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来了解治疗效果、症状负担、医疗决策和生活质量，尽管自我报告方法并非没有局限性。与实验室测量不同，实验室测量在个体之间通常是可靠的，自我报告测量受到各种被调查者因素的影响，包括人格特征，这些因素会降低其有效性。疾病和应对其身体和情感影响的努力现在被理解为改变幸存者对自己及其随后的健康状况的看法。在某种程度上，个体在患病后对自己的评价不同，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的问题，本研究提案响应通知no - od -10-032，“美国国立卫生研究院宣布通过美国国立卫生研究院基础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。”本研究在人格与社会心理学研究的基础上，采用自我增强偏差（self-enhancement bias， SEB）的概念（定义为一种“诚实但有积极偏见的自我报告”的特征倾向）来探讨自我评价的变化如何影响癌症后的健康自我报告。根据试点结果，该研究在150名儿童癌症长期幸存者的生活质量和痛苦测量中测试了SEB与情绪健康自我报告增强有关的假设，而不是身体健康。本研究利用新验证的SEB模型和测量方法，研究了该量表在该人群中的心理测量特性。本研究扩展了目前资助的一项研究的目标，该研究的目的是检查SEB在何杰金氏淋巴瘤幸存者中与非癌症对照组相比增加的程度，以及2)与癌症后创伤后生长的报告相关。通过纳入一个新的癌症幸存者队列，修订增强了原始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。研究的目的是：1)检验SEB与标准健康测量中情绪而非身体健康自我报告增强相关的假设；2)调查SEB量表的因子效度和构建效度；3)探讨SEB与疾病及治疗因素的关系。研究结果将对理解适应疾病如何影响自我感知做出重要贡献，并将对自我报告健康措施的有效性产生重要影响。

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.