expected, there was a significantly higher number of BPD patients in the category "unresolved trauma" of the AAP. The BPD patients also showed significantly more disgust during the attachment task as compared to controls. The two main results are discussed in the context of frequent traumatic experiences such as sexual ...
George, West and Pettem developed a new measure, the Adult Attachment Projective (AAP) to assess ... more George, West and Pettem developed a new measure, the Adult Attachment Projective (AAP) to assess attachment representation in adults. The AAP is comprised of a set of eight drawings, one neutral scene and seven scenes of attachment situations. Although the pictures were drawn as projective stimuli, the method of administration combines projective and interview techniques in the form of a semi-structured interview. In this paper the coding procedure and attachment classifications of the AAP will shortly be described. The current results on reliability and convergent validity are reported. Developmental studies examining correlates of attachment during the preschool-age years, as well as adult attachment classification and foster mothers' perceptions of their relationship with their at risk foster children give first evidence for the predicitve validity of the AAP. The results of a recent study with dysthymic women using the AAP add to the increasing number of studies that have id...
Advances in Mental Health and Intellectual Disabilities
Purpose The purpose of this paper is to assess whether the Adult Attachment Projective (AAP) Pict... more 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, 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. 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.
Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy i... more Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy is associated with a higher incidence of postpartum depression. Maternal self-efficacy and postpartum depression can both be buffered by social support. Maternal self-efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self-efficacy, with emotional support as a moderator. Participants were 278 first-time mothers of infants under 14 months. Cross-sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self-efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus' estimate of indirect effects. Postpartum d...
Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy i... more Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy is associated with a higher incidence of postpartum depression. Maternal self-efficacy and postpartum depression can both be buffered by social support. Maternal self-efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self-efficacy, with emotional support as a moderator. Participants were 278 first-time mothers of infants under 14 months. Cross-sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self-efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus' estimate of indirect effects. Postpartum d...
To investigate possible reasons why millions of cats and dogs are adopted and then rejected each ... more To investigate possible reasons why millions of cats and dogs are adopted and then rejected each year, 120 male and 223 female adopters from the San Francisco Bay Area shelters completed George's Pet Expectations Inventory, which rates the physical, emotional, and intellectual effects of roles pets are expected to play, and the 50 fathers and 89 mothers rated the roles expected to affect their children's lives. Six-month phone call follow-ups ascertained whether they still had the adopted pet, and if not, why not. Analysis of responses indicated that: (1) subjects who already had or previously had pets retained significantly more newly adopted pets than those who had never had pets. (2) Men rejected a significantly higher percentage of pets than did women, as did significantly more parents than nonparents. (3) Although there were no significant differences in total scores between subjects who retained and those who rejected pets either for themselves or for their children, specific role expectations differed considerably between men and women, parents and nonparents, and retainers and rejecters. Adopters held higher expectations for dogs than for cats. Present results could help shelter workers reduce the number of adopted pets abandoned and euthanized.
The role of defensive exclusion (Deactivation and Segregated Systems) in the development of early... more The role of defensive exclusion (Deactivation and Segregated Systems) in the development of early relationships and related to subsequent manifestations of symptoms of eating disorders was assessed using the Adult Attachment Projective Picture System (AAP). Fifty-one DSM-IV diagnosed women with anorexia participated in the study. Anorexic patients were primarily classified as dismissing or unresolved. Quantitative and qualitative analyses of defensive exclusion were carried out. Results showed potential benefits of using the AAP defense exclusion coding system, in addition to the main attachment classifications, in order to better understand the developmental issues involved in anorexia. Discussion concerned the processes, such as pathological mourning, that may underlie the associations between dismissing and unresolved attachment and anorexia. Implications for developmental research and clinical nosology are discussed.
Zeitschrift für psychosomatische Medizin und Psychotherapie, 2007
In this study we investigated for the first time the facial activity of patients with Borderline ... more In this study we investigated for the first time the facial activity of patients with Borderline Personality Disorder (BPD) compared to healthy controls during the Adult Attachment Projective (AAP). The AAP is a valid interview measure for assessing adult attachment representation. The attachment system is activated by eight attachment-related pictures. The subjects are asked to tell a story about each picture. The affective facial behavior during the AAP interview in 15 female patients with BPD and 14 healthy women was coded using EMFACS. Affective facial behavior was compared between diagnostic and attachment groups (resolved versus unresolved trauma). As expected, there was a significantly higher number of BPD patients in the category "unresolved trauma" of the AAP. The BPD patients also showed significantly more disgust during the attachment task as compared to controls. The two main results are discussed in the context of frequent traumatic experiences such as sexual ...
George, West and Pettem developed a new measure, the Adult Attachment Projective (AAP) to assess ... more George, West and Pettem developed a new measure, the Adult Attachment Projective (AAP) to assess attachment representation in adults. The AAP is comprised of a set of eight drawings, one neutral scene and seven scenes of attachment situations. Although the pictures were drawn as projective stimuli, the method of administration combines projective and interview techniques in the form of a semi-structured interview. In this paper the coding procedure and attachment classifications of the AAP will shortly be described. The current results on reliability and convergent validity are reported. Developmental studies examining correlates of attachment during the preschool-age years, as well as adult attachment classification and foster mothers' perceptions of their relationship with their at risk foster children give first evidence for the predicitve validity of the AAP. The results of a recent study with dysthymic women using the AAP add to the increasing number of studies that have id...
Advances in Mental Health and Intellectual Disabilities
Purpose The purpose of this paper is to assess whether the Adult Attachment Projective (AAP) Pict... more 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, 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. 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.
Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy i... more Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy is associated with a higher incidence of postpartum depression. Maternal self-efficacy and postpartum depression can both be buffered by social support. Maternal self-efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self-efficacy, with emotional support as a moderator. Participants were 278 first-time mothers of infants under 14 months. Cross-sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self-efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus' estimate of indirect effects. Postpartum d...
Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy i... more Maternal self-efficacy predicts sensitive and responsive caregiving. Low maternal self-efficacy is associated with a higher incidence of postpartum depression. Maternal self-efficacy and postpartum depression can both be buffered by social support. Maternal self-efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self-efficacy, with emotional support as a moderator. Participants were 278 first-time mothers of infants under 14 months. Cross-sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self-efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus' estimate of indirect effects. Postpartum d...
To investigate possible reasons why millions of cats and dogs are adopted and then rejected each ... more To investigate possible reasons why millions of cats and dogs are adopted and then rejected each year, 120 male and 223 female adopters from the San Francisco Bay Area shelters completed George's Pet Expectations Inventory, which rates the physical, emotional, and intellectual effects of roles pets are expected to play, and the 50 fathers and 89 mothers rated the roles expected to affect their children's lives. Six-month phone call follow-ups ascertained whether they still had the adopted pet, and if not, why not. Analysis of responses indicated that: (1) subjects who already had or previously had pets retained significantly more newly adopted pets than those who had never had pets. (2) Men rejected a significantly higher percentage of pets than did women, as did significantly more parents than nonparents. (3) Although there were no significant differences in total scores between subjects who retained and those who rejected pets either for themselves or for their children, specific role expectations differed considerably between men and women, parents and nonparents, and retainers and rejecters. Adopters held higher expectations for dogs than for cats. Present results could help shelter workers reduce the number of adopted pets abandoned and euthanized.
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Papers by Carol George