The best and worst times of life: Narratives and assessments of subjective well-being by Anamnestic Comparative Self Assessment (ACSA) in the Eastern Cape, South Africa

Abstract

The Anamnestic Comparative Self Assessment (ACSA) measure of subjective well-being (SWB) aims to reduce the problems of cultural bias and relativity to external standards by allowing people to define the endpoints or 'anchors' of the measurement scale. In medical terminology anamnestic denotes 'based on memory'. The ACSA uses subjects' memories of the best and worst periods in their lives to define the anchors of the scale. They then assess their current quality of life relative to these personal anchors. The South African pilot study tested the match between self-assessment of SWB with ACSA and the conventional single-item measures of life satisfaction and happiness used in the South African Quality of Life Trends Study and analysed the narratives of the best and worst times of life. The quota sample of 46 consisted of 26 residents of Makana district in the Eastern Cape Province, South Africa, and 20 patients undergoing treatment in the local TB hospital. Mean SWB ratings with all three measures of life satisfaction, happiness and ACSA were between 5 and 6 on a 0-10-point scale. Ratings on all three scales were positively correlated. However, on ACSA the TB patients rated their current SWB 1.84 points lower than the community respondents, suggesting a greater sensitivity of this measure. It was observed that the starting points of the life stories produced by respondents to define the anchor periods for ACSA were related to their current assessment of SWB. A typology was developed that combined the starting point of the life stories with current SWB. The majority of community respondents matched the 'Achiever' type who scored positively on ACSA (i.e., above the mid-point of the scale) and whose life stories started with the worst period of their lives and proceeded to the best period. The TB patients were the only respondents to represent the 'Survivor' type whose morale had recovered after misfortune in life. 'Survivors' started their narratives with the best period in their lives, then moved to the worst (often health-related) one, and gave positive ACSA ratings. Based on the qualitative analysis of narratives, it is concluded that ACSA is a sensitive measurement instrument and therefore particularly useful for monitoring the effects of treatments and social interventions in longitudinal studies. However, further research is required to verify its cross-cultural validity. © Springer Science+Business Media B.V. 2007.