RESUMO
INTRODUCTION: In assessing clinical change, measurement is often based on psychometric scales. However, change is best revealed within the constellation of problems salient to the patient, rather than in alterations in the abstract constructs, psychometrically measured. These patients' problems often serially unfold in qualitative stages, even before the full-blown disorder emerges. These qualitative stages constitute the natural history extending from early to late, fluctuating from mild to severe, and progressing from full-blown disorder to recovery. METHOD: We reviewed the literature on clinimetrics and patient-centred subjective measures, and related these findings to the use of the discretized-analogue scaling method. RESULTS: There is increasing recognition of clinimetric approaches that structure the pre-clinical and clinical material into a scale that reflects the symptoms, consequences and complications in a manner understandable to the patient, and enabling the quantification of severity or change. This monograph provides criteria and methods for developing these building blocks that enable the assessment of severity, stage or change. We show examples of their use in quantitative clinical outcome measurement. CONCLUSION: We encourage further studies in the ideology and procedures for measuring clinical change in terms of personally subjective experiences.
Assuntos
Transtornos Mentais/terapia , Avaliação de Resultados em Cuidados de Saúde , Atitude Frente a Saúde , Diagnóstico Diferencial , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/tratamento farmacológico , Dor/diagnóstico , Medição da Dor , Psicometria , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
Gough's theory that psychopathy stems from a deficiency in role taking, the ability to perceive and evaluate one's own behaviour as it is perceived and evaluated by others in the same culture, was tested. The Socialization scale, developed by Gough to assess role taking, was administered to a group of 20 female psychiatric patients with histrionic personality disorders, and a control group of female depressives of similar age and intelligence. Socialization scores of the histrionic personalities were significantly lower, indicating impaired role taking, and this difference was not attributable to depression of mood. The Socialization scale was a better discriminator between the groups than the scales of two other personality inventories or a test to elicit meta-impressions.
