====== Endorsement ======

**Definition:**  
In clinical and research contexts, *endorsement* refers to the **affirmative response** or **agreement with a specific item**, symptom, belief, or statement, particularly in standardized assessments or self-report questionnaires.

===== Usage in Psychometrics =====
In psychometric evaluations, endorsement typically indicates that a patient or participant:

  * Confirms the presence of a symptom (e.g., “I feel sad most of the time” – endorsed as “true”).
  * Agrees with a statement or belief (e.g., “I worry excessively”).
  * Selects a response above a threshold (e.g., Likert scale rating ≥ 4/5).

The **endorsement rate** of an item can be used to assess:

  * **Item difficulty or severity**
  * **Prevalence of a symptom**
  * **Construct validity** in scale development

===== Clinical Relevance =====
Endorsement is critical for:

  * **Diagnostic formulation** – consistent endorsement of criteria in DSM/ICD tools
  * **Treatment planning** – tracking which domains are most impaired
  * **Outcome monitoring** – change in endorsement over time may indicate improvement or deterioration

===== Examples =====
  * In the **Beck Depression Inventory**, endorsement of items like “I feel hopeless about the future” contributes to the total depression score.
  * In **structured interviews** (e.g., SCID), endorsement of core criteria supports a specific diagnosis.

===== Limitations =====
  * **Response bias** – social desirability, malingering, or denial may affect endorsement.
  * **Cultural factors** – interpretation and endorsement of certain items may vary cross-culturally.
  * **Cognitive impairment** – can reduce the accuracy of endorsement in neuropsychiatric populations.

===== See Also =====
  * [[self_report]]
  * [[symptomatology]]
  * [[validity]]
  * [[response_bias]]