PRELIMINARY RELIABILITY AND VALIDITY OF THE

APPERCEPTIVE COPING TEST

Paul Brown

B. S., University of Washington, 1993

THESIS SUBMITTED IN PARTIAL FULFILLMENT OF

THE REQUIREMENTS FOR THE DEGREE OF

MASTER OF ARTS

in the Department

of

Psychology

( C ) Paul Brown 1998

.. SIMON FRASER UNIVERSITY

November 19 9 8

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Apperceptive Coping Test iii

Preliminary Reliability and

Validity of the Apperceptive Coping Test

ABSTRACT

This study investigated the preliminary reliability and

validity of the Apperceptive Coping Test (ACT), a new

projective storytelling test that provides an overview of an

individual's personality and coping skills. Eleven of the

thirteen ACT scales were investigated in this study.

Subjects formed two groups, a patient group and a non-

patient group, and each group contained 48 subjects.

Subjects from the non-patient completed the

Apperceptive Coping Test and an additional personality

measure. Data for subjects in the patient group were

obtained from patient files. Inter-rater reliability was

calculated on twenty cases using two graduate student

raters. Inter-rater reliabilities for items were quite

varied and were undefined for some items due to a lack of

variability. Inter-rater reliabilities for ACT scales were

also varied with the affect scales having the highest

reliabilities. To assess convergent validity, t-tests were

performed to test for differences between the patient and

non-patient groups on each of the ACT variables. A

discriminant function analysis was performed to determine if

the ACT could accurately assign subjects to their respective

groups. Moderate support for the convergent validity of the

ACT was found. Concurrent validity was exami.ned by

Apperceptive Coping Test iv

comparing ACT scales to similar sca les on a more well-

established personality measure. Results f r o m concurrent

v a l i d i t y testing were mixed.

LIST OF TABLES

Table 1

Table 2 Table 3 Table 4

Table 5

Table 6

Table 7

Table 8

Table 9

Table 10

Table 11

Table 12

Table 13

Table 14

Table 15

Table 16

Table 17

Table 18 Table 19 Table 20

Projective t i iemes of Apperceptive Coping Test stimulus cards/l8

Apperceptive Coping Test Variabled20 Subject gender by group/23 Mean, standard deviation, and minimum and maximum of subject ages by group/23

ACT Variables and the PA1 Scales and Subscales that are Hypothesized to Predict these ACT scales/30

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Depression Scale Items/32

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Anxiety Scale 1tems/33

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Hostility Scale Iterns/34

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Elation Scale Items/35

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Problem Identification Itemd37

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Passive Coping Scale Itemd38

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Aggressive Coping Scale Ttems/39

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Affiliative Coping Scale Items/4O

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Self-Reliant Coping Scale 1tems/41

Means, Standard Deviations, Item-Total Cotrelations, and Intea-Rater ~eliablitities of ACT Supportive Environment Scale 1tems/42

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Obstructive Environment Scale Items/43

Means, Standard Deviations, Mean Inter-Item Correlations, and Alpha Coefficients for ACT Scales/44

Inter-Rater ~eliability for ACT ~cales/47 Correlation Matrix for ACT Scaled49 Means, Standard Deviations, and Mean Differences of Patient and non-patient Groups on ACT Scales

Introduction

The Projective Hypothesis

Altbough the history of projective assessment is said

to go back to the 1400s when Leonardo da Vinci used

ambiguous forms to evaluate potential students for

creativity (Nietzel, Bernstein d Milich, 1991), the concept

of projection was first introduced by Freud in 1895.

Initially, Freud conceptualized projection as a neurotic

mechanism whereby an individual projects an interna1 threat

outward and responds to it as though it were an external

threat. Later, Freud (1896/1962) elevated projection to the

status of a defense mechanism. Defense mechanisms are

techniques, usually of an unconscious nature, that are used

by the ego to keep unconscious conflicts and their

associated discomfort from reaching consciousness. As a

defense mechanism, projection is an unconscious process

which serves to protect the individual from anxiety

associated with his or her own threatening thoughts or

feelings by attributing this material to another individual.

I t is this meaning of projection which is most familiar ta

psychologists.

In regard to projective tests, the connotation of the

term projection..has undergone yet another modification.

Current theories of evaluation of responses to projective

test stimuli recognize that material produced on projective

tests is neither necessarily defensive nor unconscious

(Anderson, 1951; Zubin, Eron, h Schumer, 1965). Many

psychological processes in addition to projection, both

defensive and nondefensive, conscious and unconscious, may

influence how an individual responds to a projective test

stimulus. Hence, several euthors have suggested alternative

terms for projective tests such as "misperception" tests

(Cattell, 1951) or "apperceptionw tests (Bellak, 1950). The

t em projective test, however, has remained the conventional

label for this class of assessment instruments.

Earlv Projective Tests

Since the introduction of the Rorschach lnkblot Test

(Rorschach, 1921/1942) and the Thematic Apperception Test

(TAT: Morgan & Murray, 1935) in the first half of the 20th

century, projective tests have evolved into a major class of

instruments available to psychologists for the assessment of

personality and psychological functioning. As a whole, the

class of projective tests encompasses an extremely large and

diversified group of instruments with various types of

stimuli and methods of administration. The one unifying

factor common to each of these instruments is their

foundation on the projective hypothesis. Frank (1939)

defined the projective hypothesis as the assertion that when

people attempt to perceive an ambiguous or vague stimulus,

their interpretation of that stimulus reflects their needs,

feelings, experiences, prior conditioning, thought

processes, and so forth. However, as with the other

3

c h a r a c t e r i s t i c s of p r o j e c t i v e tests, even t h e degree of

ambiguity of t h e s t imulus n ia ter ia l s v a r i e s ac ross t h e s e

instruments.

The Rorschach Inkblo t T e s t and the Thematic

Apperception T e s t are no exceptions. The Rorschach and t h e

TAT d i f f e r considerably i n t h e s t r u c t u r e and content of

t h e i r p r o j e c t i v e s t i m u l i . The scenes portrayed i n t h e TAT

stimulus cards compared ta the Rorschach i n k b l o t s are far

more f i g u r a t i v e and deno ta t ive and f a r less ambiguous i n

content , It i s t h e more s t r u c t u r e d p ro jec t ive stimuli, such

as t h o s e found i n t h e TAT, t h a t are t y p i c a l l y used i n

p r o j e c t i v e s t o r y t e l l i n g t e s t s t o e l i c i t information with

regard t o an ind iv idua l ' s coping s t y l e , in t e rpe r sona l

percept ions, and emotional state.

A f t e r i t s in t roduc t ion i n 1935, t h e TAT r a p i d l y gained

acceptance i n t h e psychological community. I n 1947, L o u t t i t

and Browne surveyed c l i n i c s regarding t h e i r use of

psychological t e s t s and found t h a t t h e TAT was among t h e

most commonly used psychological t e s t s ( L o u t t i t and Browne,

1947) . O f al1 p r o j e c t i v e t e s t s t h e TAT was second only t o

t h e Rorschach Inkblo t Tes t and f o u r t h among a l 1

psychological tests i n the number of tirnes it w a s c i t e d i n

t h e psychological l i t e r a t u r e between t h e years of 1948 and

1951 (Sundberg, 1951). The TAT had quickly become an

important psychological assessrnent t o o l . More r e c e n t data

i n d i c a t e t h a t over t h e p a s t 4 5 yea r s t h e TAT has r e t a i n e d

much of its original status. As of 1985, the TAT was still

ranked as the seventh most frequently used psychological

test and had stimulated the third largest number of research

studies behind only the MMPI and the Rorschach (Lubin,

Larsen, Matarazzo & Seever, 1985). A sizable proportion of

these studies, however, are undoubtedly concerned with the

questionable validity of the TAT and as a result the measure

no longer enjoys i t s original unconditional acceptance.

Early users of projective techniques tended to accept

the utility of these instruments without sufficient

empirical demonstration of their reliability and validity.

For example, Macfarlane and Tuddenham (1951) noted that, in

Bell's ciassic book on projective tests only 14 of 91

references to the TAT were primarily concerned with the

validation of the instrument, However, after the initial

honeymoon between psychologists and projective techniques

was over, some researchers began to question both the

psychometric properties and the theoretical assumptions

underlying projective techniques. Other researchers,

supporters of projective techniques, began to actively

investigate projective tests in order to defend the utility

of these instruments.

In 1951, when the American Psychological Association

issued its "~echnical Recomrnendations for Psychological

Tests and Diagnostic Techniques," which was later revised

and published as Standards for Psvcholoqical Tests and

5

Manuais (1966), investigators were provided with guidelines

against which to evaluate the TAT. During the 1960s the

field began to examine the reliability and validity of the

TAT and the results were prolific if not definitive. Many

reviews of the TAT have been inconclusive if not unfavorable

(Jensen, 1959; Murstein, 1963; Swartz, 1978), however, some

researchers' reviews of the literature, Harrison (1965) for

example, have found evidence that supports the use of the

TAT . Tt rnay not be so much that the studies these authors

reviewed for their conclusions reported different levels of

reliability and validity for the TAT, but rather that their

interpretation of this data differed. Confusing the issue

is the fact that these studies use a variety of TAT stimulus

cards, often investigate a small subset of the TAT scales,

use any one of a variety of subjective or objective scoring

systems, and analyze the data using one of several different

statistics. Argument continues as to if it is even

xeasonable ta expect projective tests to exhibit certain

types of reliability and validity (interna1 consistency for

example) and as to how to calculate them. In addition, many

of these studies, especially the earlier studies, are

riddled wlth methodological problems. Monetheless, it is

possible to report some general findings.

Researchers have attempted to find several types of

reliability for the TAT. Attempts to find inter-rater

6

reliability for the TAT have been the most successful with

coefficients of agreement approaching or even exceeding .90

when there is training and supervision of scorers and when

the scoring system is specific with systematic rules,

Correlations of this level, however, were at the upper

bounds of a range of coefficients, some of which were below

. 5 0 , Efforts to show test-retest, split-half, and interna1

consistency reliabilities have been less successful but the

appropriateness of these methods of reliability testing for

projective measures continues to be debated,

Studies regarding the validity of the TAT are as

difficult to interpret as those regarding its reliability,

In general, these studies have focused on the measure as a

whole rather than investigating individual scales, A large

proportion of the studies on the validity of the TAT have

atternpted to show diagnostic or concurrent validity for the

measure, That is, to determine if the TAT can accurately

differentiate between. nosological groups or assign subjects

to these gsoups. The available evidence does not appear to

support the TAT's ability to perform this task , Studies

that have attempted to use the TAT to predict behavior have

also not been very successful,

Criticisms of the TAT

The lack of empirical support for the reliability and

validity of the TAT does not lie in the failure of the

projective hypothesis, but rather in the characteristics of

the TAT itself. Many clhicians and researchers have

concerns about the TAT of a more basic nature than its

reliability and validity, and if these shortcomings are

corrected a significant increase in the reliability and

validity coefficients of the TAT may be expected. These

criticisms include the predominantly negative "pull" of the

stimulus cards, the lack of relevance of the situations

portrayed in the stimulus cards, and the complexity of the

TAT scoring system. An additional problern with the TAT is

the stimulus cards' elicitation of psychoanalytic themes

such as unconscious or highly defended fantasies. The TAT

stimuli's association with psychoanalytic coricepts makes its

interpretation for nonpsychoanalyticalIy-oriented

psychologists difficult.

The first two of these criticisms concern what may be

the most critical factor in the diagnostic validity problems

of the TAT -- that is the likelihood that the content of a TAT story is determined as much by the stimulus demands of

the pictures as by the personality and/or psychopathological

characteristics of the respondent. The affective imbalance

of the TAT stimulus cards artificially restricts the range

of projective material. generated by the test (Eron, 1950;

Eron, Terry & Callahan, 1950; Goldfried & Zax, 1965). The

cards are cast in dark shading t o n e s and most scenes portray

characters in low-keyed, gloomy situations (Ritzler, Sharkey

b Chudy, 1980). Many of the cards also possess a

8

surrealistic quality. Critics have also concluded that the

few pictures involving more positively toned situations have

a motionless, almost lifeless, quality and depict characters

who expend little physical energy (Ritzler, Sharkey & Chudy,

1980). As a resul.t, TAT stimulus cards elicit projective

material that is more reflective of the negative "pull" of

the cards than of the subject8s personality, thereby

eliciting a biased and inaccurate sample of behavior.

The passage of t h e may also be partly responsible for

the poor diagnostic validity of the TAT. m e r the past 60

years the figures, clothing, and settings of the stimulus

cards have become increaslngly dated. The outdated nature

of the TAT stimulus cards may reduce their effectiveness and

adversely affect the TAT's psychometric properties.

Inconsistencies in the administration of the TAT rnay be

another major factor in the failure of literature reviews to

support the reliability and validity of the TAT (Swartz,

1978). The TAT as Murray designed it consists of a total of

31 stimulus cards. Ten of these cards are routinely

administered to al1 subjects and an additional 10 cards for

each subject are administered from the rentaining 21. Which

10 cards are selected is determined by the age and gender of

the subject. Although the TAT manual recommends the use of

these 20 stimulus cards, this advice is rarely followed.

Currently different numbers of cards are utilized by

different administrators, but from 8 to 10 cards are the

9

most common numbers used (Karp, Silber, Holmstrom, Banks &

Karp, 1992), The use of these abbreviated forms of the TAT

leads to problems with generalizability between studies and

to reduced reliability of the measure. To solve the

confusion, Hartman (1970) called for a standard set of TAT

cards to be used in TAT research. Today, far from using a

standard set and nrimber of stimulus cards, tests

administered under the guise of the TAT may contain a

variety of cards in addition to the original 31 developed by

Murray (Keiser & Prather, 1990).

A similar problem exists in regard to the TAT's scoring

system. In his review of the TAT literature, Murstein

(1963, p, 23) stated, "There would seem to be as many

thematic scoring systems as there were hairs in the beard of

Rasputin." Although dramatic, Murstein's statement

accurately describes the current state of the TAT, The name

TAT no longer refers to a single technique with a single

scoring system or manual. Peterson (1990) lists Bellak

(1986), Harrison (1965), Henry (1956), Murray (1943),

Rappaport, Gill & Schafer (1946), Stein (1955), and Tompkins

(1947) as just "some of the basic TAT 'manuals'." Several

of tbese authors have attempted to rectify a problem they

have identified with the TAT by revising or completely

replacing the scoring system. The original TAT scoring

system devised by Murray (1943) was doomed from the

beginning with its lack of detailed scoring instructions and

the spaxsely detailed manual in general. Although several

other quantitative systems have been devised to replace

Murray's system, as a whole, quantitative scoring systems

for the TAT have been f airly unpopular. Most TAT examiners

find the available quantitative scoring systems overly

elaborate, complex, and time consuming. Accordingly, they

therefore tend to use nonquantitative, more subjective

methods of interpretation and suffer the accompanying

reduction in reliability.

Another complaint users have with the TAT is that it is

heavily rooted in psychoanalytic theory, Murray (1943)

acknowledges the link between the TAT and psychoanalysis

early in the TAT manual, "an interpreter of the TAT should

have ... if he is to get much below the surface, knowledge of psychoanalysis and some practice in translating the

imagery of dreams and ordinary speech lnto elementary

psychological components" (Murray, 1943, p, 6).

The TAT is based on Murray's (1938) personality theory

of needs and presses (Kaplan & Saccuzzo, 1993, p. 471).

"Presses" are forces within the environment which exert

their positive and negative influences upon the individual.

The term "need" as used by Murray refers to an enduring

potentiality or readiness to respond in a certain way under

given conditions. In order to classify the complex

behaviors and motivations exhibited by individuals in their

daily lives and in theix TAT responses, Murray has further

11

refined the concept of need and postulated complex relations

between needs, These relations take the form of fusions,

subsidiations, contrafactions, conflicts, and others. Fused

needs are multiple needs which may be satisfied by a single

action pattern. Subsidiarv needs are needs which are

invoked in the service of a dominant or overriding need,

Contrafacton needs are commonly related to their opposites

in a temporal configuration. Conflictorv needs are those

which are in conflict with each other and may give rise to

spiritual dilemmas. Among the distinctions Murray has drawn

between different types of needs axe conscious versus

unconscious and manifest versus latent needs. Latent needs

are those which are not manifested objectively but are

exhibited in fantasy, and unconscious needs are tbose which

are in opposition and unacceptable to the individual's

conscious awareness (Murray, 1938). The TAT was developed

to elicit, via projection, these latent and unconscious

needs, and to elicit needs which the individual may be

hesitant to xeveal.

Murray advocates the use of a comprehensive list of 28

needs, over 30 presses, and their resulting thema (need-

press interactions) to uncover unconscious and consciously

suppressed or inhibited tendencies. The chief value of the

TAT is in its ability to elicit stories which are

interpretable in terms of these tendencies. Information on

"depth interpretation," however, the technique used to

translate needs, presses, and thema into subject tendencies,

is omitted from the manual. Devoting the few available

paragraphs to depth interpretation -- a technique that requires knowledge of psychoanalysis, according to the

manual -- would be "presumptuous and misleading relevant to its considerable importance" (Murray, 1943, p. 17).

Regardless whether or not interpretations deriving from

psychoanalytic theory are discussed in the TAT manual, they

play an integral part in the use and interpretation of the

TAT, and administrators lacking these skills will find the

TAT onerous if useful at all.

The Children8s Apperception Test

The initial boom in popularity of the TAT prompted the

development of other, similar thematic picture tests. The

Children8s ~pperception Test (CAT; Bellak & Bellak, 1949) is

one of these measuxes. The CAT, however, is not intended to

compete with or substitute for the TAT. The CAT is designed

for the personality assessmant of children who are 3 to

approximately 10 years old, an age group for whom the TAT is

less than ideal. Although the TAT is not strictly limited

to use with adults and Murray (1943) indicated that 17 of 31

cards on the TAT are appropriate for use with children;

children are pictured on only 2 of the 31 cards making their

relevance for children lhuited.

Although the CAT administration and interpretation

technique are similar to that of the TAT, the CAT is

specifically designed to facilitate

children's drives and relationships

consists of 10 stimulus cards which

13

understanding of

(Bellak, 1993). The CAT

are believed to be more

relevant than the TAT stimuli to children's lives. Bellak

reasoned that since stimuli which portray situations more

relevant to an individual's daily life and experience tend

to be more effective in eliciting projective material, an

apperceptive test that contained stimuli more relevant to

children than that of the TAT would more readily facilitate

understanding of their drives and relationships. He further

reasoned that since animals play such a large role in

children's physical and emotional lives and that since

animals, like children, tend to be "underdogs"; children

would more readily identify with animal rather than human

figures. ~ollowin~ this reasoning, the CAT stimuli depict

animal rather than human characters.

Unfortunately, because the CAT is modeled so closely

after the TAT, the two measures have similar problems. A

major limitation of the CAT is its lack of a widely accepted

standardized scoring system. Although a few objective

scoring systems have been proposed for the CAT, none has

gained broad acceptance (McArthur & Roberts, 1982), Another

problem with the CAT is the stimuli's elicitation of

psychoanalytic themes. As is the case with the TAT, the CAT

stimuli's association with psychoanalytic concepts makes its

interpretation for nonpsychoanalytically oriented

14

psychologists difficult. A problem more specific to the CAT

is that although the measure was developed for children

between the ages of 3 and 10, experience has shown that only

very young children respond seriously to the animals

portrayed on its stimulus cards. Thus, the CAT is

inappropriate for most school-aged children (McArthur &

Roberts, 1982).

The Roberts ~pperceptive Test for Children

An example of a successful attempt to design a

projective measure that retains the form of and the

theoretical base upon which the TAT was developed while

bproving upon its most criticized aspects is the Roberts

Apperception Test for Children (RATC; McArthur & Roberts,

1982). The most noteable improvement of the RATC over the

TAT involves changes to the stimulus cards. The RATC

stimulus cards, which portray a range of interpersonal

interactions common to contemporary life, sharply contrast

with the TAT stimuli's portrayal of antiquated and/or

obscure situations. In addition, while the TATfs dark

shading tones lend a surrealistic quality to its stimulus

cards, the realistic line drawings of the RATC stimuli

provide minimal extraneous detail and are more relevant to

daily life. Developrnent of the RATC stimulus cards

was a rigorous process that began with a review of the

literature to identify characteristics of stimulus cards

that would facilitate elicitation of clinically relevant

15

material. Two specific characteristics w e r e identified and

applied during the development of the RATC stimulus cards:

(1) stimuli should be realistic in terma of an individua18s

daily life, and (2) that the pull of the stimulus be strong

enough to suggest a particular theme but weak enough to be

ambiguous about how that theme is to be expressed. Roberts

then sampled children8s preferences regarding the format of

stimulus cards and determined that stimulus cards with line

drawings were preferred to those with photographs. He also

identified twenty-three stimulus situations that produced

the most clinically useful responses. Twenty-three

handdrawn stimulus cards were then produced to represent

these stimulus situations and a subset of these cards were

selected for the RATC. The 16 stimulus cards whlch comprise

the RATC were selected from this larger set of prelhinary

cards because they produced the most projective material,

produced clinically significant information, resulted in the

highest percentage of agreement among children on theme and

stimulus figure, and met the criteria suggested by research

for eliciting the most clinically relevant material. N o t

only has this rigorous selection process resulted in

stimulus cards which produce abundant and clinically

relevant projective material but it has also kept a standard

set of stimulus cards in use,

Another major improvement of the RATC over the TAT is

its objective rather than subjective system for interpreting

subjects8 responses. This quantitative scoring system

consists of 3 indicators, 13 profile scales, and an

interpersonal matrix. A childfs score on each of the 3

indicators and 13 profile scales, which are further divided

in to 8 adaptive scales and 5 clinical scales, is the sum of

16 present (1) or absent (O) ratings for that dimension.

These ratings correspond to the subject8s stories for each

of the 16 RATC stimulus cards. ~uring interpretation the

thirteen profile scores are plotted on the Profile Fornt and

examined for significantly high or low scores. Comparison

of the mean adaptive scale and clinical scale scores and

examination of interscale variability lend additional

information. The Interpersonal Matrix attempts to help the

examiner focus on the kind and degree of the child8s

interaction with particular significant others.

Abbreviations for the profile scales appear across the top

of the matrix and the left-hand column lists significant

individuals in the child8s life. These include child,

mother, father, parents, family, siblings, peers, and school

personnel among others. Numbers representing each stimulus

card are placed in the box corresponding to the scale or

indicator and the characters portrayed in the childfs story.

When interpreting the Interpersonal Matrix, both excessive

and absent scores may be significant.

Al1 of the theoretical advances of the RATC would be

meaningless if the measure did not possess adequate levels

17

of reliability and validity. In order to test t h i s issue

the psychometric properties of the RATC have been examined

from several perspectives. The reliability of the RATC was

investigated by two methods: (1) inter-rater agreement, and

(2) split-half reliability. Inter-rater agreement was

generally high across al1 16 profile scales and indicators

with doctoral-level raters averaging over 89% agreement.

Split-half reliabilities were lower and ranged from - 4 4 to

.86. The validity of the RATC was investigated by

comparison of contrasting groups. A multiple regression was

calculated with the 13 profile scale scores used to predict

group membership. The regression analysis yielded a '

multiple correlation of - 7 9 and indicates that approximately

62% of the variance in group membership was accounted for by

the 13 profile scales. In addition, analyses of variance

were perfomed on each of the 16 profile scales and

indicators. Clinic and nonclinic children differed at the

-01 level of significance on 12 out of 15 rating variables

(data for the refusal indicator is not reported). As can be

seen from these data, the RATC possesses high levels of

reliability and validity.

The Apperceptive Copins Test

The Apperceptive Coping Test (ACT; Bilsker & Gilbert,

1994) is a new projective story-telling test for adults that

was modeled after the RATC and designed to retain its

psychometric properties. It has been developed by Dan

Bilsker, PhoDo, and Merv Gilbert, Ph.Dœ, at Vancouver

General Hospital, Vancouver, British Columbia, Canada, and a

preliminary manual (Bilsker & Gilbert, 1994) containing

scoring criteria and examples has been developed and

circulated within the psychology department at this

institution.

The ACT consists of 12 stimulus cards which depict a

variety of social situations as l i s t e d in Table 1-

Table 1

Projective Themes of A~perceptive Copinq Test Stimulus Cards

Projective Themes 1. Partner Conflict

Partner Support Peer Support Family Interaction Relating to a Social Group Relating to Legal Authority Relating to Medical Authority Work Attitude Relating to Job Authority Coping with Sadness Coping with Anger Acceptance of Positive Affect

The stimulus cards of the ACT have been designed to be more

representative of situations encountered in daiPy life than

are those of the TAT. Most portray social situations

suggestive of either interpersonal conflict or supportive

interaction, but four cards depict a protagonist alone. ACT

stimulus cards portray a broad range of affect which is

intended to elicit a more balanced and accurate

representation of a subject's emotional state than the dark,

dreary TAT stimulus cards. Figures in the ACT cards are

contemporary in appearance and are portrayed in situations

relevant to contemporary life. ACT stimulus cards have a

less bizarre, surreal quality than those of the TATo The

improvements in the ACT stimuli reflect the developers'

belief that the.,quality and quantity of projective material

produced in response to a stimulus card is not adversely

affected, but enhanced by more relevant stimulus material.

The more representative subject matter of the ACT cards

should yield a higher level of content validity than the

rather arcane subject matter of the TAT cards. In addition,

the broader range of affect portrayed in the ACT stimulus

cards allow the administrator to distinguish between the

"pull" of the card and the emotional status and personality

characteri.stics of the respondent . The theoretical organization of the ACT stimuli also

differs from that of the TAT stimuli. The ACT stimulus

cards exchange the psychoanalytic orientation of the TAT

cards for a more atheoretical approach. The atheoretical

orientation of the ACT stimuli allow them to be interpreted

in either a behavioral, interpersonal, cognitive,

humanistic, or psychodynamic context. The ACT scales also

reflect the atheoretical orientation of the measure. The

scales are oriented toward clinical settings and emphasize

variables that are indicative of impaired coping but also

contain variables intended to reflect positive coping

resources. The ACT scales (shown in Table 2), with the

exceptions of Problem Identification and Autism, are grouped

together in three categories.

Table 2

Apperceptive Co~inq Test Variables

ACT Variable Problem ~dentification Autism

AFFECT

COPING

Depression Anxiety Hostility Elation STYLE Passive Aggressive ~ffiliative Self-reliant Maladaptive

INTERPERSONAL ENVIRONMENT Supportive Obstructive

The ACT contains four affect scales (Depression, Arixiety,

Hostility, and Elation), five coping scales (Passive,

Aggressive, Affiliative, Self-Reliant, and Maladaptive), and

two interpersonal environment scales (Supportive and

Obstructive). These variables, similar to the stimulus

cards, can be interpreted in a variety of theoretical

contexts . A quantitative scoring system has been developed for

the ACT that is less complex and requires far less t h e to

use than MurrayIs TAT scoring system; this should enhance

the accuracy with which normative comparisons can be made.

21

The scoring system is straightforward, easy to learn, and

presented clearly in the ACT manual. For these reasons the

ACT scoring system is believed to be to more appropriate

than the TAT scoring system for clinical use.

The Purpose - of this Studv

The purpose of the present study was not to compare the

ACT with the TAT, but to provide preliminary data on the

psychometric properties of the ACT. The first goal of the

study was to examine interrater reliability for individual

ACT items and for the eleven basic ACT scales. The ACT was

then evaluated for two types of validity. The second goal

of the study was to test individual scales and to test the

ACT as a whole for concurrent validity. Concurrent validity

for individual scales waç examined by contrasting scores

from the patient and non-patient groups. Concurrent

validity for the measure as a whole was examlned by

evaluating the ACT'S ability to correctly assign patient and

non-patient subjects to their respective groups. The third

goal of the study was to assess convergent validity by

testing for hypothesized relationships between ACT scales

and similas scales and subscales from a more well-

established personality measure. Relationships between the

ACT scales were also examined. Direct cornparisons of the

ACT to the TAT or other projective measures will have to be

made in future studies.

Method

Subiects

Two subject groups were used for the present study.

These were a patient group and a non-patient (student)

group. Due to limited availability of subject hours in the

university subject pool and the difficulty in obtaining data

from patients appropriate for t h e study a goal of obtaining

50 subjects in each group seemed reasonable. The patient

group consisted of patients recruited from t h e psychiatric

assessment unit (PAU) of Vancouver General Hospital. The

majority of individuals seen in the PAU have psychotic,

neurotic compiaints or suffer from personality disorders,

with 80 - 90% being depressed and/or suicidai. Exclusionary

criteria for potential subjects in the current study

included individuals with psychoses and individuals with

extreme scores on the validity scales of the construct

validation measure. Patients seen in the PAU have been

ref errad for a psychological assessment through various

avenues and may be admitted to the hospital's inpatient

psychiatric unit after receiving a DSM-IV diagnosis. The

non-patient Group consisted of university students selected

from lower level undergraduate psychology courses. The

students received course credit for their participation.

Data for the present study was obtained from a total of

96 subjects. Subjects were evenly split between the two

subject groups with each group having 48 subjects. Subject

23

gender and age were recorded for subjects in both groups and

are reported in Tables 3 and 4 respectively. O f the 48

subjects i n the patient group 23 (48%) were female and 25

(52%) were male. Subjects in the patient group had a mean

age of 32 .4 and a standard deviation of 9 .48 . The youngest

individual i n the pat ient group was 20 and the o ldes t was

54 . O f the 48 subjects i n t h e non-patient group 2 7 (56%)

w e r e female and 21 (44%) were male. Subjects in the non-

patient group were considerably younger than subjects in the

pat ient group with a mean age of 19 .73 and a standard

deviat ion of 2 . 5 8 . The youngest individual i n t h e non-

patient group was 17 and the oldest was 29.

Table 3

Subiect qender bv sroup

GROUP Non-patients Patients T o t a l

SEX female Count 27 23 50 8 within SEX 54 .0% 46 .0% 100 .0% % w i t h i n GROUP 56 .3% 47 .9% 52.1%

male Count 21 25 4 6 % within SEX 4 5 . 7 % 54 .3% 100.0% % within GROUP 43 .8% 52 .1% 47.9%

Total Count 48 48 96 % within SEX 50.0% 50.0% 100.0% % within GROUP 100 . 0% 100.0% 100.0%

Table 4

Mean, standard deviation, and minimum and maximum of subiect acres bv qroup

GROUP Mean (SD) Min. Max. Patients 32 .40 ( 9 . 4 8 ) 20 54

Measures

Two measures were used in this study, the new

Apperceptive Coping Test (ACT), and the Personality

Assessment Inventory (PAI: Morey, 1991), a well-established

self-report personality scale.

The Apperceptive Coping Test is a projective story

telling test consisting of twelve stimulus cards. The cards

involve various numbers of characters and portray a range of

semi-ambiguous social situations. The ACT has both a male

and female version; these differ in the gender of the

protagonist and are identical in al1 other respects.

Subjects are adainistered the cards in a preset order and

are instructed to tell a story about the situation portrayed

in each card. A standard script was developed for this

purpose :

Here is a set of pictures showing people in

different situations. T want you to tell me a

story about each picture explaining what might be

happening in that picture. Tell me what happens

in each story and how it endso

Information about the protagonist's feelings and

actions are of particular interest when scoring the ACT,

therefore nondirective prompts are used during

administration to elicit relevant information that has not

been provided spontaneously. Prompts were only used in two

25

situations during the validation study; to clarify how the

protagonist felt, and to clarify the protagonist's actions.

The subject's responses to each card were recorded verbatim

and later scored on a O to 1 scale (O to 2 for ACT affect

scales) for each of the eleven variables investigated in

this study. At this stage of its development, the twelve

scores (one for each stimulus card) for each variable are

then summed to create a larger, more reliable ACT scale

score, which is considered to describe the subject's current

functioning on that dimension. The ACT scale scores used in

the present study were generated in this rnanner.

The present study investigated a subset of the thirteen

ACT scales. The Autisrn and Maladjustment ACT variables were

not investigated because of their low rate of occurrence in

most populations. The Problem Identification variable,

however, which is scored for each story but is not usually

s m e d to create a larger ACT scale score, was evaluated as

a full scale in this study. Instead of being summed into an

interpretable çcale score Problem Identification scores are

typically used as an aid in scoring the coping variables. A

problem as identified by the Problem Identification variable

must be evident in each story before that story can be

scored for the ACT coping variables. The Problem

Identification scores for the twelve stories are also used

to prorate the subject's coping scale scores. Prorating of

coping scale scores is necessary in order to standardize

these scores and allow cornparisons to be drawn between

individuals. These changes leave eleven ACT scales for

analysis . The second measure that was be used in the study was

the Personality Assessrnent Inventory. The PA1 is a 344

item self-report measure of personality psychopathology with

a $-point Likert-type response format. For each item the

subject is asked to select the most accurate response from

among the options of false, slishtlv true, mainlv true, or

verv true. The conibined weighted responses from these items

yield scores on 22 nonoverlapping full scales: 4 validity

scales, 11 clinical scales, 5 treatment scales, and 2

interpersonal scales. Ten of these full scales contain

conceptually derived subscales designed to more fully cover

the breadth of these complex clinical constructs and to

facilitate their interpretation. Scores on the PA1 scales

and subscales are presented in the f o m of llnear T scores

that have a mean of 50 and a standard deviation of 10.

Elevated scores represent pathology and a score of more than

two standard deviations above the normal population mean is

considered a pronounced deviation from the typical response

of adults living in the community. The PA1 was standardized

within a normal and a clinical sample and was designed to be

used as

both of

the PA1

a measure of specific personality constructs within

these populations. The psychometric properties of

are strong and well-documented. The PA1 manual

(Morey, 1991) reports a median interna1 consistency

reliability of .81 for its 22 full scales and provides

voluminous data on the PAIfs extensive validity testing.

Procedures

The Apperceptive Coping Test and the Personality

Assessrnent Inventory were administered to the non-patient

group by a psychology honors student trained in the

administration of the ACT. During administration, the non-

patient subjectsr responses on the ACT were audiotaped and

also recorded by hand. The non-patientsf responses were

recorded by hand in order to maintain similarity between the

administration of the ACT to the patient and non-patient

groups. The written record also served as a backup when the

audio quality of the recording was poor. A verbatim

transcript from the audiotape was used when scoring the

responses. The non-patient subjectsf transcripts were

scored by two researchers trained in the ACT scoring system.

The ACT and the PA1 have been routinely administered to

patients as part of a larger assessment battery during

clinical assessments by a doctoral-level clinical

psychologist at the PAU. The assessment battery was used by

the psychologist to form a preliminary DSM-IV diagnosis for

each subject. The preliminary diagnosis was presented to

the clinical team at the PAU and the team arrived adt: a final

DSM-IV diagnosis for that subject. Data needed for the

patient group in this study were acquired from these

archived assessments. No additional measures were

administered to PAU patients as a result of this study.

During administration the responses of the patients to

the ACT cards were recorded verbatim by the staff member

administering the test. Because of potential ethical

concerns the sessions were not audiotaped. Although the ACT

was scored by the psychologist in order to arrive at a

preliminary DÇM-IV diagnosis, the written transcripts were

rescored by the..same researchers scoring the non-patient

population's transcripts. Patients' responseç were rescored

to provide standard scoring across the both groups.

Analvses

Interrater reliability was assessed using transcripts

from a randomly selected group of ten patient and ten non-

patient subjects. These transcripts were scored by two

clinical psychology graduate student raters who were trained

in the ACT scoring system. Correlations between the

graduate studentst ratings were reported for individual ACT

items and for ACT scales. Ari exploration of the

relationships between ACT scales was also performed, The

correlation matrix was examined for this purpose.

The concurrent validity of the ACT scales was

investigated by contrasting the patient and non-patient

groupsf mean scale scores for each of the tan ACT variables.

Differences between the patient group and the non-patient

samples were tested for significance using a & test. The

29

concurrent validity of the ACT was also assessed by

evaluating the ACT'S ability to correctly assign subjects to

their respective groups, A discriminant function analysis

was perforxned for this purpose.

The convergent validity of the ACT was assessed using

the PA1 and involved both groups, To minimize restricted

ranges the groups were combined. Scores on individual

scales and subscales of the Personality Assessment Inventory

were hypothesized to predict scores on specific ACT scales

which were believed ta measure sImllar constructs. To test

this hypothesis the PA1 scales and subscales were regressed

upon the ACT scales which they were hypothesized to predict.

The ACT scales under investigation and the PA1 scales and

subscales which were hypothesized to predict these ACT

scales are listed in Table 5,

Table 5

ACT Variables and the PA1 Scales and Subscales that are Hv~othesized to Predict these ACT Scales

PA1 Scale or Subscale Scores ACT Scaie not predicted by any scale Problem ID

AFFECT SCALES high Affective ~epression Depression

subscale score high Affective anxiety Anxiety

subscale score high Aggressive Attitude Aggression Hostility

subscale score low Affective Depression Elation

subscale score COPING STYLE SCAWES

low Dominance scale score Passive high Dominance scale score Aggressive high Warmth scale score Affiliative low Warmth scale score Self-reliant

INTERPERSONAL ENVIRONMENT SCALES

low Nonsupport scale score Supportive hiah Nonsup~ort scale score Obstructive

Results

Item Properties

Tables 6 through 16 display the means, standard

deviations, item-total correlations, and inter-rater

reliabilities of the 132 ACT items which which were

investigated in this study. Items on the four ACT affect

scales were scored on a O - 1 - 2 scale, where high scores meant a stronger presence of that variable in the subject's

response. The remaining ACT scales were scored using a O - 1 scale. Item statistics were calculated using 96 cases,

with the exception of inter-rater reliability which was

calculated using 20 cases that were scored by two raters.

Restricted ranges on some items periodically resulted in a

lack of variability across the 20 cases used to determine

inter-rater reliabilities. Inter-rater reliabilities were

unable to be calculated for these items and are shown as

missing data in"~ab1es 4-14. An even smaller number of

items had no variation across al1 96 cases and the item-

total correlation in addition to the inter-rater reliability

could not be calculated.

Table 6 lists statistics for ACT Depression Scale

items. The means for the 12 items that comprise the

Depression Scale were quite variable. Item means for items

3 and 10 were quite high at 1.07 and 1.26 respectively and

item 11 was somewhat smaller than the other item means at

.08. The remainder of the items had means ranging from .10

Table 6

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Depression Scale Items

Item Mean (B) Item-Total Inter-Rater Correlation Correlation

1,Pastner Conflict .17 .45 O1 .36 2,Partner Support .11 .35 17 1.00 3,Peer Support 1.07 .82 , 01 .71 4.Family Interaction .11 -35 22 9-...-

5,~elating to a - 3 9 .55 11 75 Social Group

6,Relating to Legal -18 -46 -19 - 2 5 Authority

7,~elating to .14 .43 01 1 00 Medical Authority

8.Work Attitude .19 .47 .O3 .92 9,Relating to Job .14 .43 .O8 1 , O0

Authority 10.Coping with 1.26 .81 .O5 .66

Sadness ll=Coping with Anger . O 8 .35 . 13 -11-

12.Acceptance of .IO .37 . 05 1.00 Positive Affect

Note: Depression items scored on a O - 2 scale. Mean inter- item correlation equals -04.

to .20 with the exception of item 5 at -39. Although item

11 had a low mean it was relatively well correlated with the

other Depression Scale items and was one of only five items

with item-total correlations above .10. The correlations

for these five items ranged from .11 to -22. Items 1, 3, 7,

8, 9, 10, and 12 al1 had item-total correlations below .10.

Inter-rater reliabilities ranged from .25 to 1.00, Inter-

rater reliabilities for items 4 and 11 were undefined due to

a lack of variability.

Statistics for the ACT Anxiety Scale items are

presented in Table 7.

Table 7

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater ~eliablitities of ACT Anxiety Scale Items

Item Mean (ÇD) Item-Total Inter-Rater Correlation Correlation

LPartner Conflict - 2 2 -51 17 1.00 2,Partner Support .O2 -14 10 --LI

3.Peer Support -04 -20 0-04 1-00 4,Family Interaction -10 -37 .21 1-00 5 Relating to a -18 -46 .21 O-O-

Social Group 6,Relating to Legal .32 ,66 . 06 .94

Authority 7,Relating to - 3 4 -65 32 O 94

Medical Authority 8 Work Attitude ' -13 -42 -. IO 89 9 Relating to Job - 4 7 - 6 0 -29 -60

Authority 10-Coping with -17 -47 -20 - 7 8

Sadness 1l.Coping with Anger -09 -41 .O7 ---- 12.Acceptance of .O9 -36 14 1 O0

Positive Affect Note: Anxiety items scored on a O - 2 scale- Mean intex- item correlation equals .25.

Items on the Anxiety Scale were more evenly endorsed than

were items on the Depression Scale, Means for items 2 and 3

however were very low at -02 and -04 respectively, Means

for the remaining items ranged fsom items 11 and 12 at - 0 9

to item 9 at .47 . Item-total correlations for items 4, 5,

7, 9, and 10 were good and ranged from .20 to .32- Item 1

at .17 and item 12 at -14 had relatively good item-total

correlations and item 2 was borderline with an itern-total

correlation of .10. Items 3, 6, 8, and 11 had poor or

negative item-total correlations. Inter-rater reliabilities

ranged from -60 to 1.00 with items 2, 5 and 11 being

undefined.

ACT Hostility Scale item statistics are reported in

Table 8,

Table 8

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Hostilitv Scale Items

Item Mean (a) Item-Total Inter-Rater Correlation Correlation

1.Partner Conflict .53 .61 .O9 -90 2.Partner Support 3.Peer Support 4,Family Interaction 5.Relating to a

Social Group 6,Relating to L e g a l

Authority 7,Relating to

Medical Authority 8.Work Attitude 9,Relating to Job

Authority 10.Coping with

Sadness I1,Coping with Anger 12 .Acceptance of

~osltive Affect Note: Hostility items scored on a O - 2 scale. Mean inter- item correlation equals - 0 2 .

Items 2, 3, 7, 10, and 12 al1 had means at or below .04.

Item 11 had an extremely high mean at 1.36. The remaining

items had means ranging from .14 to .53. Item-total

correlations were varied. Only three items had acceptable

item-total correlations. These were items 5, 8, and 9 at

.17, .24, and .10 respectively. Item 9 at .10 and items 1,

4, 6, and 10 at .O9 had marginal item-total correlations,

The remaining items had poor or negative item-total

correlations including item 11 which had an item-total

correlation of -.16. Inter-rater reliabilities ranged from

.46 to 1.00. Inter-rater reliabilities for items 2, 3, 7,

and 10 were undefined due to lack of variability,

Table 9 lists Elation Scale statistics.

Table 9

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Elation Scale Items

Item Mean (a) Item-Total Inter-Rater Correlation Correlation

1.Partner Conflict .O0 .O0 o.-- ---- 2.Partner Support -63 - 8 0 . O 4 71 3, Peer Support .14 - 3 4 - . O0 .76 4.Family Interaction .O3 -17 .O3 -L I -

5.Relating to a .14 .34 . 17 .61 Social Group

6.Relating to Legal ,O2 .14 -.Il ---- Authority

7. Relating to .. - 2 8 -54 . 10 - 8 9 Medical Authority

8.Work Attitude .O2 - 1 4 . 19 ---- 9,Relating to Job .O5 .22 .OS ----

Authority 10.Coping with .O3 -17 -11 -111-

Sadness 11.Coping with Anger .O4 .25 .20 .41 12 .Acceptance of -77 - 5 9 .20 -21

Positive Affect Note: Elation items scored on a O - 2 scale. Mean inter- item correlation equals 003.

Means for the majority of the Elation Scale items were low.

Items 1, 4, 6, 8, 9, 10, and 11 al1 had means at or below

. 0 5 . Item 1 was never scored. The remaining items had

means ranging from .14 to - 7 7 . Item-total correlations for

Elation Scale items were also low. Due to a lack in

variability the item-total correlation for item 1 could not

36

be calculated. Four items had poor item-total correlations.

Items 2, 3, and 4 al1 had correlations at or below .04.

Item 6 had marginal item-total correlation but in the

negative direction at -.Il. Items 7 and 9 also had marginal

item-total correlations at -10 and -08 respectively. Item

10 was slightly better at -11 and the remaining items al1

had item-total correlations at or above .17. H a l f of the

Elation Scale items had inter-rater reliabilities that were

undefined. The remaining inter-rater reliabilities ranged

from .2O to -89.

The statistics for the Problem ~dentification items are

presented in Table 10. Means of the Problem Identification

Scale items were quite high. Item 1 was always scored as a

problem and had a mean of 1.00. In addition, items 3, 4, 6,

8, 9, 10, and 11 al1 had means at or above -83. Means for

items 2 and 12 were respectable but low. in comparison with

the other Problem Identification Scale items at - 2 7 and .16

respectively. Item-total correlations were quite good for

most of the items. The item-total correlation for item 1

could not be calculated due to a lack of variability. Item

9 had a marginal item-total correlation of .10. The

remaining items.had item-total correlations ranging between

.16 and - 3 8 . Lack of variability resulted in the inter-

rater reliabilities of items 1, 3, 5, 8, 9, and 10 being

undefined. The inter-rater reliabilities for the remaining

items were low and ranged from .19 to . 55 .

Table 10

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Problem Identification Items

Item Mean (a) Item-Total Inter-Rater Correlation Correlation

1.Partner Conflict 1.00 .O0 O--- ----

2.Partner Support 3,Peer Support 4,Family ~nteraction 5,Relating to a ,

Social Group ' 6.Relating to L e g a l

Authority 7.Relating to

Medical Authority 8.Work Attitude 9.Relating to Job

Authority 10.Coping with

Sadneçs 11,Coping with Anger 12.Acceptance of

positive Affect Note: Problem Identification items scored on a O - 1 scale. Mean inter-item correlation equals .10.

Passive Coping Scale item statistics are shown in Table

11. Item means for the Passive Coping Scale were good with

the exception of items 2, 7, and 12. Al1 three of these

items had means of .04. The remaining item means ranged

from -14 to - 5 2 . Item-total correlations were not nearly as

good. Correlations for items 2, 3, 7, 9, 10, and 11 were

al1 in the negativa range. The item-total correlation for

item 6 was only .O8 but the correlations for the remaining

items were al1 at or above .12. Inter-rater reliabilities

were low and ranged from .17 to .69. Inter-rater

reliabilities for items 2 and 12 could not be calculated-

Table 11

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Passive Copina Scale Items

Item Mean (E) Item-Total Inter-Rater Correlation Correlation

LPartner Conflict - 3 3 -47 - 3 6 -34 ,Partner Support -Peer Support .Familv Interact ion

S - ~ e l a t i n ~ to a Social Group

6,Relating to Legal Authority

7.Relating to Medical Authority

8aWork Attitude 9,Relating to Job

Authority 10.Coping with

Sadness 11.Coping with Anges 12,Acceptance of

~osqtive Affect Note: Passive Coping items scored on a O - 1 scale. Mean inter-item correlation equals .OZa

Aggressive Coping Scale statistics are presented in

Table 12. The majority of the Aggressive Coping Scale item

means were low, Only five items had means which were

marginal or better. Item 10 had a mean of - 0 9 and items 1,

4, 6, and 11 al1 had means of - 2 0 or better. Item-total

correlations were quite low and only items 6, 9, 10, and 12

had item-total correlations at or above .11- Item 1 had a

relatively strong item-total correlation but it was in the

negative direction at -.15. Inter-rater reliabilities for

the Aggressive Coping Scale items rangea from -25 to 1.00.

Inter-rater reliabilities could not be calculated for items

Table 12

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Aasressive Copins Scale Items

Item Mean (m) Item-Total Inter-Rater Correlation Correlation

I.Partner Conflict .44 -50 -015 -91 2,Partner Support .O1 -10 .O3 -...-O 3.Peer Support .O6 - 2 4 02 ---- 4,FamiLy Interaction .22 -42 . 07 1-00 5,Relating to a .O5 .22 .O4 ----

Social Group 6.Relating to Legal - 2 0 -40 -11 - 2 5

Authority 7.Relating to .O1 -10 -. 06 --m...

Medical Authority 8.Work Attitude .O4 .20 9-02 O--i

9,Relating to Job .O7 .26 .11 . 33 Authority

10 .Coping with . .O9 - 2 9 -20 1.00 Sadness

11 .Coping with Anger .44 -50 .O6 -90 12.Acceptance of - 0 2 -14 .31

Positive Affect Note: Aggressive Coping items scored on a O - 1 scale. Mean inter-item correlation equals . 0 2 .

2, 3 , 5, 7, 8, and 12 due to a lack of variability.

Statistics for Affiliative Coping items are listed in

Table 13. Means for Affiliate Coping items were relatively

good w i t h the exception of items 8 and 12 which were -07 and

.O3 respectively. The mean for item 10 was only -09 but the

remaining items al1 had means at or above .13. Item-total

correlations for the Affiliative Coping items were also

relatively good'with a few exceptions. Item-total

correlations for items 3, 4, 8, and 11 ranged from .O7 to

.11. The remaining items however al1 had item-total

correlations at or above A4. Inter-rater reliabilities

Table 13

Means, Standard ~eviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Affiliative Copina Scale Items

Item Mean (m) Item-Total Inter-Rater Correlation Correlation

1.Partner Conflict .33 -47 -16 .61 2.Partner Support 3.Peer Support 4.Family ~nteraction 5 .Relating to a

Social Group 6.Relating to Legal

~uthority .. 7.Relating to

Medical Authority 8.Work ~ttitude 9.~e1ating to Job

Authority 10. Coping with

Sadness 1I.Coping with Anger 12 .Acceptance of

positive Affect Note: ~ffiliative Coping items scored on a O - 1 scale. Mean inter-item correlation equals -06.

were able to be calculated for al1 of the Affiliative Coping

items except item 12. Levels of inter-rater reliability

varied widely across the items and ranged from 0.33 to 1.0.

Table 14 contains statistics for Self-Reliant Coping

Scale items. None of the Self-reliant Coping Scale items

were endorsed with any degree of regularity. The highest

mean for the Self-reliant Coping items was .O4 and seven of

the items were never scored. Item-total correlations for

the Selforeliant Coping items ranged from 0.04 to .27 but

are not reliable due to the restricted range of this

variable. Inter-rater reliabilities could be calculated

Table 14

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT SelfaReliant Copina Scale Items

Item Mean (m) Item-Total Inter-Rater Correlation Correlation

1,Partner Confl ict .O0 .O0 ---- -O--

2,Partner Support .O0 .O0 ---- ---- 3.Peer Support .O2 .14 18 o.-.

4.Family ~nteraction .O1 .IO - 27 -005 5.Relating to a .O0 . O 0 O--œ ----

Social Group 6,Relating to Legal .O0 .O0 --.O ----

Authority 7,Relating to - 0 0 -00 --CI ----

Medical Authority 8.Work Attitude .O4 .20 . 12 1,OO 9.Relating to Job .O2 -14 . 18 ---O

Authority 10.Coping with .O0 .O0 -.-o.I ---O

Sadness 1l.Coping with Anger -02 -14 - . O 4 ---- 12.Acceptance of .O0 .O0 ---- --II

~ositive A f f e c t Note: Self-Reliant Coping items scored on a O - 1 scale. Mean inter-item correlation equals .08.

for only two of the twelve items and are also unreliable

due to range restriction,

Statistics for Supportive Environment items are

recorded in Table 15. Means for items 8, 10, 11, and 12

were low and ranged from .O5 to ,08. Items 4 and 6 both had

means of .10. Means for the remaining items ranged from .20

to .82. Item-total correlations for the Supportive

Environment items were also fairly good with a few

exceptions. Items 2 and 8 had correlations of .O3 and .O2

respectively. The item-total correlation for item 3 was

also low at ,08 . Correlations for items 6 and 12 were both

Table 15

Means, Standard..Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Supportive Environment Scale Items

Item Mean (m) Item-Total Inter-Rater Correlation Correlation

1,Partner Conflict .21 .41 ,22 ,67 2, Partner Support .76 .43 .O3 ,29 3,Peer Support .82 .38 . O 8 1-10

4,Family Interaction .IO .31 .17 1.00 5. Relating to a .23 - 4 2 - 2 9 , 44

Social Group 6,~elating to Legal -10 .31 10 .14

Authority 7.Relating to .26 .44 . 2 3 -66

Medical Authority 8. Work Attitude .O6 - 2 4 . 02 1=00 9,~elating to Job .20 ,40 .23 -40

Authority 10.Coping with .O7 .26 16 .44

Sadness 11. Coping with Anger .O5 .22 .24 -44 12,Acceptance of .O8 .28 . 10 .44

positive Affect Note: Supportive Environment items scored on a O - 1 scale . Mean inter-item correlation equals .06.

.IO. The remaining items al1 had item-total correlations at

or above .16. Inter-rater xeliabilities were generally low

but ranged from .14 to 1.00 with the exception of item 3

which could not be calculated.

Table 16 contains statistics for the Obstructive

Environment Scale items. Means for Obstructive Environment

items ranged from .17 to .75 with the exception of items 2,

3, 7 , and 12. Item 3 had a mean of .O9 and the remaining

items had meandat or below .05. Item-total correlations

were varied with aïmost half of the items having

Table 16

Means, Standard Deviations, Item-Total Correlations, and Inter-Rater Reliablitities of ACT Obstructive Environment Scale Items

Item Mean (m) Item-Total Inter-Rater Correlation Correlation

1,Partner Conflict .75 .44 - 2 9 .40 2.Partner Support .O4 .20 - 22 ---- 3.Peer Support .O9 .29 -14 4.Family Interaction -51 -50 -28 .66 5.Relating to a .40 .49 .37 .58

Social Group 6,Relating to Legai -20 .40 -. O5 -40

Authority 7.Reiating to .O5 -22 .O9 .79

Medical Authority 8.Work Attitude -17 -37 . 14 .41 9,Relating to Job -64 -48 .O3 .36

Authority 10.Coping with -25 -44 .31 .73

Sadness 11.Coping with Anger .65 .48 -.O1 .74 12 .Acceptance of .O5 .22 .12 1.00

Positive Affect Note: Obstructive Environment items scored on a O - 1 scale. Mean inter-item correlation equals .06.

correlations at or above .22. An additional four items had

item-total correlations between .14 and .09. Items 6, 9,

and 11 had correlations at or below .03. Inter-rater

reliabilities ranged from .40 to 1.00. I t e m s 2 and 3 were

undefined due to a lack of

variability.

Overall, shveral general trends characterize the data

presented in this section. In general, item means were l o w

and reflect the infrequency with which stories were scored

as containing themes measured by a particular scale. There

were exceptions to this trend, however, and most scales had

44

a small number of items that had relatively high means.

These items typically generated most of the 'zariability for

their respective scales . Overall, item-total correlations

tended to be low. Item-total correlations for individual

items varied with correlations for some items being fairly

high and correlations for others being almost zero. A few

items even had negative item-total correlations. Inter-

rater reliabilities for individual items varied widely and

often could not be calculated due to a lack of variability

in the inter-rater reliability sample.

Scale Properties

Table 17 lists the means, standard deviations, mean

inter-item correlations, and alpha coefficients of the 11

ACT scales investigated in this study. Mean scores on the

scales were low with most of the scale means clustered

between 1.7 and 4.0 out of a possible maximum score of 12.01

Table 17

Means, Standard Deviations, Mean Inter-Item Correlations, and Alpha Coefficients for ACT Scales

ACT Scale Mean (SD) Mean Inter-Item Alpha Correlation Coefficient

Depression 3.94 2.00 .O4 .23 Anxiety 2.18 2.01 . 05 .40 ~ostility 3.11 1.58 .O2 .16 Elation 2.15 1.49 .O3 .24 Problem ID 8.80 1.74 .IO .56 passive Coping 3.08 1.59 . 02 .23 ~ggressive Coping 1.66 1.16 . O2 .14 Affiliate Coping 2.28 1.65 .O6 -41 Self-reliant Coping 0.11 0.38 .O8 -28 Supportive Environ. 2.96 1.56 .O6 - 4 3 Obstructive Environ. 3.79 1.75 .O6 .42

45

These scores do not currently have any clinical significance

because there is no standardization sample against which to

draw comparisons. These low scale means are of concern

statistically however, because there isn't enough

variability to make scale scores meaningful. Although the

items on the four affect scales were scored on a O - 2 scale, the means for these scales were not particularly

higher than the remaining seven scales on which items were

scored O or 1. The Depression, Anxiety, ~ostility, and

Elation scales had means of 3.94 ( 2 . 0 0 ) , 2.18 (2.01), 3.11

(1.58), 2.15 (1.49) respectively. The Passive, Aggressive,

and Affiliative Coping scales were part of this cluster of

scales and had means of 3.08 ( 1 . 5 9 ) , 1-66 (1.16), and 2 - 2 8

(1.65) respectively. The Supportive Environment scale had a

mean of 2.96 (1.56) and the Obstructive Environment scale

had a mean of 3.79 (1.75). Two scale means fell outside of

the cluster of scales. The Self-Reliant Coping Scale mean

was extremely low at 0.11 (0.38). Stringent scoring

criterla resulted in this variable almost never being

scored. The Problem Identification Scale mean was much

higher than the other scale means at 8.80 (1.74). A Problem

Identification Scale mean of this magnitude is not

particularly surprising because the ACT stimulus cards were

specifically designed to be suggestive of problematic

situations. Tn fact, since a subject's response must be

scored as containing a problem before it can be scored for a

coping response, a lower Problem Identification Scale mean

would impede the proper functioning of the ACT Coping

scales. Furthemore, the Problem Identification Scale was

developed primarily to assist in scoring for coping

responses and was not designed as a clinical tool. Low

scores on this scale can however be interpreted as

indicating deceptiveness or denial in a normal or clinical

population. Mean inter-item correlations for the scales

range from -02 to -10 with most of the scales clustered

between .O2 and -06 . The Problem Identification and Self-

reliant Coping Scales have mean inter-item correlations that

fa11 outside of-this range at -10 and - 0 8 respectively. The

Problem ~dentification Scale also has the highest alpha

coefficient of al1 11 scales at .56. An alpha coefficient

of this magnitude suggests that the Problem Identification

Scale, contrary to its initial conceptualization as purely

an aid in scoring the coping scales, may measure some

underlying dimension of clinical relevance. The Anxiety,

Affiliative Coping, Supportive Environment, and Obstructive

Environment scales had alphas between .40 and -43 . Alpha

coefficients for the Depression, Elation, and Self-reliant

Coping scales ranged between 2 3 and .28. The Aggressive

Coping and ~ostility scales had the lowest alphas at .14 and

.16 respectively.

Inter-rater Reliabilitv

Inter-rater agreement was computed for ACT Scale scores

4 7

as well as for individual ACT items. Inter-rater agreement

for individual items was reported in Tables 4 through 14 and

Inter-rater agreement for Scale scores is reported in Table

Table 18

InteruRater Reliability for ACT Scales

ACT Scale Inter-rater Reliabilitv Depression - 9 0 Anxiety . 90 Hostility - 8 0 Elation . 44 Problem Identification -24 Passive Coping .62 ~ggressive Coping .50 Affiliate Coping -36 Self-reliant Coping - 4 0 Supportive Environment .71 obstructive Environment -71

ACT scale inter-rater reliabilities were calculated using

the sme 20 (10 patient and 10 non-patient) cases that were

previously used to calculate item inter-rater reliabilities.

Item scores from these profiles were summed to create Scale

scores, and a Pearson correlation coefficient was calculated

to test the level of similarity between the Scale scores of

the two raters.. Inter-rater agreement for Scale scores was

quite varied. The highest degree of agreement between the

two raters was on the four affect scales, with the Anxiety,

Depression, and Bostility scales al1 having inter-rater

reliabilities of -80 or greater. The Elation Scale with an

inter-rater reliability of -44 was the only affect scale

that did not show a high level of inter-rater reliability.

48

The Elation Scalefs inter-rater reliability however was

adversely affected by the scalers restricted range and might

have been higher with increased variability, The

Interpersonal Environment scales also showed adequate inter-

rater agreement, both of which reached the .71 level. The

lowest level of'agreement was on the Problem Identification

Scale at . 2 4 . The inter-rater reliability of this scale, as

with the Elation Scale, may have been adversely affected by

the scale's restricted range. Inter-rater reliabilities for

the four coping scales ranged from -36 to .62, However, the

Aggressive Coping and Self-reliant Coping Scales had range

restrictions which may have adversely affected their inter-

rater reliabilities.

Inter-Scale Correlations

Inspection of the ACT scale correlation matrix which is

reported in Table 19 reveals a large number of correlations

between ACT scales.

Affect Scales -

The four ACT affect scales (Depression, ~nxiety,

~ostility, and Elation) were relatively independent of other

scales. The Hostility scale was one of only two scales that

were not significantly correlated with any other ACT scale,

and the Anxiety scale was exclusively correlated with

Problem Identification. Not surprisingly a negative

correlation existed between the ~epression and Elation

scales. The Depression scale was also negatively correlated

Table 19

Correlation Matrix for ACT Scales

Depress Anxietv Host Elation Prob ID Passive Anxiety r - . 19 1.00 E .O6 Host r - .O5 E - 6 6 Elation r - -.23 E 9 O2 Prob ID r - .O4 E .71 Passive r - .18 E .O7

Aggress r - -16 012 .O5 -,O7 45 . 10 E .12 .26 . 62 .47 . O0 - 3 5 Af f il r - -017 .11 . O0 .O3 , 39 0.34 E . 10 .3 1 1.00 077 . O0 .O0 Self -Re r - .O5 .O6 - . 11 .O3 .O8 -017 E .62 .59 . 29 . 80 .43 .O9 Support r - - 0 2 8 -.O2 .O5 .40 -. 06 0.25 E .O1 . 84 . 63 . O0 . 55 .O1 Obstruct

X - . 06 . 15 . 13 -013 -56 .39

with the Supportive Environment scale. The ~iation scale in

addition to its negative correlation with the Depression

scale was correlated with the Problem Identification,

Passive Coping, and Supportive Environment scales. The

Elation scale appears to represent an individual's tendancy

to make generally positive interpretations of the

individual's situation and to minimize problematic issues.

Table 19 cont-

Assress Affil Self-Re Sumort Anxiety r - E Host

r - E Prob ID r - E Passive r - E

Aggres s r - 1 . 00 E Affil r - -14 1.00 E -18 Self -Re

support r - -. 17 - 4 0 -.O5 1 . O0 E . 11 . O0 66

Problem and Copins Scales

The Problem Identification Scale was correlated with a

variety of scales and appears t a be a measure of worry

and/or distress. The relationship between the Problem

Identification Scale and the Coping scales however is at

least partly a function of the scoring criteria which

dictate that an individual's response must be scored as

identifying a problem before it can be scored for the coping

variables. The Passive Coping scale correlates with the

Obstructive Environment scale and negatively correlates with

the Supportive Environment and Affiliative Coping scales.

These relationships seem logical on a conceptual level and

may reflect a decrease in functional coping due to an

unwillingness to reach out for assistance from an

interpersonal environment which is percaived as uncaring or

hostile. The negative correlation between passive Coping

and Elation is less l o g i c a l . In addition to its previously

described relationship with Problem Identification the

Aggressive Coping scale correlated with only one other

scale. T h i s scale's highly significant correlation with the

Obstructive Environment Scale may indicate that in large

part the Aggressive Coping Scale was measuring the

behavioral response to a perception of a hostile

interpersonal environment. Similarly, the Affiliative

Coping Scale's highly significant correlation with the

Supportive Environment Scale m a y indicate that the

Affiliative Coping Scale measures a behavioral response to

what is perceived of as a supportive, nurturing

interpersonal environment. The Self-Reliant Coping Scale

did not correlate with any other scales. ~ h i s was most

likely due to the severely restricted range of t h i s

variable.

Environment Scales

The Supportive Environment Scale was correlated with

52

~lation and Affiliative Coping and was negatively correlated

with Depression, Passive Coping, and Obstructive

~nvironment . Interpretation of these correlatiok suggests

that the Supportive Environment Scale may be a measure of

generalized well-being. The Obstructive Environment Scale

was correlated with Problem Identification, Passive Coping,

and ~ggressive Coping. The Obstructive Environment Scale

was also negatively correlated with Supportive Environment.

Individuals who viewed their interpersonal environment as

obstructive more readily identified issues as problematic

and attempted to deal with these issues with less

appropriate coping strategies, but tended not to associate

the negative environmental factors with affect.

Validitv

Concurrent Validity

Concurrent validity was investigated for individual ACT

scales and on a multi-scale level. Concurrent validity for

individual scales was assessed by performing t-tests for

differences between the patient and non-patient groups on

each of the ACT scales. Results of these t-tests are

presented in Table 20. Attempts to demonstrate concurrent

validity of ACT scales in this study were mixed. The affect

scales of the ACT appeared best able to differentiate

between the patient and non-patient groups, with the

Depression and Hostility scales reaching a high level of

significance. The Problem Identification Scale was also

Table 20

Means, Standard Deviations, and Mean Differences of Patient and nonopatient G~OUDS on ACT Scales with T-scores and Sianificances of T-tests for Differences amonq Groups

Scale Group Mean Std. - t E Deviation

Depression Patients 4.60 1.97 -3.45 . O0 Non-patients 3-27 1.82

Anxiety Patients 2.46 2-43 -1 38 17 Non-patients 1.90 1.45

Hostility Patients 3.52 1 68 -2-60 .O1 Non-patients 2-71 1.37

Elation Patients 2.21 1.47 -0.41 68 Non-patients 2.08 1.51

Problem ~dentification Patients ' 8-33 1.93 2.72 .O1 Non-patients 9.27 1.41

Passive Coping patients 3-04 1 . 65 0.26 -80 Non-patients 3.13 1.54

Aggressive Coping Patients 1.58 1-16 0.61 . 54 Non-patients 1.73 1.16

Affiliative Coping Patients 1.81 1.48 2.90 . 01 Non-patients 2.75 1 68

Self-Reliant Coping Patients 0.13 O 39 -0-27 . 79 Non-patients 0.10 O. 37

supportive Environment Patients 2.58 1.40 2-42 .O2 Non-patients 3 33 1 . 63

Obstructive Environment Patients 3.58 1.76 1-17 -25 Non-patients 4.00 1.73

Note: Al1 g tests have 94 df.

able to differentiate between the groups. The difference

however was not in the expected direction, with the non-

patients identifying more problems than the patients. Only

two other scales, the Affiliative Coping and Supportive

Environment Scales, differentiated between the patient and

non-patient groups. In general the small differences in

mean scores between the patient and non-patient groups even

for scales that were able to reliably differentiate between

these groups is concerning.

A cananical discriminant function analysis was

performed to d e t e d n e how accurately the ACT could

discriminate between the two groups. The discriminant

function identified for this analysis utilized the

Depression, Hostility, Affiliative Coping, and Passive

Coping variables. As s h o w in Table 21, the discriminant

function correctly classified 77.1% of non-patients and

70.8% of patients to their respective groups for a 74.0%

total correct classification of subjects. The discriminant

function predicted group membership in a cross-validation

e , "jack-knife") analysis only slightly less accurately.

Non-patients were correctly classified 75.0% of the time and

patients were correctly classified 70.8% of the time

yielding a total correct classification rate of 7269%.

Table 21

Canonical Discriminant Function Classification Results

Predicted Group Membership Non-~atients Patients

Original Patients 29.2% 70.8% Non-patients 77 1% 22-93

Cross-Validated Patients 29.2% 70.8% Non-patients 75.0% 25.0%

55

These results indicate that the ACT can discriminate between

the patient and non-patient groups.

Converqent ~aliditv

Convergent validity of the ACT was assessed using

scales and subscales from the Personality Assessrnent

Inventory which were hypothesized to predict scores on

corresponding ACT scales. Successful prediction of ACT

scale scores from PA1 scales and subscales would lend

convergent validity to the ACT scales. Analysis reveals

that the strength of the relationship between the ACT scales

and PA1 scales and subscales varies greatly, as shown in

Table 22. The ACT Depression and Anxiety scales were found

to be moderately correlated with their respective PA1

subscales. This is not surprising considering these

concepts are well-established and should be, at least on an

intellectual level, relatively similar across measures. The

negative correlation between the ACT Passive Coping and the

PA1 Domhance Scale was significant. The correlation

coefficients representing the hypothesized relationships

between the remaining ACT scales and PA1 scales or subscales

were not significant.

56

Table 22

Correlations between ACT Scales and PA1 Scales and Subscales

ACT Scale PA1 Scale or - r E - - Subscale

~epression Affective Depression .31 . 00 Anxiety Affective Anxiety . 34 . 00 Hostility Aggressive Attitude .O7 .52 Elation Affective Depression -.IO 34 Passive Coping Dominance -.22 -04 ~ggressive Coping Dominance 0.20 . 06 Affiliative Coping Warmth .O9 -40 Self-Reliant Coping Warmth 0-02 .87 Supportive Environ. Nonsupport --12 -28 Obstructive Environ. Nonsumort -03 .8O NOTE: The ACT Problem Identification Scale was not hypothesized to correlate with any PA1 scale or subscale.

Discussion

Important findinas

Evaluation of the descriptive statistics and

statistical analyses that were reported in the previous

section of this paper generates several important findings

which help to illuminate the performance of the ACT in this

study. These findings are discussed in order from the more

general issues which affect the functioning of the ACT, to

evaluation of specific ACT scales, and, finally, to a global

evaluation of how the ACT perforxned in this study.

Low Scale Means

Inspection of the data from the present study reveals

that, in general, means for the scales investigated in this

study were quite low. These low scale means reflected the

low frequency with which items on particular scales were

scored as containing themes measured by that scale. Item

response rates of this level l i m i t e d the variability in

these scales and lowered their discriminant power thus

decreasing their reliability and validity. Increasing the

projective material elicited by the ACT stimulus cards,

modifying the scoring system, and adding additional stimulus

cards to the ACT are al1 methods of increasing variability

and thus the discriminant power of these scales. Improving

the discriminant power of these scales would strengthen the

psychometric properties of the scales and the measure as a

whole .

Item Inter-rater Reliabilitv

Inter-rater reliability for ACT items ranged from

complete agreement to no agreement at al1 across .the 20

cases selected for the inter-rater reliability sample. A

lack of variability in the inter-rater reliability sample

prevented reliabilities for some items from being calculated

and may have adversely affected the inter-rater

reliabilities of the remaining items. This lack of

variability makes interpretation of the item inter-rater

reliability statistics difficult.

Affect Scale Performance

ACT affect scales performed well during this study.

The Depression, Anxiety, and Hostility scales al1 showed

high levels of inter-rater reliability. The Depression and

Anxiety scales also correlated well with similar scales on

the PA1 and supported the convergent validity of these

scales. In addition, the Depression and Hostility scales

were able to differentiate between the patient and non-

patient groupe supported the concurrent validity of these

scales. The ACT affect scales with the exception of Elation

outperformed the remaining ACT scales.

Copinq Scale Performance

The performance of the ACT coping scales in this study

was disappointing. None of the coping scales exhibited

acceptable levels of inter-rater reliability but

reliabilities for the Passive and Aggressive Coping scales

were noticeably higher than reliabilities for the other two

coping scales. Interestingly, however, the Passive Coping

scale correlated significantly with the PA1 Dominance scale

as hypothesized. Also of interest, was that the Affiliative

Coping scale was able to reliably differentiate between the

patient and non-patient groups.

Interpersonal Environment Scale Performance

ACT interpersonal environment scale performance was

mediocre. The Supportive and Obstructive Interpersonal

Environment scales both had acceptable levels of inter-rater

reliability however, only the Supportive Environment scale

was able to differentiate between the patient and non-

patient groups. Neither interpersonal scale was correlated

with its hypothesized PA1 scale.

Overall Performance

Overall, these results indicate that the ACT

performed moderately well with the affect scales perfodng

quite well and the remaining scales functioning more poorly.

Five of the eleven scales investigated in this study reached

acceptable levels of inter-rater reliability. An additional

five scales showed evidence of concurrent validity by

discriminating between the patient and non-patient groups.

Finally, three of the eleven scales demonstrated convergent

validity by correlating with their hypothesized PAS scale or

subscale . Was this a fair assessment?

Although the ACT certainly has psychometric

shortcomings that need to be addressed there are several

issues that may make this initial impression an overly harsh

assessment.

One of the most notable aspects of the current study is

the large number of items for which an inter-rater

reliability could not be calculated due to a lack of

variability in the inter-rater reliability sample. The

generally small size of the ACT item meana (the low

endorsement rate for the ACT items) contributed to the this

lack of variability. The low item means however were not

solely responsible for the absence of variability in the

inter-rater reliability sample. The small size of the

inter-rater reliability sample, a factor external to the

ACT, also negatively affected inter-rater reliability

testing. An examination of ACT items with low or

incalculable inter-rater reliabilities reveals this issue

was particularly problematic for the items which had the

lowest means. Lack of variability in the inter-rater

reliability sample however, was occasionally a problem even

for items with relatively high means. Even though these

items were endorsed more conslstently than items with lower

means, the 20-case sample selected for inter-rater

reliability testing was skewed and did not reflect this

increase in variability. It is therefore reasonable to

assume that increasing the size of the inter-rater

reliability sample, thereby decreasing sampling error and

increasing variability, would have reduced the numbex: of

items for which a inter-rater reliability coefficient could

not be calculated. Increasing the variability in the inter-

rater reliability sample would also tend to reduce the error

variance in previously calculated inter-rater reliability

coefficients and cause the low inter-rater reliabilities of

some items to become more moderate.

Another area of the present study which deserves a

more in-depth examination, is the convergent validity

testing. Ten of the eleven scales investigated in this

study wese hypothesized to correlate with specific scales or

subscales of the P A L Although the PA1 was selected to test

t h e convergent validity of the ACT, it was acknowledged that

t h e PAX was not t h e ideal measure for this purpose. Only

seven of the ten ACT scales that underwent convergent

validity testing had corresponding scales or subscales on

t h e PA1 which measured the same construct. The remaining

three ACT scales (Elation, Aggressive Coping, and Self-

reliant Coping) had scales or subscales on the PA1 which

rneasured similar but not identical constructs. Although

these ACT scales were not expected to correlate as highly

with their respective PAX scales or subçcales it was

believed that the constructs were similar enough that there

should still b & a relationship between the scales.

During convergent validity testing only three of the

ten ACT scales were found to correlate significantly with

their hypothesized PA1 scales or subscales. The Depression,

Anxiety, and Passive Coping scales were found to have

significant relationships with their predicted PA1 scales.

The significant correlation between these scales and their

respective PA1 scales and subscales provides strong evidence

for the validity of these scales. Not surprisingly these

three scales w e r e f r o m the group of ACT scales that were

believed to mesh well conceptually with scales or subscales

from the P A L The Hostility, Affiliative Coping, and

Supportive and Obstructive Environment scales were also

believed to be quite similar conceptually to their

corresponding PA1 scales and subscales. Unfortunately, the

convergent validity of these scales was not supported in the

present study.

As stated earlier, the PA1 was not an optimal

convergent validation measure for the remaining ACT scales.

Tt was, however, expected that that these scales would still

correlate, although to a lesser degree, with their

respective PA1 scale or subscale. The Aggressive Coping

scale which exhibited poor levels of convergent validity was

one of these scales. The Aggressive Coping scale was

validated against the PA1 Dominance scale. Rather than

being a measure of pure aggression the Dominance scale

measures the extent to which a person is controlling or

submissive in interpersonal relationships. Conversely, the

63

ACT Aggressive Coping scale measures the extent to which an

individual responds in a manner which is harmful to another

or ignores another's rights. Although these may be related

concepts in that aggressive people may be quite controlling

in their relationships it does not necessarily follow that

controlling people are necessarily aggressive. It is for

this reason that the PAX Dominance scale is not an optimal

scale against which to test the ACT Aggressive Coping

scale's convergent validity. One would expect however that

since these scales are believed to be at least similar

conceptually the Aggressive Coping scale should have

performed bettes than it did. Similar concerns might have

been raised regarding the Elation and Self-reliant Coping

scales however means for these scales were too low for a

relationship with their predicted PA1 scale to be detected

however stsong.

A third issue which may have affected the ACT'S

performance in this study relates to the characteristics of

the two subject groups. The present study attempted to show

concurrent validity for the ACT by testing for significant

differences between the means of the two subject groups on

each of the ACT scales. The optimal situation for a

validation study of this type is that the subjects front the

two separate groups are similar in every way except for the

one dimension that separates them into their respective

groups. Unfortunately, the subjects that comprised the two

64

groups used in this study differed on a variety of

dimensions. The average subject from the non-patient group

when compared to the average subject from the patient group

was significantly younger (by 12 years) and more highly

educated. It is entirely possible that these differences

could lead to differences in the quality and quantity of

their verbal expression thereby inflating the non-patient

group8s response rate as compared to the patient group.

Suqsested Im~rovements to Methodolacm -- Future Research These criticisrns of the current study lead to a variety

of recommendations for improvements to the methodology of

future studies.

The first of the recommendations for improvements to

the methodology of future studies is that a more appropriate

measure than the PA1 be used to test convergent validity of

the ACT Elation, and Aggressive and Self-reliant Coping

scales. Although the PA1 is an appropriate measure to test

the convergent validity of most of the ACT scales it does

not have scales or subscales that match well conceptually

with these three ACT scales. A second recommendation for

future studies is an increase in the size of the inter-rater

reliability sample. Due to the infrequent endorsement of

many ACT items it will be necessary to increase the size of

samples used to test ACT inter-rater reliability.

~ncreasing the size of these samples will decrease the

likelihood that'the cases for any particular item will have

65

little or no variability and will yield a much clearer

picture of the inter-rater reliability of ACT items. The

third recommendation for future studies is that the same

individual administer the ACT to al1 subject groups involved

in the study. Two administrators were used in the present

study -- one for each of the subject groups. This was

necessary because the study used archiva1 data for the

patient group. Although both administrators were trained in

the administration of the ACT there was a significant

difference in their level of experience with this measure

and it is unknown to what extent this affected the present

study.

Sussested Improvements to the ACT

Several issues will need to be addressed before the ACT

will reach acceptable levels of reliability and validity.

Low Scale means which reflect .the high frequency with w h i c h

items were scored as not containing scale themes represent

the most significant of these issues. Increasing the

frequency with which ACT items are endorsed as containing

scale themes can be approached from two directions modifying

the stimulus cards and/or increasing the sensitivity of the

scoring system. Modification of the stimulus cards would

increase the amount of projective material elicited frorn the

subject and modification of the scoring system would allow

more accurate coding of themes in projective material

already present.

66

Modification of the stimulus cards presents a challenge

however, because the ACT stimuli were designed to

representatively sample basic situations of adult life and

to be fairly neutral in content, thus making it easier to

distinguish the respondent's own projections from the "pull"

of the stimulus cards. In order to increase item response

rates however it will be necessary to modify the stimuli to

increase the pull of the cards. Increasing the pull of the

stimulus cards should increase the likelihood that the cards

would elicit projective responses and thereby tend to

increase item means. It is important however to retain the

aspects of the ACT stimulus cards suc11 as their modern

appearance and their depiction of a broad range of social

situations that distinguish them from the TAT stimulus

cards . Modifying the ACT scoring system to more accurately

code the projective material elicited by the stimulus cards

would also raise item and scale means. Increasing the

sensitivity of the ACT scoring system would increase item

and scale means because it was not uncomon during this

study for subject responses to be highly suggestive of scale

themes but not meet scoring criteria. These responses

therefore could not be scored as containing those scale

themes. Unfortunately, as has often been the case with

objective scoring systems for other projective tests, the

increased reliability of the ACT'S objective scoring system

is accornpanied by a decrease in the sensitivity of the

instrument. When scoring the ACT one sometimes feels that

more knowledge and understanding of the subject is possessed

than can be expressed by the scoring system and/or that the

individual should have scored higher on specific scales than

he or she in fact did. Item means would undoubtedly

increase if the ACT8s objective scoring system were able to

detect these more subtle themes in subject's tesponses.

Increasing the number of stimulus cards may also be a

way to raise scale scores. Adding new cards to the existing

twelve stimulus cards would also have the additional benefit

of sampling a wider variety of social situations and thus

providing a more comprehensive evaluation of an individua18s

functioning. Modifications or outright deletions of

stlinulus cards which do not produce sufficient projective

material or tend to have negative item-total correlations

may also be necessary.

Implications for Projective Theory

Since their inception projective tests have

consistently shown that when people attempt to perceive an

ambiguous or vague stimulus, their interpretation of that

stimulus reflects their needs, feelings, experiences, prior

conditioning, thought processes, and so forth. The present

study is no exception. Convergent validity testing in this

study clearly shows that at least some ACT scales which are

proposed to measure aspects of an individual's psychological

68

functioning Vary in conjunction with those constructs as

assessed by a more well-established personality measure.

However, these results also suggest that projective stimuli

should not be too vague or ambiguous and that some "pull"

seems necessary to reliably produce projective material.

Less clear is support for the theory that more contemporary

and less arcane stimuli which portray situations more

relevant to an individual's daily life, are more effective

in eliciting projective material, or that this material has

higher content validity than that produced by more

traditional projective stimuli. Support for this assertion

may develop if the ACT stimuli are refined and the measure

itself can be shown to have higher levels of reliability and

validity than were found in the present study.

~mplications for Projective Testinq

As outlined in the introduction section of this papex,

forma1 projective tests enjoyed a prolonged period of

unconditional acceptance after their introduction in the

early part of the 20th century. Slowly at first and then

with increasing vigor, practitioners began to question this

unconditional acceptance. With the advent of the American

Psychological Association's "Technical Recommendations for

~sychological Tests and Diagnostic Techniques" psychologists

had definitive standards against which to judge projective

measures. As the ensuing evaluation period of projective

measures progressed psychologists became increasingly

69

dissatisfied with the inconsistency and subjectiveness of

clinical interpretation. This dissatisfaction spurred the

movement to develop more reliable quantitative &ring

systems for projective tests. The early criticism of t h e s e

objective scoring systems was t h a t in the effort to create

scoring systems that produced more reliable, quantifiable

results rich clinical material was lost and the utility of

projective techniques were significantly diminished. In the

following years measures such as the Roberts Apperception

Test for Children have been developed which show high levels

of reliability and validity yet still retain most of the

clinical information that was lost with earlier objective

projective tests. The ACT shows promise that with

significant refinement it may become part of this second

generation of projective tests with reliable and functional

objective scoring systems. As this second generation of

projective tests are developed, with their ability to elicit

clinical information that may not be accessible to other

classes of diagnostic instruments, projective testing will

begin to regain a degree of its previous status as an

important diagnostic approach.

APPENDIX 1

APPERCEPTIVE COPING CEEST MANUAL

The ACT includes 12 cards &ch portray a range of sûcial situations (Table I). Most of these situations involve intcrpasonal d g but several display supportive intciactions and several show the protagonist alone. It can be obsemed that tht bai card is one which elicits positive dikt this serves to end the tesang session on a h o p 4 note, a clinicaiiy d stmtegy. Thtrc are male and fimale versions of the ACT. These diEér in îbe gender of the pratagonist and portray paralle1 situations.

73

Table 1: Projective thems.

1, Description of the variables

PiRoBLEM IDEN'IWICATlON (0-1) This is scoreci as 1 when the respondent i-es a problem m the shatio11 This is scorcd

A distinction to keep in mind is dut betwœn th actions of P and tfte outcûmt: a negative or unspeded ouîcunte does na t h f o r e mean rbar the top@ action was inappropriate. This disîinction is important when rhcre is w change in a pmblcm despire P's actions: tbis dœs not in itself indicaie that P was paSsivt.

Aggressive (û-1): The= are two requiranmtr &r the scorhg of this variable. Fbt, P respondç aciively in a mamer which is harmfirl to another or isnorcs the otheis rigb. S e a d , the response is c l d y ~pmp~.~saiarionkoncinwiii&al~fOrcefuirerpotuewouldkexpeded~~~t6t cornparison is nat m the opthai or i d d respaose, buî to a rraçonably -le level of assertiveaess.

Types ufaggressive coping: 1.Aaiogha~whichviobtestheathdsn~thraugtrphysi01orverbdagiessi0t~ 2.Rejectingamtf~xmafercefiil-. 3. Aiim@g to solve a pmblan by vioiahg b law (eg. o&rhg a bribe to a plice officer).

Affiliative (04): P initiates or d v e i y engages in posirive bxadiat wïtb otbers, whdher to obtain or provide suppart.

Typtsof- . .

coping: 1.Sedangoutsociainteracti0~ 2. RspondinginmacplicitlypasmivtmanrintoammsiMtiatedbyathers. Note the distmction between merely bekg in a situlicm wbich may be a E i M h e (eg. in card 3 witb

thepeeror card 7withthepEiys ic ian)andact ivefy~ol~or responding inanacceptingmannerto another ( d d y or behaviody): only tht active respoase is scoreci as affit;nr;ve. "She's visitirig her doctor", "His fnead is comforting him" are not scored as MEihtive. Also, the otûer's responsc does not detemine îhis scciring: rejection of one's aEi&ive behaviour does no? invalidate it.

Note: These fenns of copiq are wt mirhially exclusive: thus, a sbry may mclude passive and affiliative, or evai (rardy) passive and -ive, cap*

Supportive (0-1): Scored w h the imapersonal c n v i r o m is perceid as supportmg P's tope &rts: nurturant, approMng or helpfùi. Wherc there has becn an idcntSed problcm, other peopk are shown a s ficilitating the solution. It should be noted that only interpersonal support is scored (not impersonal conditions such as sunxty &ys or lottey Wmç) and diat support may bc scortd even wberc an initial problemwascausedbyotbers, ie. ifotfiersalsoWpFirlehbsohtb:~Whennoproblemwasi~ this is scored ifotfiers are shown as provim intuadion which is pleasurablc, codbrqiag, dc.

Sco* Comments: 1) Tbese VariabIes arc mutually QCClusivc: the ciinician must dccide Wh* the portrayed environment is Supportive, ObstrucÛvc, or mamal (unsarai). 2) There must be m g h information in the story to iadicate thaz thc cmriromneac has a supportive (or obstructive) quality: if P simply expressa angcr at othtrs in bis lin, bis Qes mt in itscifsbow obstnrchvc~lcss. Simiiariy P may be aEMive, but one omMt assume h m this, unless spa&d, that athers rrspond in a supportive way.

This is scoreci 1 d e n the projective story has bizam violates the constraints of logic or otherwiSe indicate~ poor reality-kdng. ExampIes of dis would be stories m which P hears a voim which tek him what to do or in which a chacter has incxplicabiy cbangai in some basic idenû@îq . . chamcmmc.

MALADAfTIVE: COPING (0-1) This is scored 1 wtiea tbe copnDg has beea ni.i.ct?iveive, ie- cither a primaRly passive or primarily

oggressive coping strategy was Snplanaitrri Note tbat sadmcs P wiil aqage in mdad@ve behaviour? then adopt a more appropriate strategy in order to soive th p m b h dis wouid nu? be scored as Mahdapive Caping.

II. Guidelines for scoring individual car& (Where needed, gender of respondent has been indi& F=Fenalt Zaespondwt M=Male Respondent)

C

Parsive: F:"husband and mfe, ha* a -h ncds idmidated by him, heu pmbably win, he seans very aggressivve, she fkek M. ~:"tbey'& sht fkis sui, ma* thqr'il make up, maybc they won't". M: W s hxdnat4 shels hurt, botfrwin walk away me fèe@ rcsoiveci" M:"hey're argum% man and wifé, over finacial problems, Ws rcady to hit her, diey probably rnake up Iater and iive happiiy ever after" (magieal solution). Aggrasive: F:"Ttiq.'re ha* a fi& a màmed couple, téey'rt pLsed off, sbe's germa de& him any second". M: "A household dispute, he feeh anger, rage, he's mt dohg his s k m of housework, hc says forget i5 got his work to do, heli probabiy lœep dninp the samt thing and sbe11 keep compiahiq". Aflliative: "Man and a woman, macriai, k y ' r t having an arguniab, tkffi talk it ouf sort it out and givt each d e r a hug, say they're sorry". "lIBey?l probably make up W. "ibey go &de for a wdkw. Supprrive Envrronment: F: Two -le t?pfitm9. tire wom;m féds anger and ~~ lôtet he apoIogizes to her fOr not listening". "ïhq+re arguing ovcr marey, tbcy tq to be hoafft witb each atber, to solve the problem". Obsrmctive 1Siniironment: F:"She's taise, she feelç clef& aüaid the guy will be abusive, he walks out the door and slams it". M:"hcls hmtcd, Ws sc0Iding him fbr cuning hane latt but hc doesnt think sbe's un&-% enougtr".

2. PARTNER SUPPORT P m this cardis the samesex*

Given the positive naatn o P k intexadon dcpicted kt tbc p r e ~ ~ l c c of perceived pmblans, negativt affect, maaadaptive cqing or obstrucbonistic ~1viroamurt are particularly notable (M:"this wornan is approachrng him with an edammt anci bt is not auc dher mothiion". M:% says I lovc you too but get your hand off my face, he fèels she's bcing tao d a k").

Elarion and Afllisftion: Scored often on tbis d "A girfiad and boyhend, she is thk& hCm for doing sornething. She is happy to be wiîh him, they kiss."

3. PEER SUPPORT P m this card is the drmnicast figurt holdmg the papa and btmg touched on the shoulder.

Depression and Supportive Envimnmenî: S c o d oAen on this c a d 7k gitl dîd something wfong, she fèek ashmed, the mother is bciq u k s î d h @ . "A g9lfnend mama& her fnend w W s fCtIiap discouraged, mayk sbe11 afFcI. a bit ofheip and en-. Passive: P £iils to take appropriate auion or move doser to a soliitaoa, Teiiîug fier friend how bad she W, her f i e d says dont guiIty aU the time, she fieels tfie goes to a iiquor store". "Father berating the son, n o t h g will bappen, son is just thaî stance to have it end quicker, it's a idmique". Aggressive: "The boss just tdd him he's h d , be f#is deprcsed, hell hit him and waik out". "Ifit boss is tryingm~~mtOrthim,thereport~agl'ttohis~bpdoit~besayçto~boss~itIikeitis,or else', so he quits." Aflliative: scored whai P has deliberately swgfit emotional suppart h m the other ("she went to get advia h m her mothef) or responds in an appreciative way ID tbc profféred support ("he's k ü q damn lucky he's got someone who cares enough to put a hand on his shouldcf; The person gives him cWèmt ideas and ways of looking at the problem").

5. RELATiNG TO A SOCIAL GROUP P i s t h e f i g u r G o n ~ p a i p b e r y o f t h e ~ , ~ a r m s ~

Passive: "SWs g a h g Mt out of the group. Hopimg &Ti ~ e r mvibed m but she won? go in wittwut beiag i n v a e d N o b o c t y e l s e ~ t o m t i ~ ~ s ~ a n d t o o ~ s o ~ f E e I s ~ o n t d n j ~ " . " I n e ~ p e r s o n k s t a a d m g o n ~ o i d s i d e a n d ~ l ~ I i ? k e k ~ t a g r e c ~ w h a t ~ ~ s a y i n g o r m o ~ likeheféeisleftart. It'sea~ym~et~VVifh~~0pltWhCIl~v0~'~fCA~ht2ljuSth~arounddwalk

away." A@liarive: "Guy on the nght may fiel a Me inseaire, but ht's inwivcd m the group as much as anyone, he'ii sit dowu and talk tn this lady". 'Woman kls envious cause îhe d e r woman is enjoying ai i the d a n . Shell try and btduce herse& I dont know what happens." Supportive Envifonment: "They'iI ask him to job them, helI feel betttr". "Somcone h m die p u p wiU di her over". Obsmctive Environment: "Zhese 4 are having a grand hme but thiS one is on the outside. Maybe she's just a secmary, îhey're higher in rank aad they dont case what she says."Inis is a M y , praîsing a son. T h othcr son is feeling left out, he is aiways the rmt, in the ba& he wishes he was the other guy."

Amery: "Ibis gufs in trouble, he Iodrs womdn. Hostility: "He's pissed oE, probably thinking he a h d y has a bunch of tickets iu his drawtr, so hhe b e r taUc fast". Aggressiwe: F: "He'll lose his tcmper, start swioging his 5sts and became vident The poIicexnan looks

+ wimpyandkmi~w~SUCVi~e,soIhopthe'sgood~hisgun"."Iheofficer~~thispersoti ja)rwallang and decided to give him a ticket. 'Are you ki&üng, why Qn't you go a,rrcst someo~lt do'= sometbg serious?' The officer wiii arrest him, he was bemg mouîhy, and cbarge him with disturbing the peace". "Polictman talkmg ta the man who's done something wrong and wants to b n i the policcman. Policeman says OK, no problem, no one wili am known. (Tbis is scored Aggressive becarise it d e s on antisocial behaviour, even though the bribe was accepted). Obsnirctive Environmeni: Nate that ifthe police officer eriforces the iaw, he is not b e i q obstructive to a . solution. If, however, tbe officer is porûayed as vindictive, arbîorary or vicious, h Obstructive should be smd 4

7. RELATING TO MEDICAL AUTHOIRITY ' P is the patient.

Passive: "Not a good prognusis, lots of pi&. SheU go sommkre and cry, 1 dont k m wIiat tiappens.'' "Doctor t e h g her she nPPdc to take this drug and this drug. She fîds imcertain whaher he is campeter& wb- i t s tOt red. So s k probably wan't take the pills, after shc stiIl has the disease." AflIicirive: Note that &qly k i n g m the medical situation does not- AiEMx scoring; t h must be an indication thaï the doaois as&ance is perceived positmly ador complied whh "She tak the medic&m the way he toici hcr tom. "She klç happy that she's gectiag the help she &". Obsmcfive Errvironrnent: "Like the ntany doctors I'vc been to sce. Therets 4 bottles of medicine just so yuu can feci thqCre doing something, she k l s fkstrated, shell go home to a11 the same problems and heY go home to his h c y dinner and beautiful car." Self-relia: "A dodor tehg htr shc bas a &ai disease. Shtl l fèel sad and confused Shell just have bb look*herseIf."

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