Department of Psychiatry, Dartmouth Psychiatric Research Center, Dartmouth Medical School, Hanover, NH, USA.
Schizophr Bull. 2012 May;38(3):396-404. doi: 10.1093/schbul/sbr171. Epub 2012 Feb 1.
Retrospective reports are often used as the primary source of information for important diagnostic decisions, treatment, and clinical research. Whether such reports accurately represent individuals' past experiences in the context of a serious mental illness such as schizophrenia is unclear. In the current study, 24 individuals with schizophrenia and 26 nonclinical participants used a mobile device to complete multiple real-time/real-place assessments daily, over 7 consecutive days. At the end of the week, participants were also asked to provide a retrospective report summarizing the same period. Comparison of the data captured by the 2 methods showed that participants from both groups retrospectively overestimated the intensity of negative and positive daily experiences. In the clinical group, overestimations for affect were greater than for psychotic symptoms, which were relatively comparable to their retrospective reports. In both samples, retrospective reports were more closely associated with the week's average than the most intense or most recent ratings captured with a mobile device. Multilevel modeling revealed that much of the variability in weekly assessments was not explained by between-person differences and could not be captured by a single retrospective estimate. Based on the findings of this study, clinicians and researchers should be aware that while retrospective summary reports of the severity of certain symptoms compare relatively well with average momentary ratings, they are limited in their ability to capture variability in one's affective or psychotic experiences over time.
回顾性报告通常被用作重要诊断决策、治疗和临床研究的主要信息来源。但此类报告是否能准确反映个体在严重精神疾病(如精神分裂症)背景下的过去经历尚不清楚。在当前研究中,24 名精神分裂症患者和 26 名非临床参与者使用移动设备,在连续 7 天内每天多次进行实时/真实地点评估。在一周结束时,参与者还被要求提供一份回顾性报告,总结同一时期的情况。比较这两种方法采集的数据显示,两组参与者都对负面和正面日常经历的强度进行了过高估计。在临床组中,对情绪的高估大于对精神病症状的高估,而后者与他们的回顾性报告相对可比。在两个样本中,回顾性报告与每周的平均水平更相关,而不是与移动设备采集的最强烈或最近的评分相关。多层次模型显示,每周评估的大部分可变性无法用个体间差异来解释,也无法用单次回顾性评估来捕捉。基于这项研究的结果,临床医生和研究人员应该意识到,虽然某些症状严重程度的回顾性总结报告与平均瞬间评分相对较好地比较,但它们在捕捉个体随时间变化的情感或精神病体验的可变性方面存在局限性。