What to Do about Positive and Negative Items in Studies of Psychological Well-Being and Ill-Being?

items (or subfactors) also score low on negative items (or subfactors). Considerable literature documents that mixed valence items do not always perform as bipolar continua. For example, the bipolarity (versus independence) of positive and negative affect has been extensively disputed [1–4] ; similarly, among those who have jointly assessed psychological well-being and ill-being, there is clear evidence that the absence of ill-being is no guarantee of the presence of well-being, or vice versa [5, 6] . Collectively, such research has clarified that diverse combinations of positive and negative psychological functioning are an empirical reality. A second point involves the challenge of how to conceptualize psychological well-being (or ill-being). Here we emphasize the important role of theoretical constructs, which provide defining features of what it means to have good (or poor) mental health. Using psychological well-being as an illustration, we reiterate that the six dimensions of positive psychological functioning central to our research emerged from an integration of numerous strands of theory [7] . Building on points of convergence in these diverse conceptualizations, six separate aspects of well-being were articulated. These were then translated to the empirical level using the construct-oriented approach to personality assessment [8] . Specifically, definitions of high scorers and low scorers for each dimension served as the basis for writing self-descriptive items to measure the degree to which an individual has, or lacks, particular aspects of well-being. Thus, to receive a high score on self-acceptance, for example, the respondent must strongly endorse items written to describe a high scorer and strongly disagree with items written to describe a low scorer. This mixing of item valence is done to comprehensively capture the meaning of theoretical constructs that guide the enterprise. And, as noted in our first point above, strongly agreeing with positive aspects for any dimension of well-being does inevitably mean that one will also strongly disagree with the negative aspects. Hence, the central reason for why it is critical to measure both. A third reason for employing both positively and negatively worded items in the measurement of psychological well-being (or ill-being) is methodological. Here the concern is with ‘acquiescence response bias’ – i.e., the tendency shown by some, perhaps inattentive respondents, to agree with all items. Numerous well-established personality inventories [9–11] routinely employ mixed-valence items for this reason. Controlling for such response sets thus also motivates the use of positively and negatively worded items. Adding to the complexity, we note that item valence (i.e. positive versus negative wording) is not synonymous with whether items describe high versus low scorers on any dimension of well-being. That is, both positively and negatively phrased items are used to operationalize what it means to be high or low on autonomy. Simply put, valence itself does not signify item content (whether it measures high or low wellbeing for any dimension); rather, content is determined by each We appreciate the observations from Stephen Joseph regarding an important matter in mental health research – namely, how to deal with the mix of positively and negatively worded items that comprise many scales designed to assess constructs of psychological well-being and ill-being. Joseph illustrates this issue with items from the Center for Epidemiological Studies Depression Scale (CES-D), four of which measure positive qualities (feeling hopeful, happy, enjoying life, seeing oneself as good as other people), while the remaining 16 items address different depressive symptoms. Factor analytic studies have shown that positive affect indeed constitutes a separate subfactor of the CES-D. Joseph describes this mix of positively and negatively worded items as the ‘statistical bipolarity of the CES-D,’ and asks whether it undermines, or at least confuses, our efforts to assess whether psychological well-being and ill-being have different biological correlates. The implication is that such a question cannot be clearly answered if what is deemed ill-being (e.g., the CES-D) is, itself, composed of both positively and negatively worded items. This concern could not be more on target with regard to the conceptualization and measurement of mental health, broadly defined. In responding to it, we note that the issues pertain to more than the CES-D. That is, all six scales of psychological wellbeing also, by design, include a balanced mix of positively and negatively worded items. For example, purpose in life is measured with items that exemplify both a high scorer (e.g., ‘I have a sense of direction and purpose in life’) as well as items that define a low scorer (e.g., ‘My daily activities often seem trivial and unimportant to me’). Why is this so? And more importantly, does it muddy the waters when we seek to contrast good psychological functioning from psychological maladjustment and probe biological correlates of each? We offer three observations on these issues. The first pertains largely to terminology, namely, the phrase ‘scale bipolarity. ’ That both positively and negatively worded items are included in a scale does not inherently mean that it functions as a bipolar continuum. Only by analyzing the empirical data can it be determined, whether mixed valence items are, indeed, strongly inversely correlated, such that those who score high on positive