As well as what new topics to add, participants were asked about how existing questionnaire content from the 2014 survey should be updated or adapted for the 2022 survey. Several participants flagged the need to maintain consistency in questions so that trends over time can be constructed, and how this needed to be balanced against the benefits of updating any section. In some academic events people expressed frustration when a question changed between waves, inhibiting the ability to monitor temporal trends, making it difficult to control in the same way or to test whether a strength of association had changed over time. Any move to improve questions or modules can involve a trade off, and it is not always possible to anticipate where changing an item will cause problems for a future analysis. Changes therefore should be undertaken with caution and where there is a real need.
Childhood sexual abuse (CSA)
APMS asks about experience of childhood sexual abuse (CSA). Government participants requested expanding this section to ask about perpetration of CSA as well. They explained that information about perpetration and how many people have a sexual interest in children is unknown and would be helpful for policy decisions. They stated that European and Canadian surveys asked a similar question. Related queries were raised about the low levels of reporting of domestic violence perpetration.
Additionally, there was a request to include people who had experienced CSA, about whether they had accessed and taken-up support for this; as well as the barriers they experienced to accessing support.
Discrimination and stigma
There was a request to expand the 2014 discrimination questions and to gather more information about the nature and location (e.g. at work, on transport/in public, at home) of incidents of discrimination.
Furthermore, participants with lived experience of mental ill-health suggested the survey may benefit from collecting information of the experience of mental health stigma, both in terms of stigma experienced by people with a mental health condition, but broader public perceptions of those with mental health conditions. They did not suggest a particular scale to use. Stigma has already been explored on other surveys, such as the British Social Attitudes series.
Drugs, alcohol, and smoking/nicotine
The consultation highlighted that the illicit drug use response options will need to be updated for the 2022 survey, to reflect changes in language since the last survey.
Those using the alcohol data for secondary analysis favoured the Alcohol Use Disorders Identification Test (AUDIT, 10-item) and suggested the Severity of Alcohol Dependence Questionnaire (SADQ, 20-item) could be removed and questions on drug and alcohol treatment included instead.
Additionally, there was concern that alcohol consumption is asked about in terms of ‘units’. Respondents questioned whether the general public understand alcohol unit measures and therefore how accurate their responses are. An alternative approach was not proposed.
Respondent’s highlighted that those who did not currently drink alcohol but who may have former or sustained alcohol related problems were not identifiable in the data.
One further suggestion was to ask about family substance use history. And another to ask if individuals had obtained prescribed medication illegally.
There was a suggestion to ask about vaping, alongside smoking.
Since the 2014 APMS, there has been an increasing interest in accurate measurement of personality disorder. As such, consultation participants suggested the need to revise and update the personality disorder questions. They suggested that the 2014 APMS questions are limited and too narrow in focus. In 2014 the SCID-II was used to measure antisocial personality disorder (ASPD), however consultation participants questioned how honestly people respond to these items, given their sensitivity. An alternative scale was not suggested. One alternative approach was to conduct an analysis of a cluster of behaviours, symptoms and experiences that are common among those with a personality disorder.
Consultation participants recommended that the APMS should review naming and symptom conventions for mental health conditions to make sure these are up to date with any changes since 2014. For example, there are more personality disorders, a growing interest in complex post-traumatic stress disorder, as well as disassociation disorder.
Post-traumatic stress disorder (PTSD)
There was a request to expand the 2014 trauma questions to collect information on when incidents happened, (e.g. the year).
Participants also asked if complex-PTSD would be captured in the next survey.
The 2014 survey included an item on whether the survey respondent had ever been in prison. This item has proved useful, and suggestions were made for follow-up questions to be asked of those reporting having been in prison, including: how long since they most recently left, how many terms served, length of longest sentence, psychiatric service contact in prison, nature of any treatment in prison, and whether referred for psychiatric treatment at point of release.
Suggested content - Other
The following content was mentioned by one or two survey participants as possible topics to add or amend. Although these are not being prioritised for inclusion in the 2022 survey, we recommend that they be considered when the next survey in the series is being planned.
- Alexithymia – difficulty with identifying and describing emotions
- Caffeine dependence and impact
- Chronic fatigue
- Climate related exposures
- Coping strategies
- Dissociative Identity Disorder
- Electromagnetic radiation exposure
- Head injuries
- Health literacy and public health messaging – sources of information
- Hypermobility conditions
- Iatrogenic trauma – harm caused by medical examination or treatment
- Mental health awareness in education and training
- Misdiagnosis – differences between self-identified conditions and the views of health professionals, and changes over time in how symptoms are viewed.