Journal of Happiness Studies

, Volume 7, Issue 2, pp 227–250 | Cite as

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

  • Jan L. BernheimEmail author
  • Peter Theuns
  • Mehrdad Mazaheri
  • Joeri Hofmans
  • Herbert Fliege
  • Matthias Rose


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.


(measurement of) quality of life subjective well-being life satisfaction happiness relativity biases 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Andrews, F.M., Whithey, S.B. 1976Social Indicators of Well-being Plenum PressNew YorkGoogle Scholar
  2. Argyle, M. 2002The Psychology of Happiness Taylor & Francis IncNew YorkGoogle Scholar
  3. Aristotle, Ethica Nicomachea,-Traditional Bekker pagination 1095 a13–b6Google Scholar
  4. Bernheim, J.L. 1983‘L’auto-évaluation anamnestique comparative (ACSA).I. Description d’une méthode de mesure de la qualité subjective de la vie des malades cancéreux’Psychologie médicale1516151617Google Scholar
  5. Bernheim, J.L. 1999‘How to get serious answers to the serious question: How have you been? Subjective quality of life (QOL) as an individual experiential emergent construct’Bioethics13272287CrossRefGoogle Scholar
  6. Bernheim, J.L., P. Theuns, M. Mazaheri, Piet Calcoen, F. Heylighen and M. Rose: 2005, ‘Bridging cultural relativity in Quality of Life by Anamnestic Comparative Self Assessment (ACSA)’, Proceedings Australian Quality of Life Conference.
  7. Bernheim, J.L., Buyse, M. 1984‘The Anamnestic Comparative Self Assessment for measuring the subjective quality of life of cancer patients’Journal Psychosocial Oncology12538CrossRefGoogle Scholar
  8. Brickman, P., Coates, D., Bulman, J. 1980‘Influence of extraversion and neuroticism on subjective well-being: Happy and Unhappy people’Journal of Personality and Social Psychology38668678CrossRefGoogle Scholar
  9. Buyse M., J.L. Bernheim and N. Rotmensz: 1983, L'auto-évaluation anamnestique comparative (ACSA). II. Résultats d'une étude pilote portant sur 65 patients cancéreux. Psychologie médicale 15, pp. 1623–1624Google Scholar
  10. Campbell, A., Converse, P.E., Rodgers, W.L. 1976The Quality of American Life New York Russell Sage FoundationNew YorkGoogle Scholar
  11. Cantril, H. 1965The Pattern of Human Concerns Rutgers University PressNew JerseyGoogle Scholar
  12. Cummins, R.A. 1996‘The domains of life satisfaction: an attempt to order chaos’Social Indicators Research38303328CrossRefGoogle Scholar
  13. Haes, J.C.J.M. 1992‘The distinction between affect and cognition in the quality of life of cancer patients: Sensitivity and stability’Quality of Life Research1315322CrossRefGoogle Scholar
  14. Diener, E., Diener, M. 1995‘Cross-cultural correlates of life satisfaction and self-esteem’Journal of Personality and Social Psychology68653663CrossRefGoogle Scholar
  15. Erubami, M. and I.R. Young: 2003, ‘Nigerian violence: A review of statistics and perceptions’, Centre for Human Rights Research and Development, CHRRD RESEARCH REVIEW No. 4,
  16. Fayers, M., Machin, D. 2000Quality of Life: Assessment, Analysis and Interpretation John Wiley & SonsNew YorkGoogle Scholar
  17. Garhammer, M. 2002‘Pace of life and enjoyment of life’Journal of Happiness Studies3217256CrossRefGoogle Scholar
  18. Gill, T.M., Feinstein, A.R. 1994‘A critical appraisal of the quality of life measurements’Journal of the American Medical Association272619626CrossRefGoogle Scholar
  19. Hagerty, M.R., Cummins, R.A., Ferris, A.L., Land, K., Michalos, A.C., Peterson, M., Sharpe, A., Sirgy, J., Vogel, J. 2001‘Quality of life indexes for national policy: Review and agenda for research’Social Indicators Research55191CrossRefGoogle Scholar
  20. Hampton, N., Marshall, A. 2000‘Culture, gender, self-efficacy, and life satisfaction: A comparison between Americans and Chinese people with spinal cord injuries’Journal of Rehabilitation662128Google Scholar
  21. Heylighen, F., Bernheim, J.L. 2000a‘Global progress. I: Empirical evidence for ongoing increases in quality of life’Journal of Happiness Studies1323349CrossRefGoogle Scholar
  22. Heylighen, F., Bernheim, J.L. 2000b‘Global progress. II: Evolutionary mechanisms and their side-effects’Journal of Happiness Studies1351374CrossRefGoogle Scholar
  23. Inglehart, R.: 2004, World Values Survey.
  24. Joyce, A., Camfield, C., Carpay, H., Helmstaedter, C., Longfitt, J., Malmgren, K., Wiebe, S. 2002‘Principles of health related quality of life: Assessment in clinical trails’Epilepsia4910841095Google Scholar
  25. Kahn, R., Juster, F. 2002‘Well-being: Concept and measures’Journal of Social Issues58627644CrossRefGoogle Scholar
  26. Lau, A., Cummins, R. 2004‘The subjective wellbeing of Asian Chinese and Western populations: A cross-cultural perspective’Quality of Life Research131496Google Scholar
  27. Layard, P.R.G. 2005Happiness: Lessons from a New Science Penguin PressNew YorkGoogle Scholar
  28. McHorney, C.A., Ware, J.E.,Jr., Lu, J.F.R., Sherbourne, C.D. 1994‘The MOS 36-item Short-Form Health Survey (SF−36), III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups’Medical Care324066Google Scholar
  29. Muthny, F.A.: 1991, Lebenszufriedenheit bei koronärer Herzkrankheit; ein Vergleich mit anderen Iebensbedrohlichen Erkrankungen, in M. Ludwig Bullinger and N. Steinbuechel (eds), Lebensqualität bei kardiovaskulären Erkrankungen. Grundlagen, Messverfahren and Ergebnisse (Goettingen, Hogrefe), pp. 196–210.Google Scholar
  30. Nijenhuis, E.R.S., Vanderlinden, J., Spinhoven, P. 1998‘Animal defensive reactions as a model for trauma-induced dissociative reactions’Journal of Abnormal Psychology1076373CrossRefGoogle Scholar
  31. Nunnally, J.C. 1978Psychometric Theory2McGraw-HillNew YorkGoogle Scholar
  32. Ouweneel, P., Veenhoven, R. 1991Cross-national differences in happiness: cultural bias or societal quality?Bleichrodt, NDrenth, P.J. eds. Contemporary Issues in Cross-cultural PsychologySwets & ZeitlingerAmsterdam168184Google Scholar
  33. Rose, M., Fliege, H., Danzer, G., Klapp, B.F. 2000Gesundheitsbezogene Lebensqualität” ein Teil “aligemeiner LebensqualitätBullinger, M.Ravens-Sieberer, U. eds. Jahrbuch der Medizinischen PsychologieHogrefeGöttingen, Germany206222Google Scholar
  34. Schimmack, U., Radhakrishnan, P., Oishi, S., Dzokoto, V., Ahadi, S. 2002‘Culture, personality, and subjective well-being: Integrating process models of life-satisfaction’Journal of Personality and Social Psychology82582593CrossRefGoogle Scholar
  35. Schwartz, C.E., Sprangers, M.A.G. 2000Adaptation to Changing Health: Response Shift in Quality-of-Life Research American Psychological AssociationWashington, DCGoogle Scholar
  36. Schwarz, N., Strack, F. 1999Reports on subjective well-being: Judgmental processes and their methodological implicationsKahneman, D.Diener, E.Schwarz, N. eds. Well-being: The Foundation of Hedonic Psychology Russell SageNew York6184Google Scholar
  37. Souris, M., Ledure, G., Bernheim, J.L. 1983‘L’auto-évaluation anamnestique comparative (ACSA). III. Fiabilité de la méthode et tolérance des malades cancéreux’Psychologie médicale1516251626Google Scholar
  38. Steel, P., Ones, D.S. 2002‘Personality and happiness: A national-level analysis’Journal of Personality and Social Psychology83767781CrossRefGoogle Scholar
  39. Veenhoven, R.: 2005, World Database of Happiness.
  40. WHOQOL.BREF1996Introduction, Administration, Scoring and Generic Version of the AssessmentWorld Health OrganizationGenevaGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Jan L. Bernheim
    • 1
    Email author
  • Peter Theuns
    • 1
  • Mehrdad Mazaheri
    • 1
  • Joeri Hofmans
    • 1
  • Herbert Fliege
    • 1
  • Matthias Rose
    • 1
  1. 1.Department of Human Ecology and End-of-Life Care Research Group, Faculty of MedicineVrije Universiteit BrusselBrussselsBelgium

Personalised recommendations