title: Subjective experience and meaning of psychoses: the German Subjective Sense in Psychosis Questionnaire (SUSE).
abstract: BACKGROUND
  Clinical research on subjective determinants of recovery and health has increased, but no instrument has been developed to assess the subjective experience and meaning of psychoses. We have therefore constructed and validated the Subjective Sense in Psychosis Questionnaire (SUSE) to measure sense making in psychotic disorders.
  
  
  METHODS
  SUSE was based on an item pool generated by professionals and patients. For pre-testing, 90 psychosis patients completed the instrument. Psychometric properties were assessed using methods of classical test theory. In the main study, SUSE was administered to a representative sample of 400 patients. Factor structure, reliability and validity were assessed and confirmatory factor analyses (CFAs) were used for testing subscale coherence and adequacy of the hypothesized factor structure. Response effects due to clinical settings were tested using multilevel analyses.
  
  
  RESULTS
  The final version of SUSE comprises 34 items measuring distinct aspects of the experience and meaning of psychoses in a consistent overall model with six coherent subscales representing positive and negative meanings throughout the course of psychotic disorders. Multilevel analyses indicate independence from clinical context effects. Patients relating psychotic experiences to life events assessed their symptoms and prospects more positively. 76% of patients assumed a relationship between their biography and the emergence of psychosis, 42% reported positive experience of symptoms and 74% ascribed positive consequences to their psychosis.
  
  
  CONCLUSIONS
  SUSE features good psychometric qualities and offers an empirical acquisition to subjective assessment of psychosis. The results highlight the significance of subjective meaning making in psychoses and support a more biographical and in-depth psychological orientation for treatment.
authors: Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. k.klapheck@uke.uni-hamburg.de
authors: K
authors: K
authors: Klapheck
authors: S
authors: S
authors: Nordmeyer
authors: H
authors: H
authors: Cronjäger
authors: D
authors: D
authors: Naber
authors: T
authors: T
authors: Bock
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001317:Austria; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D005858:Germany; D006801:Humans; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D055361:Multilevel Analysis; D025341:Principal Component Analysis; D011594:Psychometrics / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D060685:Sense of Coherence; D011795:Surveys and Questionnaires; D055815:Young Adult