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Date Joined Sep 2005
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   Posted 7/12/2008 5:48 AM (GMT -7)   
In the last few months I've been asked to participate in a few Crohn's related studies, and most of them ask about depression symptoms/ stress levels / coping styles.

Why is it that, even though the studies have been created by different people in different institutions and sometimes even different countries, the questions are identical, even down to the words used?

Why is that?

I am also starting to feel as if the studies are starting to define our problems for us. I can tick certain boxes, but they don't necessarily describe the main way that I feel, and there's no opportunity for me to include that in the study.

Is it just me, or is this a real problem with these studies?
Co-Moderator Crohn's Forum.

Veteran Member

Date Joined Jan 2003
Total Posts : 1928
   Posted 7/12/2008 6:19 AM (GMT -7)   
Hey Ivy

Good questions and observations.

I guess first, the goal of research is to take a representative sample of people and apply what you find to the larger population. So, if I want to understand coping in people with Crohn's, I'd survey 200 people with Crohn's and hope that I could say "it's likely that people with Crohn's..." I can never survey every single person with Crohn's, so I want to find a group that's diverse enough that they could in theory represent everyone with Crohn's. Easier said than done, but that's what we try to do.

Why are the questions identical across studies? Research is generally concerned about reliability (are the findings repeatable) and validity (is it actually measuring what it says it is). To ensure that this is happening, people use "reliable and valid" questionnaires. These are surveys that have been tested and re-tested for reliability and validity across hundreds (more likely thousands) of people. If it's a questionnaire that's been widely used for decades, then it's considered the gold standard to get at a certain area of study. So you see a lot of overlap. It's less reliable and valid to create your own set of questions to ask, unless you first run statistics to ensure they're measuring what you really want them to measure. While it seems like you could just look at the questions and say well yeah those are questions about depression or coping, it's not that simple unfortunately.

The 2nd point is one of the main debates within the research community, especially for psychologists. People are so complicated, how can we reduce them to check boxes? And the real answer is you can't get the whole picture, ever, in these studies. For one, it would be way too complicated. So, researchers are trying to look at just certain areas of interest. They may ask questions about related things as well (which gets at validity). When you participate in a study using questionnaires, it's a "quantitative" study. Which basically means the goal is to get numbers (or quantify) people's experiences so that the researcher can run statistics to look for relationships between variables. These can get quite crazy in their complexity. At the end of the day though, there are always other factors (called confounds) that make it so a researcher can almost never conclude that A causes B. We can make observations, make some guesses, but rarely can we say A causes B. Because as I said, people are just too complicated.

There's another type of research called qualitative research, which is more in depth and involves interviews, case studies, observation, etc. It's much more rich in terms of understanding the unique experience of the person. The problem is they're not very generalizable to the larger population. But, they are highly valuable in trying to understand an area that hasn't been heavily studied in the past.

I hope this makes sense :)

I've done both types of research, and I really enjoyed the qualitative stuff. It's so much more in depth. Unfortunately, it's not the norm in the research world. I plan on doing more, but for many people it's too time consuming, cost prohibitive, or they want the numbers to analyze versus the words.

I could probably write about 40 pages on this, but I hope this helps clarify. Any other questions, just ask.
"Only the meek get pinched...the bold survive."

Veteran Member

Date Joined May 2003
Total Posts : 9448
   Posted 7/12/2008 8:37 AM (GMT -7)   
The MMPI 2 is an interesting instrument. It can be scored by 'puter - BUT - its really not all that "accurate" until the trained "counselor" applies that scoring to their personal interaction w/the "patient" to more accurately interpret the data.

You wanna talk about what appear to be repetitive questions?? Take the full length MMPI 2. You wanna talk about not really having a choice of answers that really applies to you? Take the full length MMPI 2.

Its really quite fascinating if you can see the raw data especially. Have you had much experience using the MMPI2, BetaGirl?? Since one of its greatest weaknesses is for those w/chronic illness or chronic pain it would REALLY be interesting to see it applied to a large group of diverse crohnies. The computer scoring is cheap enough. Of course, FINDING those fortunate crohnies w/very mild Crohn's to take the MMPI 2 to accurately balance the numbers .....
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Veteran Member

Date Joined Jul 2006
Total Posts : 6927
   Posted 7/12/2008 8:51 AM (GMT -7)   
She is going to get alot of MMPI data working for the VA, the military (and law enforcement) loves the MMPI. What I would like to see is if/how the MMPI data changes from being a healthy individual to a sick individual? Because I think this would be one time that you could examine that.
Forum Co-moderator - Crohn's Disease
We will find a way, or make one.-Hannibal (crossing the Alps in the 15th Century on war elephants) 
Make sure your suffering has meaning...-?
All suggestions/options/opinions are caveated with please consult with your local health care provider...

Post Edited (MMMNAVY) : 7/12/2008 9:57:09 AM (GMT-6)

Veteran Member

Date Joined Jan 2003
Total Posts : 1928
   Posted 7/12/2008 12:46 PM (GMT -7)   
Ah, the MMPI. There's a reason for the repetition, but yes it's quite tedious. I've done quite a few MMPI administrations, including the adolescent version. My first year of clinical work was doing assessment (aka testing) only.

I'd never use the MMPI in a strictly health setting. It's for diagnosing more serious mental illness and personality disorders really. And since we had a whole thread on the IBD personality and how that just doesn't hash out...

It has been validated quite extensively, and the report that the computer generates (or if you're lucky enough to score it by hand) is quite extensive. In my 2 years working in health psych, I only gave the MMPI once and that client had a heck of a lot more going on than just bowel issues. Also, I'd never just use the MMPI to diagnose anything. It's a tool, that's it. So yes, that's where the clinical judgment and training comes in. And you know, actually talking to the person to find out what's going on :)

MMMNavy - yep, they sure do.
"Only the meek get pinched...the bold survive."

Veteran Member

Date Joined May 2005
Total Posts : 4219
   Posted 7/12/2008 6:19 PM (GMT -7)   
Beta - great answer. I was a criminal justice major and for years they were required to take quantitative research methods as a class. My year they opened an honors section that was chosen to take part in qualitative research. I LOVED it. I basically observed interactions at a children's soup kitchen for a semester. The only problem I had was that when they were short handed I couldn't stand back and be impartial. I ended up volunteering and helping out. But I got a ton of insight that way too. I can't even remember the purpose of my study know it was so long ago!
26 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.

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