The Potential of Anamnestic Comparative Self-Assessment (ACSA) to Reduce Bias in the Measurement of Subjective Well-Being

Background: The conventional question (CQ) on subjective well-being (SWB) is e.g. “How is life?”, with ratings between e.g. ‘Best’ and ‘Worst possible’. Disadvantages may be casualness of responses and biases of proximate, peer or cultural relativity. Alternatively, with Anamnestic Comparative Self-Assessment (ACSA), the scale anchors are the respondents’ self-defined memories of their best and worst periods in life. Thus ACSA uses life review and experiential scale anchors. Objective: To compare the validity, sensitivity and responsiveness of the CQ and ACSA. Method: ACSA and the CQ were administered in parallel to 2584 university-hospital patients suffering from a wide range of psychiatric and somatic diseases. Results: ACSA and CQ did not measure the same construct (r = 0.50). CQ ratings were almost normally distributed, whereas ACSA ratings were overall lower, and clearly positively skewed, suggesting greater sensitivity to the respondents’ diseased state. Contrary to CQ, ACSA ratings of critically ill patients with end-stage liver disease were very low. After life-saving liver transplantation, ACSA ratings increased significantly more than CQ ratings, suggesting better responsiveness of ACSA to objective change. Trait-like socio-demographic variables such as sex, age, and marital status influenced CQ, but not ACSA ratings. Conclusion: In between-subject studies, depending on one’s study objectives, ACSA should be considered as a complement or an alternative to conventional SWB instruments. The CQ is probably preferable when socio-demographic variables are study endpoints. In longitudinal or intervention studies and for intercultural comparisons, ACSA, which reduces the need for correction of several biases or confounders, seems more useful.