Spanish version of the psychosis attachment measure: Adaptation process and psychometric properties

Introduction: Attachment theory has recently been postulated as a useful framework for enhancing our understanding of the role of psychosocial and environmental factors in relation to the vulnerability, expression, and course of psychosis. In this paper we present the Spanish adaptation and psychometric properties of the Psychosis Attachment Measure (PAM), a 16-item self-report scale specifically designed to measure adult attachment in people with psychosis. Method: In study 1, the PAM was adapted into Spanish following the translation/back-translation procedure and was administered to 24 early psychosis patients to evaluate its intelligibility. In study 2, the psychometric properties of the scale were assessed in a sample of 235 university students. The students completed the PAM and the Relationship Questionnaire (RQ) via an Internet website. Results: Results from study 1 demonstrated that the Spanish version of the scale is semantically and conceptually equivalent to the original English version and that it is appropriate for use with people experiencing psychotic symptoms. Paralleling the findings from the English version of the instrument, results from study 2 indicated that two factors, conceptually representing anxiety and avoidance, underlie the Spanish version of the PAM. The anxiety and avoidance subscales were found to have adequate levels of internal reliability and to be associated in a theoretically predicted fashion with the four prototypes of adult attachment measured with the RQ. Discussion: The good psychometric properties exhibited by the instrument support its use for the assessment of adult attachment styles in the Spanish cultural context and allow for the comparability of findings across cultures. Having a Spanish instrument for assessing attachment in psychosis populations is a relevant contribution that opens up new avenues for research and clinical applications.