Klinische Bindungsforschung mit dem Adult Attachment Projective Picture System: Methodik,klinische Anwendung und Perspektiven

The Adult Attachment Projective Picture System (AAP) is an established, reliable and valid representational measure of attachment for adults. In this review we report on several studies using the AAP in the clinical and neurobiological context. Moreover we demonstrate some disorder specific characteristics in patients with different disorders in their AAP narratives. In sum the AAP is valid for assessing attachment representations in several clinical disorders in the context of psychotherapy research. The economic administration allows to apply the AAP also in the clinical routine. This measure can also be administered in adolescent participants. There are only a small number of studies examining the change of attachment status during psychotherapy. We report on a study in depressed patients and their significant change from disorganized to organized attachment representations after 15 months of psychoanalytic treatment. This study identified neural changes in patients using an adapted AAP-fMRI paradigm to assess their improvement on a neural level. The feasibility of the AAP in an fMRI environment opens new possibilities to examine neural correlates of attachment. An fMRI study on Borderline patients with attachment trauma revealed clinically relevant results, concerning the patients’ intolerance of aloneness.