It is now widely acknowledged that the personal burden of illness cannot be described fully by measures of disease status such as size of infarction, tumour load, and forced expiratory volume. Psychosocial factors such as pain, apprehension, restricted mobility and other functional impairments, difficulty fulfilling personal and family responsibilities, financial burden, and diminished cognition must also be encompassed. The area of research that has resulted from this recognition is termed "health related quality of life." It moves beyond direct manifestations of illness to study the patient's personal morbidity-that is, the various effects that illnesses and treatments have on daily life and life satisfaction. Although quality of life assessment was almost unknown 15 years ago, it has rapidly become an integral variable of outcome in clinical research; over 1000 new articles each year are indexed under "quality of life."Although the importance of quality of life is broadly acknowledged, scepticism and confusion remain about how quality of life should be measured and its usefulness in medical research. These responses may reflect important conceptual and methodological limitations of the current concept of quality of life. We offer a simple framework that describes the core elements of quality of life related to health and use this to evaluate quality of life measurement as it is currently conducted.

Purpose To evaluate racial/ethnic disparities in life satisfaction and the relative contributions of socioeconomic status (SES; education, income, employment status, wealth), health, and social relationships (social ties, emotional support) to well-being within and across racial/ethnic groups. Methods In two cross-sectional, representative samples of U.S. adults (the 2001 National Health Interview Survey and the 2007 Behavioral Risk Factor Surveillance System; combined n > 350,000), we compared life satisfaction across Whites, Hispanics, and Blacks. We also evaluated the extent to which SES, health, and social relationships ‘explained’ racial/ethnic group differences and compared the magnitude of variation explained by life satisfaction determinants across and within these groups. Results Relative to Whites, both Blacks and Hispanics were less likely to be very satisfied. Blacks were somewhat more likely to report being dissatisfied. These differences were reduced or eliminated with adjustment for SES, health, and social relationships. Together, SES and health explained 12–15% of the variation in life satisfaction, whereas social relationships explained an additional 10– 12% of the variance. Conclusions Racial/ethnic life satisfaction disparities exist for Blacks and Hispanics, and these differences are largest when comparing those reporting being ‘satisfied’ to ‘very satisfied’ versus ‘dissatisfied’ to ‘satisfied.’ SES, health, and social relationships were consistently associated with life satisfaction, with emotional support having the strongest association with life satisfaction.

The Marlowe-Crowne Social Desirability scale (Crowne & Marlowe, 1960) is widely used to assess and control for response bias in self-report research. Several abbreviated versions of the Marlowe-Crowne scale have been proposed and adopted in psychology and medicine. In this article I evaluate the adequacy of 9 short forms using confirmatory factor analysis across 2 samples (combined N = 867). There was some evidence for the adequacy of different short forms, but model adequacy was not consistent across samples. Supplementary analyses revealed a multidimensional structure to the full Marlowe-Crowne scale and indicated that the apparent adequacy of model fit for some short forms might be a statistical artifact. Using the Marlowe-Crowne scale or its various short forms as a control for response bias is discouraged on empirical and conceptual grounds.

On the basis of a theory of inhibition and psychosomatics, it was predicted that the more individuals disclosed personally traumatic experiences, the better their long-term health following the disclosure. Thirty-three Holocaust survivors talked for 1-2 hours about their personal experiences during World War II while skin conductance level (SCL) and heart rate (HR) were continuously monitored. Each videotaped interview was rated by independent judges once every minute on the degree to which the survivor's experience was traumatic. For each subject, the trauma ratings were correlated with minute-by-minute SCL and HR readings. Based on previous research, negative trauma-SCL correlations are indicative of high personal disclosure, whereas positive trauma-SCL correlations suggest low disclosure, whereas positive trauma-SCL correlations suggest low disclosure. Approximately 14 months after the interview, self-reports of the subjects' health were collected. Controlling for pre-interview health problems, degree of disclosure during the interview was found to be positively correlated with long-term health after the interview. The possible health benefits of disclosure are discussed.

More modest behavioral changes are capable of promoting weight loss, decreasing adiposity markers and sustaining these changes over 3 months. Longer-term studies comparing this approach with traditional behavioral weight loss treatments are warranted.