What does an idiographic measure (PSYCHLOPS) tell us about the spectrum of psychological issues and scores on a nomothetic measure (CORE-OM)?

Abstract

Background: Psychological Outcome Profiles ('PSYCHLOPS') is a short, idiographic mental health outcome measure, designed for use in primary care. It has convergent validity with nomothetic measures. Aims: This study determined the proportion of issues elicited by PSYCHLOPS (idiographic) which do not appear in CORE-OM items (nomothetic). The study compared the issues reported on PSYCHLOPS by clients classified as cases and as non-cases on CORE-OM. Methods: The study population consisted of 215 clients referred for talking therapy in primary care. Thematic analysis was conducted to categorise the freetext responses of PSYCHLOPS. These themes were cross-checked against the items in CORE-OM. Pre-therapy CORE-OM scores were used to determine caseness and hence compare PSYCHLOPS themes by caseness. Results: PSYCHLOPS responses were coded into 61 different themes. 'Relationship problems' were the most frequent themes. Twenty-seven of the 61 (44%) themes were not covered by CORE-OM items; 128 (60%) clients reported at least one response which did not clearly map to a CORE-OM item. Sixty-six of the 215 (31%) clients were classified as non-cases and they showed no significant differences in theme frequency from the cases. Conclusions: Idiographic measures highlight the psychological concerns of clients presenting for therapy; many of these concerns did not feature on a nomothetic measure. By using both outcome measures, we have tried to capture diversity and demonstrate the multi-faceted nature of psychological distress rather than to standardise the assessment of outcome.