How people answer when they’re unwell: Response styles and self-reported psychopathology

Response styles are systematic tendencies in how individuals respond to questionnaire items, regardless of item content. It remains unclear how individuals with various mental disorders differ in these tendencies, despite the widespread use of self-report instruments in clinical research and practice. We examined this question in an online sample of 9154 adults from the Czech Republic and Slovakia (5622 women and 3532 men) with a mean age of 35.7 years (SD = 12.5). Participants completed the Ten-Item Personality Inventory, from which we derived four response styles using the manifest approach: acquiescent, disacquiescent, midpoint, and extreme responding. Participants also reported twenty-five doctor-diagnosed and self-identified mental disorders and rated the severity of eight mental health-related symptoms. Results showed that, among individuals with psychiatric disorders, the total numbers of both doctor-diagnosed and self-identified disorders were positively associated with extreme responding, while the number of diagnosed disorders was also positively associated with disacquiescent and negatively associated with midpoint responding. Regarding specific disorders, acquiescent responding was positively associated with some disorders (e.g., anxiety) but negatively with others (e.g., depression). For disacquiescent and extreme responding, almost all associations with the presence of specific disorders were positive. Midpoint responding showed minimal associations with specific psychopathologies. Effect sizes were generally small. However, even small effects from biased responding may have meaningful consequences and hence warrant further investigation.