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Subjective experience and meaning of psychoses: the German Subjective Sense in Psychosis Questionnaire (SUSE)

Published online by Cambridge University Press:  07 July 2011

K. Klapheck ,
S. Nordmeyer ,
H. Cronjäger ,
D. Naber  and
T. Bock
K. Klapheck*
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
S. Nordmeyer
Affiliation:
St Joseph Hospital of Catholic Clinics, Oberhausen, Germany
H. Cronjäger
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
D. Naber
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
T. Bock
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
*
*Address for correspondence: K. Klapheck, Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. (Email: k.klapheck@uke.uni-hamburg.de)
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Abstract

Background

Clinical research on subjective determinants of recovery and health has increased, but no instrument has been developed to assess the subjective experience and meaning of psychoses. We have therefore constructed and validated the Subjective Sense in Psychosis Questionnaire (SUSE) to measure sense making in psychotic disorders.

Method

SUSE was based on an item pool generated by professionals and patients. For pre-testing, 90 psychosis patients completed the instrument. Psychometric properties were assessed using methods of classical test theory. In the main study, SUSE was administered to a representative sample of 400 patients. Factor structure, reliability and validity were assessed and confirmatory factor analyses (CFAs) were used for testing subscale coherence and adequacy of the hypothesized factor structure. Response effects due to clinical settings were tested using multilevel analyses.

Results

The final version of SUSE comprises 34 items measuring distinct aspects of the experience and meaning of psychoses in a consistent overall model with six coherent subscales representing positive and negative meanings throughout the course of psychotic disorders. Multilevel analyses indicate independence from clinical context effects. Patients relating psychotic experiences to life events assessed their symptoms and prospects more positively. 76% of patients assumed a relationship between their biography and the emergence of psychosis, 42% reported positive experience of symptoms and 74% ascribed positive consequences to their psychosis.

Conclusions

SUSE features good psychometric qualities and offers an empirical acquisition to subjective assessment of psychosis. The results highlight the significance of subjective meaning making in psychoses and support a more biographical and in-depth psychological orientation for treatment.

Keywords

Psychosis therapyrecoverysubjective meaningtest construction
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 1 , January 2012 , pp. 61 - 71
Copyright
Copyright © Cambridge University Press 2011

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References

Antonovsky, A (1979). Health, Stress and Coping. Jossey-Bass Publishers: San Francisco, CA.Google Scholar
Antonovsky, A (1993). The structure and properties of the sense of coherence scale. Social Science and Medicine 36, 725–733.CrossRefGoogle ScholarPubMed
Barskova, T, Oesterreich, R (2009). Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: a systematic review. Disability and Rehabilitation 31, 1709–1733.CrossRefGoogle ScholarPubMed
Bock, T, Bryzinski, T, Klapheck, K, Bening, U, Lenz, A, Naber, D (2010). On subjective meaning of psychoses. Construction, validation and first application of a new questionnaire – The SuSi-Project (Hamburg) [in German]. Psychiatrische Praxis 37, 285–291.CrossRefGoogle Scholar
Bock, T, Priebe, S (2005). Psychosis seminars: an unconventional approach. Psychiatric Services 56, 1441–1443.CrossRefGoogle ScholarPubMed
Bonney, S, Stickley, T (2008). Recovery and mental health: a review of the British literature. Journal of Psychiatric and Mental Health Nursing 15, 140–153.CrossRefGoogle ScholarPubMed
Boydell, KM, Stasiulis, E, Volpe, T, Gladstone, B (2010). A descriptive review of qualitative studies in first episode psychosis. Early Intervention in Psychiatry 4, 7–24.CrossRefGoogle ScholarPubMed
Brown, MW, Cudeck, R (1993). Alternative ways of assessing model fit. In Testing Structural Equation Models (ed. Bollen, K. A. and Long, J. S.), pp. 136–161. Sage: Newbury Park, CA.Google Scholar
Buck-Zerchin, D (2007). On the Trail of the Morning Star: Psychosis as Self-discovery [in German]. Anne Fischer: Norderstedt.Google Scholar
Byrne, B (2001). Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. Lawrence Erlbaum Associates: London.Google Scholar
Calhoun, LG, Tedeschi, RG (eds) (2006). Handbook of Posttraumatic Growth: Research and Practice. Erlbaum: Mahwah, NJ.Google Scholar
Davis, CG, Nolen-Hoeksema, S, Larson, J (1998). Making sense of loss and benefiting from the experience: two construals of meaning. Journal of Personality and Social Psychology 75, 561–574.CrossRefGoogle ScholarPubMed
Eriksson, M, Lindström, B (2006). Antonovsky's sense of coherence scale and the relation with health: a systematic review. Journal of Epidemiology and Community Health 60, 376–381.CrossRefGoogle ScholarPubMed
Eriksson, M, Lindström, B (2007). Antonovsky's sense of coherence scale and its relation with quality of life: a systematic review. Journal of Epidemiology and Community Health 61, 938–944.CrossRefGoogle ScholarPubMed
Fjelland, JE, Barron, CR, Foxall, M (2008). A review of instruments measuring two aspects of meaning: search for meaning and meaning in illness. Journal of Advanced Nursing 62, 394–406.CrossRefGoogle ScholarPubMed
Frankl, VE (1988). The Will to Meaning: Foundations and Applications of Logotherapy. First published 1969. Plume: New York City.Google Scholar
Frankl, VE (2006). Man's Search for Meaning: An Introduction to Logotherapy. First published 1947. Beacon Press: Boston.Google Scholar
Haro, J, Kamath, S, Ochoa, S, Novick, D, Rele, R, Fargas, A (2003). The Clinical Global Impression – Schizophrenia Scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatrica Scandinavica 107 (Suppl. 416), 16–23.CrossRefGoogle Scholar
Hu, L, Bentler, PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 6, 1–55.CrossRefGoogle Scholar
Kay, S, Fiszbein, A, Opler, LA (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Koenig, HG (2009). Research on religion, spirituality and mental health: a review. Canadian Journal of Psychiatry 54, 283–291.CrossRefGoogle ScholarPubMed
Mohr, S, Gillieron, C, Borras, L, Brandt, PY, Huguelet, P (2007). The assessment of spirituality and religiousness in schizophrenia. Journal of Nervous and Mental Disease 195, 247–253.CrossRefGoogle ScholarPubMed
Muthén, LK, Muthén, BO (2010). Mplus, version 6.0 (computer software), Muthén & Muthén: Los Angeles, CA.Google Scholar
Muthny, FA (1989). Freiburger Fragebogen zur Krankheitsverarbeitung: FKV. [Freiburg Questionnaire of Coping with Illness]. Weinheim: Beltz-Test.Google Scholar
Papaioannou, A, Marsh, HW, Theodorakis, Y (2004). A multilevel approach to motivational climate in physical education and sport settings: an individual or a group level construct? Journal of Sport and Exercise Psychology 26, 90–118.CrossRefGoogle Scholar
Park, CL (2010). Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin 136, 257–301.CrossRefGoogle ScholarPubMed
Rasmussen, HN, Scheier, MF, Greenhouse, JB (2009). Optimism and physical health: a meta-analytic review. Annals of Behavioral Medicine 37, 239–256.CrossRefGoogle Scholar
Raudenbush, SW, Bryk, AS (2002). Hierarchical Linear Models: Applications and Data Analysis Methods, 2nd edn. Sage Publications: Thousand Oaks, CA.Google Scholar
Roessler, W, Salize, H, Cucchiaro, G, Reinhard, I, Kernig, C (1999). Does the place of treatment influence the quality of life of schizophrenics? Acta Psychiatrica Scandinavica 100, 142–148.CrossRefGoogle Scholar
Strauss, J (2011). Subjectivity and severe psychiatric disorders. Schizophrenia Bulletin 37, 8–13.CrossRefGoogle ScholarPubMed
White, CA (2004). Meaning and its measurement in psychosocial oncology. Psycho-Oncology 13, 468–481.CrossRefGoogle ScholarPubMed
WHO (2009). ICD-10 International Statistical Classification of Diseases and Related Health Problems, 10th edn. World Health Organization: Geneva.Google Scholar
Zoellner, T, Maercker, A (2006). Posttraumatic growth in clinical psychology: a critical review and introduction of a two component model. Clinical Psychology Review 26, 626–653.CrossRefGoogle ScholarPubMed