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.