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.

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

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

• 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.

• 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.

• self_report
• symptomatology
• validity
• response_bias