The Bird's Nest Drawing: A study of construct validity and interrater reliability

The Arts in Psychotherapy 42 (2015) 1–9

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The Arts in Psychotherapy

The Bird’s Nest Drawing: A study of construct validity and interrater reliability Gaelan Harmon-Walker, MS a,∗,1 , Donna H. Kaiser, PhD b,2 a

Trillium Family Services, 3415 SE Powell Blvd, Portland, OR 97202, United States Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, 1601 Cherry Street, Mail Stop 7905, Philadelphia, PA 19102, United States b

a r t i c l e

i n f o

Article history: Available online 6 January 2015 Keywords: Bird’s Nest Drawing Art therapy assessment Attachment theory Experiences in Close Relationships Questionnaire Inventory of Parent and Peer Attachment

a b s t r a c t The Bird’s Nest Drawing (BND; Kaiser, 1996) is a single drawing art therapy assessment developed as a projective measure of attachment security. This study examined the individual graphic indicators and overall impression ratings of 136 adult undergraduate BNDs using two rating scales to determine interrater reliability and construct validity. Participants completed the BND, the Inventory of Parent and Peer Attachment (IPPA), and the Experiences in Close Relationships Questionnaire (ECR). Chi-square analyses were conducted to assess the frequency distributions of graphic indicators and overall impression ratings in high and low ECR and IPPA groups. Two of 11 graphic indicators reached statistical significance when compared with attachment score groups. The inclusion of a family of birds was significantly associated with high IPPA scores (2 = 4.371, p = .037), and bottomless nests were associated with low ECR scores (2 = 7.253, p = .007). An association was also found between overall impression ratings and the ATM subscale of the IPPA (2 = 12.5733, p = .006). These results provide preliminary support for a growing trend in art-based assessment in which overall impression scoring systems are used with theory-based drawing assessments. © 2014 Elsevier Ltd. All rights reserved.

The Bird’s Nest Drawing (Kaiser, 1996, 2012a) is a single drawing art-based assessment developed as a projective measure of attachment security. The selection of the BND was based upon the notion that a bird’s nest is symbolic of relational patterns of early life in its manifestation of images related to protection, nurturance, a holding space, interpersonal closeness, and parental attunement (Kaiser, 1996). Kaiser (1996) developed the BND checklist, a coding system used to quantify structural and content indicators in BNDs, and has modified the rating system as other studies were done to test its validity over a span of 20 years (Kaiser & Deaver, 2009). The BND is grounded in attachment theory, a framework which provides a model for understanding the cognitive, emotional, and behavioral aspects of internalized early childhood experiences (Bowlby, 1969). In particular, BND validity research has focused on the convergence of BND rating scales with adolescent and adult

∗ Corresponding author at: 9305 SW Terwilliger Blvd, Portland, OR 97219, United States. Tel.: +1 503 730 9863. E-mail addresses: [email protected] (G. Harmon-Walker), [email protected] (D.H. Kaiser). 1 Research was conducted at Johnston Center for Integrative Studies, University of Redlands, 1200 East Colton Ave P.O. Box 3080, Redlands, CA 92373, United States. 2 Present address: Drexel University, 3001 Market St. Suite 300, Philadelphia, PA 19104, United States. http://dx.doi.org/10.1016/j.aip.2014.12.008 0197-4556/© 2014 Elsevier Ltd. All rights reserved.

attachment constructs (Francis, Kaiser, & Deaver, 2003; Kaiser, 1996; Kaiser & Deaver, 2009). Next, we describe salient aspects of attachment measures that have been developed for adults, the use of family drawings to assess attachment security with children, and the current state of the research on the BND. Adult attachment research Attachment theory has emerged as one of the most visible and empirically grounded frameworks in the fields of social and emotional development (Cassidy & Shaver, 2008). Rooted in the theoretical work of John Bowlby (1969) and the experimental procedures of Mary Ainsworth (1969), modern attachment theory provides a model for understanding human responses to perceived separations from caregivers or other emotional threats occurring over the lifespan. Attachment security in infancy has been correlated with numerous outcomes in later life, such as emotional health, academic achievement, suicide risk, and quality of life (Cassidy & Shaver, 2008). Awareness of a client’s attachment organization can help clinicians plan treatment and build trusting therapeutic relationships that match a client’s attachment status (Cassidy & Shaver, 2008). Following Ainsworth’s (1969) pioneering Strange Situation research, numerous investigators have attempted to expand upon

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the four-category model of infant attachment to account for attachment dynamics in adolescents and adults. These theorists have argued that primary relationships between infants and caregivers are internalized and generalized to other relationships throughout life. Attempts to clarify the similarities and differences between child, adolescent, and adult models of attachment have led to overlaps and distinctions among measures developed in different lines of research (Crowell, Fraley, & Shaver, 2008). Thus, BND validity research has been complicated by the inherent gaps between various attachment research paradigms and their associated instruments. Contemporary adult attachment research is dominated by two methods: (1) those that assess a person’s state of mind with regard to attachment such as the Adult Attachment Interview (AAI; Hesse, 2008) and the Adult Attachment Projective Picture System (AAP; George & West, 2012), and (2) self-report questionnaires that tap people’s perceptions of their own attachment style (Rholes & Simpson, 2004; Solomon & George, 2008). The AAI is a semistructured interview during which adults are asked to describe their experiences with childhood caregiver relationships and to evaluate the impact of these experiences on their current functioning (George, Kaplan, & Main, 1996). The operational variables of the AAI are adapted from coherence theory, and are scored quantitatively (Hesse, 2008). The AAI has been subjected to a series of psychometric tests of stability and discriminant validity (van Ilzendoorn, 1995) and has been applied to numerous populations and cultures (Hesse, 2008). A second, completely independent line of adult attachment research began when Hazan and Shaver (1987) introduced a theory of romantic attachment. The researchers followed up on Weiss’s (1993) concept that chronic loneliness in adulthood is related to insecure attachment. The authors created a simple self-report measure with items corresponding to self-partner schemata, or internal working models (Shaver & Mikulincer, 2004). That same year, two new adult measures were published by other attachment theorists: a self-report Inventory of Parent and Peer Attachment (IPPA; Armsden & Greenberg, 1987), that aims to assess the security of adolescents’ relationships with peers and parents; and a multidimensional Adult Attachment Scale (AAS) designed to analyze an adult’s relationship with a particular attachment figure (West, Sheldon, & Reiffer, 1987). Of these initial instruments, the majority of subsequent researchers adopted Hazan and Shaver’s (1987) measure because of its novelty, brevity, face validity, and ease of administration (Crowell et al., 2008; Shaver & Mikulincer, 2004). Bartholomew (1990) proposed that a single representational system underlies the previously described assessments. Brennan, Clark, and Shaver (1998) conducted a factor analysis of all previous dimensional measures of attachment based on Bartholomew’s two orthogonal dimensions and found that all 60 attachment constructs could be reduced using Bartholomew’s model. Based on this, they combined all previous questionnaires into a single measure, the Experiences in Close Relationships Questionnaire (ECR), which has been found to be highly reliable and to have excellent construct validity (Shaver & Mikulincer, 2002).

Drawing tasks for assessing attachment Researchers have sought multiple approaches for accessing models of close relationships that emerge in childhood and manifest in thoughts and behaviors across the lifespan. Drawing tasks constitute one approach to eliciting internal models of attachment that has been developed primarily for use with school-aged children. Kaplan and Main (1986) developed the first system to assess attachment representation in children’s family drawings. Based on specific content items and the overall organization of the drawings,

Kaplan and Main (1986) described four suites of characteristics to describe infant/child attachment patterns. The characteristics that correlated with secure attachment included realism, implied happiness, and complete figures that depicted family members with individual differences. Drawings characterized as ambivalent had either very large or very small people, and were either divided by boundary lines or the figures were overlapping. The characteristics associated with avoidance included an overall impression of invulnerability, exaggerated positivity, and a lack of movement. Drawings that were disorganized included bizarre components such as violent or fantastic themes, incomplete objects or figures, inexplicable marks, and irrational or exaggerated sweetness (Kaplan & Main, 1986). In a normative study, Pianta, Longmaid, and Ferguson (1999) assessed the reliability and validity of Kaplan and Main’s (1986) rating system with a nonclinical sample consisting of 200 kindergarten children of diverse racial and socioeconomic status. Controlling for age, intelligence, and fine-motor skills, kappas for overall drawing patterns exceeded .80 and a mean kappa for drawing indicators was .82; however, over half of the 53 drawing indicators could not be reliably coded. Pianta et al. (1999) concluded that the system demonstrated limited reliability. The first substantial evidence that drawing performance could be correlated with early life attachment organization came a decade after Kaplan and Main’s (1986) initial research. Building on Kaplan and Main’s (1986) work, Fury, Carlson, and Sroufe (1997) developed a theoretically based 7-point scale to measure the global variables in children’s family drawings. The authors collected family drawings from 171 high-risk, racially mixed youth aged eight to nine years of age. Each child completed a family drawing with 10 colored felt-tipped pens and a 12 × 18 inch sheet of white drawing paper. Although initial analyses based on Kaplan and Main’s (1986) framework showed mixed results, secondary analyses combining indicators into aggregates produced significant findings. Fury et al.’s (1997) 7-point global rating scales (vitality, family pride, vulnerability, emotional distance, tension/anger, role reversal, bizarreness/dissociation, and global pathology) were scored based on the examiner’s overall impression of a drawing. Both the indicator aggregates and rating scales were significantly related to Strange Situation attachment security as it had been assessed in infancy. Fury et al. (1997) concluded that drawing tasks may be a robust means of accessing children’s internal attachment models. The finding that overall impressions and aggregations had superior predictive power when compared with indicator matching was repeated in subsequent research. Madigan, Ladd, and Goldberg (2003) rated a sample of 123 seven year olds’ family drawings using Kaplan and Main’s (1986) system, Fury et al.’s (1997) global rating scales, and a new clinical rating system. Their aim was to determine whether Fury et al.’s (1997) findings were generalizable to a low-risk population. As in previous studies, although individual indicators failed to distinguish between groups, aggregated scores and global variables were successful. Similarly, in a longitudinal study, Carlson, Sroufe, and Egeland (2004) determined that global ratings of 185 children’s drawings at age 8 correlated with attachment interviews from preschool and from a second assessment at age 12. In a smaller sample, Behrens and Kaplan (2011) determined that the drawing-based attachment organization of 47 Japanese six year olds could predict maternal secure/insecure status judged by the AAI. Goldner and Scharf (2011, 2012) examined correlations between drawing-based attachment security and personality, psychosocial functioning, and problem internalization. They collected family drawings from 222 Israeli children of low socioeconomic status. Drawings were rated using both Kaplan and Main’s (1986) and Fury et al.’s (1997) systems, and compared with teachers’

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ratings of the children on the Strengths and Difficulties Questionnaire (Goodman, 1997). A multivariate analysis of variance with attachment organization as the independent variable and the eight global scales serving as the dependent variables revealed a significant main effect for attachment. Although no significant relationships between attachment categories and personality variables were found, prosocial behavior was correlated with secure attachment and behavioral problems were correlated with insecure organization (Goldner & Scharf, 2012). Examining internalization subscales of the Strengths and Difficulties Questionnaire, the researchers found small to moderate correlations between individual indicators and internalization variables, which differed between genders. They concluded that this supported previous findings that a global variable rating system is useful for analyzing children’s family drawings.

The Bird’s Nest Drawing The Bird’s Nest Drawing (BND) is a an art therapy task and rating system used to predict the attachment security of individuals based on their response to the directive “draw a picture of a bird’s nest” (Kaiser, 2012a, p. 4). An advantage of the BND, as opposed to family drawings, is that participants usually perceive it as non-threatening and/or as providing emotional distance (Kaiser & Deaver, 2009). Kaiser (1996) noted that: The depiction of a bird’s nest, initially perceived as an innocuous task by most people, often yields rich associations about the contents of the nest, the physical nature of the nest form, the absence or presence of nurturing figures and the fate of the eggs or baby birds drawn or omitted. (p. 333) Unlike family drawings that require participants to visually depict their family members, the BND is success-oriented and does not require explicit depiction of family members. This may reduce anxiety in adults, who are more likely to be self-conscious about their drawing skill and feel that they are unable to draw human figures well (Kaiser, 1996). Kaiser (1996) conducted initial research on the BND, collecting drawings from 41 mothers at a university day-care center in the eastern United States. She operationalized nine hypothesized characteristics to identify in a given drawing, e.g., “whether the nest is supported by the tree” and “line quality” (Kaiser, 1996, p. 335), that might be theoretically tied to attachment status. Using the Attachment to Mother (ATM) subscale of the IPPA, two groups were formed: those with higher attachment scores and those with lower. Initially, no significant differences in frequencies were found when comparing high and low ATM groups and the indicators though there were some trends toward significance. Based on a review of drawing samples, five new items were rated and analyzed, yielding two significant relationships. A significant association was found between inclusion of either parents or baby birds and high ATM scores 2 (1, N = 41) = 7.04, p < .01; and between inclusion of baby birds and high ATM scores 2 (1, N = 41) = 3.88, p < .05. Kaiser (1996) concluded that the presence of birds in BNDs might be associated with secure attachment. To investigate further, Francis et al. (2003) used indicators showing promise from Kaiser’s (1996) research and additional indicators to compare the drawings and adult attachment styles of 70 Veterans Administration hospital patients. This sample compared two groups: patients diagnosed with a substance abuse disorder (n = 43) and those with no history of substance abuse (n = 27). Prior to analyses, the sample of drawings was examined to identify other possible indicators. Items were added which appeared at least six times across drawings. Then through discussion items were identified that may have had theoretical value (Francis et al., 2003).

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Three independent raters achieved satisfactory interrater reliability (kappas ranging from .66 to 1) for 18 of the 19 BND rating scale items. Chi-square analyses of the remaining 18 items yielded significant differences between the substance abuse group and the control group for two items: the use of four or more colors 2 (1, N = 70) = 9.99, p < .05; and the dominance of the color green 2 (1, N = 70) = 9.12, p < .05. However, when the two groups were combined, significance was reached for 8 of the 18 items. The researchers concluded that further investigation of the BND was warranted. The results of several unpublished BND studies were reported by Kaiser and Deaver (2009). Overbeck (2002) compared BND Checklist (revised from the BND rating scale) indicators with Relationship Questionnaire (RQ) attachment groups from a sample of 32 highrisk pregnant women. Significant associations were not found in this study, likely because of its small heterogeneous sample. Hyler (2002) compared BND Checklist indicators with family drawingbased attachment categories of 49 children aged 9–11. Hyler (2002) found that children with securely-rated family drawings used green as the dominant color in their BNDs 2 (1, N = 49) = 6.5, p = .034. This study extended the use of the BND to the child population and provided support for the proportional use of the color green by securely attached individuals (Kaiser & Deaver, 2009). Lastly, Trewartha (2004) compared BND Checklist items and RQ attachment groups of a sample of 14 adolescents in foster care. One item, drawing a nest off-center, was significantly associated with self-reported security; however, this was viewed as a spurious relationship. Goldner (2014) investigated the validity of the BND comparing both global approaches and an indicator-based method, assessing attachment security with a sample of 81 Israeli children. Collecting a BND, a family drawing, and a children’s attachment inventory from each child, her analyses using the drawing indicator approach revealed an association between drawing a baby bird and secure attachment and drawing a tiny bird (presumably small in size compared to paper space) and insecure attachment. Results from comparing markers from BNDs with children’s family drawings attachment classifications revealed associations between the following indicators and secure attachment: presence of a grounded tree, presence of a dry tree, portraying a large bird, use of over 20% of the paper space, and portraying a protected nest. Using global scales for scoring the BNDs resulted in scores on scales for vitality and optimism being significantly related to secure attachment when compared to children judged as having disorganized or ambivalent attachment. Children with secure attachment also scored significantly lower on scales of pathology than those with disorganized or ambivalent attachment. Goldner concluded that these findings suggest the BND is useful for assessing attachment status in children in elementary school and that a global approach to classifying the drawings is more promising than an indicator-based method. Current study To assess the convergent validity of the BND as a measure of attachment organization, we compared two BND rating scales with two attachment instruments: the IPPA, which was used in Kaiser’s (1996) original study, and the ECR, an attachment style outcome measure used by Francis et al. (2003). We hypothesized that BND content indicator items theoretically associated with attachment security would correlate with attachment security (high scores on the ATM and low scores on the ECR), and those items associated with insecurity would correlate with attachment insecurity (low scores on the ATM and high scores on the ECR). We also hypothesized that attachment security as determined by the BND Four Category Overall Impression Form (Kaiser, 2012b) would correlate with attachment security on both measures.

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Methodology Sample Participants included a nonrandom sample of convenience consisting of 136 students (55 males, 83 females, Mage = 19.3 years, age range: 18–23) from a small liberal arts college in southern California. Although 138 students participated, two did not complete questionnaires and their drawings were removed from analysis. Participant ethnicity varied between European American (n = 83, 61%), Hispanic/Latino (n = 23, 16.9%), African American (n = 2, 1.5%), Asian American (n = 11, 8.1%), and Other (n = 17, 12.5%). Students received research credits in their classes for participating in this study. Instrumentation This study is unique because it included two reliable and valid outcome measures that measure different attachment constructs. Francis et al. (2003) suggested that future researchers utilize the ECR in BND research. This study was designed to incorporate both the ECR and the IPPA, one scale of which was used in Kaiser’s (1996) pilot study. The inclusion of two outcome measures in this study allowed for data to be assessed under each instrument separately and for comparisons to be made between instruments. The relative “match” between BND ratings and the two outcome measures was expected to provide convergent and/or discriminant data in order to identify which internal working models of attachment the BND most readily taps in an undergraduate population. The Experiences in Close Relationships Questionnaire (ECR) was the first measure used. Based on the premise that attachment history might play a role in the experience of adult loneliness, the ECR assesses self-reported beliefs about current romantic love and relationship patterns (Bartholomew & Shaver, 1998). The ECR and its revision, the ECR-R, are thought of as being psychometrically strong, and are currently the most commonly used self-report measures of adult attachment style (Crowell et al., 2008). The Inventory of Parent and Peer Attachment (IPPA) was the second measure. Armsden and Greenberg (1987) developed the IPPA to assess adolescent attachment security as expressed in a self-report on relationships with parents and peers. The three subscales of the IPPA (Attachment to Mother, Attachment to Father, and Attachment to Peers) all have high reliability and validity, with Cronbach’s alphas of approximately .90 (Armsden & Greenberg, 2009; Crowell et al., 2008). After pilot testing, the Attachment to Father (ATF) subscale was excluded from the IPPA in this study in order to approximate time-directive consistency with previous BND research.

The Bird’s Nest Drawing Two Category Checklist (BND-TCC; Kaiser, 2012b) was used to evaluate the BNDs. It is the most commonly used scale in BND research and is used to identify content indicators within a drawing sample, e.g., “Are bird(s) depicted in the drawing?” and “Is there an environment depicted?” (Kaiser, 2012b, p. 6). A total of eleven items are included in the BND-TCC. The first five items are associated with secure attachment (Kaiser, 2012b): whether birds are depicted in the drawing, whether birds are depicted in a family group, whether an environment is depicted, whether four or more colors are depicted, and whether green is the dominant color in the drawing. The remaining six items are associated with insecure attachment (Kaiser, 2012b): whether brown is the dominant color in the drawing, whether the nest is tilted such that it appears the contents would fall out, whether the nest lacks a bottom such as that it appears the contents would fall out, the depiction of the nest in a vulnerable position, the presence of restarts, erasures, or crossed-out areas, and unusual, incoherent, or disorganized elements in the drawings. The items on the BND-TCC have been revised substantially since its introduction (Kaiser, 1996), a complicating factor in statements regarding its reliability and validity. Although the first rating system used by Kaiser and the current BND-TCC items have differed in content, the interrater reliability scores of BND raters have been consistently acceptable (Kaiser & Deaver, 2009). Kaiser (1996) achieved kappa values greater than .7 for all except one item with the original rating system. Similarly, kappa values in Francis et al. (2003) ranged from .66 to 1 for all except one item. The lowest of these scores fell within the psychometrically acceptable range of .4 to .75 (moderate agreement). Assuming generalizability across studies, the rating scale has demonstrated preliminary interrater reliability. However, the validity of the BND-TCC has yet to be determined by systematic research. The Bird’s Nest Drawing Four Category Overall Impression Form (BND-OIF; Kaiser, 2012b) was the second measure used to evaluate the drawings. The term “Overall Impression” was borrowed from Kaplan and Main’s (as cited in Kaiser & Deaver, 2009) methodology for determining attachment classifications based on children’s drawings. The BND-OIF provides the operational definitions of four suites of drawing characteristics that are theoretically associated with the four categories of child attachment organization. Raters are trained to categorize drawings into one of four overall impression categories. This study constituted a first look at the psychometric properties of the BND-OIF (Table 1). Fig. 1 includes examples of drawings that were categorized into each attachment category assessed by the BND-OIF. With calm, realistic elements, the top left drawing represents a secure rating. With predominant emptiness the top right drawing represents a dismissing-avoidant rating. With the nest drawn in an exposed or

Table 1 BND Four Category Overall Impression Form category descriptions. Group

Brief description

Secure (1)

The overall impression is cheerful, realistic, and/or calm; communicates a generally welcoming quality. The following descriptors may apply to the drawing. The drawing communicates a welcoming quality. The image is organized. A realistic environment may be included. Birds or a bird are depicted. Green is the dominant color in the drawing. The overall impression is isolation or emptiness, absence of connectedness, and/or absence of events/movement. The following descriptors may apply to the drawing. Nest is empty or may contain eggs but no birds (other than schemas). Little or no color is used. Little or no environment is drawn. The nest may be tilted and/or have no bottom (wreath-shaped). The overall impression is vulnerability—nest appears unsafe or unprotected from the elements and/or predators—nest is drawn in an exposed fashion. The following descriptors may apply to the drawing. The nest is drawn precariously on the end of a limb (with an “out on a limb” or fragile quality). The nest is on top of a tree or other support or on the ground in an exposed fashion. Brown is the dominant color. The nest or its contents are unusually large or unusually small. The drawing crowds paper edges. The drawing has quality of excessive cuteness or sweetness. The overall impression is irrational, disorganized, ominous, and/or foreboding. The following descriptors may apply to the drawing. Drawing communicates unsettling quality. Restarts on other side of paper provided or on new paper. Excessive erasures are included (that do not improve image). Strange marks, irrational elements, unfinished objects, and/or scratched-out objects are included. Significant elements are off the paper edge, such as a parent bird feeding babies, or just the head of a parent bird on the paper edge.

Avoidant (2) Preoccupied (3)

Fearful (4)

Source: Adapted from Kaiser (2012a,b).

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Fig. 1. Examples of participant drawings categorized by BND Four Category Overall Impression Form.

“out-on-a-limb” position, the bottom left drawing represents a preoccupied rating. With irrational/disorganized elements, the bottom right drawing represents a dismissing-fearful rating. Assessment procedures Participants were tested in groups in an introductory psychology class or a quiet dormitory room. Each participant was provided a 9 × 12 sheet of off-white drawing paper, a 24-count pack of crayons, a 24-count pack of colored pencils, a 10-count pack of thin markers, a drawing pencil, and a sheet of 8-1/2 × 11 lined paper (Francis et al., 2003). Each participant completed a consent form and then a demographic questionnaire, asking for gender, age, and ethnicity. Participants were then asked to complete the ATM, ATP, and ECR questionnaires. After completing the questionnaires, they were asked to “draw a picture with a bird’s nest” (Francis et al., 2003, p. 128). Finally, participants were asked to “write a 2–5 sentence story” about their drawings. Participants were allotted 15 minutes to complete the questionnaires and 15 minutes to complete the drawing and story. Two raters, blind to the nature of the study, were trained to use the BND-TCC and the BND-OIF. Training consisted of a collaborative read-through of the rating manual with the first investigator, followed by practice scoring on the manual’s sample drawings and discussion and clarifications of items when inconsistencies arose. Immediately following training, the raters were given the study drawings in random order. After ratings were completed, data from the ratings and from the self-report measures were analyzed.

Results Cohen’s kappa was calculated for each BND Checklist item and Pearson’s r was calculated for BND-OIF categorizations (Table 2). Kappa scores varied across the graphic indicators. One item, restarts and cross-outs, had poor reliability at −.011, and two had fair reliability, at .374 and .362. Items which did not achieve interrater reliability were not removed from subsequent statistical analyses. The average kappa magnitude across items on the BND-TCC was .56, which is moderate according to Landis and Koch and fair by Fleiss’s standards (Zwick, 1988). Pearson’s product-moment correlation coefficients were calculated to assess the interrater reliability of Table 2 Interrater reliability for Two Category Checklist items and Overall Impression Form. Two Category Checklist items

Cohen’s kappa

1. Birds included 2. Family of birds included 3. Environment included 4. Four or more colors 5. Green is the dominant color 6. Brown is the dominant color 7. The nest is tilted 8. The nest has no bottom 9. The nest is in a vulnerable Position 10. There are restarts, cross-outs, or erasures 11. There are bizarre, incoherent, or disorganized elements The Four Category Overall Impression BND Form

0.924* 0.750* 0.536* 0.642* 0.511* 0.374* 0.765* 0.775* 0.362* −0.011 0.487* Pearson’s r .736*

*

p < .01.

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Table 3 Chi-square analyses: Attachment to Mother by Two Category Checklist items. Two Category Checklist items 1. Birds included 2. Family of birds included 3. Environment included 4. Four or more colors 5. Green is the dominant color 6. Brown is the dominant color 7. The nest is tilted 8. The nest has no bottom 9. The nest is in a vulnerable position 10. There are restarts, cross-outs, or erasures 11. There are bizarre, incoherent, or disorganized elements *

Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No

High Group

Low Group

Chi-Square

n = 43 n = 25 n = 34 n = 34 n = 43 n = 25 n = 48 n = 20 n=8 n = 60 n = 19 n = 49 n = 20 n = 48 n=8 n = 60 n = 29 n = 39 n=2 n = 67 n = 16 n = 51

n = 36 n = 32 n = 22 n = 46 n = 40 n = 28 n = 45 n = 23 n=7 n = 61 n = 19 n = 49 n = 13 n = 55 n=9 n = 59 n = 40 n = 28 n=1 n = 68 n = 25 n = 43

1.480

.224

4.371

.037*

0.278

.598

0.306

.580

0.075

.784

0.000

Significance

1.0

1.961

.161

0.067

.795

3.560

.059

0.341

.559

2.649

.104

p < .05.

the BND-OIF. Substantial agreement was found between the two raters (r = .736). To test for confounding variables, chi-square analyses were calculated between demographic variables and ECR and IPPA scores. All but one of these correlations proved to be small and insignificant, ruling out significant associations between age, gender, and ethnicity and scores on the ECR and ATM. A significant relationship was found between gender and the ATP subscale of the IPPA, 2 (1, N = 136) = 5.029, p = .25; men were more likely to have a higher ATP score. Chi-square analyses were calculated to test the differences in frequencies between BND-TCC items and IPPA subscale groups (Table 3); and BND-TCC items and ECR groups (Table 4). Using the .05 alpha level, two items reached significance. The inclusion of a family of birds (Fig. 2) was significantly associated with high scores on the ATM 2 (1, N = 136) = 4.371, p = .037. The lack of a bottom drawn on a nest (Fig. 3) was significantly associated with ECR security 2 (1, N = 136) = 7.253, p = .007.

Chi-square analyses were also calculated to test for correlations between instruments (Table 5). There were no significant differences in frequencies when comparing ECR groups and ATM groups, or ECR groups and BND-OIF categories. Statistical significance was reached between ATM groups and BND-OIF categories at 2 (1, N = 136) = 12.573, p = 0.006; between ATP and ATM groups 2 (1, N = 136) = 6.619, p = 0.01; and between ECR and ATP groups 2 (1, N = 136) = 5.785, p = 0.016. Thus, high ATP scores were positively associated with high ATM and high ECR scores.

Discussion This study set out to test two rating systems for the BND, a theoretically based art therapy assessment that has undergone validation research for over 20 years. The central findings were associations between BND security designations and the ATM subscale

Table 4 Chi-square analyses: Experiences in Close Relationships groups by Two Category Checklist items. Two Category Checklist items 1. Birds included 2. Family of birds included 3. Environment included 4. Four or more colors 5. Green is the dominant color 6. Brown is the dominant color 7. The nest is tilted 8. The nest has no bottom 9. The nest is in a vulnerable position 10. There are restarts, cross-outs, or erasures 11. There are bizarre, incoherent, or disorganized elements *

p < .05.

Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Insecure ECR

Secure ECR

Chi-square

n = 38 n = 19 n = 24 n = 33 n = 35 n = 22 n = 40 n = 17 n=8 n = 60 n = 16 n = 41 n = 10 n = 47 n=2 n = 55 n = 31 n = 26 n=0 n = 57 n = 19 n = 37

n = 41 n = 38 n = 32 n = 47 n = 48 n = 31 n = 53 n = 26 n=7 n = 61 n = 22 n = 57 n = 23 n = 56 n = 15 n = 64 n = 38 n = 41 n=3 n = 76 n = 22 n = 57

2.966

Significance .085

0.035

.085

0.006

.939

0.146

.702

0.075

.784

0.001

.977

2.412

.120

7.253

.007*

0.523

.470

2.213

.137

0.573

.449

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Fig. 2. Examples of item 2, “A bird family is depicted in the participant’s drawing”.

Fig. 3. Examples of item 8, “The nest has no bottom”.

Table 5 Chi-square analyses: instrument comparisons. High ATM

Low ATM

ECR

Insecure Secure

n = 34 n = 34

n = 23 n = 45

ATP

High Low

n = 42 n = 26

n = 27 n = 41

Secure Dismissing-Avoidant Preoccupied Dismissing-Fearful

n = 38 n = 12 n=9 n=9

n = 24 n=6 n = 22 n = 16

High ATP

Low ATP

BND OIF

ECR

Insecure Secure

n = 22 n = 47

n = 35 n = 32

BND OIF

Secure Dismissing-Avoidant Preoccupied Dismissing-Fearful

n = 34 n=8 n = 14 n = 13

n = 28 n = 10 n = 17 n = 12

Insecure

Secure

n = 37 n=9 n = 17 n = 16

n = 25 n=9 n = 14 n=9

BND OIF

* **

Secure Dismissing-Avoidant Preoccupied Dismissing-Fearful

Chi-square

Significance

3.654

.056

6.619

.001**

12.537

.006**

Chi-square

Significance

5.785

.016*

1.104

.776

Chi-square

1.041

Significance

.791

p < .05. p < .01

of the IPPA, and a significant correlation between a secure BND overall impression and high ATM score. The inclusion of a family of birds was associated with the high attachment ATM group. The first hypothesis—that all BND graphic indicators would correlate with attachment security or insecurity in expected directions—was not supported by the data. The significant finding that individuals who scored in the high attachment group tended to draw a family of birds was consistent with past research (Kaiser, 1996; Kaiser & Deaver, 2009). Overall, however, a coherent pattern

of correlations between BND-TCC items and attachment scores did not emerge in this study. The second hypothesis—that BND-OIF security designations would correlate with scores on both measures—was partially supported. A unique finding of this study was a significant correlation between a secure BND overall impression rating and a participant’s high ATM score 2 (1, N = 136) = 12.573, p = 0.006. Higher scores on the ATM subscale were associated with “cheerful, realistic, and/or calm” drawings (Kaiser, 2012b, p. 12), and lower scores were

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G. Harmon-Walker, D.H. Kaiser / The Arts in Psychotherapy 42 (2015) 1–9

associated with empty, vulnerable, or disorganized drawings. However, significance was not achieved between BND-OIF categories and ECR groups. Of the two outcome measures, only the two scales of the adolescent instrument (IPPA) correlated with BND scores. This finding invites further consideration of the differences between the theoretical bases of the IPPA with its ATM subscale and the ECR. The IPPA and ECR differ in terms of what they assess. The ECR assesses adult romantic attachment styles via items such as “When my partner is out of sight, I worry that he or she might become interested in someone else” (Brennan et al., 1998, p. 70). The subscales of the IPPA used in this study tap adolescents’ perceptions of the cognitive and affective dimensions of relationships with mother or peers—the items on the ATM subscale ask about how well one’s mother provides psychological security (mutual trust, quality of communication with mother, amount of anger or alienation present in the relationship) rather than measuring attachment style in a romantic context (Armsden & Greenberg, 1987). In step with the field of adult attachment research in general, BND research has shifted from the IPPA to romantic relationship measures such as the RQ and the ECR (Francis et al., 2003; Kaiser & Deaver, 2009). This may have been a misstep methodologically—the findings of this study suggest that such a switch was premature. In some cases, the symbolism of the bird’s nest may be romantic: two birds meet, join in the construction of a nest, guard eggs until they hatch, and then share the responsibility of feeding and protecting their young. Or it may be a coming-of-age story, in which helpless baby birds are sheltered and fed by their parents until finally taking flight. Arguably, the BND allows for the projection of either narrative into the image. Undergraduate students occupy the boundary between adolescence and adulthood (Sprecher, 2013), and it may be that bird nest imagery more readily conjures parental attachment internal working models than their adult romantic derivatives in this population. Based on the extensive experience conducting research on the BND, the second author asserts that it is probably the nature of the image of a bird’s nest that it accesses internalized working models of attachment rather than romantic attachment styles. The results of this study also provide some evidence for the utility of aggregate or global ratings approaches for formal art therapy assessment. Several authors investigating child attachment through drawing tasks have found stronger correlations when applying aggregate systems over individual indicator scales (Fury et al., 1997; Goldner, 2014; Goldner & Scharf, 2012; Pianta et al., 1999). In part, the results of this study support this trend. The success of the aggregate BND-OIF over the BND-TCC mirrors a broader movement in art therapy assessment research away from isolated drawing variables and toward global, composite, formal, or structural variables (Betts, 2006; Bucciarelli, 2011; Cohen, Hammer, & Singer, 1988). Kaiser (2012b) is currently using such a scale that aggregates patterns of graphic indicators, and the BND story. A limitation of this study was the fact that the raters were not trained to the rigorous extent of prior studies. A more rigorous scoring would have included drawings that were not from the manual and used a far larger number of sample drawings for practice. In addition, although age, gender, and ethnicity data were gathered in this study, drawing development was not assessed. It may be that individuals with a lower drawing development level were more likely to produce sparser, less realistic drawings; whereas trained artists may be inclined to use a wider palette and depict more realistic details leading to elements that would be rated as secure. Ideally, an art therapy assessment should be sensitive to the constructs it seeks to assess without being influenced by drawing skill level (Betts, 2013). Despite these limitations, the strengths of the study include moderate to good interrater agreement, a more racially and

ethnically diverse sample than previous studies, and a promising first look at the use of an overall impression rating approach in BND research. Substantial interrater reliability was found for the BND-OIF and for 5 of the 11 BND-TCC indicators. The items which achieved the highest reliability scores were Birds Included, Family of Birds, The Nest is Tilted, and the Nest Has No Bottom. The significant finding that individuals in the higher ATM score group also tended to draw visible family units in their drawing supports the bedrock assumption of the BND that depictions of birds are a symbolic vehicle for individuals to construct or project family dynamics and/or caregiver attachment. This finding is also consistent with Francis et al. (2003). Several replicative studies with large samples are required in order to make confident statements regarding the capacity of the BND in assessing or predicting adult attachment organization (Francis, 2012). It is suggested that future BND research include the collection of drawing developmental data in order to gauge whether a participant’s drawing skill confounds BND performance. It is also suggested that future BND researchers use the IPPA scales in validity studies on adolescents and adults as the BND seems to access state of mind with respect to attachment rather than romantic attachment style. In addition, using BND global ratings will likely be more productive than evaluating single indicators based on our results. Bowlby (1969) asserted that attachment “characterizes human beings from the cradle to the grave” (p. 129). Although the objects of attachment relationships and expressions of the attachment behavioral system shift over time, the internal models forged in childhood tend to remain the same. In this study, the two BND rating scales differed in terms of their sensitivities to parental and romantic adult attachment organization. In both cases, associations were found between the drawing characteristics and attachment status arising from parent/child dyad experiences. In early childhood, attachment to the primary caregiver is a synchronous relationship that is defined by emotional reciprocity, nurturance, and facilitation of survival via close proximity to the caregiver. It is a template for future close relationships. Although attachment behaviors shift over the lifespan away from caregivers and toward other adults, the internal working models forged in early life tend to remain stable. Perhaps this study demonstrates that, for undergraduate students in the midst of this transition, the comforts and anxieties of original attachment dyads are still accessible to the metaphor of a bird’s nest. References Ainsworth, M. D. S., & Wittig, B. A. (1969). Attachment and exploratory behavior of one year-olds in a strange situation. In B. M. Foss (Ed.), Determinants of infant behaviour IV (pp. 111–136). London: Methuen. Armsden, G. C., & Greenberg, M. T. (1987). The Inventory of Parent and Peer Attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16(5), 427–454. Armsden, G. C., & Greenberg, M. T. (2009). The Inventory of Parent and Peer Attachment (IPPA). Unpublished manuscript. Bartholomew, K. (1993). From childhood to adult relationships: Attachment theory and research. In S. Duck (Ed.), Understanding relationship processes: Vol. 2. Learning about relationships (pp. 30–62). Beverly Hills, CA: Sage. Bartholomew, K., & Shaver, P. R. (1998). Methods of assessing adult attachment: Do they converge? In J. A. Simpson, & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 25–45). New York: Guilford Press. Behrens, K., & Kaplan, N. (2011). Japanese children’s family drawings and their link to attachment. Attachment and Human Development, 13(5), 437–450. Betts, D. (2006). Art therapy assessments and rating instruments: Do they measure up? The Arts in Psychotherapy, 33(5), 422–434. Betts, D. (2013). A review of the principles for culturally appropriate art therapy assessment tools. Art Therapy: Journal of the American Art Therapy Association, 30(3), 98–106. Bowlby, J. (1969). . Attachment and loss (vol. 1–3). London: Basic Books. Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult romantic attachment: An integrative overview. In J. A. Simpson, & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York: Guilford Press.

G. Harmon-Walker, D.H. Kaiser / The Arts in Psychotherapy 42 (2015) 1–9 Bucciarelli, A. (2011). A normative study of the Person Picking an Apple From a Tree (PPAT) assessment. Art Therapy: Journal of the American Art Therapy Association, 28(1), 31–36. Carlson, E., Sroufe, L., & Egeland, B. (2004). The construction of experience: A longitudinal study of representation and behavior. Child Development, 75, 66–83. Cassidy, J., & Shaver, P. R. (2008). Handbook of attachment: Theory, research, and clinical applications. New York, NY: Guilford Press. Cohen, B., Hammer, J., & Singer, S. (1988). The Diagnostic Drawing Series: A systematic approach to art therapy evaluation and research. The Arts in Psychotherapy, 15, 11–21. Crowell, J. A., Fraley, R. C., & Shaver, P. R. (2008). Measurement of individual differences in adolescent and adult attachment. In J. Cassidy, & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (2nd ed., vol. 1–3, pp. 599–634). New York: Guilford Press. Francis, G. (2012). Publication bias and the failure of replication in experimental psychology. Psychonomic Bulletin Review, 19, 975–991. Francis, D., Kaiser, D., & Deaver, S. (2003). Representations of attachment security in the Bird’s Next Drawings of clients with substance abuse disorders. Art Therapy: Journal of the American Art Therapy Association, 20, 124–137. Fury, G., Carlson, E., & Sroufe, L. (1997). Children’s representations of attachment relationships in family drawings. Child Development, 68, 1154–1164. George, C., Kaplan, N., & Main, M. (1996). Adult Attachment Interview protocol (3rd ed.). Berkeley, CA: University of California at Berkeley. Unpublished manuscript. George, C., & West, M. (2012). The Adult Attachment Projective Picture System: Attachment theory and assessment in adults. New York, NY: Guilford Press. Goldner, L. (2014). Revisiting the Bird’s Nest Drawing: Towards a global approach. The Arts in Psychotherapy, 41, 391–399. Goldner, L., & Scharf, M. (2011). Children’s family drawings: A study of attachment, personality, and adjustment. Art Therapy: Journal of the American Art Therapy Association, 28(1), 11–18. Goldner, L., & Scharf, M. (2012). Children’s family drawings and internalizing problems. The Arts in Psychotherapy, 39, 262–271. Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry and Allied Disciplines, 38, 581–586. Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511–524. Hesse, E. (2008). The Adult Attachment Interview: Protocol, method of analysis, and empirical studies. In J. Cassidy, & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (2nd ed., pp. 552–598). New York: Guilford Press. Hyler, C. (2002). Children’s drawings as representations of attachment. Unpublished master’s thesis. Norfolk: Eastern Virginia Medical School. Kaiser, D. (1996). Indications of attachment theory in a drawing task. The Arts in Psychotherapy, 23, 333–340.

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Kaiser, D. H. (2012a). Kaiser Bird’s Nest Drawing Rating Scale. Unpublished manuscript. Kaiser, D. H. (2012b). Kaiser’s Bird’s Nest Drawing Two Category Checklist and Four Category Overall Impression Manual. Unpublished manuscript. Kaiser, D. H., & Deaver, S. (2009). Assessing attachment with the Bird’s Nest Drawing: A review of the research. Art Therapy: Journal of the American Art Therapy Association, 26, 26–33. Kaplan, N., & Main, M. (1986). Instructions for the classification of children’s family drawings in terms of representation of attachment. Berkeley, CA: University of California at Berkeley. Unpublished manuscript. Madigan, S., Ladd, M., & Goldberg, S. (2003). One picture is worth a thousand words: Children’s representations of family as indicators of early attachment. Attachment and Human Development, 5, 19–37. Overbeck, L. (2002). A pilot study of pregnant women’s drawings. Unpublished master’s thesis. Norfolk, VA: Eastern Virginia Medical School. Pianta, R., Longmaid, K., & Ferguson, K. (1999). Attachment-based classifications of children’s family drawings: Psychometric properties and relations with children’s adjustment in kindergarten. Journal of Clinical Psychology, 28, 244–255. Rholes, W., & Simpson, J. (2004). Adult attachment: Theory, research, and clinical implications. New York: Guilford Press. Shaver, P. R., & Mikulincer, M. (2002). Dialogue on adult attachment: Diversity and integration. Attachment and Human Development, 4, 243–257. Shaver, P. R., & Mikulincer, M. (2004). What do self-report attachment measures assess? In W. S. Rholes, & J. A. Simpson (Eds.), Adult attachment: Theory, research, and clinical implications (pp. 17–54). New York: Guilford Press. Solomon, J., & George, C. (2008). The measurement of attachment security and related constructs in infancy and early childhood. In J. A. Simpson, & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 383–416). New York: Guilford Press. Sprecher, S. (2013). Attachment style and sexual permissiveness: The moderating role of gender. Personality and Individual Differences, 55, 428–432. Trewartha, S. (2004). Attachment strategies of adolescents in foster care: Indicators and implications. Unpublished master’s thesis. Norfolk, VA: Eastern Virginia Medical School. van Ilzendoorn, M. H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis on the predictive validity of the Adult Attachment Interview. Psychological Bulletin, 177, 387–403. Weiss, R. S. (1993). Attachment in adult life. In C. M. Parkes, & J. Stephenson-Hinde (Eds.), The place of attachment in human behavior (pp. 171–184). New York: Basic Books. West, M., Sheldon, A. E. R., & Reiffer, L. (1987). An approach to the delineation of adult attachment: Scale development and reliability. Journal of Nervous and Mental Disease, 175, 738–741. Zwick, R. (1988). Another look at interrater agreement. Psychological Bulletin, 103(3), 374–378.