demerits of case study in psychology

10 Case Study Advantages and Disadvantages

A case study in academic research is a detailed and in-depth examination of a specific instance or event, generally conducted through a qualitative approach to data.

The most common case study definition that I come across is is Robert K. Yin’s (2003, p. 13) quote provided below:

“An empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident.”

Researchers conduct case studies for a number of reasons, such as to explore complex phenomena within their real-life context, to look at a particularly interesting instance of a situation, or to dig deeper into something of interest identified in a wider-scale project.

While case studies render extremely interesting data, they have many limitations and are not suitable for all studies. One key limitation is that a case study’s findings are not usually generalizable to broader populations because one instance cannot be used to infer trends across populations.

Case Study Advantages and Disadvantages

1. in-depth analysis of complex phenomena.

Case study design allows researchers to delve deeply into intricate issues and situations.

By focusing on a specific instance or event, researchers can uncover nuanced details and layers of understanding that might be missed with other research methods, especially large-scale survey studies.

As Lee and Saunders (2017) argue,

“It allows that particular event to be studies in detail so that its unique qualities may be identified.”

This depth of analysis can provide rich insights into the underlying factors and dynamics of the studied phenomenon.

2. Holistic Understanding

Building on the above point, case studies can help us to understand a topic holistically and from multiple angles.

This means the researcher isn’t restricted to just examining a topic by using a pre-determined set of questions, as with questionnaires. Instead, researchers can use qualitative methods to delve into the many different angles, perspectives, and contextual factors related to the case study.

We can turn to Lee and Saunders (2017) again, who notes that case study researchers “develop a deep, holistic understanding of a particular phenomenon” with the intent of deeply understanding the phenomenon.

3. Examination of rare and Unusual Phenomena

We need to use case study methods when we stumble upon “rare and unusual” (Lee & Saunders, 2017) phenomena that would tend to be seen as mere outliers in population studies.

Take, for example, a child genius. A population study of all children of that child’s age would merely see this child as an outlier in the dataset, and this child may even be removed in order to predict overall trends.

So, to truly come to an understanding of this child and get insights into the environmental conditions that led to this child’s remarkable cognitive development, we need to do an in-depth study of this child specifically – so, we’d use a case study.

4. Helps Reveal the Experiences of Marginalzied Groups

Just as rare and unsual cases can be overlooked in population studies, so too can the experiences, beliefs, and perspectives of marginalized groups.

As Lee and Saunders (2017) argue, “case studies are also extremely useful in helping the expression of the voices of people whose interests are often ignored.”

Take, for example, the experiences of minority populations as they navigate healthcare systems. This was for many years a “hidden” phenomenon, not examined by researchers. It took case study designs to truly reveal this phenomenon, which helped to raise practitioners’ awareness of the importance of cultural sensitivity in medicine.

5. Ideal in Situations where Researchers cannot Control the Variables

Experimental designs – where a study takes place in a lab or controlled environment – are excellent for determining cause and effect . But not all studies can take place in controlled environments (Tetnowski, 2015).

When we’re out in the field doing observational studies or similar fieldwork, we don’t have the freedom to isolate dependent and independent variables. We need to use alternate methods.

Case studies are ideal in such situations.

A case study design will allow researchers to deeply immerse themselves in a setting (potentially combining it with methods such as ethnography or researcher observation) in order to see how phenomena take place in real-life settings.

6. Supports the generation of new theories or hypotheses

While large-scale quantitative studies such as cross-sectional designs and population surveys are excellent at testing theories and hypotheses on a large scale, they need a hypothesis to start off with!

This is where case studies – in the form of grounded research – come in. Often, a case study doesn’t start with a hypothesis. Instead, it ends with a hypothesis based upon the findings within a singular setting.

The deep analysis allows for hypotheses to emerge, which can then be taken to larger-scale studies in order to conduct further, more generalizable, testing of the hypothesis or theory.

7. Reveals the Unexpected

When a largescale quantitative research project has a clear hypothesis that it will test, it often becomes very rigid and has tunnel-vision on just exploring the hypothesis.

Of course, a structured scientific examination of the effects of specific interventions targeted at specific variables is extermely valuable.

But narrowly-focused studies often fail to shine a spotlight on unexpected and emergent data. Here, case studies come in very useful. Oftentimes, researchers set their eyes on a phenomenon and, when examining it closely with case studies, identify data and come to conclusions that are unprecedented, unforeseen, and outright surprising.

As Lars Meier (2009, p. 975) marvels, “where else can we become a part of foreign social worlds and have the chance to become aware of the unexpected?”

Disadvantages

1. not usually generalizable.

Case studies are not generalizable because they tend not to look at a broad enough corpus of data to be able to infer that there is a trend across a population.

As Yang (2022) argues, “by definition, case studies can make no claims to be typical.”

Case studies focus on one specific instance of a phenomenon. They explore the context, nuances, and situational factors that have come to bear on the case study. This is really useful for bringing to light important, new, and surprising information, as I’ve already covered.

But , it’s not often useful for generating data that has validity beyond the specific case study being examined.

2. Subjectivity in interpretation

Case studies usually (but not always) use qualitative data which helps to get deep into a topic and explain it in human terms, finding insights unattainable by quantitative data.

But qualitative data in case studies relies heavily on researcher interpretation. While researchers can be trained and work hard to focus on minimizing subjectivity (through methods like triangulation), it often emerges – some might argue it’s innevitable in qualitative studies.

So, a criticism of case studies could be that they’re more prone to subjectivity – and researchers need to take strides to address this in their studies.

3. Difficulty in replicating results

Case study research is often non-replicable because the study takes place in complex real-world settings where variables are not controlled.

So, when returning to a setting to re-do or attempt to replicate a study, we often find that the variables have changed to such an extent that replication is difficult. Furthermore, new researchers (with new subjective eyes) may catch things that the other readers overlooked.

Replication is even harder when researchers attempt to replicate a case study design in a new setting or with different participants.

Comprehension Quiz for Students

Question 1: What benefit do case studies offer when exploring the experiences of marginalized groups?

a) They provide generalizable data. b) They help express the voices of often-ignored individuals. c) They control all variables for the study. d) They always start with a clear hypothesis.

Question 2: Why might case studies be considered ideal for situations where researchers cannot control all variables?

a) They provide a structured scientific examination. b) They allow for generalizability across populations. c) They focus on one specific instance of a phenomenon. d) They allow for deep immersion in real-life settings.

Question 3: What is a primary disadvantage of case studies in terms of data applicability?

a) They always focus on the unexpected. b) They are not usually generalizable. c) They support the generation of new theories. d) They provide a holistic understanding.

Question 4: Why might case studies be considered more prone to subjectivity?

a) They always use quantitative data. b) They heavily rely on researcher interpretation, especially with qualitative data. c) They are always replicable. d) They look at a broad corpus of data.

Question 5: In what situations are experimental designs, such as those conducted in labs, most valuable?

a) When there’s a need to study rare and unusual phenomena. b) When a holistic understanding is required. c) When determining cause-and-effect relationships. d) When the study focuses on marginalized groups.

Question 6: Why is replication challenging in case study research?

a) Because they always use qualitative data. b) Because they tend to focus on a broad corpus of data. c) Due to the changing variables in complex real-world settings. d) Because they always start with a hypothesis.

Lee, B., & Saunders, M. N. K. (2017). Conducting Case Study Research for Business and Management Students. SAGE Publications.

Meir, L. (2009). Feasting on the Benefits of Case Study Research. In Mills, A. J., Wiebe, E., & Durepos, G. (Eds.). Encyclopedia of Case Study Research (Vol. 2). London: SAGE Publications.

Tetnowski, J. (2015). Qualitative case study research design.  Perspectives on fluency and fluency disorders ,  25 (1), 39-45. ( Source )

Yang, S. L. (2022). The War on Corruption in China: Local Reform and Innovation . Taylor & Francis.

Yin, R. (2003). Case Study research. Thousand Oaks, CA: Sage.

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Principles of Social Research Methodology pp 313–321 Cite as

• R. M. Channaveer 4 &
• Rajendra Baikady 5  
• First Online: 27 October 2022

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This chapter reviews the strengths and limitations of case study as a research method in social sciences. It provides an account of an evidence base to justify why a case study is best suitable for some research questions and why not for some other research questions. Case study designing around the research context, defining the structure and modality, conducting the study, collecting the data through triangulation mode, analysing the data, and interpreting the data and theory building at the end give a holistic view of it. In addition, the chapter also focuses on the types of case study and when and where to use case study as a research method in social science research.

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Introduction to Psychology/Case Studies

Case study in psychology refers to the use of a descriptive research approach to obtain an in-depth analysis of a person, group, or phenomenon. A variety of techniques may be employed including personal interviews, direct-observation , psychometric tests , and archival records. The psychology case studies are mostly used in clinical research to describe rare events and conditions, which contradict well established principles in the field of psychology . [1] Case studies are generally a single-case design, but can also be a multiple-case design, where replication instead of sampling is the criterion for inclusion. [2] Like other research methodologies within psychology, the case study must produce valid and reliable results in order to be useful for the development of future research. Distinct advantages and disadvantages are associated with the case study in psychology.

• 1 Advantages
• 2 Disadvantages
• 3 Famous case studies in psychology
• 4 References

Advantages [ edit | edit source ]

One major advantage of the case study in psychology is the potential for the development of novel hypotheses for later testing. Second, the case study can provide detailed descriptions of specific and rare cases.

Disadvantages [ edit | edit source ]

The major disadvantages of the case study in psychology is the inability to draw cause and effect relationships or test hypotheses. Further, with the case study it is impossible to generalize the findings to a wider population. [1]

Famous case studies in psychology [ edit | edit source ]

• Phineas Gage
• Freud and Little Hans
• John Money and the John/Joan case
• Genie (feral child)
• Piaget's studies
• Washoe (sign language)

References [ edit | edit source ]

• ↑ a b Christensen, L. B. (1994).“Experimental methodology"( 6th ed).,Simon & Schuster:Needham Heights, MA. ISBN 978-0-205-15506-4 .
• ↑ Yin, R.(1994). “Case study research: Design and methods” (2nd ed.).Sage Publishing:Beverly Hills, CA. ISBN 978-0-7619-2553-8 .

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What Is a Case Study in Psychology?

Categories Research Methods

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A case study is a research method used in psychology to investigate a particular individual, group, or situation in depth . It involves a detailed analysis of the subject, gathering information from various sources such as interviews, observations, and documents.

In a case study, researchers aim to understand the complexities and nuances of the subject under investigation. They explore the individual’s thoughts, feelings, behaviors, and experiences to gain insights into specific psychological phenomena. 

This type of research can provide great detail regarding a particular case, allowing researchers to examine rare or unique situations that may not be easily replicated in a laboratory setting. They offer a holistic view of the subject, considering various factors influencing their behavior or mental processes. 

By examining individual cases, researchers can generate hypotheses, develop theories, and contribute to the existing body of knowledge in psychology. Case studies are often utilized in clinical psychology, where they can provide valuable insights into the diagnosis, treatment, and outcomes of specific psychological disorders. 

Case studies offer a comprehensive and in-depth understanding of complex psychological phenomena, providing researchers with valuable information to inform theory, practice, and future research.

Table of Contents

Examples of Case Studies in Psychology

Case studies in psychology provide real-life examples that illustrate psychological concepts and theories. They offer a detailed analysis of specific individuals, groups, or situations, allowing researchers to understand psychological phenomena better. Here are a few examples of case studies in psychology: 

Phineas Gage

This famous case study explores the effects of a traumatic brain injury on personality and behavior. A railroad construction worker, Phineas Gage survived a severe brain injury that dramatically changed his personality.

This case study helped researchers understand the role of the frontal lobe in personality and social behavior. 

Little Albert

Conducted by behaviorist John B. Watson, the Little Albert case study aimed to demonstrate classical conditioning. In this study, a young boy named Albert was conditioned to fear a white rat by pairing it with a loud noise.

This case study provided insights into the process of fear conditioning and the impact of early experiences on behavior. 

Genie’s case study focused on a girl who experienced extreme social isolation and deprivation during her childhood. This study shed light on the critical period for language development and the effects of severe neglect on cognitive and social functioning. 

These case studies highlight the value of in-depth analysis and provide researchers with valuable insights into various psychological phenomena. By examining specific cases, psychologists can uncover unique aspects of human behavior and contribute to the field’s knowledge and understanding.

Types of Case Studies in Psychology

Psychology case studies come in various forms, each serving a specific purpose in research and analysis. Understanding the different types of case studies can help researchers choose the most appropriate approach. 

Descriptive Case Studies

These studies aim to describe a particular individual, group, or situation. Researchers use descriptive case studies to explore and document specific characteristics, behaviors, or experiences.

For example, a descriptive case study may examine the life and experiences of a person with a rare psychological disorder. 

Exploratory Case Studies

Exploratory case studies are conducted when there is limited existing knowledge or understanding of a particular phenomenon. Researchers use these studies to gather preliminary information and generate hypotheses for further investigation.

Exploratory case studies often involve in-depth interviews, observations, and analysis of existing data. 

Explanatory Case Studies

These studies aim to explain the causal relationship between variables or events. Researchers use these studies to understand why certain outcomes occur and to identify the underlying mechanisms or processes.

Explanatory case studies often involve comparing multiple cases to identify common patterns or factors. 

Instrumental Case Studies

Instrumental case studies focus on using a particular case to gain insights into a broader issue or theory. Researchers select cases that are representative or critical in understanding the phenomenon of interest.

Instrumental case studies help researchers develop or refine theories and contribute to the general knowledge in the field. 

By utilizing different types of case studies, psychologists can explore various aspects of human behavior and gain a deeper understanding of psychological phenomena. Each type of case study offers unique advantages and contributes to the overall body of knowledge in psychology.

How to Collect Data for a Case Study

There are a variety of ways that researchers gather the data they need for a case study. Some sources include:

• Directly observing the subject
• Collecting information from archival records
• Conducting interviews
• Examining artifacts related to the subject
• Examining documents that provide information about the subject

The way that this information is collected depends on the nature of the study itself

Prospective Research

In a prospective study, researchers observe the individual or group in question. These observations typically occur over a period of time and may be used to track the progress or progression of a phenomenon or treatment.

Retrospective Research

A retrospective case study involves looking back on a phenomenon. Researchers typically look at the outcome and then gather data to help them understand how the individual or group reached that point.

Benefits of a Case Study

Case studies offer several benefits in the field of psychology. They provide researchers with a unique opportunity to delve deep into specific individuals, groups, or situations, allowing for a comprehensive understanding of complex phenomena.

Case studies offer valuable insights that can inform theory development and practical applications by examining real-life examples. 

Complex Data

One of the key benefits of case studies is their ability to provide complex and detailed data. Researchers can gather in-depth information through various methods such as interviews, observations, and analysis of existing records.

This depth of data allows for a thorough exploration of the factors influencing behavior and the underlying mechanisms at play. 

Unique Data

Additionally, case studies allow researchers to study rare or unique cases that may not be easily replicated in experimental settings. This enables the examination of phenomena that are difficult to study through other psychology research methods . 

By focusing on specific cases, researchers can uncover patterns, identify causal relationships, and generate hypotheses for further investigation.

General Knowledge

Case studies can also contribute to the general knowledge of psychology by providing real-world examples that can be used to support or challenge existing theories. They offer a bridge between theory and practice, allowing researchers to apply theoretical concepts to real-life situations and vice versa. 

Case studies offer a range of benefits in psychology, including providing rich and detailed data, studying unique cases, and contributing to theory development. These benefits make case studies valuable in understanding human behavior and psychological phenomena.

Limitations of a Case Study

While case studies offer numerous benefits in the field of psychology, they also have certain limitations that researchers need to consider. Understanding these limitations is crucial for interpreting the findings and generalizing the results. 

Lack of Generalizability

One limitation of case studies is the issue of generalizability. Since case studies focus on specific individuals, groups, and situations, applying the findings to a larger population can be challenging. The unique characteristics and circumstances of the case may not be representative of the broader population, making it difficult to draw universal conclusions. 

Researcher bias is another possible limitation. The researcher’s subjective interpretation and personal beliefs can influence the data collection, analysis, and interpretation process. This bias can affect the objectivity and reliability of the findings, raising questions about the study’s validity. 

Case studies are often time-consuming and resource-intensive. They require extensive data collection, analysis, and interpretation, which can be lengthy. This can limit the number of cases that can be studied and may result in a smaller sample size, reducing the study’s statistical power. 

Case studies are retrospective in nature, relying on past events and experiences. This reliance on memory and self-reporting can introduce recall bias and inaccuracies in the data. Participants may forget or misinterpret certain details, leading to incomplete or unreliable information.

Despite these limitations, case studies remain a valuable research tool in psychology. By acknowledging and addressing these limitations, researchers can enhance the validity and reliability of their findings, contributing to a more comprehensive understanding of human behavior and psychological phenomena. 

While case studies have limitations, they remain valuable when researchers acknowledge and address these concerns, leading to more reliable and valid findings in psychology.

Alpi, K. M., & Evans, J. J. (2019). Distinguishing case study as a research method from case reports as a publication type. Journal of the Medical Library Association , 107(1). https://doi.org/10.5195/jmla.2019.615

Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A., & Sheikh, A. (2011). The case study approach. BMC Medical Research Methodology , 11(1), 100. https://doi.org/10.1186/1471-2288-11-100

Paparini, S., Green, J., Papoutsi, C., Murdoch, J., Petticrew, M., Greenhalgh, T., Hanckel, B., & Shaw, S. (2020). Case study research for better evaluations of complex interventions: Rationale and challenges. BMC Medicine , 18(1), 301. https://doi.org/10.1186/s12916-020-01777-6

Willemsen, J. (2023). What is preventing psychotherapy case studies from having a greater impact on evidence-based practice, and how to address the challenges? Frontiers in Psychiatry , 13, 1101090. https://doi.org/10.3389/fpsyt.2022.1101090

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

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The clinical case report: a review of its merits and limitations

Trygve nissen.

1 Department of Clinical Medicine, University of Tromsø, N-9038 Tromsø, Norway

2 Division of General Psychiatry, University Hospital of North Norway, N-9291 Tromsø, Norway

3 Division of Addictions and Specialized Psychiatry, University Hospital of North Norway, N-9291 Tromsø, Norway

The clinical case report has a long-standing tradition in the medical literature. While its scientific significance has become smaller as more advanced research methods have gained ground, case reports are still presented in many medical journals. Some scholars point to its limited value for medical progress, while others assert that the genre is undervalued. We aimed to present the various points of view regarding the merits and limitations of the case report genre. We searched Google Scholar, PubMed and select textbooks on epidemiology and medical research for articles and book-chapters discussing the merits and limitations of clinical case reports and case series.

The major merits of case reporting were these: Detecting novelties, generating hypotheses, pharmacovigilance, high applicability when other research designs are not possible to carry out, allowing emphasis on the narrative aspect (in-depth understanding), and educational value. The major limitations were: Lack of ability to generalize, no possibility to establish cause-effect relationship, danger of over-interpretation, publication bias, retrospective design, and distraction of reader when focusing on the unusual.

Conclusions

Despite having lost its central role in medical literature in the 20th century, the genre still appears popular. It is a valuable part of the various research methods, especially since it complements other approaches. Furthermore, it also contributes in areas of medicine that are not specifically research-related, e.g. as an educational tool. Revision of the case report genre has been attempted in order to integrate the biomedical model with the narrative approach, but without significant success. The future prospects of the case report could possibly be in new applications of the genre, i.e. exclusive case report databases available online, and open access for clinicians and researchers.

Throughout history the clinical case report and case report series have been integral components of medical literature [ 1 ]. The case report genre held a strong position until it was sidelined in the second half of the 20 th century [ 2 , 3 ]. New methodologies for research articles paved the way for evidence-based medicine. Editors had to make space for these research articles and at the same time signaled less enthusiasm for publishing case reports [ 4 ]. This spurred some heated debates in medical journals as readers were worried that the traditional case report was in jeopardy [ 5 , 6 ]. Those who welcomed the new trend with fewer case reports being published pointed mainly to their low quality and inclination to emphasize mere curiosa [ 7 - 9 ]. Some of the proponents of the genre claimed that the case report had been and still was indispensible for furthering medical knowledge and that it was unique in taking care of the detailed study of the individual patient as opposed to the new research methods with their “…nomothetic approach [taking] precedence…” [ 5 ]. Still, the case report got a low ranking on the evidence hierarchy. After a decline in popularity a new interest for the case report emerged, probably beginning in the late 1990s [ 2 ]. A peer-reviewed ‘Case reports’ section was introduced in the Lancet in 1995 [ 10 ]. In 2007, the first international, Pubmed-listed medical journal publishing only case reports was established [ 11 , 12 ]. In the following years, several similar journals, for the most part online and open-access, have been launched.

The present debate is not so much focused on whether case reporting is obsolete or not. Some of the discussions after the turn of the century have been about adapting the case report genre to new challenges. One example is the suggestion of incorporating the narrative, i.e. “… stressing the patient’s story”, in the case report [ 13 ]. The authors termed their initiative “The storied case report”. Their endeavor was not met with success. In analyzing the causes for this, they wondered if “… junior trainees find it too hard to determine what is relevant and senior trainees find it too hard to change their habits” [ 13 ]. A similar attempt was done when the editors of the Journal of Medical Case Reports in 2012 encouraged authors to include the patients’ perspectives by letting patients describe their own experiences [ 14 ].

Notwithstanding, we feel there is much to be gained from having an ongoing discussion highlighting the indications and contraindications for producing case reports. This can to some degree be facilitated by getting an understanding of the merits and limitations of the genre. The objective of this article is to present the merits and limitations of case reports and case series reports.

We adopted Taber’s Cyclopedic Medical Dictionary’s definition of the case report : “A formal summary of a unique patient and his or her illness, including the presenting signs and symptoms, diagnostic studies, treatment course and outcome” [ 15 ]. A case report consists of one or two cases, most often only one. The case series or case series report usually consists of three to ten cases [ 16 ]. (In the following we use the term case report to denote both case reports and case series report). Case reports are most often naturalistic and descriptive. Sometimes, however, they can be prospective and experimental.

As literature specifically dealing with the case report genre seemed harder to elicit from the databases than the vast amount of particular case reports, we performed iterative searches. We searched Google Scholar and PubMed using the search terms ‘case report(s)’, ‘case series’, ‘case series report(s)’, ‘case reporting’ in various combinations with ‘clinical’, ‘medical’, ‘anecdotal’, ‘methodology’, ‘review’, ‘overview’, ‘strengths’, ‘weaknesses’, ‘merits’, and ‘limitations’. Further references were identified by examining the literature found in the electronic searches. We also consulted major textbooks on epidemiology [ 17 , 18 ], some scholars of medical genres [ 19 , 20 ] and a monograph on case reporting by the epidemiologist M. Jenicek [ 16 ]. We delimited our review to the retrospective, naturalistic, and descriptive case report, also labeled the “traditional” or “classic” case report, and case series including such reports. Thus we excluded other types, such as the planned, qualitative case study approach [ 21 ] and simulated cases [ 22 - 24 ]. Finally, we extracted the relevant data and grouped the merits and limitations items in rank order with the items we judged to be the most important first.

New observations

The major advantage of case reporting is probably its ability to detect novelties [ 16 ]. It is the only way to present unusual, uncontrolled observations regarding symptoms, clinical findings, course of illness, complications of interventions, associations of diseases, side effects of drugs, etc. In short, anything that is rare or has never been observed previously might be important for the medical community and ought to be published. A case report might sensitize readers and thus facilitate detection of similar or identical cases.

Generating hypotheses

From a single, or preferably several single case reports or a case series, new hypotheses could be formulated. These could then be tested with formal research methods that are designed to refute or confirm the hypotheses, i.e. comparative (observational and experimental) studies.

There are numerous examples of new discoveries or major advancements in medicine that started with a case report or, in some cases, as humbly as a letter to the editor. The first concern from the medical community about the devastating side effect of thalidomide, i.e. the congenital abnormalities, appeared as a letter to the editor in the Lancet in 1961 [ 25 ]. Soon thereafter, several case reports and case series reports were published in various journals. Case reporting is thus indispensable in drug safety surveillance (pharmacovigilance) [ 26 ].

Sometimes significant advancements in knowledge have come not from what researchers were pursuing, but from “accidental discoveries”, i.e. by serendipity. The story of Alexander Fleming’s discovery of penicillin in 1928 is well known in the medical field [ 27 ]. Psychiatry has profited to a large degree from this mode of advancing medical science as many of the drugs used for mental disorders have been discovered serendipitously [ 27 ]. One notable example is the discovery of the effect of lithium on manic episodes in patients with manic-depressive disorder [ 28 ]. A more recent discovery is the successful treatment of infantile hemangiomas with systemic propranolol. This discovery was published, as a case series report, in the correspondence section in New England Journal of Medicine [ 29 ]. However, the evidence for the effect of this treatment is still preliminary, and several randomized trials are under way [ 30 , 31 ].

Clear and operational entities are prerequisites for doing medical research. Descriptions must come before understanding. Clinical observations that lead to new disorders being described are well suited for case reporting. The medical literature is replete with case-based articles describing new diseases and syndromes. One notable example is the first description of neurasthenia by G. Beard in Boston Medical and Surgical Journal in 1869 [ 32 ].

Researching rare disorders

For rare disorders randomized controlled trials (RCTs) can be impossible to run due to lack of patients to be enrolled. Research on drug treatment and other kinds of interventions must therefore be based on less rigorous methodologies, among them case series and case reports. This would be in accordance with the European Commission’s recommendation to its members to improve health care for those with rare disorders [ 33 ].

Solving ethical constraints

Case reporting can be valuable when ethical constraints prohibit experimental research. Take as an example the challenge of how to manage the side effects of accidental extravasation of cytotoxic drugs. As RCTs on humans seem unethical in this clinical situation the current guidelines rest on small observational studies, case reports and animal studies [ 34 ]. Or another example: Physical restraint is sometimes associated with sudden, unexpected death. The cause or causes for this are to some degree enigmatic, and it is hard to conceive of a controlled study that could be ethical [ 35 , 36 ]. Case reports and case series being “natural experiments” might be the only evidence available for guiding clinical practice.

In-depth narrative case studies

Case reporting can be a way of presenting research with an idiographic emphasis. As contrasted to nomothetic research, an idiographic approach aims at in-depth understanding of human phenomena, especially in the field of psychology and psychiatry. The objective is not generalizable knowledge, but an understanding of meaning and intentionality for an individual or individuals. Sigmund Freud’s case studies are relevant examples. This usage of case reports borders on qualitative research. Qualitative studies, although developed in the social sciences, have become a welcome contribution within health sciences in the last two decades.

Educational value

Clinical medical learning is to a large degree case-based. Typical case histories and vignettes are often presented in textbooks, in lectures, etc. Unusual observations presented as published case reports are important as part of doctors’ continuing medical education, especially as they demonstrate the diversity of manifestations both within and between medical diseases and syndromes [ 37 , 38 ]. Among the various medical texts, the case report is the only one that presents day-to-day clinical practice, clinicians’ diagnostic reasoning, disease management, and follow-up. We believe that some case reports that are written with the aim of contributing to medical knowledge turn out to be of most value educationally because the phenomena have already been described elsewhere. Other case reports are clearly primarily written for educational value [ 37 ]. Some journals have regular sections dedicated to educational case reports, e.g. The Case Records of the Massachusetts General Hospital in the New England Journal of Medicine and the Clinical Case Conference found in the American Journal of Psychiatry.

The cost of doing a case report is low compared to planned, formal studies. Most often the necessary work is probably done in the clinical setting without specific funding. Larger studies, for instance RCTs, will usually need an academic setting.

Fast publication

The time span from observation to publication can be much shorter than for other kinds of studies. This is obviously a great advantage as a case report can be an important alert to the medical community about a serious event. The unexpected side effects of the sedative-antinauseant thalidomide on newborn babies is a telling story. The drug had been prescribed during pregnancy to the babies’ mothers. After the first published observation of severe abnormalities in babies appeared as a letter to the editor of the Lancet in December 16 th , 1961 [ 25 ], several case reports and series followed [ 39 , 40 ]. It should be mentioned though that the drug company had announced on December 2 nd , 1961, i.e. two weeks before the letter from McBride [ 25 ], that it would withdraw the drug form the market immediately [ 41 ].

Flexible structure

Riaz Agha, editor of the International Journal of Surgery Case Reports suggests that the case report, with its less rigid structure is useful as it “… allows the surgeon(s) to discuss their diagnostic approach, the context, background, decision-making, reasoning and outcomes” [ 42 ]. Although the editor is commenting on the surgical case report, the argument can be applied for the whole field of clinical medicine. It should be mentioned though, that other commentators have argued for a more standardized, in effect more rigid, structure [ 43 ].

Clinical practice can be changed

Case reporting can lead to or contribute to a change in clinical practice. A drug might be withdrawn from the market. Or a relabeling might change the attitude to and treatment of a condition. During Word War I the shell shock syndrome was labeled and described thoroughly in several articles in the Lancet , the first of them appearing in February 1915 [ 44 ]. The author was the British captain and military doctor Charles S. Myers. Before his efforts to bring good care and treatment to afflicted soldiers there had been a common misconception that many of these dysfunctional soldiers were malingerers or cowards.

Exercise for novice researchers

The case report format is well suited for young doctors not yet trained as researchers. It can be an opportunity for a first exercise in authoring an article and a preparation for a scientific career [ 37 , 45 , 46 ].

Communication between the clinical and academic fields

Articles authored by clinicians can promote communication between practicing clinicians and academic researchers. Observations published can generate ideas and be a trigger for further studies. For instance, a case series consisting of several similar cases in a short period can make up the case-group for a case–control study [ 47 ]. Clinicians could do the observation and publish the case series while the case–control study could be left to the academics.

Entertainment

Some commentators find reading case reports fun. Although a rather weak argument in favor of case reporting, the value of being entertained should not be dismissed altogether. It might inspire physicians to spend more time browsing and reading scientific literature [ 48 ].

Studying the history of medicine

Finally, we present a note on a different and unintended aspect of the genre. The accumulated case reports from past eras are a rich resource for researching and understanding medical history [ 49 , 50 ]. A close study of old case reports can provide valuable information about how medicine has been practiced through the centuries [ 50 , 51 ].

Limitations

No epidemiological quantities.

As case reports are not chosen from representative population samples they cannot generate information on rates, ratios, incidences or prevalences. The case or cases being the numerator in the equation, has no denominator. However, if a case series report consists of a cluster of cases, it can signal an important and possibly causal association, e.g. an epidemic or a side effect of a newly marketed drug.

Causal inference not possible

Causality cannot be inferred from an uncontrolled observation. An association does not imply a cause-effect relationship. The observation or event in question could be a mere coincidence. This is a limitation shared by all the descriptive studies [ 47 ]. Take the thalidomide tragedy already mentioned as an example; Unusual events such as congenital malformations in some of the children born to mothers having taken a specific drug during pregnancy does not prove that the drug is the culprit. It is a mere hypothesis until further studies have either rejected or confirmed it. Cause-effect relationships require planned studies including control groups that to the extent possible control for chance, bias and confounders [ 52 ].

Generalization not possible

From the argument above, it follows that findings from case reports cannot be generalized. In order to generalize we need both a cause-effect relationship and a representative population for which the findings are valid. A single case report has neither. A case series, on the other hand, e.g. many “thalidomide babies” in a short time period, could strengthen the suspicion of a causal relationship, demanding further surveillance and research.

Publication bias could be a limiting factor. Journals in general favor positive-outcome findings [ 53 ]. One group of investigators studying case reports published in the Lancet found that only 5% of case reports and 10% of case series reported treatment failures [ 54 ]. A study of 435 case reports from the field of dentistry found that in 99.1%, the reports “…clearly [had] a positive outcome and the intervention was considered and described as successful by the authors” [ 55 ].

Overinterpretation

Overinterpretation or misinterpretation is the tendency or temptation to generalize when there is no justification for it. It has also been labeled “the anecdotal fallacy” [ 56 ]. This is not a shortcoming intrinsic to the method itself. Overinterpretation may be due to the phenomenon of case reports often having an emotional appeal on readers. The story implicitly makes a claim to truth. The reader might conclude prematurely that there is a causal connection. The phenomenon might be more clearly illustrated by the impact of the clinician’s load of personal cases on his or her practice. Here exemplified by a young doctor’s confession: “I often tell residents and medical students, ‘The only thing that actually changes practice is adverse anecdote.’” [ 57 ].

Emphasis on the rare

As case reporting often deals with the rare and atypical, it might divert the readers’ attention from common diseases and problems [ 58 ].

Confidentiality

Journals today require written informed consent from patients before publishing case reports. Both authors and publishers are responsible for securing confidentiality. A guarantee for full confidentiality is not always possible. Despite all possible measures taken to preserve confidentiality, sometimes the patient will be recognized by someone. This information should be given to the patient. An adequately informed patient might not consent to publication. In 1995 in an Editorial in the British Journal of Psychiatry one commentator, Isaac Marks, feared that written consent would discourage case reports being written [ 59 ]. Fortunately, judged form the large number of reports being published today, it seems unlikely that the demand for consent has impeded their publication.

Other methodological limitations

Case reports and series are written after the relevant event, i.e. the observation. Thus, the reports are produced retrospectively. The medical record might not contain all relevant data. Recall bias might prevent us from getting the necessary information from the patient or other informants such as family members and health professionals.

It has also been held against case reporting that it is subjective. The observer’s subjectivity might bias the quality and interpretation of the observation (i.e. information bias).

Finally, the falsification criterion within science, which is tested by repeating an experiment, cannot be applied for case reports. We cannot design another identical and uncontrolled observation. However, unplanned similar “experiments” of nature can be repeated. Several such observations can constitute a case series that represents stronger indicative evidence than the single case report.

The major advantages of case reporting are the ability to make new observations, generate hypotheses, accumulate scientific data about rare disorders, do in-depth narrative studies, and serve as a major educational tool. The method is deficient mainly in being unable to deliver quantitative data. Nor can it prove cause-effect relationship or allow generalizations. Furthermore, there is a risk of overinterpretation and publication bias.

The traditional case report does not fit easily into the qualitative-quantitative dichotomy of research methods. It certainly shares some characteristics with qualitative research [ 16 ], especially with regard to the idiographic, narrative perspective – the patient’s “interior world” [ 60 ] – that sometimes is attended to. Apart from “The storied case report” mentioned in the Background-section, other innovative modifications of the traditional case report have been tried: the “evidence-based case report” [ 61 ], the “interactive case report” [ 62 ] and the “integrated narrative and evidence based case report” [ 63 ]. These modifications of the format have not made a lasting impact on the way case reports in general are written today.

The method of case reporting is briefly dealt with in some textbooks on epidemiology [ 17 , 18 ]. Journals that welcome case reports often put more emphasis on style and design than on content in their ‘instruction to authors’ section [ 64 ]. As a consequence, Sorinola and coworkers argue for more consensus and more consistent guidance on writing case reports [ 64 ]. We feel that a satisfactory amount of guidance concerning both style and content now exists [ 12 , 16 , 65 , 66 ]. The latest contribution, “The CARE guidelines”, is an ambitious endeavor to improve completeness and transparency of reports [ 66 ]. These guidelines have included the “Patient perspective” as an item, apparently a bit half-heartedly as this item is placed after the Discussion section, thus not allowing this perspective to influence the Discussion and/or Conclusion section. We assume this is symptomatic of medicine’s problem with integrating the biomedical model with “narrative-based medicine”.

In recent years the medical community has taken an increased interest in case reports [ 2 ], especially after the surge of online, exclusive case report journals started in 2007 with the Journal of Medical Case Reports (which was the first international, Pubmed-listed medical journal publishing only case reports) as the first of this new brand. The climate of skepticism has been replaced by enthusiasm and demand for more case reports. A registry for case reports, Cases Database, was founded in 2012 [ 67 ]. On the condition that it succeeds in becoming a large, international database it could serve as a register being useful for clinicians at work as well as for medical research on various clinical issues. Assuming Pamela P. Powell’s assertion that “[a]lmost all practicing physicians eventually will encounter a case worthy of being reported” [ 60 ] is valid, there should be no shortage of potential cases waiting to be reported and filed in various databases, preferably online and open access.

Limitations of this review

There are several limitations to this study. It is a weakness that we have not been able to review all the relevant literature. The number of publications in some way related to case reports and case report series is enormous, and although we have attempted to identify those publications relevant for our purpose (i.e. those that describe the merits and limitations of the case report genre), we might have missed some. It was difficult to find good search terms for our objective. Still, after repeated electronic searches supplemented with manual searches in reference lists, we had a corpus of literature where essentially no new merits or limitations emerged.

As we point out above, the ranking of merits and limitations represents our subjective opinion and we acknowledge that others might rank the importance of the items differently.

The perspective on merits and limitations of case reporting has been strictly medical. As a consequence we have not analyzed or discussed the various non-medical factors affecting the publication of case reports in different medical journals [ 2 ]. For instance, case reports are cited less often than other kinds of medical research articles [ 68 ]. Thus they can lower a journal’s impact factor, potentially making the journal less attractive. This might lead some high-impact journals to publish few or no case reports, while other journals have chosen to specialize in this genre.

Before deciding on producing a case report or case series based on a particular patient or patients at hand, the observant clinician has to determine if the case report method is the appropriate article type. This review could hopefully assist in that judgment and perhaps be a stimulus to the continuing debate in the medical community on the value of case reporting.

Competing interests

The authors declare that there are no competing interests.

Authors’ contributions

TN contributed to the conception, drafting, and revision of the article. RW contributed to the conception, drafting, and revision of the article. Both authors approved the final manuscript.

Acknowledgements

There was no specific funding for this study.

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Research Methods In Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

Learn about our Editorial Process

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

Research methods in psychology are systematic procedures used to observe, describe, predict, and explain behavior and mental processes. They include experiments, surveys, case studies, and naturalistic observations, ensuring data collection is objective and reliable to understand and explain psychological phenomena.

Hypotheses are statements about the prediction of the results, that can be verified or disproved by some investigation.

There are four types of hypotheses :

• Null Hypotheses (H0 ) – these predict that no difference will be found in the results between the conditions. Typically these are written ‘There will be no difference…’
• Alternative Hypotheses (Ha or H1) – these predict that there will be a significant difference in the results between the two conditions. This is also known as the experimental hypothesis.
• One-tailed (directional) hypotheses – these state the specific direction the researcher expects the results to move in, e.g. higher, lower, more, less. In a correlation study, the predicted direction of the correlation can be either positive or negative.
• Two-tailed (non-directional) hypotheses – these state that a difference will be found between the conditions of the independent variable but does not state the direction of a difference or relationship. Typically these are always written ‘There will be a difference ….’

All research has an alternative hypothesis (either a one-tailed or two-tailed) and a corresponding null hypothesis.

Once the research is conducted and results are found, psychologists must accept one hypothesis and reject the other. 

So, if a difference is found, the Psychologist would accept the alternative hypothesis and reject the null.  The opposite applies if no difference is found.

Sampling techniques

Sampling is the process of selecting a representative group from the population under study.

A sample is the participants you select from a target population (the group you are interested in) to make generalizations about.

Representative means the extent to which a sample mirrors a researcher’s target population and reflects its characteristics.

Generalisability means the extent to which their findings can be applied to the larger population of which their sample was a part.

• Volunteer sample : where participants pick themselves through newspaper adverts, noticeboards or online.
• Opportunity sampling : also known as convenience sampling , uses people who are available at the time the study is carried out and willing to take part. It is based on convenience.
• Random sampling : when every person in the target population has an equal chance of being selected. An example of random sampling would be picking names out of a hat.
• Systematic sampling : when a system is used to select participants. Picking every Nth person from all possible participants. N = the number of people in the research population / the number of people needed for the sample.
• Stratified sampling : when you identify the subgroups and select participants in proportion to their occurrences.
• Snowball sampling : when researchers find a few participants, and then ask them to find participants themselves and so on.
• Quota sampling : when researchers will be told to ensure the sample fits certain quotas, for example they might be told to find 90 participants, with 30 of them being unemployed.

Experiments always have an independent and dependent variable .

• The independent variable is the one the experimenter manipulates (the thing that changes between the conditions the participants are placed into). It is assumed to have a direct effect on the dependent variable.
• The dependent variable is the thing being measured, or the results of the experiment.

Operationalization of variables means making them measurable/quantifiable. We must use operationalization to ensure that variables are in a form that can be easily tested.

For instance, we can’t really measure ‘happiness’, but we can measure how many times a person smiles within a two-hour period. 

By operationalizing variables, we make it easy for someone else to replicate our research. Remember, this is important because we can check if our findings are reliable.

Extraneous variables are all variables which are not independent variable but could affect the results of the experiment.

It can be a natural characteristic of the participant, such as intelligence levels, gender, or age for example, or it could be a situational feature of the environment such as lighting or noise.

Demand characteristics are a type of extraneous variable that occurs if the participants work out the aims of the research study, they may begin to behave in a certain way.

For example, in Milgram’s research , critics argued that participants worked out that the shocks were not real and they administered them as they thought this was what was required of them. 

Extraneous variables must be controlled so that they do not affect (confound) the results.

Randomly allocating participants to their conditions or using a matched pairs experimental design can help to reduce participant variables. 

Situational variables are controlled by using standardized procedures, ensuring every participant in a given condition is treated in the same way

Experimental Design

Experimental design refers to how participants are allocated to each condition of the independent variable, such as a control or experimental group.

• Independent design ( between-groups design ): each participant is selected for only one group. With the independent design, the most common way of deciding which participants go into which group is by means of randomization. 
• Matched participants design : each participant is selected for only one group, but the participants in the two groups are matched for some relevant factor or factors (e.g. ability; sex; age).
• Repeated measures design ( within groups) : each participant appears in both groups, so that there are exactly the same participants in each group.
• The main problem with the repeated measures design is that there may well be order effects. Their experiences during the experiment may change the participants in various ways.
• They may perform better when they appear in the second group because they have gained useful information about the experiment or about the task. On the other hand, they may perform less well on the second occasion because of tiredness or boredom.
• Counterbalancing is the best way of preventing order effects from disrupting the findings of an experiment, and involves ensuring that each condition is equally likely to be used first and second by the participants.

If we wish to compare two groups with respect to a given independent variable, it is essential to make sure that the two groups do not differ in any other important way. 

Experimental Methods

All experimental methods involve an iv (independent variable) and dv (dependent variable)..

• Field experiments are conducted in the everyday (natural) environment of the participants. The experimenter still manipulates the IV, but in a real-life setting. It may be possible to control extraneous variables, though such control is more difficult than in a lab experiment.
• Natural experiments are when a naturally occurring IV is investigated that isn’t deliberately manipulated, it exists anyway. Participants are not randomly allocated, and the natural event may only occur rarely.

Case studies are in-depth investigations of a person, group, event, or community. It uses information from a range of sources, such as from the person concerned and also from their family and friends.

Many techniques may be used such as interviews, psychological tests, observations and experiments. Case studies are generally longitudinal: in other words, they follow the individual or group over an extended period of time. 

Case studies are widely used in psychology and among the best-known ones carried out were by Sigmund Freud . He conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

Case studies provide rich qualitative data and have high levels of ecological validity. However, it is difficult to generalize from individual cases as each one has unique characteristics.

Correlational Studies

Correlation means association; it is a measure of the extent to which two variables are related. One of the variables can be regarded as the predictor variable with the other one as the outcome variable.

Correlational studies typically involve obtaining two different measures from a group of participants, and then assessing the degree of association between the measures. 

The predictor variable can be seen as occurring before the outcome variable in some sense. It is called the predictor variable, because it forms the basis for predicting the value of the outcome variable.

Relationships between variables can be displayed on a graph or as a numerical score called a correlation coefficient.

• If an increase in one variable tends to be associated with an increase in the other, then this is known as a positive correlation .
• If an increase in one variable tends to be associated with a decrease in the other, then this is known as a negative correlation .
• A zero correlation occurs when there is no relationship between variables.

After looking at the scattergraph, if we want to be sure that a significant relationship does exist between the two variables, a statistical test of correlation can be conducted, such as Spearman’s rho.

The test will give us a score, called a correlation coefficient . This is a value between 0 and 1, and the closer to 1 the score is, the stronger the relationship between the variables. This value can be both positive e.g. 0.63, or negative -0.63.

A correlation between variables, however, does not automatically mean that the change in one variable is the cause of the change in the values of the other variable. A correlation only shows if there is a relationship between variables.

Correlation does not always prove causation, as a third variable may be involved. 

Interview Methods

Interviews are commonly divided into two types: structured and unstructured.

A fixed, predetermined set of questions is put to every participant in the same order and in the same way. 

Responses are recorded on a questionnaire, and the researcher presets the order and wording of questions, and sometimes the range of alternative answers.

The interviewer stays within their role and maintains social distance from the interviewee.

There are no set questions, and the participant can raise whatever topics he/she feels are relevant and ask them in their own way. Questions are posed about participants’ answers to the subject

Unstructured interviews are most useful in qualitative research to analyze attitudes and values.

Though they rarely provide a valid basis for generalization, their main advantage is that they enable the researcher to probe social actors’ subjective point of view. 

Questionnaire Method

Questionnaires can be thought of as a kind of written interview. They can be carried out face to face, by telephone, or post.

The choice of questions is important because of the need to avoid bias or ambiguity in the questions, ‘leading’ the respondent or causing offense.

• Open questions are designed to encourage a full, meaningful answer using the subject’s own knowledge and feelings. They provide insights into feelings, opinions, and understanding. Example: “How do you feel about that situation?”
• Closed questions can be answered with a simple “yes” or “no” or specific information, limiting the depth of response. They are useful for gathering specific facts or confirming details. Example: “Do you feel anxious in crowds?”

Its other practical advantages are that it is cheaper than face-to-face interviews and can be used to contact many respondents scattered over a wide area relatively quickly.

Observations

There are different types of observation methods :

• Covert observation is where the researcher doesn’t tell the participants they are being observed until after the study is complete. There could be ethical problems or deception and consent with this particular observation method.
• Overt observation is where a researcher tells the participants they are being observed and what they are being observed for.
• Controlled : behavior is observed under controlled laboratory conditions (e.g., Bandura’s Bobo doll study).
• Natural : Here, spontaneous behavior is recorded in a natural setting.
• Participant : Here, the observer has direct contact with the group of people they are observing. The researcher becomes a member of the group they are researching.  
• Non-participant (aka “fly on the wall): The researcher does not have direct contact with the people being observed. The observation of participants’ behavior is from a distance

Pilot Study

A pilot  study is a small scale preliminary study conducted in order to evaluate the feasibility of the key s teps in a future, full-scale project.

A pilot study is an initial run-through of the procedures to be used in an investigation; it involves selecting a few people and trying out the study on them. It is possible to save time, and in some cases, money, by identifying any flaws in the procedures designed by the researcher.

A pilot study can help the researcher spot any ambiguities (i.e. unusual things) or confusion in the information given to participants or problems with the task devised.

Sometimes the task is too hard, and the researcher may get a floor effect, because none of the participants can score at all or can complete the task – all performances are low.

The opposite effect is a ceiling effect, when the task is so easy that all achieve virtually full marks or top performances and are “hitting the ceiling”.

Research Design

In cross-sectional research , a researcher compares multiple segments of the population at the same time

Sometimes, we want to see how people change over time, as in studies of human development and lifespan. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time.

In cohort studies , the participants must share a common factor or characteristic such as age, demographic, or occupation. A cohort study is a type of longitudinal study in which researchers monitor and observe a chosen population over an extended period.

Triangulation means using more than one research method to improve the study’s validity.

Reliability

Reliability is a measure of consistency, if a particular measurement is repeated and the same result is obtained then it is described as being reliable.

• Test-retest reliability :  assessing the same person on two different occasions which shows the extent to which the test produces the same answers.
• Inter-observer reliability : the extent to which there is an agreement between two or more observers.

Meta-Analysis

A meta-analysis is a systematic review that involves identifying an aim and then searching for research studies that have addressed similar aims/hypotheses.

This is done by looking through various databases, and then decisions are made about what studies are to be included/excluded.

Strengths: Increases the conclusions’ validity as they’re based on a wider range.

Weaknesses: Research designs in studies can vary, so they are not truly comparable.

Peer Review

A researcher submits an article to a journal. The choice of the journal may be determined by the journal’s audience or prestige.

The journal selects two or more appropriate experts (psychologists working in a similar field) to peer review the article without payment. The peer reviewers assess: the methods and designs used, originality of the findings, the validity of the original research findings and its content, structure and language.

Feedback from the reviewer determines whether the article is accepted. The article may be: Accepted as it is, accepted with revisions, sent back to the author to revise and re-submit or rejected without the possibility of submission.

The editor makes the final decision whether to accept or reject the research report based on the reviewers comments/ recommendations.

Peer review is important because it prevent faulty data from entering the public domain, it provides a way of checking the validity of findings and the quality of the methodology and is used to assess the research rating of university departments.

Peer reviews may be an ideal, whereas in practice there are lots of problems. For example, it slows publication down and may prevent unusual, new work being published. Some reviewers might use it as an opportunity to prevent competing researchers from publishing work.

Some people doubt whether peer review can really prevent the publication of fraudulent research.

The advent of the internet means that a lot of research and academic comment is being published without official peer reviews than before, though systems are evolving on the internet where everyone really has a chance to offer their opinions and police the quality of research.

Types of Data

• Quantitative data is numerical data e.g. reaction time or number of mistakes. It represents how much or how long, how many there are of something. A tally of behavioral categories and closed questions in a questionnaire collect quantitative data.
• Qualitative data is virtually any type of information that can be observed and recorded that is not numerical in nature and can be in the form of written or verbal communication. Open questions in questionnaires and accounts from observational studies collect qualitative data.
• Primary data is first-hand data collected for the purpose of the investigation.
• Secondary data is information that has been collected by someone other than the person who is conducting the research e.g. taken from journals, books or articles.

Validity means how well a piece of research actually measures what it sets out to, or how well it reflects the reality it claims to represent.

Validity is whether the observed effect is genuine and represents what is actually out there in the world.

• Concurrent validity is the extent to which a psychological measure relates to an existing similar measure and obtains close results. For example, a new intelligence test compared to an established test.
• Face validity : does the test measure what it’s supposed to measure ‘on the face of it’. This is done by ‘eyeballing’ the measuring or by passing it to an expert to check.
• Ecological validit y is the extent to which findings from a research study can be generalized to other settings / real life.
• Temporal validity is the extent to which findings from a research study can be generalized to other historical times.

Features of Science

• Paradigm – A set of shared assumptions and agreed methods within a scientific discipline.
• Paradigm shift – The result of the scientific revolution: a significant change in the dominant unifying theory within a scientific discipline.
• Objectivity – When all sources of personal bias are minimised so not to distort or influence the research process.
• Empirical method – Scientific approaches that are based on the gathering of evidence through direct observation and experience.
• Replicability – The extent to which scientific procedures and findings can be repeated by other researchers.
• Falsifiability – The principle that a theory cannot be considered scientific unless it admits the possibility of being proved untrue.

Statistical Testing

A significant result is one where there is a low probability that chance factors were responsible for any observed difference, correlation, or association in the variables tested.

If our test is significant, we can reject our null hypothesis and accept our alternative hypothesis.

If our test is not significant, we can accept our null hypothesis and reject our alternative hypothesis. A null hypothesis is a statement of no effect.

In Psychology, we use p < 0.05 (as it strikes a balance between making a type I and II error) but p < 0.01 is used in tests that could cause harm like introducing a new drug.

A type I error is when the null hypothesis is rejected when it should have been accepted (happens when a lenient significance level is used, an error of optimism).

A type II error is when the null hypothesis is accepted when it should have been rejected (happens when a stringent significance level is used, an error of pessimism).

Ethical Issues

• Informed consent is when participants are able to make an informed judgment about whether to take part. It causes them to guess the aims of the study and change their behavior.
• To deal with it, we can gain presumptive consent or ask them to formally indicate their agreement to participate but it may invalidate the purpose of the study and it is not guaranteed that the participants would understand.
• Deception should only be used when it is approved by an ethics committee, as it involves deliberately misleading or withholding information. Participants should be fully debriefed after the study but debriefing can’t turn the clock back.
• All participants should be informed at the beginning that they have the right to withdraw if they ever feel distressed or uncomfortable.
• It causes bias as the ones that stayed are obedient and some may not withdraw as they may have been given incentives or feel like they’re spoiling the study. Researchers can offer the right to withdraw data after participation.
• Participants should all have protection from harm . The researcher should avoid risks greater than those experienced in everyday life and they should stop the study if any harm is suspected. However, the harm may not be apparent at the time of the study.
• Confidentiality concerns the communication of personal information. The researchers should not record any names but use numbers or false names though it may not be possible as it is sometimes possible to work out who the researchers were.

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• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

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In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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What Is A Case Study In Psychology?

When people think about psychology studies, they are most likely to think about studies involving several participants split across a number of experimental and control groups. Studies like this are a good way to investigate the effect of a certain treatment or activity, but they are not always the best option. For example, if a scientist is interested in a specific rare disease, they cannot always find enough people with that disease to participate in a useful study. Similarly, one cannot give a group of participants a rare disease (for obvious reasons) and compare them to a group of participants without that disease. For situations like this, there are case studies.

What is a case study?

A case study is, as the name suggests, a study of a single case. For example, if someone has an extremely rare disease, a group of scientists might conduct a case study of that disease rather than attempting to set up an experimental study. In that case study, the researchers might test the effectiveness of a certain drug in treating that disease and carefully document the response of that participant over time.

Of course, the results seen in that one participant will not necessarily apply to all people with that rare disease. However, if the case study shows promising results, that treatment can then be tested in a larger experimental study. If it does not, it indicates that the treatment is not necessarily effective, at least in people that are similar to the original participant in the case study.

Why are case studies useful in psychology?

When people are still learning about psychology, they might think that group studies showing group effects are always better than individual studies showing individual effects. Of course, there is some truth to this notion, as results obtained from a large number of people are likely to be more generalizable than results obtained from a single person. However, this does not mean that we should discount the importance of individual effects.

Consider the following: In studies looking solely at group effects, individual effects can be masked. In other words, certain statistical quirks can lead to the appearance of a group effect despite the fact that no single individual showed that effect. While this is rare, it is possible. For this reason, it is important to consider individual effects. That is why, even in experimental studies examining groups, it can be useful to examine individual effects within that group. This underlines the value of case studies.

Wrapping up

At the end of the day, there are many good reasons that experimental studies examining groups are the most common types of psychological studies. However, case studies are also extremely valuable, particularly when group experiments are less feasible. Just as psychology is a large topic encompassing a wide variety of factors, both case studies and experimental group studies should be used in the larger overall strategy of psychology research.

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Case Study Method – 18 Advantages and Disadvantages

The case study method uses investigatory research as a way to collect data about specific demographics. This approach can apply to individuals, businesses, groups, or events. Each participant receives an equal amount of participation, offering information for collection that can then find new insights into specific trends, ideas, of hypotheses.

Interviews and research observation are the two standard methods of data collection used when following the case study method.

Researchers initially developed the case study method to develop and support hypotheses in clinical medicine. The benefits found in these efforts led the approach to transition to other industries, allowing for the examination of results through proposed decisions, processes, or outcomes. Its unique approach to information makes it possible for others to glean specific points of wisdom that encourage growth.

Several case study method advantages and disadvantages can appear when researchers take this approach.

List of the Advantages of the Case Study Method

1. It requires an intensive study of a specific unit. Researchers must document verifiable data from direct observations when using the case study method. This work offers information about the input processes that go into the hypothesis under consideration. A casual approach to data-gathering work is not effective if a definitive outcome is desired. Each behavior, choice, or comment is a critical component that can verify or dispute the ideas being considered.

Intensive programs can require a significant amount of work for researchers, but it can also promote an improvement in the data collected. That means a hypothesis can receive immediate verification in some situations.

2. No sampling is required when following the case study method. This research method studies social units in their entire perspective instead of pulling individual data points out to analyze them. That means there is no sampling work required when using the case study method. The hypothesis under consideration receives support because it works to turn opinions into facts, verifying or denying the proposals that outside observers can use in the future.

Although researchers might pay attention to specific incidents or outcomes based on generalized behaviors or ideas, the study itself won’t sample those situations. It takes a look at the “bigger vision” instead.

3. This method offers a continuous analysis of the facts. The case study method will look at the facts continuously for the social group being studied by researchers. That means there aren’t interruptions in the process that could limit the validity of the data being collected through this work. This advantage reduces the need to use assumptions when drawing conclusions from the information, adding validity to the outcome of the study over time. That means the outcome becomes relevant to both sides of the equation as it can prove specific suppositions or invalidate a hypothesis under consideration.

This advantage can lead to inefficiencies because of the amount of data being studied by researchers. It is up to the individuals involved in the process to sort out what is useful and meaningful and what is not.

4. It is a useful approach to take when formulating a hypothesis. Researchers will use the case study method advantages to verify a hypothesis under consideration. It is not unusual for the collected data to lead people toward the formulation of new ideas after completing this work. This process encourages further study because it allows concepts to evolve as people do in social or physical environments. That means a complete data set can be gathered based on the skills of the researcher and the honesty of the individuals involved in the study itself.

Although this approach won’t develop a societal-level evaluation of a hypothesis, it can look at how specific groups will react in various circumstances. That information can lead to a better decision-making process in the future for everyone involved.

5. It provides an increase in knowledge. The case study method provides everyone with analytical power to increase knowledge. This advantage is possible because it uses a variety of methodologies to collect information while evaluating a hypothesis. Researchers prefer to use direct observation and interviews to complete their work, but it can also advantage through the use of questionnaires. Participants might need to fill out a journal or diary about their experiences that can be used to study behaviors or choices.

Some researchers incorporate memory tests and experimental tasks to determine how social groups will interact or respond in specific situations. All of this data then works to verify the possibilities that a hypothesis proposes.

6. The case study method allows for comparisons. The human experience is one that is built on individual observations from group situations. Specific demographics might think, act, or respond in particular ways to stimuli, but each person in that group will also contribute a small part to the whole. You could say that people are sponges that collect data from one another every day to create individual outcomes.

The case study method allows researchers to take the information from each demographic for comparison purposes. This information can then lead to proposals that support a hypothesis or lead to its disruption.

7. Data generalization is possible using the case study method. The case study method provides a foundation for data generalization, allowing researches to illustrate their statistical findings in meaningful ways. It puts the information into a usable format that almost anyone can use if they have the need to evaluate the hypothesis under consideration. This process makes it easier to discover unusual features, unique outcomes, or find conclusions that wouldn’t be available without this method. It does an excellent job of identifying specific concepts that relate to the proposed ideas that researchers were verifying through their work.

Generalization does not apply to a larger population group with the case study method. What researchers can do with this information is to suggest a predictable outcome when similar groups are placed in an equal situation.

8. It offers a comprehensive approach to research. Nothing gets ignored when using the case study method to collect information. Every person, place, or thing involved in the research receives the complete attention of those seeking data. The interactions are equal, which means the data is comprehensive and directly reflective of the group being observed.

This advantage means that there are fewer outliers to worry about when researching an idea, leading to a higher level of accuracy in the conclusions drawn by the researchers.

9. The identification of deviant cases is possible with this method. The case study method of research makes it easier to identify deviant cases that occur in each social group. These incidents are units (people) that behave in ways that go against the hypothesis under consideration. Instead of ignoring them like other options do when collecting data, this approach incorporates the “rogue” behavior to understand why it exists in the first place.

This advantage makes the eventual data and conclusions gathered more reliable because it incorporates the “alternative opinion” that exists. One might say that the case study method places as much emphasis on the yin as it does the yang so that the whole picture becomes available to the outside observer.

10. Questionnaire development is possible with the case study method. Interviews and direct observation are the preferred methods of implementing the case study method because it is cheap and done remotely. The information gathered by researchers can also lead to farming questionnaires that can farm additional data from those being studied. When all of the data resources come together, it is easier to formulate a conclusion that accurately reflects the demographics.

Some people in the case study method may try to manipulate the results for personal reasons, but this advantage makes it possible to identify this information readily. Then researchers can look into the thinking that goes into the dishonest behaviors observed.

List of the Disadvantages of the Case Study Method

1. The case study method offers limited representation. The usefulness of the case study method is limited to a specific group of representatives. Researchers are looking at a specific demographic when using this option. That means it is impossible to create any generalization that applies to the rest of society, an organization, or a larger community with this work. The findings can only apply to other groups caught in similar circumstances with the same experiences.

It is useful to use the case study method when attempting to discover the specific reasons why some people behave in a specific way. If researchers need something more generalized, then a different method must be used.

2. No classification is possible with the case study method. This disadvantage is also due to the sample size in the case study method. No classification is possible because researchers are studying such a small unit, group, or demographic. It can be an inefficient process since the skills of the researcher help to determine the quality of the data being collected to verify the validity of a hypothesis. Some participants may be unwilling to answer or participate, while others might try to guess at the outcome to support it.

Researchers can get trapped in a place where they explore more tangents than the actual hypothesis with this option. Classification can occur within the units being studied, but this data cannot extrapolate to other demographics.

3. The case study method still offers the possibility of errors. Each person has an unconscious bias that influences their behaviors and choices. The case study method can find outliers that oppose a hypothesis fairly easily thanks to its emphasis on finding facts, but it is up to the researchers to determine what information qualifies for this designation. If the results from the case study method are surprising or go against the opinion of participating individuals, then there is still the possibility that the information will not be 100% accurate.

Researchers must have controls in place that dictate how data gathering work occurs. Without this limitation in place, the results of the study cannot be guaranteed because of the presence of bias.

4. It is a subjective method to use for research. Although the purpose of the case study method of research is to gather facts, the foundation of what gets gathered is still based on opinion. It uses the subjective method instead of the objective one when evaluating data, which means there can be another layer of errors in the information to consider.

Imagine that a researcher interprets someone’s response as “angry” when performing direct observation, but the individual was feeling “shame” because of a decision they made. The difference between those two emotions is profound, and it could lead to information disruptions that could be problematic to the eventual work of hypothesis verification.

5. The processes required by the case study method are not useful for everyone. The case study method uses a person’s memories, explanations, and records from photographs and diaries to identify interactions on influences on psychological processes. People are given the chance to describe what happens in the world around them as a way for researchers to gather data. This process can be an advantage in some industries, but it can also be a worthless approach to some groups.

If the social group under study doesn’t have the information, knowledge, or wisdom to provide meaningful data, then the processes are no longer useful. Researchers must weigh the advantages and disadvantages of the case study method before starting their work to determine if the possibility of value exists. If it does not, then a different method may be necessary.

6. It is possible for bias to form in the data. It’s not just an unconscious bias that can form in the data when using the case study method. The narrow study approach can lead to outright discrimination in the data. Researchers can decide to ignore outliers or any other information that doesn’t support their hypothesis when using this method. The subjective nature of this approach makes it difficult to challenge the conclusions that get drawn from this work, and the limited pool of units (people) means that duplication is almost impossible.

That means unethical people can manipulate the results gathered by the case study method to their own advantage without much accountability in the process.

7. This method has no fixed limits to it. This method of research is highly dependent on situational circumstances rather than overarching societal or corporate truths. That means the researcher has no fixed limits of investigation. Even when controls are in place to limit bias or recommend specific activities, the case study method has enough flexibility built into its structures to allow for additional exploration. That means it is possible for this work to continue indefinitely, gathering data that never becomes useful.

Scientists began to track the health of 268 sophomores at Harvard in 1938. The Great Depression was in its final years at that point, so the study hoped to reveal clues that lead to happy and healthy lives. It continues still today, now incorporating the children of the original participants, providing over 80 years of information to sort through for conclusions.

8. The case study method is time-consuming and expensive. The case study method can be affordable in some situations, but the lack of fixed limits and the ability to pursue tangents can make it a costly process in most situations. It takes time to gather the data in the first place, and then researchers must interpret the information received so that they can use it for hypothesis evaluation. There are other methods of data collection that can be less expensive and provide results faster.

That doesn’t mean the case study method is useless. The individualization of results can help the decision-making process advance in a variety of industries successfully. It just takes more time to reach the appropriate conclusion, and that might be a resource that isn’t available.

The advantages and disadvantages of the case study method suggest that the helpfulness of this research option depends on the specific hypothesis under consideration. When researchers have the correct skills and mindset to gather data accurately, then it can lead to supportive data that can verify ideas with tremendous accuracy.

This research method can also be used unethically to produce specific results that can be difficult to challenge.

When bias enters into the structure of the case study method, the processes become inefficient, inaccurate, and harmful to the hypothesis. That’s why great care must be taken when designing a study with this approach. It might be a labor-intensive way to develop conclusions, but the outcomes are often worth the investments needed.

Home » Pros and Cons » 12 Case Study Method Advantages and Disadvantages

12 Case Study Method Advantages and Disadvantages

A case study is an investigation into an individual circumstance. The investigation may be of a single person, business, event, or group. The investigation involves collecting in-depth data about the individual entity through the use of several collection methods. Interviews and observation are two of the most common forms of data collection used.

The case study method was originally developed in the field of clinical medicine. It has expanded since to other industries to examine key results, either positive or negative, that were received through a specific set of decisions. This allows for the topic to be researched with great detail, allowing others to glean knowledge from the information presented.

Here are the advantages and disadvantages of using the case study method.

List of the Advantages of the Case Study Method

1. it turns client observations into useable data..

Case studies offer verifiable data from direct observations of the individual entity involved. These observations provide information about input processes. It can show the path taken which led to specific results being generated. Those observations make it possible for others, in similar circumstances, to potentially replicate the results discovered by the case study method.

2. It turns opinion into fact.

Case studies provide facts to study because you’re looking at data which was generated in real-time. It is a way for researchers to turn their opinions into information that can be verified as fact because there is a proven path of positive or negative development. Singling out a specific incident also provides in-depth details about the path of development, which gives it extra credibility to the outside observer.

3. It is relevant to all parties involved.

Case studies that are chosen well will be relevant to everyone who is participating in the process. Because there is such a high level of relevance involved, researchers are able to stay actively engaged in the data collection process. Participants are able to further their knowledge growth because there is interest in the outcome of the case study. Most importantly, the case study method essentially forces people to make a decision about the question being studied, then defend their position through the use of facts.

4. It uses a number of different research methodologies.

The case study method involves more than just interviews and direct observation. Case histories from a records database can be used with this method. Questionnaires can be distributed to participants in the entity being studies. Individuals who have kept diaries and journals about the entity being studied can be included. Even certain experimental tasks, such as a memory test, can be part of this research process.

5. It can be done remotely.

Researchers do not need to be present at a specific location or facility to utilize the case study method. Research can be obtained over the phone, through email, and other forms of remote communication. Even interviews can be conducted over the phone. That means this method is good for formative research that is exploratory in nature, even if it must be completed from a remote location.

6. It is inexpensive.

Compared to other methods of research, the case study method is rather inexpensive. The costs associated with this method involve accessing data, which can often be done for free. Even when there are in-person interviews or other on-site duties involved, the costs of reviewing the data are minimal.

7. It is very accessible to readers.

The case study method puts data into a usable format for those who read the data and note its outcome. Although there may be perspectives of the researcher included in the outcome, the goal of this method is to help the reader be able to identify specific concepts to which they also relate. That allows them to discover unusual features within the data, examine outliers that may be present, or draw conclusions from their own experiences.

List of the Disadvantages of the Case Study Method

1. it can have influence factors within the data..

Every person has their own unconscious bias. Although the case study method is designed to limit the influence of this bias by collecting fact-based data, it is the collector of the data who gets to define what is a “fact” and what is not. That means the real-time data being collected may be based on the results the researcher wants to see from the entity instead. By controlling how facts are collected, a research can control the results this method generates.

2. It takes longer to analyze the data.

The information collection process through the case study method takes much longer to collect than other research options. That is because there is an enormous amount of data which must be sifted through. It’s not just the researchers who can influence the outcome in this type of research method. Participants can also influence outcomes by given inaccurate or incomplete answers to questions they are asked. Researchers must verify the information presented to ensure its accuracy, and that takes time to complete.

3. It can be an inefficient process.

Case study methods require the participation of the individuals or entities involved for it to be a successful process. That means the skills of the researcher will help to determine the quality of information that is being received. Some participants may be quiet, unwilling to answer even basic questions about what is being studied. Others may be overly talkative, exploring tangents which have nothing to do with the case study at all. If researchers are unsure of how to manage this process, then incomplete data is often collected.

4. It requires a small sample size to be effective.

The case study method requires a small sample size for it to yield an effective amount of data to be analyzed. If there are different demographics involved with the entity, or there are different needs which must be examined, then the case study method becomes very inefficient.

5. It is a labor-intensive method of data collection.

The case study method requires researchers to have a high level of language skills to be successful with data collection. Researchers must be personally involved in every aspect of collecting the data as well. From reviewing files or entries personally to conducting personal interviews, the concepts and themes of this process are heavily reliant on the amount of work each researcher is willing to put into things.

These case study method advantages and disadvantages offer a look at the effectiveness of this research option. With the right skill set, it can be used as an effective tool to gather rich, detailed information about specific entities. Without the right skill set, the case study method becomes inefficient and inaccurate.

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ORIGINAL RESEARCH article

Emotional regulation and self-perceived quality of life in high-performance mountain sports athletes.

• 1 Physical Activity for Education, Performance and Health (PAEPH) Research Group, Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
• 2 Physical and Health Literacy and Health-Related Quality of Life (PHYQoL), Faculty of Sport Science, University of Extremadura, Cáceres, Spain
• 3 BioẼrgon Research Group, University of Extremadura, Cáceres, Spain
• 4 Grupo AFySE, Escuela de Pedagogía en Educación Física, Facultad de Educación, Investigación en Actividad Física y Salud Escolar, Universidad de Las Américas, Santiago, Chile

Emotional regulation is an indispensable capacity for human beings, so that alterations in it can lead to the appearance of psychological, social and/or cognitive disorders. Therefore, possessing adequate emotional strategies is intimately related to the quality of life that a person presents. In this sense, high-level athletes suffer constant setbacks and frustrations due to the performance of their sporting activity, in addition to continuous modifications of their daily life activities. Thus, the objective of this research is to explore the emotional regulation and self-perceived quality of life of high-level athletes in mountain sports, analyzing the possible influences of gender, demographic location, body mass index and age. Fifty-four athletes belonging to the High Performance Technification Center of Cáceres (Extremadura, Spain) completed a sociodemographic questionnaire, as well as the Cognitive Emotion Regulation Questionnaire and the WHOQOL-BREF. The Shapiro–Wilkins test was used to analyze the normality of the variables collected and nonparametric statistics were used since the assumption was not met. Both gender and demographic location showed significant differences in the dimensions of the two questionnaires. Likewise, age was associated with the dimensions of both scales, but not body mass index, which was only associated with self-perceived quality of life. In addition, the stepwise linear regression model predicted self-perceived quality of life with a value of 60% across self-culpability, gender body mass index and planning. Therefore, it appears that gender, demographic location, age and body mass index could exert modifications on the levels of emotional regulation and self-perceived quality of life of high-level mountain athletes.

1 Introduction

Emotions are a crucial part of the human condition. Without them, there would be no such thing as the exhilaration of victory or the agony of defeat ( Ford and Gross, 2018 ). Learning to regulate them is crucial in the pursuit of well-being, in fact Koechlin et al. (2018) , conclude that people who rate themselves as effective in regulating their emotions also report less negative affect and better quality of life. Valenzuela and La Portillo (2018) in their study, conclude that a relationship can be observed between people’s emotional intelligence and the achievement of the goals they set for themselves, just as Vaquero Solis et al. (2018) , who deduce from the results obtained in their study that physical activity (PA), motivation levels and adaptability or emotional regulation are closely related. Psychologists Salovey and Mayer (1990) coined the concept of “emotional intelligence,” being directly linked to the term emotional regulation which constitutes the key process of emotional intelligence. This refers to those processes by which people exert an influence on the emotions they have, when they have them and how they experience and express them ( Gross, 1999 ). Likewise, the regular practice of PA has a direct impact on emotional regulation and quality of life ( Barbosa Granados and Urrea Cuéllar, 2018 ). Since the beginning, human beings have lived through movement, whether for utilitarian or recreational purposes. In contrast, nowadays sedentary lifestyles have become part of people’s lives, bringing with them a decrease in health, not only physical but also psychological ( García Matamoros, 2019 ). The World Health Organization (WHO) ( OMS, 2022 ) defines PA as any bodily movement produced by skeletal muscles, with consequent energy consumption. It further adds that PA refers to any movement, including during leisure time, to move to and from certain places, or as part of a person’s work.

Both PA and emotional regulation are an essential part of a person’s quality of life, so it is important to reject behaviors that diminish it ( Ahrendt et al., 2016 ) and to stay active ( Perea-Caballero et al., 2020 ). The widespread use of the term “quality of life” and research on it developed since the 1970s ( Ramírez-Coronel et al., 2021 ). Years later, the WHO ( OMS, 1998 ) defined it as individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals. Additionally, the transition to adolescence is marked by enormous changes in social, biological and personality development ( Brandes et al., 2020 ), with some of the main challenges of this stage being the lack of social discipline or the influence of negative emotions from family members ( Verdecia et al., 2018 ). Thus, the increase in the quality of life in adolescence lies in leaving behind sedentary lifestyles, adopting healthy and higher quality dietary patterns or behaviors, as evidence has been found of their importance in increasing it ( Wu et al., 2019 ). The latest research, the importance of adolescence as a critical period for the development of emotional regulation has been recognized by several investigations ( Lennarz et al., 2019 ), as for example shown by Silva et al. (2018) , where they specify that the level of affect, expressive suppression and cognitive reappraisal influence the emotional regulation of adolescents and their daily lives. Adaptive processes and changes that occur within adolescence ( Verdecia et al., 2018 ), as well as interpersonal relationships, are complex processes that require self-analysis, however, that capacity is not completely internalized ( Bernal et al., 2018 ), hence the importance of emotional regulation at this stage of life.

As discussed, being physically active is one of the most important things people can do to improve physical and mental health ( OECD, 2023 ). However, sedentary lifestyles and the rise of social networks, as well as the way adolescents communicate and interact nowadays, have contributed to a decrease in the level of PA, which is associated with a greater risk of suffering alterations in the psychological, emotional and social state of adolescents ( Mascia et al., 2020 ). In summary, the practice of PA prevents the onset of diseases ( Warburton and Bredin, 2016 ), which consequently leads to an increase in the quality of life ( Yagüe Nogué et al., 2021 ), which in turn allows adolescents to acquire higher levels of emotional regulation ( Simón-Saiz et al., 2018 ). In this sense, during the last few years and in favor of achieving a high quality of life, there has been growing interest in the positive benefits that can be obtained from natural environments and time spent outdoors ( Ballester Martínez et al., 2022 ). PA carried out in nature brings with it a positive impact and even has synergistic effects ( Eigenschenk et al., 2019 ). In fact, in the systematic review by Ballester Martínez et al. (2022) on studies related to PA, nature and mental well-being, the existence of a significant influence of PA in nature on the psychological well-being of the participants is shown.

In this context, there are numerous studies that analyze the relationships between emotional regulation or quality of life ( Hervás and Moral, 2017 ; Lennarz et al., 2019 ; Salinas Ponce and Villacres, 2021 ), as well as the influence that PA has on these psychological issues, however these terms have been little explored in high performance athletes who develop their activity in the natural environment. Therefore, the aim of this study is to analyze emotional regulation and quality of life, as well as their relationship with sex, age and body mass index (BMI), in athletes of mountain sports modalities who carry out their activity regularly in the natural environment. Consequently, the main hypothesis for this study would be: There is a significant direct relationship between emotional regulation and quality of life in high-performance mountain athletes and the secondary hypothesis would be: Variables of sex, demographic location, age and body mass index could exert modifications on the levels of emotional regulation and self-perceived quality of life of high-level mountain athletes.

2 Materials and methods

2.1 participants.

The sample was selected using the non-probabilistic sampling method based on convenience sampling ( Salkind et al., 1999 ). Of the total sample ( n  = 54), 68.5% were boys and 31.5% were girls, so it can be considered a gender-balanced sample. The inclusion criteria of the participants were to have the accreditation of technification, high performance or high-level athletes in any of the disciplines considered as mountain sports by the Spanish Federation of Mountaineering and Climbing.

To characterize the sample ( Table 1 ), other variables were defined, such as level of education, demographic location, considering rural centers to be those with less than 20,000 inhabitants, and the sports modality of the athletes. The mean age was 21.78 years (SD = 7.88) and the mean BMI was 20.99 (SD = 2.64), calculated from the height and weight data self-reported by the participants.

Table 1 . Sample characterization ( N  = 54).

2.2 Procedure

The method of data collection was by digital means and the technique used was the realization of self-administered questionnaires, this type of technique facilitates the collection of data to be able to work with them later, saving time and costs ( Anderson and Kanuka, 2003 ). Its main advantage is the possibility of being able to carry them out remotely, in this case the questionnaire was elaborated with the digital application Google Forms.

The questionnaire was completely anonymous and consisted of three parts, two of which were the instruments and one of which was the instruction sheet for proper understanding. The average completion time was about 3 min. All data were collected between October 2022 and March 2023.

It was distributed through telephone contacts, social networks and by email to the various federations that have athletes at the National Technification Center in Cáceres (Spain).

2.3 Instruments

First, a questionnaire was designed with six sociodemographic questions (sex, age, demographic location, height, weight and sport modality) through self-reporting. The BMI (kg/m 2 ) was obtained by applying the following formula: BMI = weight in kilograms / (height in meters) 2 .

Emotional regulation was also assessed using the Cognitive Emotion Regulation Questionnaire (CERQ) ( Garnefski et al., 2001 ). The CERQ instrument is composed of 36 items that evaluate nine cognitive-emotional coping strategies for dealing with stressful situations and events. This scale is based on a 5-point Likert-type scale, where 1 is “Sometimes” and 5 is “Always.” The dimensions that make up the questionnaire are the following: (1) Self-blame (e.g., “I feel that I am to blame for what happened”); (2) Acceptance (e.g., “I think I have to accept what has happened”); (3) Rumination (e.g., “I often think about how I feel in relation to what has happened to me”); (4) Positive focus (e.g., “I think of something more pleasant than what has happened to me”); (5) Planning (e.g., “I think about what is the best thing I could do”); (6) Positive reassessment (e.g., “I think I can learn something from the situation”); (7) Perspective taking (e.g., “I think it could have been much worse”); (8) Catastrophism (e.g., “I often think that what has happened to me is much worse than what has happened to other people”); and (9) Blame others (e.g., “It seems to me that others are to blame for what happened”). Similarly, these 9 dimensions can be grouped into adaptive strategies (Acceptance, Positive focus, Planning, Positive reassessment and Perspective taking) and disadaptive strategies (Self-blame, Rumination, Catastrophism and Blame others). The internal consistency reported through Cronbrach’s alpha in the different subscales ranges from 0.68 (Blame others) to 0.83 (Rumination). Also, in the Spanish version for adolescents ( Chamizo-Nieto et al., 2020 ), the internal consistency of the different subscales ranges from 0.62 (Catastrophism) to 0.83 (Positive focus).

Finally, the self-perceived quality of life was analyzed using the WHOQOL-BREF ( Nejat et al., 2006 ). The instrument has 26 items consisting of four domains: (1) Physical health (7 items), including items on mobility, daily activities, functional ability, energy, pain, and sleep; (2) Psychological health (6 items), referring to self-image, negative thoughts, positive attitudes, self-esteem, mentality, learning ability, memory concentration, religion and state of mind; (3) Social relationships (3 items), complementing information on personal relationships, social support and sex life; and (4) Environmental health (8 items); covering issues related to financial resources, safety, health and social services, physical living environment, opportunities for acquiring new skills and knowledge, recreation, general environment (noise, air pollution, etc.) and transportation. Each individual item of the questionnaire is scored from 1 to 5 on a Likert-type response scale, and the scores for each dimension are then transformed into a scale from 1 to 100.

2.4 Statistical analysis

Prior to the analysis, 3 negative WHOQOL-BREF items were inverted to unify the analysis domain. Then, to determine the type of statistical tests to be used, the distribution of the data was explored to see if the normality assumption was met using the Shapiro–Wilk test, since a sample size of around 50 participants was obtained ( Mendes and Pala, 2003 ). This test determined that this assumption was not met, so it was decided to use nonparametric statistical tests.

In order to analyze the differences between the scores of each of the dimensions according to sex or demographic location, the Mann Whitney U test was used, establishing a significance level of p  < 0.05. Also, to determine the degree of relationship between each of the dimensions and age or BMI, Spearman’s Rho test was used. For the interpretation of this statistic, the ranges established by Mondragón Barrera (2014) were taken into account: coefficients between 0.01 and 0.10 determine the existence of a low correlation, values between 0.11 and 0.50 imply a medium degree of correlation, from 0.51 to 0.75 a strong correlation, from 0.76 to 0.90 a high correlation, and above 0.91 the correlation is perfect.

In addition, a simple stepwise regression test was used to analyze changes in quality of life taken as a construct consisting of the dimensions that make up the WHOQOL-BREF in relation to the CERQ dimensions, gender and BMI of the participants. A significance level of less than 0.05 was required to enter the variables in the predictive model.

Finally, Cronbach’s Alpha was used to analyze the reliability of the instrument. According to Nunnally and Bernstein (1994) , reliability values between 0.60 and 0.70 can be considered acceptable, while values between 0.70 and 0.90 can be considered satisfactory.

Table 2 shows the descriptive data for each of the CERQ dimensions according to sex and demographic location based on the mean and standard deviation. The statistical significance was obtained from the Mann–Whitney U test to analyze differences between groups.

Table 2 . Descriptive analysis and differences in the CERQ dimensions.

Girls scored higher than boys on the dimensions self-blame, acceptance, rumination, planning, positive reassessment, perspective taking, adaptive strategies and disadaptive strategies. In turn, boys scored higher on the dimensions positive focus, catastrophism and blame others. However, significant differences with respect to gender were only obtained in the third (Rumination) and fifth dimension (Planning). On the other hand, demographic location exhibited the highest scores in rural settings on most factors, except for self-blame and catastrophism. Statistically significant differences were also found in acceptance, planning, positive reassessment and adaptive strategies, all of which were in favor of rural settings.

Table 3 shows the scores and differences obtained in each of the dimensions of the WHOQOL-BREF instrument. With regard to sex, significant differences were observed in the psychological health dimension, with men showing higher scores in all dimensions of the scale. With regard to demographic location, significant differences were again observed in the psychological health dimension, and physical health was added. Similarly, the scores follow a clear trend, with the rural locations scoring higher except in the environment dimension.

Table 3 . Descriptive data and differences in each dimension of the WHOQOL-BREF as a function of gender and demographic location.

Table 4 used Spearman’s Rho test to analyze the relationship between each of the dimensions with age and BMI. As for CERQ, age appears to be directly, mean and significantly related to positive focus and adaptive strategies. Also, with the same characteristics but inversely, the dimension of catastrophism is related to age. Likewise, BMI does not seem to be related to CERQ factors. With regard to the WHOQOL-BREF, only environmental health showed significance when associated with age and BMI, with both relationships being mean and inverse.

Table 4 . Relationships between the dimensions of the questionnaires with age and BMI variables.

Table 5 shows a model for predicting quality of life using the simple regression test. This predictive model (perceived quality of life scores = 0.057 x Planning – 0.312 x Self-blame – 0.052 x BMI – 0.374 x Gender) shows a predictive capacity for changes in quality of life of approximately 60%, with R2 being 0.60.

Table 5 . Model predicting changes in quality of life.

Finally, Table 6 shows the Cronbach’s alpha values reported for each of the CERQ and WHOQOL-BREF dimensions. Even with a small sample, satisfactory values were obtained (between 0.70 and 0.90), except in the social relations dimension.

Table 6 . Cronbach’s alpha coefficients for each dimension of the scales.

4 Discussion

The purpose of this study was to determine the influence of emotional regulation on the quality of life of high-performance athletes. In the analysis of the main hypothesis between emotional regulation and self-perceived quality of life in athletes, no significant relationships were found between the dimensions; this may be due to the low sample size and low internal consistency of the items and dimensions of the instruments used. However, differences were found between different items and dimensions of the instruments used.

Emotional regulation as an influential factor in the quality of life of athletes is an aspect that has been addressed in several studies, inferring that, possessing emotional regulation strategies helps to improve mental well-being in the daily lives of people ( Lennarz et al., 2019 ; Bird et al., 2021 ) and in this case athletes ( Tamminen et al., 2021 ). Furthermore, in the study by Ono et al. (2019) , testimonies of athletes are shared in which they consider that the pressure of training combined with the rest of daily tasks generates a mental impact on their life. Likewise Simón-Saiz et al. (2018) also show that resilience, an aspect closely linked to emotional regulation, generates a positive effect on quality of life, being able to conclude then that the acquisition of emotional regulation strategies helps athletes to improve it. Regarding the gender variable, the scientific literature provides information in which, as in this study, there are differences between the male and female sexes in emotional regulation processes ( Kwon et al., 2013 ; Dixon-Gordon et al., 2015 ). Goubet and Chrysikou (2019) demonstrated in their research results that women possessed a significantly higher repertoire than men, suggesting that they may have access to a greater number of strategies, coinciding with the results obtained in the present study where girls presented higher scores in the different dimensions of the CERQ. On the other hand, the influence of demographic location on emotional regulation has not been a focus extensively investigated by the authors. On this issue there are contrary results, on the one hand some research shows that the place of residence influences emotional regulation ( Kar et al., 2014 ) while on the other hand there are studies that reflect that there is no significant evidence between both aspects ( Kant, 2019 ; Sørensen, 2021 ).

Since the WHO created the WHOQOL-BREF instrument, several authors have made use of this tool to determine the quality of life of people in a given context. In this study, the relationships that exist between the sex and demographic location of the participants and their quality of life have been verified, revealing that there are differences between both sexes in relation to the “psychological health” dimension. Several studies corroborate this result ( Fisk, 2018 ; Esteban-Gonzalo et al., 2020 ; Walton et al., 2021 ) concluding that gender may be a factor influencing quality of life. On the other hand, in the present study higher levels of quality of life in most dimensions are seen in the rural setting ( Cai and Wang, 2018 ) also obtained similar results, while in the study of ( Sompolska-Rzechula and Kurdys-Kujawska, 2020 ) the results show significant variation between quality of life between rural and urban settings.

Using Spearman’s Rho test, the relationship between the different dimensions of the CERQ and the WHOQOL-BREEF was analyzed to see if age and BMI influenced them. The results shown in this study linked to age and the different dimensions of the CERQ hint that there is some relationship between them, coinciding with the results of different studies ( Deng et al., 2019 ; Perry et al., 2019 ; Burr et al., 2021 ) in which it is shown that there is a significant relationship between these two aspects, with a large number of age-related changes occurring in emotional regulation during adolescence ( Deng et al., 2019 ). In contrast, the values found in the CERQ results focused on BMI show that no relationship is found with the dimensions of that instrument. No research has been found that specifically addresses the influence of emotional regulation on BMI in high-performance athletes, but evidence of some influence of emotional regulation on BMI can be found in people who practice PA at a non-professional level ( Jones et al., 2019 ; Ruzanska and Warschburger, 2019 ). Quality of life measured through the WHOQOL-BREF instrument has also been the subject of study with a focus on how age and BMI affect it. In our study we only found a relationship with both variables in the environmental health dimension, as Wallas et al. (2019) , whose results provide an environmental influence on BMI, or Lange et al. (2011) who state that environmental factors are significantly associated with adolescent BMI.

Quality of life is a concept that is determined by multiple factors involving physical, psychological and social aspects ( Irigaray and Trentini, 2009 ). In this research, a prediction of change in quality of life of 60% was found based on the correlation between variables such as self-culpability, BMI, sex and planning. Although there are not many findings in the scientific literature on the correlation between these four elements in favor of quality of life, we do find studies such as that of Kyeong et al. (2020) in which it is explained that those with low quality of life may be more vulnerable to being negatively affected by self-criticism. On the other hand, different research has found findings of a correlation between sex and BMI in different populations ( Aksoydan and Çakır, 2011 ; Nwizu et al., 2011 ).

Therefore, the first hypothesis was declined but the second hypothesis has been reaffirmed.

4.1 Limitations

Some limitations can be found in this study. The research was carried out by means of non-probabilistic convenience sampling, which did not fully ensure the representativeness of the sample and could have generated various biases. Likewise, another limitation of the study is the low sample size, which could have limited the results. Likewise, data collection was done through online surveys being faster and cheaper than standard surveys but may entail disadvantages such as low response rates ( Iversen et al., 2020 ).

4.2 Future lines of research

Future research could try to extend the information in the current scientific literature on the correlation between dimensions such as self-culpability, planning and aspects such as gender and BMI and how they influence the quality of life of a larger sample of high-performance athletes. Similarly, a line of research could be opened in relation to the rural or urban environment and how it influences the quality of life of athletes.

5 Conclusion

The influence of emotional regulation on the quality of life of high-performance athletes was the main object of analysis of this study and results were found that may indicate that emotional regulation influences the quality of life of these athletes, although not significantly. Women scored higher on some of the CERQ dimensions, indicating that they may possess more regulation strategies than men. In addition, demographic location, age and body mass index could exert modifications on the levels of emotional regulation and self-perceived quality of life of high-performance athletes. Studies such as this one allow a better understanding of the importance of the application of emotional regulation strategies and it would be interesting for coaches to be aware of them in order to favor not only the performance of athletes, but also to increase their mental well-being and their self-perceived quality of life.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The use of these data did not require approval from an accredited ethics committee, as they are not covered by data protection principles, i.e., they are non-identifiable, anonymous data collected through an anonymous survey for teachers. In addition, based on Regulation (EU) 2016/679 of the European Parliament and of the Council on 27 April 2016 on the protection of individuals concerning the processing of personal data and on the free movement of such data (which entered into force on 25 May 2016 and has been compulsory since 25 May 2018), data protection principles do not need to be applied to anonymous information (i.e., information related to an identifiable natural person, nor to data of a subject that is not, or is no longer, identifiable). Consequently, the Regulation does not affect the processing of our information. Even for statistical or research purposes, its use does not require the approval of an accredited ethics committee. The informed consent of the subjects participating in the study was not necessary, as the data were collected anonymously and there were no minors under 14 years of age. Therefore, and in compliance with paper 13.1 of the LOPD Regulation, which states that “in the case of minors under fourteen years of age, the consent of the parents or guardians shall be required”, although the document was created, it was not required.

Author contributions

PR-R: Conceptualization, Investigation, Project administration, Resources, Writing – original draft, Writing – review & editing. CG-A: Investigation, Resources, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. SG-P: Investigation, Resources, Writing – original draft, Writing – review & editing, Methodology, Software. AC-P: Supervision, Visualization, Writing – original draft, Writing – review & editing, Funding acquisition, Investigation, Resources. JR-R: Methodology, Software, Writing – original draft, Writing – review & editing, Data curation, Project administration, Supervision, Visualization.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: emotional regulation, quality of life, high-level athletes, natural environment, physical activity

Citation: Rojo-Ramos P, Galán-Arroyo C, Gómez-Paniagua S, Castillo-Paredes A and Rojo-Ramos J (2024) Emotional regulation and self-perceived quality of life in high-performance mountain sports athletes. Front. Psychol . 15:1370124. doi: 10.3389/fpsyg.2024.1370124

Received: 14 January 2024; Accepted: 04 April 2024; Published: 16 April 2024.

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Copyright © 2024 Rojo-Ramos, Galán-Arroyo, Gómez-Paniagua, Castillo-Paredes and Rojo-Ramos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Antonio Castillo-Paredes, [email protected]

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• Open access
• Published: 15 April 2024

Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study

• Natasha Biscoe   ORCID: orcid.org/0000-0003-3471-6472 1 ,
• Emma New 2 &
• Dominic Murphy   ORCID: orcid.org/0000-0002-9530-2743 1 , 3  

BMC Psychology volume  12 , Article number:  209 ( 2024 ) Cite this article

Metrics details

Less is known about complex posttraumatic stress disorder (CPTSD) than postrraumatic stress disorder (PTSD) in military veterans, yet this population may be at greater risk of the former diagnosis. Executive function impairment has been linked to PTSD treatment outcomes. The current study therefore aimed to explore possible associations between each CPTSD symptom cluster and executive function to understand if similar treatment trajectories might be observed with the disorder.

A total of 428 veterans from a national charity responded to a self-report questionnaire which measured CPTSD symptom clusters using the International Trauma Questionnaire, and executive function using the Adult Executive Function Inventory. Single and multiple linear regression models were used to analyse the relationship between CPTSD symptom clusters and executive function, including working memory and inhibition.

Each CPTSD symptom cluster was significantly associated with higher executive function impairment, even after controlling for possible mental health confounding variables. Emotion dysregulation was the CPTSD symptom cluster most strongly associated with executive function impairment.

Conclusions

This is the first study to explore the relationship between executive function and CPTSD symptom clusters. The study builds on previous findings and suggests that executive function could be relevant to CPTSD treatment trajectories, as is the case with PTSD alone. Future research should further explore such clinical implications.

Peer Review reports

Military veterans face a greater risk of experiencing PTSD than the general UK population [ 1 ] and are more likely to meet criteria for Complex PTSD (CPTSD) than PTSD [ 2 ]. PTSD encompasses a set of symptoms which may be experienced following a traumatic event, including hyperarousal, re-experiencing (nightmares, intrusions), cognitive and behavioural avoidance and negative alterations in mood (DSM-V; [ 3 ]). CPTSD was added to the International Classification of Diseases in 2011 [ 4 ] as a distinct disorder. A diagnosis of CPTSD includes experiencing clusters of symptoms that encompass PTSD, as well as symptom clusters referred to as Disturbances in Self-Organisation (DSO), which are: emotion dysregulation, interpersonal difficulties, and negative self-concept, as well as functional impairment connected to both PTSD and DSO symptoms.

CPTSD has been linked with sustained and multiple traumas [ 5 ] as well as interpersonal trauma [ 6 ]. Military veterans appear to be at greater risk of CPTSD than PTSD [ 7 ]. Indeed, CPTSD appears to be more prevalent in UK treatment-seeking veterans than PTSD (with 80% meeting criteria for CPTSD compared to 20% for PTSD; [ 2 , 8 ]. Additionally, proportionally higher treatment dropout rates are reported for veterans with CPTSD [ 9 ]. It is therefore clinically important to understand factors which may be relevant to both PTSD and CPTSD, as interventions may need to be tailored to each disorder respectively.

PTSD and executive function

An association between impairments in executive function (EF), and posttraumatic stress disorder (PTSD) is well-established in the literature (for review see: [ 10 , 11 , 12 ]). EFs are a collection of abilities grouped together for their relevance to planning and executing complex, goal-directed behaviour [ 13 , 14 , 15 ]. There is significant variation in both definitions of the concept and how the construct is operationalised, although the current study follows Miyake and colleagues [ 16 ] as this conceptualisation aligns well with the self-report measure of executive function used in this study. These authors identify cognitive flexibility, working memory and inhibition as core EFs, deficits in all of which may be relevant to PTSD [ 17 , 18 , 19 , 20 , 21 ]. Furthermore, one study has reported that greater inhibitory control is associated with a better improvement in PTSD symptoms following psychological treatment, indicating the possible relevance of EF in PTSD recovery trajectories [ 22 ]. Less is known about whether similar trajectories would be observed in those with CPTSD. However, insight may be drawn from neurocognitive explanations of the observed associations between EF and PTSD.

Neurocognitive models of PTSD and EF

Several meta-analyses of lesion and neuroimaging studies implicate the prefrontal cortex (PFC) as key in supporting EF [ 23 , 24 , 25 ]. The PFC has been theorised as a control centre, mediating between sensory inputs and behavioural outputs via regulation of brain systems central to emotion processing such as the amygdala [ 26 ]. The PFC is also structurally associated with PTSD, as well as the amygdala, hippocampus, and cingulate cortex [ 27 ], with this system key to attaching emotional valence to memories relevant to the fear-based experiences that lead to PTSD [ 19 ].

The shared relevance of these brain systems to both EF and PTSD suggests a neurocognitive explanation for the overlap observed between the two constructs. For example, one neurocognitive model of PTSD posits that PFC (and associated deficits in EF) may be ineffectively regulating hyperarousal of the amygdala in individuals with PTSD when a perceive threat is observed in a safe environment [ 28 , 29 , 30 ]. Furthermore, elevated arousal – a symptom of PTSD – may deplete cognitive resources leading to deficits in EF as attention is focused instead on regulating hyperarousal [ 20 , 31 , 32 , 33 ].

EFs and CPTSD

Neuroimaging studies reinforce this theory and suggest functional connectivity between the PFC and brain regions relevant to emotion regulation are key to supporting EF [ 34 , 35 ]. Emotion dysregulation therefore may be pertinent to the observed overlap between PTSD and EF. Given emotion dysregulation is a DSO symptom of CPTSD, exploring associations between CPTSD and EFs could inform understanding of the disorder and how existing PTSD interventions could be tailored to improve treatment response in veterans seeking treatment for CPTSD. In a study using an adolescent sample, deficits in EFs were associated with greater CPTSD severity [ 36 ]. However, less is known about the relationship between CPTSD and EFs in veteran populations.

The current study

Given the potential relevance of EF to PTSD treatment outcomes in veterans, and the need to further understand CPTSD in this population, the current study explores the relationship between both PTSD and CPTSD and a self-report measure of EF (inhibition and working memory) in a clinical sample of UK veterans. Associations between each PTSD symptom cluster and EFs are separately investigated, including the DSO clusters that encompass CPTSD. In line with previous studies [ 36 ], it is hypothesised that lower executive functioning scores (both working memory and inhibition) will be associated with greater severity of CPTSD symptoms.

This study was approved by [blinded for review].

Participants

Of the veterans seeking treatment UK charity, a 20% random sample was selected to assess whether they met study inclusion criteria: (1) having a valid email address; (2) having provided consent to contact from the research team about studies; (3) had attended one or more appointments (classed as treatment-seeking). In total 989 veterans were emailed with the study link, to which 428/989 responded (43.3% response rate; M age =50.4, SD age =10.9). Participation was voluntary. No differences were found between those who returned completed questionnaires and non-responders [ 2 ]. We determined this by analysing predictors of returning a completed survey, including age, sex and service branch.

Eligible and consenting veterans were emailed the link to a self-report questionnaire hosted on Survey Monkey, which included demographic questions and the measures described below. Responses were collected between August and October 2020 and participants were emailed not more than five times. The questionnaire took approximately 20 min to complete. Full study procedure has been described previously [ 2 ].

The Adult Executive Function Inventory (ADEXI; [ 37 ]), measures EF on a 14-item self-report scale, with responses on a five-point Likert scale ranging from zero (definitely not true) to four (definitely true). Items 1, 2, 5, 7, 8, 9, 11, 12 and 13 comprise the working memory subscale, e.g.: “I have difficulty remembering lengthy instructions” and “when someone asks me to do several things, I sometimes only remember the first or last”. The remaining items make up the inhibition subscale, e.g.: “I have a tendency to do things without first thinking about what could happen” and “I sometimes have difficulty stopping myself from doing something that I like even though someone tells me that it is not allowed”. A higher score on the scale or each of the subscales indicates greater impairment. The ADEXI has good internal consistency and test-retest reliability, but poor convergent validity with neuropsychological tests of EF [ 37 ]. The ADEXI has good internal consistency (α = 0.68–0.72; [ 37 ]).

Symptoms of PTSD and CPTSD were measured using the International Trauma Questionnaire [ 38 ], an 18-item scale with responses on a 5-point Likert scale ranging from zero (not at all) to four (extremely). Two items measure each of the three PTSD symptom clusters: hyperarousal, re-experiencing and avoidance. Two items measure each of the three disturbances in self-organisation (DSO) symptom clusters that comprise CPTSD: negative self-concept, interpersonal relationships and affect dysregulation. Three identical items then measure functional impairment related to the PTSD and DSO symptom clusters respectively. The ITQ has strong psychometric properties [ 39 ]. Possible caseness for PTSD is indicated by a score of two or higher on at least one of each item measuring each PTSD symptom cluster, as well scoring two or higher on one of the three functional impairment items relating to PTSD symptom clusters. Possible caseness for CPTSD is indicated by meeting the criteria for PTSD, as well as scoring two or higher on at least one of the two items for each DSO symptom cluster, and at least a two on one of the functional impairment items relating to DSO symptoms. The ITQ has good internal consistency (α = 0.90; [ 39 ]).

Symptoms of generalised anxiety and depression were measured with the General Health Questionnaire (GHQ-12; [ 40 ]), a 12-item scale where a score of four or higher is indicative of potential caseness for common mental health difficulties (CMDs). The GHQ-9 has good internal consistency (α = 0.72; [ 41 ]).

Somatic symptoms were measured using the Patient Health Questionnaire (PHQ-15; [ 41 ]), a 15-item scale where a score above 15 indicates higher severity of somatic symptoms. The PHQ-15 has good internal consistency (α = 0.80; [ 42 ]).

Symptoms of poor sleep quality were measured using the Sleep Condition Indicator (SCI; [ 43 ]), an eight-item scale where a score below 16 is indicative of a potential insomnia disorder. The SCI has good internal consistency (α = 0.86; [ 44 ]).

Symptoms of difficulties with anger were measured using the Dimensions of Anger Reactions (DAR-5; [ 45 ]), a five-item scale where a score higher than 12 is indicative of possible anger difficulties. The DAR-5 has good internal consistency (α = 0.89–0.90; [ 46 ]).

Symptoms of alcohol misuse were measured using the Alcohol Use Disorders Identification Test (AUDIT; [ 47 ]), a 10-item scale where scores higher than eight and 16 respectively are classified as possible hazardous and harmful alcohol use. The AUDIT has good internal consistency (α = 0.60–0.80; [ 48 ]).

Data analysis

Data were prepared in STATA 13.0 and analysed in SPSS v.26. Continuous variables were ADEXI scores and subscale scores. These were averaged so that comparisons could be made across scores calculated from different numbers of items. All other variables were categorical, divided into case and no case or high severity and lower severity for each health outcome, and no PTSD, PTSD, and CPTSD for the ITQ variable. To understand the relationship between mental health variables, including PTSD and EF, single linear regression models were used with demographic and mental health caseness variables as predictors, and ADEXI and inhibition and working memory subscale scores as outcome variables in separate analyses. This was to understand possible confounding variables for any relationship between PTSD and CPTSD with EF. Multiple linear regression models were then used with PTSD and CPTSD caseness as predictor variables, and ADEXI score, and subscale scores as outcome variables. Those variables which were significant in the single linear regression models were included in the multiple regression models to adjust for possible confounding factors. Single linear regression models explored the relationships between individual PTSD and DSO symptom clusters with EF. ‘Caseness’ for each symptom cluster was calculated as a score of two or higher on at least one of the two items measuring each cluster. The sample met assumptions for multiple linear regression: the data were normally distributed (W = 0.96, p  = 0.23), there was low multicollinearity and there is a linear relationship between the variables used in the regression models. As described in [ 2 ], analyses were restricted to responders only and missing data were not included in the models due to the assumption that data were missing at random. A power analysis was not conducted for the present study as the analysis was exploratory and data were collected through convenience sampling [ 49 ]. In regression analysis, B values below 0.1. between 0.1 and 0.5 and above 0.5 are broadly considered small, medium and high respectively [ 50 ].

Demographic characteristics are described in Table  1 , as well as descriptive statistics for the variables included in regression models.

Single regression models

Single linear regression models for demographic and mental health factors are presented in Table  2 . Being unemployed and having an ethnicity other than white were significantly associated with higher overall EF, inhibition and working memory impairment. Having high somatic symptoms and meeting caseness for probable common mental health difficulties were also associated with higher overall EF, inhibition and working memory impairment. In addition, scores indicating hazardous alcohol use were associated with working memory and inhibition impairment, and sleep disturbances were associated with a higher working memory impairment.

Multiple regression models

Multiple regression models for PTSD adjusted for all other significant variables besides CPTSD caseness observed in the single regression models. The same models were analysed including CPTSD as a predictor and not PTSD caseness. These models are displayed in Table  3 . Across all adjusted models, both PTSD and CPTSD remained significant predictors for EF, inhibition and working memory.

PTSD and DSO symptom clusters

Linear regression models for each of the PTSD and DSO symptom clusters and EF, inhibition and working memory are displayed in Table  4 . In line with our hypothesis, each symptom cluster was significantly associated with EF, as well as inhibition and working memory subscales.

The aim of the current study was to explore the associations between CPTSD symptom clusters and EF in a clinical sample of UK veterans. Both PTSD and CPTSD caseness were significantly associated with greater impairment in inhibition and working memory, in line with our hypothesis. All PTSD symptom clusters, and the DSO symptom clusters which encompass CPTSD, were associated with inhibition and working memory. In particular, the DSO symptom emotion dysregulation was most strongly associated with EF impairment. PTSD encompasses symptoms hyperarousal, re-experiencing and avoidance. CPTSD is a relatively new separate diagnosis which includes PTSD symptoms as well as DSO symptoms: emotion dysregulation, negative self-concept and interpersonal difficulties, as well as functional impairment relating to these domains [ 4 ].

These associations remained after controlling for the following possible confounders, which were also found to be associated with greater EF impairment: employment status, ethnicity, somatisation severity, common mental health disorders, alcohol misuse and for working memory, sleep function. The finding that EF impairment is associated with worse health coheres with previous research, which has observed relationships between EF deficits and both depression [ 51 ] and somatisation disorder [ 52 ]. Additionally, sleep deprivation is consistently associated with impairments in working memory [ 53 , 54 ].

Emotion dysregulation and EF impairment

Our finding that emotion dysregulation was the CPTSD symptom cluster most associated with EF coheres with and builds on neurocognitive models espoused in the literature. Previous research has suggested functional connectivity between the PFC and limbic system is key in the overlap observed between PTSD chronicity, severity, and EF impairment [ 10 , 55 ]. In one study, those with greater functional connectivity in this system - termed the frontal parietal control and limbic network (FPCN) - were observed to have less chronicity of and greater reduction in PTSD symptoms [ 56 ]. The FPCN underlies emotion processing [ 57 ], mind wandering [ 58 ] and is neurally connected with the default mode network (DMN; [ 59 ]), all of which are associated with PTSD [ 60 ]. Moreover, the development of the DMN is particularly sensitive during childhood, with research suggesting its development could be affected by early and prolonged trauma [ 61 , 62 ]. Given these factors are more strongly associated with CPTSD than PTSD [ 5 ], the finding that DSO symptom cluster emotion dysregulation was most related to EF suggests similar neurobiological mechanisms may be involved in CPTSD as those espoused for the overlap between EF and PTSD.

Limitations

A number of limitations to the present study should be noted. Firstly, whilst the self-report measure of EF facilitated the collection of data from a larger sample, it has limited convergent validity with neuropsychological measures of EF [ 37 ]. However, as a self-report measure, the scale has strong psychometric properties [ 37 ] and self-report EF measures are strongly related to functional impairment [ 63 ]. Secondly, the scale does not include items measuring cognitive flexibility, although this would be difficult to capture on a self-report measure. Data were collected during the Covid-19 pandemic, and environmental factors related to restrictive measures at the time could have affected participants’ responses. However, our research suggests veterans’ mental health difficulties remained relatively stable throughout the pandemic. Finally, no causal relationships can be interpreted from the current findings due to the cross-sectional design of the study. However, the observed finding of an association between DSO symptom clusters and EF impairment builds on previous findings of similar association with PTSD clusters and this can inform future research and clinical studies.

Implications for treatment

Taken together, the findings of the present study suggest that CPTSD interventions may – as observed with PTSD treatment outcomes [ 22 ] – result in better symptom improvement in patients who display greater inhibitory control in neuropsychological tests. By separately analysing both PTSD and DSO symptom clusters, the current study has highlighted the potential role of emotion dysregulation in the overlap between EF impairment and PTSD observed in previous studies [ 10 , 11 , 12 ]. Future research might explore whether veterans with better inhibitory control and working memory respond better to CPTSD interventions. For example, Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR; [ 64 ]) is a modular CPTSD treatment which sequentially targets each DSO symptom – including emotion dysregulation. Future studies might explore whether building skills in emotion regulation reduces impairment in EF and subsequently improves recovery trajectories.

This was the first study to explore the relationship between EF and CPTSD symptom clusters in a clinical sample of UK Armed Forces veterans. That DSO symptom clusters, in addition to PTSD clusters, were associated with EF builds on previous findings and suggests that CPTSD treatment outcomes could similarly be affected by levels of EF impairment in veteran patients. Future research should explore the clinical implications of these findings further.

Data availability

The datasets analysed during the current study are not publicly available due to patient confidentiality.

Abbreviations

Complex posttraumatic stress disorder

Default mode network

Disturbances in self-organisation

• Executive function

Posttraumatic stress disorder

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Biscoe, N., New, E. & Murphy, D. Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study. BMC Psychol 12 , 209 (2024). https://doi.org/10.1186/s40359-024-01713-w

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DOI : https://doi.org/10.1186/s40359-024-01713-w

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The majority (86%) of employees believe empathetic leadership boosts morale while 87% of employees say empathy is essential to fostering an inclusive environment.

As many employees face downsizings, restructurings and a looming global recession, most say that empathic leadership is a desired attribute but feel it can be disingenuous when not paired with action, according to the 2023 Ernst & Young LLP ( EY US )  Empathy in Business Survey .

The study of more than 1,000 employed US workers examines how empathy affects leaders, employees, and operations in the workplace. The survey follows the initial EY Consulting analysis of empathy in 2021 and finds workers feel that mutual empathy between company leaders and employees leads to increased efficiency (88%), creativity (87%), job satisfaction (87%), idea sharing (86%), innovation (85%) and even company revenue (83%).

“A  transformation’s success  or failure is rooted in human emotions, and this research spotlights just how critical empathy is in leadership,” said  Raj Sharma , EY  Americas Consulting  Vice Chair. “Recent years taught us that leading with empathy is a soft and powerful trait that helps empower employers and employees to collaborate better, and ultimately create a culture of accountability.”

The evolving state of empathy in the workplace

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“Time and again we have found through our research that in order for businesses to successfully transform, they must put humans at the center with empathetic leadership to create transparency and provide employees with psychological safety,” said  Kim Billeter , EY Americas  People Advisory Services  Leader. “Empathy is a powerful force that must be embedded organically into every aspect of an organization, otherwise the inconsistency has a dramatic impact on the overall culture and authenticity of an organization.”

In fact, half (52%) of employees currently believe their company’s efforts to be empathetic toward employees are dishonest ― up from 46% in 2021, and employees increasingly report a lack of follow-through when it comes to company promises (47% compared to 42% in 2021).

To fulfill the authenticity equation, previous EY research indicates offering flexibility is essential. In the 2022 EY US Generation Survey, 92% of employees surveyed across all four workplace generations said that company culture has an impact on their decision to remain with their current  employer.

Lead with empathy  now  to combat the workplace challenges ahead

While leaders may experience lower employee attrition rates now when compared to the Great Resignation, a resurgence is brewing. Many economists expect a soft landing from the looming recession and with it may come turnover, particularly if employees already feel disconnected from their employer or from each other.

In fact, failing to feel a sense of belonging at work or connection with coworkers is a growing reason why employees quit their jobs. About half (50% and 48% in 2021) left a previous job because they didn’t feel like they belonged, and more employees now say they left a previous job because they had difficulty connecting with colleagues (42% vs. 37% in 2021).

“What happens outside of work has a direct impact on how people show up. It’s no longer enough for leaders to think of a person in one dimension – as an employee or as a professional within the organization,” said  Ginnie Carlier , EY Americas Vice Chair – Talent. “Leading with empathy helps move from the transactional and to the transformational Human Value Proposition, where people feel supported both personally and professionally.”

2023 EY Empathy in Business Survey methodology

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