Popular magazines (women’s and teenage ones especially) frequently contain personality quizzes, “what sort of lover are you?” “Wild cat or pussy cat?” and so on. These are very popular, and I have to confess, quite amusing, particularly if a group of you do one together. It seems to me that psychiatric and psychological services use these as much, if not more than the magazines do.
Recently, after an 18 month wait I had my first pre-commitment session prior to starting DBT properly very soon. I mentioned in my last blog that I left that appointment feeling slightly overwhelmed, yet hopeful. My second session is looming and I have done my homework which consisted of a bit of reading and six questionnaires aimed at measuring base line mood and tendency to specific problems.
Of course I understand that these multi choice “screening tools” aka quizzes, are developed carefully and tested for statistical validity and diagnostic accuracy. However, you can become to reliant on tools not entirely fit for purpose. Let me give you an example from the BD1-11 sheet which consists of 21 questions where you have to pick the statement most relevant to you.
Question 11 – Agitation:
0 I am no more restless or agitated than usual
1 I feel more restless or wound up than usual
2 I am so restless or agitated that it’s hard to stay still
3 I am so restless or agitated that I have to keep moving or doing something
Question 15 – Loss of Energy
0 I have as much energy as ever
1 I have less energy than I used to have
2 I don’t have enough energy to do very much
3 I don’t have enough energy to do anything
The sheet asked me to think back over the previous two weeks to answer the questions. Now, bearing in mind rapid mood swings is one of the diagnostic criteria for BPD you might think they would see the problem with this form. Over two weeks, at different times I could answer every single category of both questions. Even if I try to pick out the most prevalent answer it is still inadequate in so much as all could be true in one day. Indeed, in the space of one day I can swing from 3, in question 11 to 3 in question 15 and back again. The fact is I have done on more than one occasion in the last two weeks. So, how should I complete the forms?
I have done it, but to do so I have had to contort my memories and experiences to fit the questions. That’s not the same as making them up, it’s just I have answered them based on a moment in the last two weeks rather than the majority of the time. Perhaps the culmination of moments will equal a helpful indication of whatever the test is for – but I’m doubtful. I’ve had to fill the margins with annotations explaining the inadequacy of my responses. I don’t really see how it can be of any value.
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