The Scale to Assess Narrative Development

Abstract

While changes in self-experience have been suggested as an element of recovery from schizophrenia, little is known about how they are linked with other subjective indicators of recovery. To examine this, we have developed methods of eliciting narratives of self and illness in schizophrenia and quantitatively rating self-experience expressed within those narratives. In this study, we rated the narratives of 34 persons with schizophrenia spectrum disorder prior to entry into rehabilitation using the Scale to Assess Narrative Development (STAND). STAND scores were then correlated with concurrent assessments of self-esteem using the Rosenberg Self Esteem schedule and readiness for change using the Stages of Change Questionnaire. Results indicated that higher ratings on the STAND were associated with greater levels of self-esteem and greater overall readiness for change. This may suggest that qualities of self-experience within personal narratives of persons with schizophrenia are linked to objective and subjective assessments of recovery.

Criteria for symptom remission revisited: a study of patients affected by schizophrenia and schizoaffective disorders

“…Regression on functional outcome showed a significant predictive effect only for PANSS-TScr remission (p = .005, β = .36), while neither RSWGcr nor PANSS-PNScr alone were significant predictors of functioning. The explained variance for the model was moderate (R [2] = .26). The analysis on cognitive outcome showed no significant predictor effect for any of the remission criteria used.…”

“…However, the dimensions to be included in the concept of recovery are still the object of ongoing debate [1]. It is generally assumed that recovery will comprise both objective and subjective [2] components, otherwise defined as clinical and personal domains [3]; the objective component generally refers to clinical outcomes which are evaluated by means of operationally defined criteria; subjective recovery refers to the ongoing process of positive changes in an individual’s subjective experience of themselves as human beings [1]. Clinical objective and personal subjective recovery are largely independent phenomena [4] and both should be considered as targets for therapeutic interventions in schizophrenia and related disorders.…”

Personal Narratives, Coping, and Quality of Life in Persons Living With HIV

“…The STAND (Lysaker et al, 2006) measures the degree to which a patient generates a coherent, meaningful narrative that demonstrates a sense of agency, social worth, and connectedness, and understands the degree to which illness impacts his or her life and the lives of others. The STAND is completed by trained raters and assesses four aspects of recovery in personal narratives: Illness Conception, Alienation, Agency, and Social Worth.…”

“…Each subscale is rated on a 5-point Likert scale from 1-5, and subscales are summed to form a total score. Higher total scores on the STAND, which are indicative of more coherent, complex narrative content in these domains, have been associated with increased self-esteem, motivation for change, ability to cope, and quality of life in persons with psychosis (e.g., Lysaker et al, 2010; Lysaker et al, 2006). The STAND was adapted to rate illness narratives of medical patients for the purposes of this study.…”

“…Accordingly, in this study, we collected personal illness narratives from HIV-infected patients and rated the narratives’ coherence and complexity using the Scale to Assess Narrative Development (STAND), a method originally developed for research on psychiatric patient populations (Lysaker et al, 2006). We then investigated associations between narrative coherence and observer-rated and self-report measures of coping and quality of life.…”