Case study: Validity of subject measures

In the study by (Connell et al., 1965) of bowel habits in a healthy population, 64 people considered themselves to be constipated. Of these, 39 had at least five bowel movements each week. Were these 39 people deluded?

Yes. Five bowel movements per week lies well within the bounds of normality, and one should suspect a psychological component to these individuals' health perceptions.

Maybe. These people's bowel movement frequency is within the normal range, and some groups who complain of constipation show normal bowel function but score highly on scales of depression, anxiety and somatization. On the other hand, frequency of defecation is not the only criterion people use to judge their bowel habit and perhaps these folk experienced other difficulties not picked up by this study.

No. Bowel frequency is a crude measure of function and is entirely inadequate on its own to explain the multi-facetted experience of a symptom.

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