Satisficing in Mental Health Care Patients: The Effect of Cognitive Symptoms on Self-Report Data Quality

Abstract

Respondents may use satisficing (i.e., nonoptimal) strategies when responding to self-report questionnaires. These satisficing strategies become more likely with decreasing motivation and/or cognitive ability (Krosnick, 1991). Considering that cognitive deficits are characteristic of depressive and anxiety disorders, depressed and anxious patients may be prone to satisficing. Using data from the Netherland's Study of Depression and Anxiety ( N = 2,945), we studied the relationship between depression and anxiety, cognitive symptoms, and satisficing strategies on the NEO Five-Factor Inventory. Results showed that respondents with either an anxiety disorder or a comorbid anxiety and depression disorder used satisficing strategies substantially more often than healthy respondents. Cognitive symptom severity partly mediated the effect of anxiety disorder and comorbid anxiety disorder on satisficing. The results suggest that depressed and anxious patients produce relatively low-quality self-report data-partly due to cognitive symptoms. Future research should investigate the degree of satisficing across different mental health care assessment contexts.

Person-fit feedback on inconsistent symptom reports in clinical depression care

“…educational assessment and selection), in clinical research the causes underlying poor person fit are often of systematic nature. These causes may include the presence of comorbidity like anxiety or somatic complaints (Wanders et al 2015 a ; Wardenaar et al 2015) and cognitive difficulties (Conijn et al 2017), but also entail the presence of a different primary disorder, such as a neurological disorder (e.g. patient #187).…”

“…to prevent unwanted hospitalization). In addition, within psychopathology measurement clinical causes like comorbidity (Wanders et al 2015 a ; Wardenaar et al 2015) or concentration problems (Conijn et al 2016, 2017) may lead to inconsistent symptom reports where patients report severe symptoms without milder symptoms (Woods et al 2008; Conrad et al 2010; Wardenaar et al 2015; Conijn et al 2016). Detecting such inconsistent response patterns may have diagnostic value in clinical practice (Pallant & Tennant, 2007; Reise & Waller, 2009; Thomas, 2011).…”

“…Although many statistics are available to assess person fit, there are only few studies that examine the reason of this unexpected test behavior and how this behavior can invalidate test interpretation by a clinician. Recent person-fit studies have suggested that inconsistent symptom reports could reflect clinical factors, like an atypical suicide risk (Conrad et al 2010), or atypical presentation of symptoms (Wanders et al 2015 a ; Wardenaar et al 2015), but could also reflect causes associated with the quality of self-reported data (Conijn et al 2016), caused by, for example, cognitive problems (Conijn et al 2016, 2017). These studies analyzed large-scale archival data, which makes it difficult to retrieve and study the factors that underlie the responses for specific patients and from a more qualitative point of view (see Meijer et al 2008, for an exception in the education field).…”

The Assessment and Impact of Careless Responding in Routine Outcome Monitoring within Mental Health Care

“…As careless respondents are not purposefully manipulating their answers, careless responding is a noncontent-based response style (McGrath, Mitchell, Kim, & Hough, 2010). Recently, several studies have shown that noncontent-based response styles may be prevalent in mental health care patients because the cognitive problems of psychopathology may induce patients to satisfice (i.e., to provide nonoptimal responses) to questionnaires (Conijn, van der Ark, & Spinhoven, 2017;Gervais et al, 2017;Keeley, Webb, Peterson, Roussin, & Flanagan, 2016). Especially on longer instruments, extensive assessment batteries, or repeated assessments, mental health care patients may become tired and lose concentration or motivation.…”

Determining at What Age Children Provide Sound Self-Reports: An Illustration of the Validity-Index Approach

“…Based on validity-index values, response patterns can be classified as either “normal” or “suspect”, the latter meaning that the resulting test score is likely to be invalid. Recent research has shown the usefulness of validity indices for detecting nonoptimal response strategies (e.g., acquiescence response bias) and inconsistent or repetitive responding in survey data (e.g., Conijn, van der Ark, & Spinhoven, 2020; Meade & Craig, 2012; Niessen et al, 2016). These indices can also be expected to detect young children’s aberrant response behaviors, as research has shown that young children may produce inconsistent or repetitive response patterns due to various factors: limited cognitive ability and memory skills, limited attention span (Eddy et al, 2011; Eiser, Mohay, & Morse, 2000; Reeve et al, 2017), response biases in using rating scales such as choosing the extremes (Chambers & Johnston, 2002; Davis et al, 2007), and displaying nondifferentiation among items that assess opposite constructs (Shelton et al, 1996).…”