Enhanced Self-Appraisal After Cancer: A Bias in Survivors' Self-Report?

描述（由申请人提供）：改善美国人的健康状况越来越依赖于有效的自我报告健康措施。虽然可以从行政数据和健康记录中获得重要信息，但衡量一般人口或受疾病影响群体的身心健康状况需要对个人进行直接评估。临床医生和研究人员依靠自我报告的措施，以了解治疗效果，症状负担，医疗决策，和生活质量，虽然自我报告的方法不是没有限制。与实验室测量不同，自我报告测量通常在个体之间是可靠的，自我报告测量受到各种受访者因素的影响，包括人格特质，这会降低其有效性。现在人们认识到，疾病以及为应对疾病对身体和情感的影响所做的努力，改变了幸存者对自己的看法以及他们随后的健康状况。就个人在患病后对自己的评价不同而言，对他们自我报告的健康评级的解释是复杂的。为了解决这一调查领域，本研究提案响应通知NOT-OD-10 - 032，“NIH宣布通过NIH基本行为和社会科学机会网络（OppNet）为竞争性修订申请（R01，R03，R15，R21，R21/R33和R37）提供恢复法案资金。基于人格和社会心理学的研究，本研究采用了自我增强偏见（SEB）的概念，定义为一种特征倾向，即“给予诚实但有积极偏见的自我报告”，3以调查自我评价的变化如何影响癌症后的自我报告。根据试点结果，该研究测试了一个假设，即SEB与150名儿童癌症长期幸存者的生活质量和痛苦测量中的情绪健康而不是身体健康的自我报告增强有关。利用一个新验证的模型和措施的SEB，本研究调查的心理测量学特性的规模在这个人口。这项研究扩展了目前资助的一项研究的目标，该研究检查了SEB 1）与非癌症对照相比在霍奇金淋巴瘤幸存者中增加的程度，以及2）与癌症后创伤后生长的报告相关。通过招募新的癌症幸存者队列，修订版增强了原始R03的目标，并使更广泛地研究SEB对健康结果的影响成为可能。研究目的是：1）检验SEB与标准健康措施上的情绪而非身体健康的自我报告增强相关的假设; 2）调查SEB措施的析因效度和结构效度; 3）探索SEB与疾病和治疗因素的关联。研究结果将对理解疾病的适应如何影响自我感知做出重要贡献，并对自我报告的健康措施的有效性产生重要影响。 公共卫生相关性：自我报告的措施是必不可少的健康研究，但在某种程度上，个人评价自己不同的疾病，解释他们的自我报告的健康评级是复杂的。本研究调查了癌症康复影响个人对健康和幸福的评价的方式，以及这些健康评价的变化如何影响自我报告健康措施的有效性。研究结果对于理解疾病的适应如何影响自我认知和自我表现以及改善健康结果措施具有重要意义。

DESCRIPTION (provided by applicant): Improving the health of Americans depends increasingly on valid self-report measures of health. While important information can be obtained from administrative data and health records, measuring physical and emotional health status in the general population or in disease-affected groups requires direct assessment of individuals. Clinicians and researchers rely on self-report measures to understand treatment efficacy, symptom burden, medical decision making, and quality-of-life-though the self-report method is not without limitations. Unlike laboratory measures, which are generally reliable across individuals, self-report measures are affected by a variety of respondent factors, including personality traits, that reduce their validity. Illness and efforts to cope with its physical and emotional effects are now understood to alter survivors' perceptions of themselves and their subsequent health conditions. To the extent that individuals evaluate themselves differently following illness, interpretation of their self-reported health ratings is complex. To address this area of investigation, this research proposal responds to notice NOT-OD-10-032, "NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications (R01, R03, R15, R21, R21/R33, and R37) through the NIH Basic Behavioral and Social Science Opportunity Network (OppNet)." Building on research in personality and social psychology, this study employs the construct of self-enhancement bias (SEB), defined as a characteristic tendency "to give self-reports that are honest but positively biased", 3 to investigate how changes in self-appraisal may affect self-report of health after cancer. Following pilot results, the study tests the hypothesis that SEB is associated with enhanced self-report of emotional well-being, but not physical well- being, on quality-of-life and distress measures in a group of 150 long-term survivors of childhood cancer. Utilizing a newly validated model and measure of SEB, the study investigates the psychometric properties of the scale in this population. This study expands on the goals of a currently funded study examining the extent to which SEB is 1) increased among Hodgkin's Lymphoma survivors compared to non-cancer controls, and 2) associated with reports of posttraumatic growth after cancer. By enrolling a new cohort of cancer survivors, the revision enhances the aims of the original R03 and makes it possible to study the effect of SEB on health outcomes more broadly. Study aims will be to: 1) Test the hypothesis that SEB is associated with enhanced self-report of emotional, but not physical, well-being on standard health measures; 2) Investigate factorial and construct validity of the SEB measure; and 3) Explore the association of SEB with illness and treatment factors. Results will make an important contribution to understanding how adaptation to illness affects self- perception and will have important implications for the validity of self-reported health measures. PUBLIC HEALTH RELEVANCE: Self-report measures are essential to health research, but to the extent that individuals evaluate themselves differently following illness, interpretation of their self-reported health ratings is complex. This study investigates the ways in which recovering from cancer affects individuals' appraisals of health and well-being, and how these changes in health appraisal can affect the validity of self-report health measures. Results have important implications for understanding how adaptation to illness affects self-perception and self-presentation as well as improving health outcome measures.