Social Indicators Research

, Volume 89, Issue 1, pp 1–22 | Cite as

The Best and Worst Times of Life: Narratives and Assessments of Subjective Well-Being by Anamnestic Comparative Self Assessment (ACSA) in the Eastern Cape, South Africa

  • Valerie MøllerEmail author
  • Peter Theuns
  • Ida Erstad
  • Jan Bernheim


The Anamnestic Comparative Self Assessment (ACSA) measure of subjective well-being (SWB) aims to reduce the problems of cultural bias and relativity to external standards by allowing people to define the endpoints or ‘anchors’ of the measurement scale. In medical terminology anamnestic denotes ‘based on memory’. The ACSA uses subjects’ memories of the best and worst periods in their lives to define the anchors of the scale. They then assess their current quality of life relative to these personal anchors. The South African pilot study tested the match between self-assessment of SWB with ACSA and the conventional single-item measures of life satisfaction and happiness used in the South African Quality of Life Trends Study and analysed the narratives of the best and worst times of life. The quota sample of 46 consisted of 26 residents of Makana district in the Eastern Cape Province, South Africa, and 20 patients undergoing treatment in the local TB hospital. Mean SWB ratings with all three measures of life satisfaction, happiness and ACSA were between 5 and 6 on a 0–10-point scale. Ratings on all three scales were positively correlated. However, on ACSA the TB patients rated their current SWB 1.84 points lower than the community respondents, suggesting a greater sensitivity of this measure. It was observed that the starting points of the life stories produced by respondents to define the anchor periods for ACSA were related to their current assessment of SWB. A typology was developed that combined the starting point of the life stories with current SWB. The majority of community respondents matched the ‘Achiever’ type who scored positively on ACSA (i.e., above the mid-point of the scale) and whose life stories started with the worst period of their lives and proceeded to the best period. The TB patients were the only respondents to represent the ‘Survivor’ type whose morale had recovered after misfortune in life. ‘Survivors’ started their narratives with the best period in their lives, then moved to the worst (often health-related) one, and gave positive ACSA ratings. Based on the qualitative analysis of narratives, it is concluded that ACSA is a sensitive measurement instrument and therefore particularly useful for monitoring the effects of treatments and social interventions in longitudinal studies. However, further research is required to verify its cross-cultural validity.


Anamnestic Comparative Self Assessment (ACSA) Subjective well-being Happiness Life satisfaction Narratives Life review Anchor periods South Africa 



The research reported here was financially supported by grant ZEIN2005ZVV48 from the Vlaamse Interuniversitaire Raad-Universitaire Ontwikkelingssamenwerking (VLIR-UOS). Views are those expressed by the authors and should not be attributed to the sponsors. The authors thank Nomtunsi Api and Zizo Siwendu for assistance with fieldwork and Professor Sarah Radloff for assistance with statistics. They gratefully acknowledge the hospitality of the SANTA Temba TB hospital in Grahamstown East/Rhini.


  1. Andrews, F. M., & Withey, S. B. (1976). Social indicators of well-being. New York: Plenum Press.Google Scholar
  2. Bernheim, J. L. (1983). ‘L’auto-évaluation anamnestique comparative (ACSA). 1. Description d’une méthode de mesure de la qualité subjective de la vie des malades cancéraux. Psychologie Médicale, 15, 1615–1617.Google Scholar
  3. 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. Bioethics, 13, 272–287.CrossRefGoogle Scholar
  4. Bemheim, J. L., & Buyse, M. (1984). The anamnestic comparative self-assessment for measuring the subjective quality of life of cancer patients. Journal of Psychosocial Oncology, 1, 25–38.Google Scholar
  5. Bernheim, J. L., Theuns, P., Mazaheri, M., Calcoen, P., Heylighen, F., & Rose, M. (2005). Bridging cultural relativity in quality of life by Anamnestic Comparative Self-Assessment (ACSA). In Proceedings Australian Quality of Life Conference.
  6. Bernheim, J. L., Theuns, P., Mazaheri, M., Hofmans, J., Fliege, H., & Rose, M. (2006). The potential of anamnestic comparative self-assessment (ACSA) to reduce bias in the measurement of subjective well-being. Journal of Happiness Studies, 7(2), 227–250.CrossRefGoogle Scholar
  7. Booysen, F. le R., van Rensburg, H. C. J., Bachmann, M., Louwagie, G., & Fairall, L. (2007). The heart in HAART: Quality of life of patients enrolled in the public sector antiretroviral treatment programme in the Free State Province of South Africa. Social Indicators Research, 81(2), 283–329.CrossRefGoogle Scholar
  8. Campbell, A., Converse, P. E., & Rodgers, W. L. (1976). The quality of American life. New York: Russell Sage Foundation.Google Scholar
  9. Cantril, H. (1965). The pattern of human concerns. New Brunswick: Rutgers University Press.Google Scholar
  10. Carstensen, L. L, Pasupathi, M., Mayr, U., & Nesselroade, J. R. (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology, 79, 644–655.CrossRefGoogle Scholar
  11. Clarke, A., & Warren, L. (2007). Hopes, fears and expectations about the future: what do older people’s stories tell us about active ageing? Ageing and Society, 27(4), 465–488.CrossRefGoogle Scholar
  12. Cramm, J. (2006). Determinants of (non-)compliance with treatment for people with tuberculosis in the Eastern Cape: A Q-methodological study. Masters thesis, Institute of Health Policy and Management, Erasmus Medical Centre, Rotterdam, the Netherlands.Google Scholar
  13. Cummins, R. A. (1995). On the trail of the gold standard for subjective well-being. Social Indicators Research, 35(2), 179–200.CrossRefGoogle Scholar
  14. Cummins, R. A. (2000). Personal income and subjective well-being: a review. Journal of Happiness Studies, 1(2), 133–158.CrossRefGoogle Scholar
  15. Diener, E., & Suh, E.M. (Eds.) (2000). Culture and subjective well-being. Cambridge: MIT Press.Google Scholar
  16. Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.CrossRefGoogle Scholar
  17. Erstad, I. (2006). The resurgence of tuberculosis in South Africa: an investigation into socio-economic aspects of the disease in a context of structural violence in Grahamstown, Eastern Cape. Master of Arts thesis, Rhodes University, Grahamstown.Google Scholar
  18. Field, D. (2001). Looking back, what period of your life brought you the most satisfaction. Annual Review of Psychology, 52, 141–166.CrossRefGoogle Scholar
  19. Frederickson, B. L. (2000). Extracting meaning from past affective experiences: the importance of peaks, ends, and specific emotions. Cognition and Emotion, 14(4), 577–606.CrossRefGoogle Scholar
  20. Graham, C. (2006). Measuring quality of life in Latin America: Some insights from happiness economics and the latinobarometro. Paper presented at the 7th International Society for Quality of Life Studies conference, 17–20 July, Grahamstown, South Africa.Google Scholar
  21. Inglehart, R. (2004). World values survey.
  22. Kahn, R., & Juster, F. (2002). Well-being: concept and measures. Journal of Social Issues, 58, 627–644.CrossRefGoogle Scholar
  23. Lau, A. L. D., Cummins, R. A., & McPherson, W. (2005). An investigation into the cross-cultural equivalence of the personal wellbeing index. Social Indicators Research, 72(3), 403–430.CrossRefGoogle Scholar
  24. Layard, R. (2005). Happiness: Lessons from a new science. London: Penguin Books.CrossRefGoogle Scholar
  25. Michalos, A. C. (1985). Multiple discrepancies theory (MTD). Social Indicators Research, 16(4), 347–413.CrossRefGoogle Scholar
  26. Møller, V. (1998). Quality of life in South Africa: Post-apartheid trends. Social Indicators Research, 43(1–2), 27–68.CrossRefGoogle Scholar
  27. Møller, V. (2001). Happiness trends under democracy: Where will the new South African set-level come to rest? Journal of Happiness Studies, 2(1), 33–53.CrossRefGoogle Scholar
  28. Møller, V. (2007a). Researching quality of life In a developing country: Lessons from the South African case. In I. Gough & J.A. McGregor (Eds.), Wellbeing in developing countries: From theory to research (pp. 242–258). Cambridge: Cambridge University Press.Google Scholar
  29. Møller, V. (2007b). Quality of life in South Africa: The first ten years of democracy. Social Indicators Research, 81(2), 181–201.CrossRefGoogle Scholar
  30. Møller, V. (2007c). South Africa coming to terms with difference. In P. Molt & H. Dickow (Eds.), Comparing cultures and conflicts, festschrift for Theodor Hanf (pp. 461–475). Baden-Baden: Nomos.Google Scholar
  31. Møller, V., & Dickow, H. (2002). The role of quality of life surveys in managing social change in democratic transitions: The South African case. Social Indicators Research, 58, 267–292.CrossRefGoogle Scholar
  32. Møller, V., & Ferreira, M. (1992). Successful ageing in South Africa: Opportunity structures and subjective well-being. Southern African Journal of Gerontology, 1(1), 5–8.Google Scholar
  33. Møller, V., & Schlemmer, L. (1983). Quality of life in South Africa: Towards an instrument for the assessment of quality of life and basic needs. Social Indicators Research, 12, 225–279.CrossRefGoogle Scholar
  34. Møller, V., & Schlemmer, L. (1989). South African quality of life: A research note. Social Indicators Research, 21, 279–291.CrossRefGoogle Scholar
  35. Neugarten, B. L., Havighurst, R. J., & Tobin, S. S. (1961). The measurement of life satisfaction. Journal of Gerontology, 16, 134–143.Google Scholar
  36. Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52, 141–166.CrossRefGoogle Scholar
  37. Shmotkin, D., Berkovich, M., & Cohen, K. (2006). Combining happiness and suffering in a retrospective view of anchor periods in life: A differential approach to subjective well-being. Social Indicators Research, 77(1), 139–169.CrossRefGoogle Scholar
  38. Singer, J. A., & Buck, S. (2001). New perspectives on autobiographical memory: The integration of narrative processing and autobiographical reasoning. Review of General Psychology, 5(2), 91–99.CrossRefGoogle Scholar
  39. Staudinger, U. M. (2001). ‘Life reflection: A socialcognitive analysis of life review’. Review of General Psychology, 5, 148–160.Google Scholar
  40. Veenhoven, R. (2006). International scale interval study: improving the comparability of responses to survey questions about happiness. Paper presented at the 7th International Society for Quality of Life Studies conference, 17–20 July, Grahamstown, South Africa.Google Scholar
  41. Walker, W. R., & Skowronski, J. J. (2003). Life is pleasant––and memory helps to keep it that way. Review of General Psychology, 7(2), 203–210.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Valerie Møller
    • 1
    Email author
  • Peter Theuns
    • 3
  • Ida Erstad
    • 1
    • 2
  • Jan Bernheim
    • 4
  1. 1.Institute of Social and Economic ResearchRhodes UniversityGrahamstownSouth Africa
  2. 2.CULCOM (Cultural Complexity in the New Norway) ProgrammeUniversity of OsloOsloNorway
  3. 3.Department of PsychologyVrije Universiteit BrusselBrusselsBelgium
  4. 4.Department of Human EcologyVrije Universiteit BrusselBrusselsBelgium

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