Abstract
BACKGROUND: There is a tradition of social validation studies in the adult clinical treatment literature that has not yet been extended to narrative evaluation. This social validation process begins with lay listener holistic judgements of narrative quality for non-brain-injured narrators, and compares these judgements to clinician-researchers' assessments of the same narratives. The resulting narratives rated for quality reflect the premorbid range of skills in clinical populations, and overall narrative performance. Narratives whose quality has been assessed holistically by laypersons can be further examined for the qualitative and quantitative dimensions that characterise them. AIMS: This study explores the social validity of clinical narrative assessment. Specifically, it examines the degree to which clinicians' holistic and analytic assessments of narrative quality parallel holistic narrative quality judgements of a lay audience, for a set of narratives produced by non-brain-injured narrators. It also examines the characteristics of narratives along a continuum of quality. METHODS & PROCEDURES: A total of 14 African American and 15 Caucasian lay individuals holistically rated the quality of personal narratives produced by ethnicity-matched groups of 37 African-American and 34 Caucasian non-brain-injured narrators, respectively. Five clinical raters holistically rated all narratives. Additionally, lay raters were asked for their intuitions about what contributes to narrative quality. They also ranked six researcher-specified dimensions for their importance in determining narrative quality. High-rated and low-rated narratives were compared on dimensions of length, content, and narrative structure. OUTCOMES & RESULTS: Agreement between lay and clinical rater groups was found for a subset of high-rated and low-rated stories, which constituted one-quarter to one-third of the total narratives. A similar level of agreement was found for male and female lay raters. Rater-group disagreements at the extremes of narrative quality were rare. Certain of the lay raters' characterisations of good and poor narratives corresponded to narrative dimensions discussed in the literature and defined by the researchers. High-rated stories were longer, more conventionally structured, and different in content from low-quality stories. CONCLUSIONS: For personal narratives at the extremes of perceived quality (high and low), evidence for social validity in narrative assessment is manifested both at the holistic assessment level, and at the level of the dimensions thought to contribute to narrative quality. The results contribute to our understanding of the normal range of narrative performance. Holistic, qualitative measures of narrative production complement analytic, quantitative measures, and hold promise for narrative assessment that reflects everyday narrative performance.