One of the components of the research project I’m currently involved in is collecting mental health information using the Mini International Neuropsychiatric Interview (MINI) Plus 5.01. This is a long-ish structured diagnostic interview for the major Axis 1 psychiatric disorders in DSM-IV and ICD-10, with most of the questions requiring a Y/N answer.
There is so much variety in how the participants I’ve tested approach the MINI, despite its relatively straight-forward structure. Some of the sections are a bit confronting (like the Suicidality section), and while some people take the questions in their stride, others are quite uncomfortable and need a lot of reassurance.
Other participants have a lot of trouble with the formal language of the interview – I know it so well that I can now simplify it and make it sound more casual – more like something that someone would say, rather than something out of a textbook (the MINI is already simplified and made more accessible to the layperson, but some parts still sound very formal). Other participants (quite rightly, in a sense), react negatively to the classifications – I don’t read these out, but some of the participants either ask me or peek at the interview sheets while I’m going through them.
There is a usually some nervous chuckling and I can see how anxious some people get – even at this informal, anonymous, completely voluntary level – about any kind of stain on their character; any kind of implication of pathology, or “strangeness”, or judgement on my behalf. The fear of being seen as an “insane subject” is alive and well.
Then there is the other end of the spectrum – people who almost seem to want to be classified, despite the fact that they are well within “healthy” parameters, as far as the MINI goes.
The MINI has a section on Anorexia Nervosa; this section requires the participant’s height and weight. Interestingly, this seems to be a touchy topic for male as well as female participants. It’s hard not to make comments at this point that reflect my own politics (i.e., you should have the body shape/size/weight you want, if you’re a healthy control), when the participant make disparaging remarks about their own weight, but I don’t feel that’d be professional. It’s a personal issue and I don’t want to add to it. But I also feel that by not responding, it might seem like I’m silently agreeing with negative comments.
Anyway, the variety of responses is really interesting. I love this part of research – talking to people to collect data – as much as I like collecting non-verbal data, and looking at squigly lines on the screen.
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1. MINI Plus English Version 5.0 ©1994-2006 Sheehan DV & Lecrubier Y
The Intruder's Den 
“it might seem like I’m silently agreeing with negative comments.”
This reminds me of an article I read on “enfranchising silence” by Philip Pettit.
I’m often surprised how much can be taken from yes or no answers to questions. I suppose in series, they represent enough degrees of freedom that you can discern patterns from them. Still surprises me, I guess.
Suicidality sounds hugely confronting
But from personal experience if there was anyone I would want asking me those questions, you’d be on the list for sure.
Often (in my experience 70%+ of the time) people don’t just give Y/N answers – they volunteer details. And sometimes (say 10% of the time) I need to ask for details, depending on their answers. So yes…there is a lot of room around Y/N, heh.
I will look up the article you mentioned – I absolutely believe that silence/inaction = action. When good men [sic] do nothing, etc.
But I feel it’s unprofessional of me to present my worldview unless expressly asked to do so in these circumstances, and I don’t usually intervene unless someone becomes distressed.