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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."

2.2 Approaches to Research

Learning objectives.

By the end of this section, you will be able to:

• Describe the different research methods used by psychologists
• Discuss the strengths and weaknesses of case studies, naturalistic observation, surveys, and archival research
• Compare longitudinal and cross-sectional approaches to research
• Compare and contrast correlation and causation

There are many research methods available to psychologists in their efforts to understand, describe, and explain behavior and the cognitive and biological processes that underlie it. Some methods rely on observational techniques. Other approaches involve interactions between the researcher and the individuals who are being studied—ranging from a series of simple questions to extensive, in-depth interviews—to well-controlled experiments.

Each of these research methods has unique strengths and weaknesses, and each method may only be appropriate for certain types of research questions. For example, studies that rely primarily on observation produce incredible amounts of information, but the ability to apply this information to the larger population is somewhat limited because of small sample sizes. Survey research, on the other hand, allows researchers to easily collect data from relatively large samples. While this allows for results to be generalized to the larger population more easily, the information that can be collected on any given survey is somewhat limited and subject to problems associated with any type of self-reported data. Some researchers conduct archival research by using existing records. While this can be a fairly inexpensive way to collect data that can provide insight into a number of research questions, researchers using this approach have no control on how or what kind of data was collected. All of the methods described thus far are correlational in nature. This means that researchers can speak to important relationships that might exist between two or more variables of interest. However, correlational data cannot be used to make claims about cause-and-effect relationships.

Correlational research can find a relationship between two variables, but the only way a researcher can claim that the relationship between the variables is cause and effect is to perform an experiment. In experimental research, which will be discussed later in this chapter, there is a tremendous amount of control over variables of interest. While this is a powerful approach, experiments are often conducted in artificial settings. This calls into question the validity of experimental findings with regard to how they would apply in real-world settings. In addition, many of the questions that psychologists would like to answer cannot be pursued through experimental research because of ethical concerns.

Clinical or Case Studies

In 2011, the New York Times published a feature story on Krista and Tatiana Hogan, Canadian twin girls. These particular twins are unique because Krista and Tatiana are conjoined twins, connected at the head. There is evidence that the two girls are connected in a part of the brain called the thalamus, which is a major sensory relay center. Most incoming sensory information is sent through the thalamus before reaching higher regions of the cerebral cortex for processing.

Link to Learning

Watch this CBC video about Krista's and Tatiana's lives to learn more.

The implications of this potential connection mean that it might be possible for one twin to experience the sensations of the other twin. For instance, if Krista is watching a particularly funny television program, Tatiana might smile or laugh even if she is not watching the program. This particular possibility has piqued the interest of many neuroscientists who seek to understand how the brain uses sensory information.

These twins represent an enormous resource in the study of the brain, and since their condition is very rare, it is likely that as long as their family agrees, scientists will follow these girls very closely throughout their lives to gain as much information as possible (Dominus, 2011).

Over time, it has become clear that while Krista and Tatiana share some sensory experiences and motor control, they remain two distinct individuals, which provides invaluable insight for researchers interested in the mind and the brain (Egnor, 2017).

In observational research, scientists are conducting a clinical or case study when they focus on one person or just a few individuals. Indeed, some scientists spend their entire careers studying just 10–20 individuals. Why would they do this? Obviously, when they focus their attention on a very small number of people, they can gain a precious amount of insight into those cases. The richness of information that is collected in clinical or case studies is unmatched by any other single research method. This allows the researcher to have a very deep understanding of the individuals and the particular phenomenon being studied.

If clinical or case studies provide so much information, why are they not more frequent among researchers? As it turns out, the major benefit of this particular approach is also a weakness. As mentioned earlier, this approach is often used when studying individuals who are interesting to researchers because they have a rare characteristic. Therefore, the individuals who serve as the focus of case studies are not like most other people. If scientists ultimately want to explain all behavior, focusing attention on such a special group of people can make it difficult to generalize any observations to the larger population as a whole. Generalizing refers to the ability to apply the findings of a particular research project to larger segments of society. Again, case studies provide enormous amounts of information, but since the cases are so specific, the potential to apply what’s learned to the average person may be very limited.

Naturalistic Observation

If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances are that almost everyone in the classroom will raise their hand, but do you think hand washing after every trip to the restroom is really that universal?

This is very similar to the phenomenon mentioned earlier in this chapter: many individuals do not feel comfortable answering a question honestly. But if we are committed to finding out the facts about hand washing, we have other options available to us.

Suppose we send a classmate into the restroom to actually watch whether everyone washes their hands after using the restroom. Will our observer blend into the restroom environment by wearing a white lab coat, sitting with a clipboard, and staring at the sinks? We want our researcher to be inconspicuous—perhaps standing at one of the sinks pretending to put in contact lenses while secretly recording the relevant information. This type of observational study is called naturalistic observation : observing behavior in its natural setting. To better understand peer exclusion, Suzanne Fanger collaborated with colleagues at the University of Texas to observe the behavior of preschool children on a playground. How did the observers remain inconspicuous over the duration of the study? They equipped a few of the children with wireless microphones (which the children quickly forgot about) and observed while taking notes from a distance. Also, the children in that particular preschool (a “laboratory preschool”) were accustomed to having observers on the playground (Fanger, Frankel, & Hazen, 2012).

It is critical that the observer be as unobtrusive and as inconspicuous as possible: when people know they are being watched, they are less likely to behave naturally. If you have any doubt about this, ask yourself how your driving behavior might differ in two situations: In the first situation, you are driving down a deserted highway during the middle of the day; in the second situation, you are being followed by a police car down the same deserted highway ( Figure 2.7 ).

It should be pointed out that naturalistic observation is not limited to research involving humans. Indeed, some of the best-known examples of naturalistic observation involve researchers going into the field to observe various kinds of animals in their own environments. As with human studies, the researchers maintain their distance and avoid interfering with the animal subjects so as not to influence their natural behaviors. Scientists have used this technique to study social hierarchies and interactions among animals ranging from ground squirrels to gorillas. The information provided by these studies is invaluable in understanding how those animals organize socially and communicate with one another. The anthropologist Jane Goodall , for example, spent nearly five decades observing the behavior of chimpanzees in Africa ( Figure 2.8 ). As an illustration of the types of concerns that a researcher might encounter in naturalistic observation, some scientists criticized Goodall for giving the chimps names instead of referring to them by numbers—using names was thought to undermine the emotional detachment required for the objectivity of the study (McKie, 2010).

The greatest benefit of naturalistic observation is the validity , or accuracy, of information collected unobtrusively in a natural setting. Having individuals behave as they normally would in a given situation means that we have a higher degree of ecological validity, or realism, than we might achieve with other research approaches. Therefore, our ability to generalize the findings of the research to real-world situations is enhanced. If done correctly, we need not worry about people or animals modifying their behavior simply because they are being observed. Sometimes, people may assume that reality programs give us a glimpse into authentic human behavior. However, the principle of inconspicuous observation is violated as reality stars are followed by camera crews and are interviewed on camera for personal confessionals. Given that environment, we must doubt how natural and realistic their behaviors are.

The major downside of naturalistic observation is that they are often difficult to set up and control. In our restroom study, what if you stood in the restroom all day prepared to record people’s hand washing behavior and no one came in? Or, what if you have been closely observing a troop of gorillas for weeks only to find that they migrated to a new place while you were sleeping in your tent? The benefit of realistic data comes at a cost. As a researcher you have no control of when (or if) you have behavior to observe. In addition, this type of observational research often requires significant investments of time, money, and a good dose of luck.

Sometimes studies involve structured observation. In these cases, people are observed while engaging in set, specific tasks. An excellent example of structured observation comes from Strange Situation by Mary Ainsworth (you will read more about this in the chapter on lifespan development). The Strange Situation is a procedure used to evaluate attachment styles that exist between an infant and caregiver. In this scenario, caregivers bring their infants into a room filled with toys. The Strange Situation involves a number of phases, including a stranger coming into the room, the caregiver leaving the room, and the caregiver’s return to the room. The infant’s behavior is closely monitored at each phase, but it is the behavior of the infant upon being reunited with the caregiver that is most telling in terms of characterizing the infant’s attachment style with the caregiver.

Another potential problem in observational research is observer bias . Generally, people who act as observers are closely involved in the research project and may unconsciously skew their observations to fit their research goals or expectations. To protect against this type of bias, researchers should have clear criteria established for the types of behaviors recorded and how those behaviors should be classified. In addition, researchers often compare observations of the same event by multiple observers, in order to test inter-rater reliability : a measure of reliability that assesses the consistency of observations by different observers.

Often, psychologists develop surveys as a means of gathering data. Surveys are lists of questions to be answered by research participants, and can be delivered as paper-and-pencil questionnaires, administered electronically, or conducted verbally ( Figure 2.9 ). Generally, the survey itself can be completed in a short time, and the ease of administering a survey makes it easy to collect data from a large number of people.

Surveys allow researchers to gather data from larger samples than may be afforded by other research methods . A sample is a subset of individuals selected from a population , which is the overall group of individuals that the researchers are interested in. Researchers study the sample and seek to generalize their findings to the population. Generally, researchers will begin this process by calculating various measures of central tendency from the data they have collected. These measures provide an overall summary of what a typical response looks like. There are three measures of central tendency: mode, median, and mean. The mode is the most frequently occurring response, the median lies at the middle of a given data set, and the mean is the arithmetic average of all data points. Means tend to be most useful in conducting additional analyses like those described below; however, means are very sensitive to the effects of outliers, and so one must be aware of those effects when making assessments of what measures of central tendency tell us about a data set in question.

There is both strength and weakness of the survey in comparison to case studies. By using surveys, we can collect information from a larger sample of people. A larger sample is better able to reflect the actual diversity of the population, thus allowing better generalizability. Therefore, if our sample is sufficiently large and diverse, we can assume that the data we collect from the survey can be generalized to the larger population with more certainty than the information collected through a case study. However, given the greater number of people involved, we are not able to collect the same depth of information on each person that would be collected in a case study.

Another potential weakness of surveys is something we touched on earlier in this chapter: People don't always give accurate responses. They may lie, misremember, or answer questions in a way that they think makes them look good. For example, people may report drinking less alcohol than is actually the case.

Any number of research questions can be answered through the use of surveys. One real-world example is the research conducted by Jenkins, Ruppel, Kizer, Yehl, and Griffin (2012) about the backlash against the US Arab-American community following the terrorist attacks of September 11, 2001. Jenkins and colleagues wanted to determine to what extent these negative attitudes toward Arab-Americans still existed nearly a decade after the attacks occurred. In one study, 140 research participants filled out a survey with 10 questions, including questions asking directly about the participant’s overt prejudicial attitudes toward people of various ethnicities. The survey also asked indirect questions about how likely the participant would be to interact with a person of a given ethnicity in a variety of settings (such as, “How likely do you think it is that you would introduce yourself to a person of Arab-American descent?”). The results of the research suggested that participants were unwilling to report prejudicial attitudes toward any ethnic group. However, there were significant differences between their pattern of responses to questions about social interaction with Arab-Americans compared to other ethnic groups: they indicated less willingness for social interaction with Arab-Americans compared to the other ethnic groups. This suggested that the participants harbored subtle forms of prejudice against Arab-Americans, despite their assertions that this was not the case (Jenkins et al., 2012).

Archival Research

Some researchers gain access to large amounts of data without interacting with a single research participant. Instead, they use existing records to answer various research questions. This type of research approach is known as archival research . Archival research relies on looking at past records or data sets to look for interesting patterns or relationships.

For example, a researcher might access the academic records of all individuals who enrolled in college within the past ten years and calculate how long it took them to complete their degrees, as well as course loads, grades, and extracurricular involvement. Archival research could provide important information about who is most likely to complete their education, and it could help identify important risk factors for struggling students ( Figure 2.10 ).

In comparing archival research to other research methods, there are several important distinctions. For one, the researcher employing archival research never directly interacts with research participants. Therefore, the investment of time and money to collect data is considerably less with archival research. Additionally, researchers have no control over what information was originally collected. Therefore, research questions have to be tailored so they can be answered within the structure of the existing data sets. There is also no guarantee of consistency between the records from one source to another, which might make comparing and contrasting different data sets problematic.

Longitudinal and Cross-Sectional Research

Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again at age 40.

Another approach is cross-sectional research. In cross-sectional research , a researcher compares multiple segments of the population at the same time. Using the dietary habits example above, the researcher might directly compare different groups of people by age. Instead of studying a group of people for 20 years to see how their dietary habits changed from decade to decade, the researcher would study a group of 20-year-old individuals and compare them to a group of 30-year-old individuals and a group of 40-year-old individuals. While cross-sectional research requires a shorter-term investment, it is also limited by differences that exist between the different generations (or cohorts) that have nothing to do with age per se, but rather reflect the social and cultural experiences of different generations of individuals that make them different from one another.

To illustrate this concept, consider the following survey findings. In recent years there has been significant growth in the popular support of same-sex marriage. Many studies on this topic break down survey participants into different age groups. In general, younger people are more supportive of same-sex marriage than are those who are older (Jones, 2013). Does this mean that as we age we become less open to the idea of same-sex marriage, or does this mean that older individuals have different perspectives because of the social climates in which they grew up? Longitudinal research is a powerful approach because the same individuals are involved in the research project over time, which means that the researchers need to be less concerned with differences among cohorts affecting the results of their study.

Often longitudinal studies are employed when researching various diseases in an effort to understand particular risk factors. Such studies often involve tens of thousands of individuals who are followed for several decades. Given the enormous number of people involved in these studies, researchers can feel confident that their findings can be generalized to the larger population. The Cancer Prevention Study-3 (CPS-3) is one of a series of longitudinal studies sponsored by the American Cancer Society aimed at determining predictive risk factors associated with cancer. When participants enter the study, they complete a survey about their lives and family histories, providing information on factors that might cause or prevent the development of cancer. Then every few years the participants receive additional surveys to complete. In the end, hundreds of thousands of participants will be tracked over 20 years to determine which of them develop cancer and which do not.

Clearly, this type of research is important and potentially very informative. For instance, earlier longitudinal studies sponsored by the American Cancer Society provided some of the first scientific demonstrations of the now well-established links between increased rates of cancer and smoking (American Cancer Society, n.d.) ( Figure 2.11 ).

As with any research strategy, longitudinal research is not without limitations. For one, these studies require an incredible time investment by the researcher and research participants. Given that some longitudinal studies take years, if not decades, to complete, the results will not be known for a considerable period of time. In addition to the time demands, these studies also require a substantial financial investment. Many researchers are unable to commit the resources necessary to see a longitudinal project through to the end.

Research participants must also be willing to continue their participation for an extended period of time, and this can be problematic. People move, get married and take new names, get ill, and eventually die. Even without significant life changes, some people may simply choose to discontinue their participation in the project. As a result, the attrition rates, or reduction in the number of research participants due to dropouts, in longitudinal studies are quite high and increase over the course of a project. For this reason, researchers using this approach typically recruit many participants fully expecting that a substantial number will drop out before the end. As the study progresses, they continually check whether the sample still represents the larger population, and make adjustments as necessary.

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Case Studies

This guide examines case studies, a form of qualitative descriptive research that is used to look at individuals, a small group of participants, or a group as a whole. Researchers collect data about participants using participant and direct observations, interviews, protocols, tests, examinations of records, and collections of writing samples. Starting with a definition of the case study, the guide moves to a brief history of this research method. Using several well documented case studies, the guide then looks at applications and methods including data collection and analysis. A discussion of ways to handle validity, reliability, and generalizability follows, with special attention to case studies as they are applied to composition studies. Finally, this guide examines the strengths and weaknesses of case studies.

Definition and Overview

Case study refers to the collection and presentation of detailed information about a particular participant or small group, frequently including the accounts of subjects themselves. A form of qualitative descriptive research, the case study looks intensely at an individual or small participant pool, drawing conclusions only about that participant or group and only in that specific context. Researchers do not focus on the discovery of a universal, generalizable truth, nor do they typically look for cause-effect relationships; instead, emphasis is placed on exploration and description.

Case studies typically examine the interplay of all variables in order to provide as complete an understanding of an event or situation as possible. This type of comprehensive understanding is arrived at through a process known as thick description, which involves an in-depth description of the entity being evaluated, the circumstances under which it is used, the characteristics of the people involved in it, and the nature of the community in which it is located. Thick description also involves interpreting the meaning of demographic and descriptive data such as cultural norms and mores, community values, ingrained attitudes, and motives.

Unlike quantitative methods of research, like the survey, which focus on the questions of who, what, where, how much, and how many, and archival analysis, which often situates the participant in some form of historical context, case studies are the preferred strategy when how or why questions are asked. Likewise, they are the preferred method when the researcher has little control over the events, and when there is a contemporary focus within a real life context. In addition, unlike more specifically directed experiments, case studies require a problem that seeks a holistic understanding of the event or situation in question using inductive logic--reasoning from specific to more general terms.

In scholarly circles, case studies are frequently discussed within the context of qualitative research and naturalistic inquiry. Case studies are often referred to interchangeably with ethnography, field study, and participant observation. The underlying philosophical assumptions in the case are similar to these types of qualitative research because each takes place in a natural setting (such as a classroom, neighborhood, or private home), and strives for a more holistic interpretation of the event or situation under study.

Unlike more statistically-based studies which search for quantifiable data, the goal of a case study is to offer new variables and questions for further research. F.H. Giddings, a sociologist in the early part of the century, compares statistical methods to the case study on the basis that the former are concerned with the distribution of a particular trait, or a small number of traits, in a population, whereas the case study is concerned with the whole variety of traits to be found in a particular instance" (Hammersley 95).

Case studies are not a new form of research; naturalistic inquiry was the primary research tool until the development of the scientific method. The fields of sociology and anthropology are credited with the primary shaping of the concept as we know it today. However, case study research has drawn from a number of other areas as well: the clinical methods of doctors; the casework technique being developed by social workers; the methods of historians and anthropologists, plus the qualitative descriptions provided by quantitative researchers like LePlay; and, in the case of Robert Park, the techniques of newspaper reporters and novelists.

Park was an ex-newspaper reporter and editor who became very influential in developing sociological case studies at the University of Chicago in the 1920s. As a newspaper professional he coined the term "scientific" or "depth" reporting: the description of local events in a way that pointed to major social trends. Park viewed the sociologist as "merely a more accurate, responsible, and scientific reporter." Park stressed the variety and value of human experience. He believed that sociology sought to arrive at natural, but fluid, laws and generalizations in regard to human nature and society. These laws weren't static laws of the kind sought by many positivists and natural law theorists, but rather, they were laws of becoming--with a constant possibility of change. Park encouraged students to get out of the library, to quit looking at papers and books, and to view the constant experiment of human experience. He writes, "Go and sit in the lounges of the luxury hotels and on the doorsteps of the flophouses; sit on the Gold Coast settees and on the slum shakedowns; sit in the Orchestra Hall and in the Star and Garter Burlesque. In short, gentlemen [sic], go get the seats of your pants dirty in real research."

But over the years, case studies have drawn their share of criticism. In fact, the method had its detractors from the start. In the 1920s, the debate between pro-qualitative and pro-quantitative became quite heated. Case studies, when compared to statistics, were considered by many to be unscientific. From the 1930's on, the rise of positivism had a growing influence on quantitative methods in sociology. People wanted static, generalizable laws in science. The sociological positivists were looking for stable laws of social phenomena. They criticized case study research because it failed to provide evidence of inter subjective agreement. Also, they condemned it because of the few number of cases studied and that the under-standardized character of their descriptions made generalization impossible. By the 1950s, quantitative methods, in the form of survey research, had become the dominant sociological approach and case study had become a minority practice.

Educational Applications

The 1950's marked the dawning of a new era in case study research, namely that of the utilization of the case study as a teaching method. "Instituted at Harvard Business School in the 1950s as a primary method of teaching, cases have since been used in classrooms and lecture halls alike, either as part of a course of study or as the main focus of the course to which other teaching material is added" (Armisted 1984). The basic purpose of instituting the case method as a teaching strategy was "to transfer much of the responsibility for learning from the teacher on to the student, whose role, as a result, shifts away from passive absorption toward active construction" (Boehrer 1990). Through careful examination and discussion of various cases, "students learn to identify actual problems, to recognize key players and their agendas, and to become aware of those aspects of the situation that contribute to the problem" (Merseth 1991). In addition, students are encouraged to "generate their own analysis of the problems under consideration, to develop their own solutions, and to practically apply their own knowledge of theory to these problems" (Boyce 1993). Along the way, students also develop "the power to analyze and to master a tangled circumstance by identifying and delineating important factors; the ability to utilize ideas, to test them against facts, and to throw them into fresh combinations" (Merseth 1991).

In addition to the practical application and testing of scholarly knowledge, case discussions can also help students prepare for real-world problems, situations and crises by providing an approximation of various professional environments (i.e. classroom, board room, courtroom, or hospital). Thus, through the examination of specific cases, students are given the opportunity to work out their own professional issues through the trials, tribulations, experiences, and research findings of others. An obvious advantage to this mode of instruction is that it allows students the exposure to settings and contexts that they might not otherwise experience. For example, a student interested in studying the effects of poverty on minority secondary student's grade point averages and S.A.T. scores could access and analyze information from schools as geographically diverse as Los Angeles, New York City, Miami, and New Mexico without ever having to leave the classroom.

The case study method also incorporates the idea that students can learn from one another "by engaging with each other and with each other's ideas, by asserting something and then having it questioned, challenged and thrown back at them so that they can reflect on what they hear, and then refine what they say" (Boehrer 1990). In summary, students can direct their own learning by formulating questions and taking responsibility for the study.

Types and Design Concerns

Researchers use multiple methods and approaches to conduct case studies.

Types of Case Studies

Under the more generalized category of case study exist several subdivisions, each of which is custom selected for use depending upon the goals and/or objectives of the investigator. These types of case study include the following:

Illustrative Case Studies These are primarily descriptive studies. They typically utilize one or two instances of an event to show what a situation is like. Illustrative case studies serve primarily to make the unfamiliar familiar and to give readers a common language about the topic in question.

Exploratory (or pilot) Case Studies These are condensed case studies performed before implementing a large scale investigation. Their basic function is to help identify questions and select types of measurement prior to the main investigation. The primary pitfall of this type of study is that initial findings may seem convincing enough to be released prematurely as conclusions.

Cumulative Case Studies These serve to aggregate information from several sites collected at different times. The idea behind these studies is the collection of past studies will allow for greater generalization without additional cost or time being expended on new, possibly repetitive studies.

Critical Instance Case Studies These examine one or more sites for either the purpose of examining a situation of unique interest with little to no interest in generalizability, or to call into question or challenge a highly generalized or universal assertion. This method is useful for answering cause and effect questions.

Identifying a Theoretical Perspective

Much of the case study's design is inherently determined for researchers, depending on the field from which they are working. In composition studies, researchers are typically working from a qualitative, descriptive standpoint. In contrast, physicists will approach their research from a more quantitative perspective. Still, in designing the study, researchers need to make explicit the questions to be explored and the theoretical perspective from which they will approach the case. The three most commonly adopted theories are listed below:

Individual Theories These focus primarily on the individual development, cognitive behavior, personality, learning and disability, and interpersonal interactions of a particular subject.

Organizational Theories These focus on bureaucracies, institutions, organizational structure and functions, or excellence in organizational performance.

Social Theories These focus on urban development, group behavior, cultural institutions, or marketplace functions.

Two examples of case studies are used consistently throughout this chapter. The first, a study produced by Berkenkotter, Huckin, and Ackerman (1988), looks at a first year graduate student's initiation into an academic writing program. The study uses participant-observer and linguistic data collecting techniques to assess the student's knowledge of appropriate discourse conventions. Using the pseudonym Nate to refer to the subject, the study sought to illuminate the particular experience rather than to generalize about the experience of fledgling academic writers collectively.

For example, in Berkenkotter, Huckin, and Ackerman's (1988) study we are told that the researchers are interested in disciplinary communities. In the first paragraph, they ask what constitutes membership in a disciplinary community and how achieving membership might affect a writer's understanding and production of texts. In the third paragraph they state that researchers must negotiate their claims "within the context of his sub specialty's accepted knowledge and methodology." In the next paragraph they ask, "How is literacy acquired? What is the process through which novices gain community membership? And what factors either aid or hinder students learning the requisite linguistic behaviors?" This introductory section ends with a paragraph in which the study's authors claim that during the course of the study, the subject, Nate, successfully makes the transition from "skilled novice" to become an initiated member of the academic discourse community and that his texts exhibit linguistic changes which indicate this transition. In the next section the authors make explicit the sociolinguistic theoretical and methodological assumptions on which the study is based (1988). Thus the reader has a good understanding of the authors' theoretical background and purpose in conducting the study even before it is explicitly stated on the fourth page of the study. "Our purpose was to examine the effects of the educational context on one graduate student's production of texts as he wrote in different courses and for different faculty members over the academic year 1984-85." The goal of the study then, was to explore the idea that writers must be initiated into a writing community, and that this initiation will change the way one writes.

The second example is Janet Emig's (1971) study of the composing process of a group of twelfth graders. In this study, Emig seeks to answer the question of what happens to the self as a result educational stimuli in terms of academic writing. The case study used methods such as protocol analysis, tape-recorded interviews, and discourse analysis.

In the case of Janet Emig's (1971) study of the composing process of eight twelfth graders, four specific hypotheses were made:

• Twelfth grade writers engage in two modes of composing: reflexive and extensive.
• These differences can be ascertained and characterized through having the writers compose aloud their composition process.
• A set of implied stylistic principles governs the writing process.
• For twelfth grade writers, extensive writing occurs chiefly as a school-sponsored activity, or reflexive, as a self-sponsored activity.

In this study, the chief distinction is between the two dominant modes of composing among older, secondary school students. The distinctions are:

• The reflexive mode, which focuses on the writer's thoughts and feelings.
• The extensive mode, which focuses on conveying a message.

Emig also outlines the specific questions which guided the research in the opening pages of her Review of Literature , preceding the report.

Designing a Case Study

After considering the different sub categories of case study and identifying a theoretical perspective, researchers can begin to design their study. Research design is the string of logic that ultimately links the data to be collected and the conclusions to be drawn to the initial questions of the study. Typically, research designs deal with at least four problems:

• What questions to study
• What data are relevant
• What data to collect
• How to analyze that data

In other words, a research design is basically a blueprint for getting from the beginning to the end of a study. The beginning is an initial set of questions to be answered, and the end is some set of conclusions about those questions.

Because case studies are conducted on topics as diverse as Anglo-Saxon Literature (Thrane 1986) and AIDS prevention (Van Vugt 1994), it is virtually impossible to outline any strict or universal method or design for conducting the case study. However, Robert K. Yin (1993) does offer five basic components of a research design:

• A study's questions.
• A study's propositions (if any).
• A study's units of analysis.
• The logic that links the data to the propositions.
• The criteria for interpreting the findings.

In addition to these five basic components, Yin also stresses the importance of clearly articulating one's theoretical perspective, determining the goals of the study, selecting one's subject(s), selecting the appropriate method(s) of collecting data, and providing some considerations to the composition of the final report.

Conducting Case Studies

To obtain as complete a picture of the participant as possible, case study researchers can employ a variety of approaches and methods. These approaches, methods, and related issues are discussed in depth in this section.

Method: Single or Multi-modal?

To obtain as complete a picture of the participant as possible, case study researchers can employ a variety of methods. Some common methods include interviews , protocol analyses, field studies, and participant-observations. Emig (1971) chose to use several methods of data collection. Her sources included conversations with the students, protocol analysis, discrete observations of actual composition, writing samples from each student, and school records (Lauer and Asher 1988).

Berkenkotter, Huckin, and Ackerman (1988) collected data by observing classrooms, conducting faculty and student interviews, collecting self reports from the subject, and by looking at the subject's written work.

A study that was criticized for using a single method model was done by Flower and Hayes (1984). In this study that explores the ways in which writers use different forms of knowing to create space, the authors used only protocol analysis to gather data. The study came under heavy fire because of their decision to use only one method.

Participant Selection

Case studies can use one participant, or a small group of participants. However, it is important that the participant pool remain relatively small. The participants can represent a diverse cross section of society, but this isn't necessary.

For example, the Berkenkotter, Huckin, and Ackerman (1988) study looked at just one participant, Nate. By contrast, in Janet Emig's (1971) study of the composition process of twelfth graders, eight participants were selected representing a diverse cross section of the community, with volunteers from an all-white upper-middle-class suburban school, an all-black inner-city school, a racially mixed lower-middle-class school, an economically and racially mixed school, and a university school.

Often, a brief "case history" is done on the participants of the study in order to provide researchers with a clearer understanding of their participants, as well as some insight as to how their own personal histories might affect the outcome of the study. For instance, in Emig's study, the investigator had access to the school records of five of the participants, and to standardized test scores for the remaining three. Also made available to the researcher was the information that three of the eight students were selected as NCTE Achievement Award winners. These personal histories can be useful in later stages of the study when data are being analyzed and conclusions drawn.

Data Collection

There are six types of data collected in case studies:

• Archival records.
• Interviews.
• Direct observation.
• Participant observation.

In the field of composition research, these six sources might be:

• A writer's drafts.
• School records of student writers.
• Transcripts of interviews with a writer.
• Transcripts of conversations between writers (and protocols).
• Videotapes and notes from direct field observations.
• Hard copies of a writer's work on computer.

Depending on whether researchers have chosen to use a single or multi-modal approach for the case study, they may choose to collect data from one or any combination of these sources.

Protocols, that is, transcriptions of participants talking aloud about what they are doing as they do it, have been particularly common in composition case studies. For example, in Emig's (1971) study, the students were asked, in four different sessions, to give oral autobiographies of their writing experiences and to compose aloud three themes in the presence of a tape recorder and the investigator.

In some studies, only one method of data collection is conducted. For example, the Flower and Hayes (1981) report on the cognitive process theory of writing depends on protocol analysis alone. However, using multiple sources of evidence to increase the reliability and validity of the data can be advantageous.

Case studies are likely to be much more convincing and accurate if they are based on several different sources of information, following a corroborating mode. This conclusion is echoed among many composition researchers. For example, in her study of predrafting processes of high and low-apprehensive writers, Cynthia Selfe (1985) argues that because "methods of indirect observation provide only an incomplete reflection of the complex set of processes involved in composing, a combination of several such methods should be used to gather data in any one study." Thus, in this study, Selfe collected her data from protocols, observations of students role playing their writing processes, audio taped interviews with the students, and videotaped observations of the students in the process of composing.

It can be said then, that cross checking data from multiple sources can help provide a multidimensional profile of composing activities in a particular setting. Sharan Merriam (1985) suggests "checking, verifying, testing, probing, and confirming collected data as you go, arguing that this process will follow in a funnel-like design resulting in less data gathering in later phases of the study along with a congruent increase in analysis checking, verifying, and confirming."

It is important to note that in case studies, as in any qualitative descriptive research, while researchers begin their studies with one or several questions driving the inquiry (which influence the key factors the researcher will be looking for during data collection), a researcher may find new key factors emerging during data collection. These might be unexpected patterns or linguistic features which become evident only during the course of the research. While not bearing directly on the researcher's guiding questions, these variables may become the basis for new questions asked at the end of the report, thus linking to the possibility of further research.

Data Analysis

As the information is collected, researchers strive to make sense of their data. Generally, researchers interpret their data in one of two ways: holistically or through coding. Holistic analysis does not attempt to break the evidence into parts, but rather to draw conclusions based on the text as a whole. Flower and Hayes (1981), for example, make inferences from entire sections of their students' protocols, rather than searching through the transcripts to look for isolatable characteristics.

However, composition researchers commonly interpret their data by coding, that is by systematically searching data to identify and/or categorize specific observable actions or characteristics. These observable actions then become the key variables in the study. Sharan Merriam (1988) suggests seven analytic frameworks for the organization and presentation of data:

• The role of participants.
• The network analysis of formal and informal exchanges among groups.
• Historical.
• Thematical.
• Ritual and symbolism.
• Critical incidents that challenge or reinforce fundamental beliefs, practices, and values.

There are two purposes of these frameworks: to look for patterns among the data and to look for patterns that give meaning to the case study.

As stated above, while most researchers begin their case studies expecting to look for particular observable characteristics, it is not unusual for key variables to emerge during data collection. Typical variables coded in case studies of writers include pauses writers make in the production of a text, the use of specific linguistic units (such as nouns or verbs), and writing processes (planning, drafting, revising, and editing). In the Berkenkotter, Huckin, and Ackerman (1988) study, for example, researchers coded the participant's texts for use of connectives, discourse demonstratives, average sentence length, off-register words, use of the first person pronoun, and the ratio of definite articles to indefinite articles.

Since coding is inherently subjective, more than one coder is usually employed. In the Berkenkotter, Huckin, and Ackerman (1988) study, for example, three rhetoricians were employed to code the participant's texts for off-register phrases. The researchers established the agreement among the coders before concluding that the participant used fewer off-register words as the graduate program progressed.

Composing the Case Study Report

In the many forms it can take, "a case study is generically a story; it presents the concrete narrative detail of actual, or at least realistic events, it has a plot, exposition, characters, and sometimes even dialogue" (Boehrer 1990). Generally, case study reports are extensively descriptive, with "the most problematic issue often referred to as being the determination of the right combination of description and analysis" (1990). Typically, authors address each step of the research process, and attempt to give the reader as much context as possible for the decisions made in the research design and for the conclusions drawn.

This contextualization usually includes a detailed explanation of the researchers' theoretical positions, of how those theories drove the inquiry or led to the guiding research questions, of the participants' backgrounds, of the processes of data collection, of the training and limitations of the coders, along with a strong attempt to make connections between the data and the conclusions evident.

Although the Berkenkotter, Huckin, and Ackerman (1988) study does not, case study reports often include the reactions of the participants to the study or to the researchers' conclusions. Because case studies tend to be exploratory, most end with implications for further study. Here researchers may identify significant variables that emerged during the research and suggest studies related to these, or the authors may suggest further general questions that their case study generated.

For example, Emig's (1971) study concludes with a section dedicated solely to the topic of implications for further research, in which she suggests several means by which this particular study could have been improved, as well as questions and ideas raised by this study which other researchers might like to address, such as: is there a correlation between a certain personality and a certain composing process profile (e.g. is there a positive correlation between ego strength and persistence in revising)?

Also included in Emig's study is a section dedicated to implications for teaching, which outlines the pedagogical ramifications of the study's findings for teachers currently involved in high school writing programs.

Sharan Merriam (1985) also offers several suggestions for alternative presentations of data:

• Prepare specialized condensations for appropriate groups.
• Replace narrative sections with a series of answers to open-ended questions.
• Present "skimmer's" summaries at beginning of each section.
• Incorporate headlines that encapsulate information from text.
• Prepare analytic summaries with supporting data appendixes.
• Present data in colorful and/or unique graphic representations.

Issues of Validity and Reliability

Once key variables have been identified, they can be analyzed. Reliability becomes a key concern at this stage, and many case study researchers go to great lengths to ensure that their interpretations of the data will be both reliable and valid. Because issues of validity and reliability are an important part of any study in the social sciences, it is important to identify some ways of dealing with results.

Multi-modal case study researchers often balance the results of their coding with data from interviews or writer's reflections upon their own work. Consequently, the researchers' conclusions become highly contextualized. For example, in a case study which looked at the time spent in different stages of the writing process, Berkenkotter concluded that her participant, Donald Murray, spent more time planning his essays than in other writing stages. The report of this case study is followed by Murray's reply, wherein he agrees with some of Berkenkotter's conclusions and disagrees with others.

As is the case with other research methodologies, issues of external validity, construct validity, and reliability need to be carefully considered.

Commentary on Case Studies

Researchers often debate the relative merits of particular methods, among them case study. In this section, we comment on two key issues. To read the commentaries, choose any of the items below:

Strengths and Weaknesses of Case Studies

Most case study advocates point out that case studies produce much more detailed information than what is available through a statistical analysis. Advocates will also hold that while statistical methods might be able to deal with situations where behavior is homogeneous and routine, case studies are needed to deal with creativity, innovation, and context. Detractors argue that case studies are difficult to generalize because of inherent subjectivity and because they are based on qualitative subjective data, generalizable only to a particular context.

Flexibility

The case study approach is a comparatively flexible method of scientific research. Because its project designs seem to emphasize exploration rather than prescription or prediction, researchers are comparatively freer to discover and address issues as they arise in their experiments. In addition, the looser format of case studies allows researchers to begin with broad questions and narrow their focus as their experiment progresses rather than attempt to predict every possible outcome before the experiment is conducted.

Emphasis on Context

By seeking to understand as much as possible about a single subject or small group of subjects, case studies specialize in "deep data," or "thick description"--information based on particular contexts that can give research results a more human face. This emphasis can help bridge the gap between abstract research and concrete practice by allowing researchers to compare their firsthand observations with the quantitative results obtained through other methods of research.

Inherent Subjectivity

"The case study has long been stereotyped as the weak sibling among social science methods," and is often criticized as being too subjective and even pseudo-scientific. Likewise, "investigators who do case studies are often regarded as having deviated from their academic disciplines, and their investigations as having insufficient precision (that is, quantification), objectivity and rigor" (Yin 1989). Opponents cite opportunities for subjectivity in the implementation, presentation, and evaluation of case study research. The approach relies on personal interpretation of data and inferences. Results may not be generalizable, are difficult to test for validity, and rarely offer a problem-solving prescription. Simply put, relying on one or a few subjects as a basis for cognitive extrapolations runs the risk of inferring too much from what might be circumstance.

High Investment

Case studies can involve learning more about the subjects being tested than most researchers would care to know--their educational background, emotional background, perceptions of themselves and their surroundings, their likes, dislikes, and so on. Because of its emphasis on "deep data," the case study is out of reach for many large-scale research projects which look at a subject pool in the tens of thousands. A budget request of $10,000 to examine 200 subjects sounds more efficient than a similar request to examine four subjects.

Ethical Considerations

Researchers conducting case studies should consider certain ethical issues. For example, many educational case studies are often financed by people who have, either directly or indirectly, power over both those being studied and those conducting the investigation (1985). This conflict of interests can hinder the credibility of the study.

The personal integrity, sensitivity, and possible prejudices and/or biases of the investigators need to be taken into consideration as well. Personal biases can creep into how the research is conducted, alternative research methods used, and the preparation of surveys and questionnaires.

A common complaint in case study research is that investigators change direction during the course of the study unaware that their original research design was inadequate for the revised investigation. Thus, the researchers leave unknown gaps and biases in the study. To avoid this, researchers should report preliminary findings so that the likelihood of bias will be reduced.

Concerns about Reliability, Validity, and Generalizability

Merriam (1985) offers several suggestions for how case study researchers might actively combat the popular attacks on the validity, reliability, and generalizability of case studies:

• Prolong the Processes of Data Gathering on Site: This will help to insure the accuracy of the findings by providing the researcher with more concrete information upon which to formulate interpretations.
• Employ the Process of "Triangulation": Use a variety of data sources as opposed to relying solely upon one avenue of observation. One example of such a data check would be what McClintock, Brannon, and Maynard (1985) refer to as a "case cluster method," that is, when a single unit within a larger case is randomly sampled, and that data treated quantitatively." For instance, in Emig's (1971) study, the case cluster method was employed, singling out the productivity of a single student named Lynn. This cluster profile included an advanced case history of the subject, specific examination and analysis of individual compositions and protocols, and extensive interview sessions. The seven remaining students were then compared with the case of Lynn, to ascertain if there are any shared, or unique dimensions to the composing process engaged in by these eight students.
• Conduct Member Checks: Initiate and maintain an active corroboration on the interpretation of data between the researcher and those who provided the data. In other words, talk to your subjects.
• Collect Referential Materials: Complement the file of materials from the actual site with additional document support. For example, Emig (1971) supports her initial propositions with historical accounts by writers such as T.S. Eliot, James Joyce, and D.H. Lawrence. Emig also cites examples of theoretical research done with regards to the creative process, as well as examples of empirical research dealing with the writing of adolescents. Specific attention is then given to the four stages description of the composing process delineated by Helmoltz, Wallas, and Cowley, as it serves as the focal point in this study.
• Engage in Peer Consultation: Prior to composing the final draft of the report, researchers should consult with colleagues in order to establish validity through pooled judgment.

Although little can be done to combat challenges concerning the generalizability of case studies, "most writers suggest that qualitative research should be judged as credible and confirmable as opposed to valid and reliable" (Merriam 1985). Likewise, it has been argued that "rather than transplanting statistical, quantitative notions of generalizability and thus finding qualitative research inadequate, it makes more sense to develop an understanding of generalization that is congruent with the basic characteristics of qualitative inquiry" (1985). After all, criticizing the case study method for being ungeneralizable is comparable to criticizing a washing machine for not being able to tell the correct time. In other words, it is unjust to criticize a method for not being able to do something which it was never originally designed to do in the first place.

Annotated Bibliography

Armisted, C. (1984). How Useful are Case Studies. Training and Development Journal, 38 (2), 75-77.

This article looks at eight types of case studies, offers pros and cons of using case studies in the classroom, and gives suggestions for successfully writing and using case studies.

Bardovi-Harlig, K. (1997). Beyond Methods: Components of Second Language Teacher Education . New York: McGraw-Hill.

A compilation of various research essays which address issues of language teacher education. Essays included are: "Non-native reading research and theory" by Lee, "The case for Psycholinguistics" by VanPatten, and "Assessment and Second Language Teaching" by Gradman and Reed.

Bartlett, L. (1989). A Question of Good Judgment; Interpretation Theory and Qualitative Enquiry Address. 70th Annual Meeting of the American Educational Research Association. San Francisco.

Bartlett selected "quasi-historical" methodology, which focuses on the "truth" found in case records, as one that will provide "good judgments" in educational inquiry. He argues that although the method is not comprehensive, it can try to connect theory with practice.

Baydere, S. et. al. (1993). Multimedia conferencing as a tool for collaborative writing: a case study in Computer Supported Collaborative Writing. New York: Springer-Verlag.

The case study by Baydere et. al. is just one of the many essays in this book found in the series "Computer Supported Cooperative Work." Denley, Witefield and May explore similar issues in their essay, "A case study in task analysis for the design of a collaborative document production system."

Berkenkotter, C., Huckin, T., N., & Ackerman J. (1988). Conventions, Conversations, and the Writer: Case Study of a Student in a Rhetoric Ph.D. Program. Research in the Teaching of English, 22, 9-44.

The authors focused on how the writing of their subject, Nate or Ackerman, changed as he became more acquainted or familiar with his field's discourse community.

Berninger, V., W., and Gans, B., M. (1986). Language Profiles in Nonspeaking Individuals of Normal Intelligence with Severe Cerebral Palsy. Augmentative and Alternative Communication, 2, 45-50.

Argues that generalizations about language abilities in patients with severe cerebral palsy (CP) should be avoided. Standardized tests of different levels of processing oral language, of processing written language, and of producing written language were administered to 3 male participants (aged 9, 16, and 40 yrs).

Bockman, J., R., and Couture, B. (1984). The Case Method in Technical Communication: Theory and Models. Texas: Association of Teachers of Technical Writing.

Examines the study and teaching of technical writing, communication of technical information, and the case method in terms of those applications.

Boehrer, J. (1990). Teaching With Cases: Learning to Question. New Directions for Teaching and Learning, 42 41-57.

This article discusses the origins of the case method, looks at the question of what is a case, gives ideas about learning in case teaching, the purposes it can serve in the classroom, the ground rules for the case discussion, including the role of the question, and new directions for case teaching.

Bowman, W. R. (1993). Evaluating JTPA Programs for Economically Disadvantaged Adults: A Case Study of Utah and General Findings . Washington: National Commission for Employment Policy.

"To encourage state-level evaluations of JTPA, the Commission and the State of Utah co-sponsored this report on the effectiveness of JTPA Title II programs for adults in Utah. The technique used is non-experimental and the comparison group was selected from registrants with Utah's Employment Security. In a step-by-step approach, the report documents how non-experimental techniques can be applied and several specific technical issues can be addressed."

Boyce, A. (1993) The Case Study Approach for Pedagogists. Annual Meeting of the American Alliance for Health, Physical Education, Recreation and Dance. (Address). Washington DC.

This paper addresses how case studies 1) bridge the gap between teaching theory and application, 2) enable students to analyze problems and develop solutions for situations that will be encountered in the real world of teaching, and 3) helps students to evaluate the feasibility of alternatives and to understand the ramifications of a particular course of action.

Carson, J. (1993) The Case Study: Ideal Home of WAC Quantitative and Qualitative Data. Annual Meeting of the Conference on College Composition and Communication. (Address). San Diego.

"Increasingly, one of the most pressing questions for WAC advocates is how to keep [WAC] programs going in the face of numerous difficulties. Case histories offer the best chance for fashioning rhetorical arguments to keep WAC programs going because they offer the opportunity to provide a coherent narrative that contextualizes all documents and data, including what is generally considered scientific data. A case study of the WAC program, . . . at Robert Morris College in Pittsburgh demonstrates the advantages of this research method. Such studies are ideal homes for both naturalistic and positivistic data as well as both quantitative and qualitative information."

---. (1991). A Cognitive Process Theory of Writing. College Composition and Communication. 32. 365-87.

No abstract available.

Cromer, R. (1994) A Case Study of Dissociations Between Language and Cognition. Constraints on Language Acquisition: Studies of Atypical Children . Hillsdale: Lawrence Erlbaum Associates, 141-153.

Crossley, M. (1983) Case Study in Comparative and International Education: An Approach to Bridging the Theory-Practice Gap. Proceedings of the 11th Annual Conference of the Australian Comparative and International Education Society. Hamilton, NZ.

Case study research, as presented here, helps bridge the theory-practice gap in comparative and international research studies of education because it focuses on the practical, day-to-day context rather than on the national arena. The paper asserts that the case study method can be valuable at all levels of research, formation, and verification of theories in education.

Daillak, R., H., and Alkin, M., C. (1982). Qualitative Studies in Context: Reflections on the CSE Studies of Evaluation Use . California: EDRS

The report shows how the Center of the Study of Evaluation (CSE) applied qualitative techniques to a study of evaluation information use in local, Los Angeles schools. It critiques the effectiveness and the limitations of using case study, evaluation, field study, and user interview survey methodologies.

Davey, L. (1991). The Application of Case Study Evaluations. ERIC/TM Digest.

This article examines six types of case studies, the type of evaluation questions that can be answered, the functions served, some design features, and some pitfalls of the method.

Deutch, C. E. (1996). A course in research ethics for graduate students. College Teaching, 44, 2, 56-60.

This article describes a one-credit discussion course in research ethics for graduate students in biology. Case studies are focused on within the four parts of the course: 1) major issues, 2 )practical issues in scholarly work, 3) ownership of research results, and 4) training and personal decisions.

DeVoss, G. (1981). Ethics in Fieldwork Research. RIE 27p. (ERIC)

This article examines four of the ethical problems that can happen when conducting case study research: acquiring permission to do research, knowing when to stop digging, the pitfalls of doing collaborative research, and preserving the integrity of the participants.

Driscoll, A. (1985). Case Study of a Research Intervention: the University of Utah’s Collaborative Approach . San Francisco: Far West Library for Educational Research Development.

Paper presented at the annual meeting of the American Association of Colleges of Teacher Education, Denver, CO, March 1985. Offers information of in-service training, specifically case studies application.

Ellram, L. M. (1996). The Use of the Case Study Method in Logistics Research. Journal of Business Logistics, 17, 2, 93.

This article discusses the increased use of case study in business research, and the lack of understanding of when and how to use case study methodology in business.

Emig, J. (1971) The Composing Processes of Twelfth Graders . Urbana: NTCE.

This case study uses observation, tape recordings, writing samples, and school records to show that writing in reflexive and extensive situations caused different lengths of discourse and different clusterings of the components of the writing process.

Feagin, J. R. (1991). A Case For the Case Study . Chapel Hill: The University of North Carolina Press.

This book discusses the nature, characteristics, and basic methodological issues of the case study as a research method.

Feldman, H., Holland, A., & Keefe, K. (1989) Language Abilities after Left Hemisphere Brain Injury: A Case Study of Twins. Topics in Early Childhood Special Education, 9, 32-47.

"Describes the language abilities of 2 twin pairs in which 1 twin (the experimental) suffered brain injury to the left cerebral hemisphere around the time of birth and1 twin (the control) did not. One pair of twins was initially assessed at age 23 mo. and the other at about 30 mo.; they were subsequently evaluated in their homes 3 times at about 6-mo intervals."

Fidel, R. (1984). The Case Study Method: A Case Study. Library and Information Science Research, 6.

The article describes the use of case study methodology to systematically develop a model of online searching behavior in which study design is flexible, subject manner determines data gathering and analyses, and procedures adapt to the study's progressive change.

Flower, L., & Hayes, J. R. (1984). Images, Plans and Prose: The Representation of Meaning in Writing. Written Communication, 1, 120-160.

Explores the ways in which writers actually use different forms of knowing to create prose.

Frey, L. R. (1992). Interpreting Communication Research: A Case Study Approach Englewood Cliffs, N.J.: Prentice Hall.

The book discusses research methodologies in the Communication field. It focuses on how case studies bridge the gap between communication research, theory, and practice.

Gilbert, V. K. (1981). The Case Study as a Research Methodology: Difficulties and Advantages of Integrating the Positivistic, Phenomenological and Grounded Theory Approaches . The Annual Meeting of the Canadian Association for the Study of Educational Administration. (Address) Halifax, NS, Can.

This study on an innovative secondary school in England shows how a "low-profile" participant-observer case study was crucial to the initial observation, the testing of hypotheses, the interpretive approach, and the grounded theory.

Gilgun, J. F. (1994). A Case for Case Studies in Social Work Research. Social Work, 39, 4, 371-381.

This article defines case study research, presents guidelines for evaluation of case studies, and shows the relevance of case studies to social work research. It also looks at issues such as evaluation and interpretations of case studies.

Glennan, S. L., Sharp-Bittner, M. A. & Tullos, D. C. (1991). Augmentative and Alternative Communication Training with a Nonspeaking Adult: Lessons from MH. Augmentative and Alternative Communication, 7, 240-7.

"A response-guided case study documented changes in a nonspeaking 36-yr-old man's ability to communicate using 3 trained augmentative communication modes. . . . Data were collected in videotaped interaction sessions between the nonspeaking adult and a series of adult speaking."

Graves, D. (1981). An Examination of the Writing Processes of Seven Year Old Children. Research in the Teaching of English, 15, 113-134.

Hamel, J. (1993). Case Study Methods . Newbury Park: Sage. .

"In a most economical fashion, Hamel provides a practical guide for producing theoretically sharp and empirically sound sociological case studies. A central idea put forth by Hamel is that case studies must "locate the global in the local" thus making the careful selection of the research site the most critical decision in the analytic process."

Karthigesu, R. (1986, July). Television as a Tool for Nation-Building in the Third World: A Post-Colonial Pattern, Using Malaysia as a Case-Study. International Television Studies Conference. (Address). London, 10-12.

"The extent to which Television Malaysia, as a national mass media organization, has been able to play a role in nation building in the post-colonial period is . . . studied in two parts: how the choice of a model of nation building determines the character of the organization; and how the character of the organization influences the output of the organization."

Kenny, R. (1984). Making the Case for the Case Study. Journal of Curriculum Studies, 16, (1), 37-51.

The article looks at how and why the case study is justified as a viable and valuable approach to educational research and program evaluation.

Knirk, F. (1991). Case Materials: Research and Practice. Performance Improvement Quarterly, 4 (1 ), 73-81.

The article addresses the effectiveness of case studies, subject areas where case studies are commonly used, recent examples of their use, and case study design considerations.

Klos, D. (1976). Students as Case Writers. Teaching of Psychology, 3.2, 63-66.

This article reviews a course in which students gather data for an original case study of another person. The task requires the students to design the study, collect the data, write the narrative, and interpret the findings.

Leftwich, A. (1981). The Politics of Case Study: Problems of Innovation in University Education. Higher Education Review, 13.2, 38-64.

The article discusses the use of case studies as a teaching method. Emphasis is on the instructional materials, interdisciplinarity, and the complex relationships within the university that help or hinder the method.

Mabrito, M. (1991, Oct.). Electronic Mail as a Vehicle for Peer Response: Conversations of High and Low Apprehensive Writers. Written Communication, 509-32.

McCarthy, S., J. (1955). The Influence of Classroom Discourse on Student Texts: The Case of Ella . East Lansing: Institute for Research on Teaching.

A look at how students of color become marginalized within traditional classroom discourse. The essay follows the struggles of one black student: Ella.

Matsuhashi, A., ed. (1987). Writing in Real Time: Modeling Production Processes Norwood, NJ: Ablex Publishing Corporation.

Investigates how writers plan to produce discourse for different purposes to report, to generalize, and to persuade, as well as how writers plan for sentence level units of language. To learn about planning, an observational measure of pause time was used" (ERIC).

Merriam, S. B. (1985). The Case Study in Educational Research: A Review of Selected Literature. Journal of Educational Thought, 19.3, 204-17.

The article examines the characteristics of, philosophical assumptions underlying the case study, the mechanics of conducting a case study, and the concerns about the reliability, validity, and generalizability of the method.

---. (1988). Case Study Research in Education: A Qualitative Approach San Francisco: Jossey Bass.

Merry, S. E., & Milner, N. eds. (1993). The Possibility of Popular Justice: A Case Study of Community Mediation in the United States . Ann Arbor: U of Michigan.

". . . this volume presents a case study of one experiment in popular justice, the San Francisco Community Boards. This program has made an explicit claim to create an alternative justice, or new justice, in the midst of a society ordered by state law. The contributors to this volume explore the history and experience of the program and compare it to other versions of popular justice in the United States, Europe, and the Third World."

Merseth, K. K. (1991). The Case for Cases in Teacher Education. RIE. 42p. (ERIC).

This monograph argues that the case method of instruction offers unique potential for revitalizing the field of teacher education.

Michaels, S. (1987). Text and Context: A New Approach to the Study of Classroom Writing. Discourse Processes, 10, 321-346.

"This paper argues for and illustrates an approach to the study of writing that integrates ethnographic analysis of classroom interaction with linguistic analysis of written texts and teacher/student conversational exchanges. The approach is illustrated through a case study of writing in a single sixth grade classroom during a single writing assignment."

Milburn, G. (1995). Deciphering a Code or Unraveling a Riddle: A Case Study in the Application of a Humanistic Metaphor to the Reporting of Social Studies Teaching. Theory and Research in Education, 13.

This citation serves as an example of how case studies document learning procedures in a senior-level economics course.

Milley, J. E. (1979). An Investigation of Case Study as an Approach to Program Evaluation. 19th Annual Forum of the Association for Institutional Research. (Address). San Diego.

The case study method merged a narrative report focusing on the evaluator as participant-observer with document review, interview, content analysis, attitude questionnaire survey, and sociogram analysis. Milley argues that case study program evaluation has great potential for widespread use.

Minnis, J. R. (1985, Sept.). Ethnography, Case Study, Grounded Theory, and Distance Education Research. Distance Education, 6.2.

This article describes and defines the strengths and weaknesses of ethnography, case study, and grounded theory.

Nunan, D. (1992). Collaborative language learning and teaching . New York: Cambridge University Press.

Included in this series of essays is Peter Sturman’s "Team Teaching: a case study from Japan" and David Nunan’s own "Toward a collaborative approach to curriculum development: a case study."

Nystrand, M., ed. (1982). What Writers Know: The Language, Process, and Structure of Written Discourse . New York: Academic Press.

Owenby, P. H. (1992). Making Case Studies Come Alive. Training, 29, (1), 43-46. (ERIC)

This article provides tips for writing more effective case studies.

---. (1981). Pausing and Planning: The Tempo of Writer Discourse Production. Research in the Teaching of English, 15 (2),113-34.

Perl, S. (1979). The Composing Processes of Unskilled College Writers. Research in the Teaching of English, 13, 317-336.

"Summarizes a study of five unskilled college writers, focusing especially on one of the five, and discusses the findings in light of current pedagogical practice and research design."

Pilcher J. and A. Coffey. eds. (1996). Gender and Qualitative Research . Brookfield: Aldershot, Hants, England.

This book provides a series of essays which look at gender identity research, qualitative research and applications of case study to questions of gendered pedagogy.

Pirie, B. S. (1993). The Case of Morty: A Four Year Study. Gifted Education International, 9 (2), 105-109.

This case study describes a boy from kindergarten through third grade with above average intelligence but difficulty in learning to read, write, and spell.

Popkewitz, T. (1993). Changing Patterns of Power: Social Regulation and Teacher Education Reform. Albany: SUNY Press.

Popkewitz edits this series of essays that address case studies on educational change and the training of teachers. The essays vary in terms of discipline and scope. Also, several authors include case studies of educational practices in countries other than the United States.

---. (1984). The Predrafting Processes of Four High- and Four Low Apprehensive Writers. Research in the Teaching of English, 18, (1), 45-64.

Rasmussen, P. (1985, March) A Case Study on the Evaluation of Research at the Technical University of Denmark. International Journal of Institutional Management in Higher Education, 9 (1).

This is an example of a case study methodology used to evaluate the chemistry and chemical engineering departments at the University of Denmark.

Roth, K. J. (1986). Curriculum Materials, Teacher Talk, and Student Learning: Case Studies in Fifth-Grade Science Teaching . East Lansing: Institute for Research on Teaching.

Roth offers case studies on elementary teachers, elementary school teaching, science studies and teaching, and verbal learning.

Selfe, C. L. (1985). An Apprehensive Writer Composes. When a Writer Can't Write: Studies in Writer's Block and Other Composing-Process Problems . (pp. 83-95). Ed. Mike Rose. NMY: Guilford.

Smith-Lewis, M., R. and Ford, A. (1987). A User's Perspective on Augmentative Communication. Augmentative and Alternative Communication, 3, 12-7.

"During a series of in-depth interviews, a 25-yr-old woman with cerebral palsy who utilized augmentative communication reflected on the effectiveness of the devices designed for her during her school career."

St. Pierre, R., G. (1980, April). Follow Through: A Case Study in Metaevaluation Research . 64th Annual Meeting of the American Educational Research Association. (Address).

The three approaches to metaevaluation are evaluation of primary evaluations, integrative meta-analysis with combined primary evaluation results, and re-analysis of the raw data from a primary evaluation.

Stahler, T., M. (1996, Feb.) Early Field Experiences: A Model That Worked. ERIC.

"This case study of a field and theory class examines a model designed to provide meaningful field experiences for preservice teachers while remaining consistent with the instructor's beliefs about the role of teacher education in preparing teachers for the classroom."

Stake, R. E. (1995). The Art of Case Study Research. Thousand Oaks: Sage Publications.

This book examines case study research in education and case study methodology.

Stiegelbauer, S. (1984) Community, Context, and Co-curriculum: Situational Factors Influencing School Improvements in a Study of High Schools. Presented at the annual meeting of the American Educational Research Association, New Orleans, LA.

Discussion of several case studies: one looking at high school environments, another examining educational innovations.

Stolovitch, H. (1990). Case Study Method. Performance And Instruction, 29, (9), 35-37.

This article describes the case study method as a form of simulation and presents guidelines for their use in professional training situations.

Thaller, E. (1994). Bibliography for the Case Method: Using Case Studies in Teacher Education. RIE. 37 p.

This bibliography presents approximately 450 citations on the use of case studies in teacher education from 1921-1993.

Thrane, T. (1986). On Delimiting the Senses of Near-Synonyms in Historical Semantics: A Case Study of Adjectives of 'Moral Sufficiency' in the Old English Andreas. Linguistics Across Historical and Geographical Boundaries: In Honor of Jacek Fisiak on the Occasion of his Fiftieth Birthday . Berlin: Mouton de Gruyter.

United Nations. (1975). Food and Agriculture Organization. Report on the FAO/UNFPA Seminar on Methodology, Research and Country: Case Studies on Population, Employment and Productivity . Rome: United Nations.

This example case study shows how the methodology can be used in a demographic and psychographic evaluation. At the same time, it discusses the formation and instigation of the case study methodology itself.

Van Vugt, J. P., ed. (1994). Aids Prevention and Services: Community Based Research . Westport: Bergin and Garvey.

"This volume has been five years in the making. In the process, some of the policy applications called for have met with limited success, such as free needle exchange programs in a limited number of American cities, providing condoms to prison inmates, and advertisements that depict same-sex couples. Rather than dating our chapters that deal with such subjects, such policy applications are verifications of the type of research demonstrated here. Furthermore, they indicate the critical need to continue community based research in the various communities threatened by acquired immuno-deficiency syndrome (AIDS) . . . "

Welch, W., ed. (1981, May). Case Study Methodology in Educational Evaluation. Proceedings of the Minnesota Evaluation Conference. Minnesota. (Address).

The four papers in these proceedings provide a comprehensive picture of the rationale, methodology, strengths, and limitations of case studies.

Williams, G. (1987). The Case Method: An Approach to Teaching and Learning in Educational Administration. RIE, 31p.

This paper examines the viability of the case method as a teaching and learning strategy in instructional systems geared toward the training of personnel of the administration of various aspects of educational systems.

Yin, R. K. (1993). Advancing Rigorous Methodologies: A Review of 'Towards Rigor in Reviews of Multivocal Literatures.' Review of Educational Research, 61, (3).

"R. T. Ogawa and B. Malen's article does not meet its own recommended standards for rigorous testing and presentation of its own conclusions. Use of the exploratory case study to analyze multivocal literatures is not supported, and the claim of grounded theory to analyze multivocal literatures may be stronger."

---. (1989). Case Study Research: Design and Methods. London: Sage Publications Inc.

This book discusses in great detail, the entire design process of the case study, including entire chapters on collecting evidence, analyzing evidence, composing the case study report, and designing single and multiple case studies.

Related Links

Consider the following list of related Web sites for more information on the topic of case study research. Note: although many of the links cover the general category of qualitative research, all have sections that address issues of case studies.

• Sage Publications on Qualitative Methodology: Search here for a comprehensive list of new books being published about "Qualitative Methodology" http://www.sagepub.co.uk/
• The International Journal of Qualitative Studies in Education: An on-line journal "to enhance the theory and practice of qualitative research in education." On-line submissions are welcome. http://www.tandf.co.uk/journals/tf/09518398.html
• Qualitative Research Resources on the Internet: From syllabi to home pages to bibliographies. All links relate somehow to qualitative research. http://www.nova.edu/ssss/QR/qualres.html

Citation Information

Bronwyn Becker, Patrick Dawson, Karen Devine, Carla Hannum, Steve Hill, Jon Leydens, Debbie Matuskevich, Carol Traver, and Mike Palmquist. (1994-2024). Case Studies. The WAC Clearinghouse. Colorado State University. Available at https://wac.colostate.edu/repository/writing/guides/.

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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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Case Studies

Last updated 22 Mar 2021

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Case studies are very detailed investigations of an individual or small group of people, usually regarding an unusual phenomenon or biographical event of interest to a research field. Due to a small sample, the case study can conduct an in-depth analysis of the individual/group.

Evaluation of case studies:

- Case studies create opportunities for a rich yield of data, and the depth of analysis can in turn bring high levels of validity (i.e. providing an accurate and exhaustive measure of what the study is hoping to measure).

- Studying abnormal psychology can give insight into how something works when it is functioning correctly, such as brain damage on memory (e.g. the case study of patient KF, whose short-term memory was impaired following a motorcycle accident but left his long-term memory intact, suggesting there might be separate physical stores in the brain for short and long-term memory).

- The detail collected on a single case may lead to interesting findings that conflict with current theories, and stimulate new paths for research.

- There is little control over a number of variables involved in a case study, so it is difficult to confidently establish any causal relationships between variables.

- Case studies are unusual by nature, so will have poor reliability as replicating them exactly will be unlikely.

- Due to the small sample size, it is unlikely that findings from a case study alone can be generalised to a whole population.

- The case study’s researcher may become so involved with the study that they exhibit bias in their interpretation and presentation of the data, making it challenging to distinguish what is truly objective/factual.

• Case Studies

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Psychological Research

Descriptive Research

Learning objectives.

• Differentiate between descriptive, experimental, and correlational research
• Explain the strengths and weaknesses of case studies, naturalistic observation, and surveys

There are many research methods available to psychologists in their efforts to understand, describe, and explain behavior and the cognitive and biological processes that underlie it. Some methods rely on observational techniques. Other approaches involve interactions between the researcher and the individuals who are being studied—ranging from a series of simple questions to extensive, in-depth interviews—to well-controlled experiments.

The three main categories of psychological research are descriptive, correlational, and experimental research. Research studies that do not test specific relationships between variables are called descriptive, or qualitative, studies . These studies are used to describe general or specific behaviors and attributes that are observed and measured. In the early stages of research it might be difficult to form a hypothesis, especially when there is not any existing literature in the area. In these situations designing an experiment would be premature, as the question of interest is not yet clearly defined as a hypothesis. Often a researcher will begin with a non-experimental approach, such as a descriptive study, to gather more information about the topic before designing an experiment or correlational study to address a specific hypothesis. Descriptive research is distinct from correlational research , in which psychologists formally test whether a relationship exists between two or more variables. Experimental research goes a step further beyond descriptive and correlational research and randomly assigns people to different conditions, using hypothesis testing to make inferences about how these conditions affect behavior. It aims to determine if one variable directly impacts and causes another. Correlational and experimental research both typically use hypothesis testing, whereas descriptive research does not.

Each of these research methods has unique strengths and weaknesses, and each method may only be appropriate for certain types of research questions. For example, studies that rely primarily on observation produce incredible amounts of information, but the ability to apply this information to the larger population is somewhat limited because of small sample sizes. Survey research, on the other hand, allows researchers to easily collect data from relatively large samples. While this allows for results to be generalized to the larger population more easily, the information that can be collected on any given survey is somewhat limited and subject to problems associated with any type of self-reported data. Some researchers conduct archival research by using existing records. While this can be a fairly inexpensive way to collect data that can provide insight into a number of research questions, researchers using this approach have no control on how or what kind of data was collected.

Correlational research can find a relationship between two variables, but the only way a researcher can claim that the relationship between the variables is cause and effect is to perform an experiment. In experimental research, which will be discussed later in the text, there is a tremendous amount of control over variables of interest. While this is a powerful approach, experiments are often conducted in very artificial settings. This calls into question the validity of experimental findings with regard to how they would apply in real-world settings. In addition, many of the questions that psychologists would like to answer cannot be pursued through experimental research because of ethical concerns.

The three main types of descriptive studies are case studies, naturalistic observation, and surveys.

Case Studies

In 2011, the New York Times published a feature story on Krista and Tatiana Hogan, Canadian twin girls. These particular twins are unique because Krista and Tatiana are conjoined twins, connected at the head. There is evidence that the two girls are connected in a part of the brain called the thalamus, which is a major sensory relay center. Most incoming sensory information is sent through the thalamus before reaching higher regions of the cerebral cortex for processing.

Link to Learning

To learn more about Krista and Tatiana, watch this video about their lives as conjoined twins.

The implications of this potential connection mean that it might be possible for one twin to experience the sensations of the other twin. For instance, if Krista is watching a particularly funny television program, Tatiana might smile or laugh even if she is not watching the program. This particular possibility has piqued the interest of many neuroscientists who seek to understand how the brain uses sensory information.

These twins represent an enormous resource in the study of the brain, and since their condition is very rare, it is likely that as long as their family agrees, scientists will follow these girls very closely throughout their lives to gain as much information as possible (Dominus, 2011).

In observational research, scientists are conducting a clinical or case study when they focus on one person or just a few individuals. Indeed, some scientists spend their entire careers studying just 10–20 individuals. Why would they do this? Obviously, when they focus their attention on a very small number of people, they can gain a tremendous amount of insight into those cases. The richness of information that is collected in clinical or case studies is unmatched by any other single research method. This allows the researcher to have a very deep understanding of the individuals and the particular phenomenon being studied.

If clinical or case studies provide so much information, why are they not more frequent among researchers? As it turns out, the major benefit of this particular approach is also a weakness. As mentioned earlier, this approach is often used when studying individuals who are interesting to researchers because they have a rare characteristic. Therefore, the individuals who serve as the focus of case studies are not like most other people. If scientists ultimately want to explain all behavior, focusing attention on such a special group of people can make it difficult to generalize any observations to the larger population as a whole. Generalizing refers to the ability to apply the findings of a particular research project to larger segments of society. Again, case studies provide enormous amounts of information, but since the cases are so specific, the potential to apply what’s learned to the average person may be very limited.

Naturalistic Observation

If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances are that almost everyone in the classroom will raise their hand, but do you think hand washing after every trip to the restroom is really that universal?

This is very similar to the phenomenon mentioned earlier in this module: many individuals do not feel comfortable answering a question honestly. But if we are committed to finding out the facts about hand washing, we have other options available to us.

Suppose we send a classmate into the restroom to actually watch whether everyone washes their hands after using the restroom. Will our observer blend into the restroom environment by wearing a white lab coat, sitting with a clipboard, and staring at the sinks? We want our researcher to be inconspicuous—perhaps standing at one of the sinks pretending to put in contact lenses while secretly recording the relevant information. This type of observational study is called naturalistic observation : observing behavior in its natural setting. To better understand peer exclusion, Suzanne Fanger collaborated with colleagues at the University of Texas to observe the behavior of preschool children on a playground. How did the observers remain inconspicuous over the duration of the study? They equipped a few of the children with wireless microphones (which the children quickly forgot about) and observed while taking notes from a distance. Also, the children in that particular preschool (a “laboratory preschool”) were accustomed to having observers on the playground (Fanger, Frankel, & Hazen, 2012).

It is critical that the observer be as unobtrusive and as inconspicuous as possible: when people know they are being watched, they are less likely to behave naturally. If you have any doubt about this, ask yourself how your driving behavior might differ in two situations: In the first situation, you are driving down a deserted highway during the middle of the day; in the second situation, you are being followed by a police car down the same deserted highway (Figure 1).

It should be pointed out that naturalistic observation is not limited to research involving humans. Indeed, some of the best-known examples of naturalistic observation involve researchers going into the field to observe various kinds of animals in their own environments. As with human studies, the researchers maintain their distance and avoid interfering with the animal subjects so as not to influence their natural behaviors. Scientists have used this technique to study social hierarchies and interactions among animals ranging from ground squirrels to gorillas. The information provided by these studies is invaluable in understanding how those animals organize socially and communicate with one another. The anthropologist Jane Goodall, for example, spent nearly five decades observing the behavior of chimpanzees in Africa (Figure 2). As an illustration of the types of concerns that a researcher might encounter in naturalistic observation, some scientists criticized Goodall for giving the chimps names instead of referring to them by numbers—using names was thought to undermine the emotional detachment required for the objectivity of the study (McKie, 2010).

The greatest benefit of naturalistic observation is the validity, or accuracy, of information collected unobtrusively in a natural setting. Having individuals behave as they normally would in a given situation means that we have a higher degree of ecological validity, or realism, than we might achieve with other research approaches. Therefore, our ability to generalize the findings of the research to real-world situations is enhanced. If done correctly, we need not worry about people or animals modifying their behavior simply because they are being observed. Sometimes, people may assume that reality programs give us a glimpse into authentic human behavior. However, the principle of inconspicuous observation is violated as reality stars are followed by camera crews and are interviewed on camera for personal confessionals. Given that environment, we must doubt how natural and realistic their behaviors are.

The major downside of naturalistic observation is that they are often difficult to set up and control. In our restroom study, what if you stood in the restroom all day prepared to record people’s hand washing behavior and no one came in? Or, what if you have been closely observing a troop of gorillas for weeks only to find that they migrated to a new place while you were sleeping in your tent? The benefit of realistic data comes at a cost. As a researcher you have no control of when (or if) you have behavior to observe. In addition, this type of observational research often requires significant investments of time, money, and a good dose of luck.

Sometimes studies involve structured observation. In these cases, people are observed while engaging in set, specific tasks. An excellent example of structured observation comes from Strange Situation by Mary Ainsworth (you will read more about this in the module on lifespan development). The Strange Situation is a procedure used to evaluate attachment styles that exist between an infant and caregiver. In this scenario, caregivers bring their infants into a room filled with toys. The Strange Situation involves a number of phases, including a stranger coming into the room, the caregiver leaving the room, and the caregiver’s return to the room. The infant’s behavior is closely monitored at each phase, but it is the behavior of the infant upon being reunited with the caregiver that is most telling in terms of characterizing the infant’s attachment style with the caregiver.

Another potential problem in observational research is observer bias . Generally, people who act as observers are closely involved in the research project and may unconsciously skew their observations to fit their research goals or expectations. To protect against this type of bias, researchers should have clear criteria established for the types of behaviors recorded and how those behaviors should be classified. In addition, researchers often compare observations of the same event by multiple observers, in order to test inter-rater reliability : a measure of reliability that assesses the consistency of observations by different observers.

Often, psychologists develop surveys as a means of gathering data. Surveys are lists of questions to be answered by research participants, and can be delivered as paper-and-pencil questionnaires, administered electronically, or conducted verbally (Figure 3). Generally, the survey itself can be completed in a short time, and the ease of administering a survey makes it easy to collect data from a large number of people.

Surveys allow researchers to gather data from larger samples than may be afforded by other research methods . A sample is a subset of individuals selected from a population , which is the overall group of individuals that the researchers are interested in. Researchers study the sample and seek to generalize their findings to the population.

There is both strength and weakness of the survey in comparison to case studies. By using surveys, we can collect information from a larger sample of people. A larger sample is better able to reflect the actual diversity of the population, thus allowing better generalizability. Therefore, if our sample is sufficiently large and diverse, we can assume that the data we collect from the survey can be generalized to the larger population with more certainty than the information collected through a case study. However, given the greater number of people involved, we are not able to collect the same depth of information on each person that would be collected in a case study.

Another potential weakness of surveys is something we touched on earlier in this module: people don’t always give accurate responses. They may lie, misremember, or answer questions in a way that they think makes them look good. For example, people may report drinking less alcohol than is actually the case.

Any number of research questions can be answered through the use of surveys. One real-world example is the research conducted by Jenkins, Ruppel, Kizer, Yehl, and Griffin (2012) about the backlash against the US Arab-American community following the terrorist attacks of September 11, 2001. Jenkins and colleagues wanted to determine to what extent these negative attitudes toward Arab-Americans still existed nearly a decade after the attacks occurred. In one study, 140 research participants filled out a survey with 10 questions, including questions asking directly about the participant’s overt prejudicial attitudes toward people of various ethnicities. The survey also asked indirect questions about how likely the participant would be to interact with a person of a given ethnicity in a variety of settings (such as, “How likely do you think it is that you would introduce yourself to a person of Arab-American descent?”). The results of the research suggested that participants were unwilling to report prejudicial attitudes toward any ethnic group. However, there were significant differences between their pattern of responses to questions about social interaction with Arab-Americans compared to other ethnic groups: they indicated less willingness for social interaction with Arab-Americans compared to the other ethnic groups. This suggested that the participants harbored subtle forms of prejudice against Arab-Americans, despite their assertions that this was not the case (Jenkins et al., 2012).

Think It Over

A friend of yours is working part-time in a local pet store. Your friend has become increasingly interested in how dogs normally communicate and interact with each other, and is thinking of visiting a local veterinary clinic to see how dogs interact in the waiting room. After reading this section, do you think this is the best way to better understand such interactions? Do you have any suggestions that might result in more valid data?

CC licensed content, Original

• Modification and adaptation. Provided by : Lumen Learning. License : CC BY-SA: Attribution-ShareAlike

CC licensed content, Shared previously

• Approaches to Research. Authored by : OpenStax College. Located at : https://openstax.org/books/psychology-2e/pages/2-2-approaches-to-research . License : CC BY: Attribution . License Terms : Download for free at https://openstax.org/books/psychology-2e/pages/1-introduction.
• Descriptive Research. Provided by : Boundless. Located at : https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/researching-psychology-2/types-of-research-studies-27/descriptive-research-124-12659/ . License : CC BY-SA: Attribution-ShareAlike

research studies that do not test specific relationships between variables; they are used to describe general or specific behaviors and attributes that are observed and measured

tests whether a relationship exists between two or more variables

tests a hypothesis to determine cause and effect relationships

observational research study focusing on one or a few people

observation of behavior in its natural setting

inferring that the results for a sample apply to the larger population

when observations may be skewed to align with observer expectations

measure of agreement among observers on how they record and classify a particular event

list of questions to be answered by research participants—given as paper-and-pencil questionnaires, administered electronically, or conducted verbally—allowing researchers to collect data from a large number of people

the collection of individuals on which we collect data.

a larger collection of individuals that we would like to generalize our results to.

General Psychology Copyright © by OpenStax and Lumen Learning is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Cognitive Approach 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.

Cognitive psychology is the scientific study of the mind as an information processor. It concerns how we take in information from the outside world, and how we make sense of that information.

Cognitive psychology focuses on studying mental processes, including how people perceive, think, remember, learn, solve problems, and make decisions.

Cognitive psychologists try to build up cognitive models of the information processing that goes on inside people’s minds, including perception, attention, language, memory, thinking, and consciousness.

Cognitive psychology became of great importance in the mid-1950s. Several factors were important in this:

• Dissatisfaction with the behaviorist approach in its simple emphasis on external behavior rather than internal processes.
• The development of better experimental methods.
• Comparison between human and computer processing of information . Using computers allowed psychologists to try to understand the complexities of human cognition by comparing it with computers and artificial intelligence.

The emphasis of psychology shifted away from the study of conditioned behavior and psychoanalytical notions about the study of the mind, towards the understanding of human information processing using strict and rigorous laboratory investigation.

Summary Table

Theoretical assumptions.

Mediational processes occur between stimulus and response:

The behaviorists approach only studies external observable (stimulus and response) behavior that can be objectively measured.

They believe that internal behavior cannot be studied because we cannot see what happens in a person’s mind (and therefore cannot objectively measure it).

However, cognitive psychologists regard it as essential to look at the mental processes of an organism and how these influence behavior.

Cognitive psychology assumes a mediational process occurs between stimulus/input and response/output. 

These are mediational processes because they mediate (i.e., go-between) between the stimulus and the response. They come after the stimulus and before the response.

Instead of the simple stimulus-response links proposed by behaviorism, the mediational processes of the organism are essential to understand. Without this understanding, psychologists cannot have a complete understanding of behavior.

The mediational (i.e., mental) event could be memory , perception , attention or problem-solving, etc. 

For example, the cognitive approach suggests that problem gambling is a result of maladaptive thinking and faulty cognitions. These both result in illogical errors being drawn, for example gamblers misjudge the amount of skill involved with ‘chance’ games so are likely to participate with the mindset that the odds are in their favour so they may have a good chance of winning.

Therefore, cognitive psychologists say that if you want to understand behavior, you must understand these mediational processes.

Psychology should be seen as a science:

The cognitive approach believes that internal mental behavior can be scientifically studied using controlled experiments . They use the results of their investigations as the basis for making inferences about mental processes. 

Cognitive psychology uses laboratory experiments that are highly controlled so they avoid the influence of extraneous variables. This allows the researcher to establish a causal relationship between the independent and dependent variables.

Cognitive psychologists measure behavior that provides information about cognitive processes (e.g., verbal protocols of thinking aloud). They also measure physiological indicators of brain activity, such as neuroimages (PET and fMRI).

For example, brain imaging fMRI and PET scans map areas of the brain to cognitive function, allowing the processing of information by centers in the brain to be seen directly. Such processing causes the area of the brain involved to increase metabolism and “light up” on the scan.

These controlled experiments are replicable, and the data obtained is objective (not influenced by an individual’s judgment or opinion) and measurable. This gives psychology more credibility.

Replicability is a crucial concept of science as it ensures that people can validate research by repeating the experiment to ensure that an accurate conclusion has been reached.

Without replicability, a scientific finding may be invalid as it cannot be falsified. Additionally, scientific research relies on the peer review of research to ensure that the research is justifiable.

Without replicability, it would be impossible to justify the accuracy of the research. 

Humans are information processors:

Cognitive psychology has been influenced by developments in computer science and analogies are often made between how a computer works and how we process information.

Information processing in humans resembles that in computers, and is based on transforming information, storing and processing information, and retrieving information from memory.

Information processing models of cognitive processes such as memory and attention assume that mental processes follow a linear sequence.

For example:

• Input processes are concerned with the analysis of the stimuli.
• Storage processes cover everything that happens to stimuli internally in the brain and can include coding and manipulation of the stimuli.
• Output processes are responsible for preparing an appropriate response to a stimulus.

This has led to models which show information flowing through the cognitive system, such as the multi-store model of memory.

Information Processing Paradigm

The cognitive approach began to revolutionize psychology in the late 1950s and early 1960s to become the dominant approach (i.e., perspective) in psychology by the late 1970s. Interest in mental processes was gradually restored through the work of Jean Piaget and Edward Tolman .

Tolman was a ‘soft behaviorist’. His book Purposive Behavior in Animals and Man in 1932 described research that behaviorism found difficult to explain. The behaviorists’ view was that learning occurred due to associations between stimuli and responses.

However, Tolman suggested that learning was based on the relationships formed amongst stimuli. He referred to these relationships as cognitive maps.

But the arrival of the computer gave cognitive psychology the terminology and metaphor it needed to investigate the human mind.

The start of the use of computers allowed psychologists to try to understand the complexities of human cognition by comparing it with something simpler and better understood, i.e., an artificial system such as a computer.

The use of the computer as a tool for thinking about how the human mind handles information is known as the computer analogy. Essentially, a computer codes (i.e., changes) information, stores information, uses information and produces an output (retrieves info).

The idea of information processing was adopted by cognitive psychologists as a model of how human thought works.

The information processing approach is based on several assumptions, including:

• Information made available from the environment is processed by a series of processing systems (e.g., attention, perception, short-term memory);
• These processing systems transform, or alter the information in systematic ways;
• The aim of research is to specify the processes and structures that underlie cognitive performance;
• Information processing in humans resembles that in computers.

The Role of Schemas

Schemas can often affect cognitive processing (a mental framework of beliefs and expectations developed from experience). As you get older, these become more detailed and sophisticated.

A schema is a “packet of information” or cognitive framework that helps us organize and interpret information. They are based on our previous experience.

Schemas help us to interpret incoming information quickly and effectively; this prevents us from being overwhelmed by the vast amount of information we perceive in our environment.

However, it can also lead to distortion of this information as we select and interpret environmental stimuli using schemas that might not be relevant.

This could be the cause of inaccuracies in areas such as eyewitness testimony. It can also explain some errors we make when perceiving optical illusions.

History of Cognitive Psychology

• Kohler (1925) published a book called, The Mentality of Apes . In it, he reported observations which suggested that animals could show insightful behavior. He rejected behaviorism in favour of an approach which became known as Gestalt psychology .
• Norbert Wiener (1948) published Cybernetics: or Control and Communication in the Animal and the Machine, introducing terms such as input and output.
• Tolman (1948) work on cognitive maps – training rats in mazes, showed that animals had an internal representation of behavior.
• Birth of Cognitive Psychology often dated back to George Miller’s (1956) “ The Magical Number 7 Plus or Minus 2 : Some Limits on Our Capacity for Processing Information.” Milner argued that short-term memory could only hold about seven pieces of information, called chunks.
• Newell and Simon’s (1972) development of the General Problem Solver.
• In 1960, Miller founded the Center for Cognitive Studies at Harvard with the famous cognitivist developmentalist, Jerome Bruner.
• Ulric Neisser (1967) publishes “ Cognitive Psychology” , which marks the official beginning of the cognitive approach.
• Process models of memory Atkinson & Shiffrin’s (1968) Multi-Store Model .
• The cognitive approach is highly influential in all areas of psychology (e.g., biological, social, neuroscience, developmental, etc.).

Issues and Debates

Free will vs. determinism.

The position of the cognitive approach is unclear as it argues, on the one hand, the way we process information is determined by our experience (schemas).

On the other hand in, the therapy derived from the approach (CBT) argues that we can change the way we think.

Nature vs. Nurture

The cognitive approach takes an interactionist view of the debate as it argues that our behavior is influenced by learning and experience (nurture), but also by some of our brains’ innate capacities as information processors e.g., language acquisition (nature).

Holism vs. Reductionism

The cognitive approach tends to be reductionist as when studying a variable, it isolates processes such as memory from other cognitive processes.

However, in our normal life, we would use many cognitive processes simultaneously, so it lacks validity.

Idiographic vs. Nomothetic

It is a nomothetic approach as it focuses on establishing theories on information processing that apply to all people.

Critical Evaluation

B.F. Skinner criticizes the cognitive approach as he believes that only external stimulus-response behavior should be studied as this can be scientifically measured.

Therefore, mediation processes (between stimulus and response) do not exist as they cannot be seen and measured. Due to its subjective and unscientific nature, Skinner continues to find problems with cognitive research methods, namely introspection (as used by Wilhelm Wundt).

Humanistic psychologist Carl Rogers believes that the use of laboratory experiments by cognitive psychology has low ecological validity and creates an artificial environment due to the control over variables . Rogers emphasizes a more holistic approach to understanding behavior.

The cognitive approach uses a very scientific method which are controlled and replicable, so the results are reliable. However, experiments lack ecological validity because of the artificiality of the tasks and environment, so it might not reflect the way people process information in their everyday life.

For example, Baddeley (1966) used lists of words to find out the encoding used by LTM, however, these words had no meaning to the participants, so the way they used their memory in this task was probably very different than they would have done if the words had meaning for them. This is a weakness as the theories might not explain how memory works outside the laboratory.

These are used to study rare conditions which provide an insight on the working of some mental processes i.e. Clive Wearing, HM. Although case studies deal with very small sample so the results cannot be generalized to the wider population as they are influenced by individual characteristics, they allow us to study cases which could not be produced experimentally because of ethical and practical reasons.

The information processing paradigm of cognitive psychology views the minds in terms of a computer when processing information. However, although there are similarities between the human mind and the operations of a computer (inputs and outputs, storage systems, the use of a central processor), the computer analogy has been criticized by many.

The approach is reductionist as it does not consider emotions and motivation, which influence the processing of information and memory. For example, according to the Yerkes-Dodson law anxiety can influence our memory.

Such machine reductionism (simplicity) ignores the influence of human emotion and motivation on the cognitive system and how this may affect our ability to process information.

Behaviorism assumes that people are born a blank slate (tabula rasa) and are not born with cognitive functions like schemas , memory or perception .

The cognitive approach does not always recognize physical ( biological psychology ) and environmental (behaviorist approach) factors in determining behavior.

Cognitive psychology has influenced and integrated with many other approaches and areas of study to produce, for example, social learning theory , cognitive neuropsychology, and artificial intelligence (AI).

Another strength is that the research conducted in this area of psychology very often has applications in the real world.

For example, cognitive behavioral therapy (CBT) has been very effective in treating depression (Hollon & Beck, 1994), and moderately effective for anxiety problems (Beck, 1993). CBT’s basis is to change how the person processes their thoughts to make them more rational or positive.

By highlighting the importance of cognitive processing, the cognitive approach can explain mental disorders such as depression, where Beck argues that it is the negative schemas we hold about the self, the world, and the future which lead to depression rather than external events.

Atkinson, R. C., & Shiffrin, R. M. (1968). Chapter: Human memory: A proposed system and its control processes. In Spence, K. W., & Spence, J. T. The psychology of learning and motivation (Volume 2). New York: Academic Press. pp. 89–195.

Beck, A. T, & Steer, R. A. (1993). Beck Anxiety Inventory Manual. San Antonio: Harcourt Brace and Company.

Hollon, S. D., & Beck, A. T. (1994). Cognitive and cognitive-behavioral therapies. In A. E. Bergin & S.L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 428—466) . New York: Wiley.

Köhler, W. (1925). An aspect of Gestalt psychology. The Pedagogical Seminary and Journal of Genetic Psychology, 32(4) , 691-723.

Miller, G. A. (1956). The magical number seven, plus or minus two: some limits on our capacity for processing information. Psychological Review , 63 (2): 81–97.

Neisser, U (1967). Cognitive psychology . Appleton-Century-Crofts: New York

Newell, A., & Simon, H. (1972). Human problem solving . Prentice-Hall.

Tolman, E. C., Hall, C. S., & Bretnall, E. P. (1932). A disproof of the law of effect and a substitution of the laws of emphasis, motivation and disruption. Journal of Experimental Psychology, 15(6) , 601.

Tolman E. C. (1948). Cognitive maps in rats and men . Psychological Review. 55, 189–208

Wiener, N. (1948). Cybernetics or control and communication in the animal and the machine . Paris, (Hermann & Cie) & Camb. Mass. (MIT Press).

Further Reading

• Why Your Brain is Not a Computer
• Cognitive Psychology Historial Development

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? | 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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Psychological Research

Introduction to approaches to research, what you’ll learn to do: describe the strengths and weaknesses of descriptive, experimental, and correlational research.

If you think about the vast array of fields and topics covered in psychology, you understand that in order to do psychological research, there must be a diverse set of ways to gather data and perform experiments. For example, a biological psychologist might work predominately in a lab setting or alongside a neurologist. A social scientist may set up situational experiments, a health psychologist may administer surveys, and a developmental psychologist may make observations in a classroom. In this section, you’ll learn about the various types of research methods that psychologists employ to learn about human behavior.

Psychologists use descriptive, experimental, and correlational methods to conduct research. Descriptive, or qualitative, methods include the case study, naturalistic observation, surveys, archival research, longitudinal research, and cross-sectional research.

Experiments are conducted in order to determine cause-and-effect relationships. In ideal experimental design, the only difference between the experimental and control groups is whether participants are exposed to the experimental manipulation. Each group goes through all phases of the experiment, but each group will experience a different level of the independent variable: the experimental group is exposed to the experimental manipulation, and the control group is not exposed to the experimental manipulation. The researcher then measures the changes that are produced in the dependent variable in each group. Once data is collected from both groups, it is analyzed statistically to determine if there are meaningful differences between the groups.

When scientists passively observe and measure phenomena it is called correlational research. Here, psychologists do not intervene and change behavior, as they do in experiments. In correlational research, they can identify a relationship between two variables but usually cannot infer what causes what.

Watch It: More on Research

If you enjoy learning through lectures and want an interesting and comprehensive summary of this section, then click on the Youtube link to watch a lecture given by MIT Professor John Gabrieli . Start at the 30:45 minute mark  and watch through the end to hear examples of actual psychological studies and how they were analyzed. Listen for references to independent and dependent variables, experimenter bias, and double-blind studies. In the lecture, you’ll learn about breaking social norms, “WEIRD” research, why expectations matter, how a warm cup of coffee might make you nicer, why you should change your answer on a multiple choice test, and why praise for intelligence won’t make you any smarter.

You can view the transcript for “Lec 2 | MIT 9.00SC Introduction to Psychology, Spring 2011” here (opens in new window) .

Learning Objectives

• Differentiate between descriptive, experimental, and correlational research
• Explain the strengths and weaknesses of case studies, naturalistic observation, and surveys
• Describe the strength and weaknesses of archival, longitudinal, and cross-sectional research
• Explain what a correlation coefficient tells us about the relationship between variables
• Describe why correlation does not mean causation
• Describe the experimental process, including ways to control for bias
• Identify and differentiate between independent and dependent variables

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Clinical Case Studies by Psychologists Strengths and Weaknesses of Case Studies from a Clinical Perspective

by Dua Imran | Aug 26, 2019 | Case Studies | 0 comments

A case study is essentially a comprehensive and in-depth investigation that is conducted on one single person so as to gain insight into a respective phenomenon. In order to carry out this research, several measures are utilised like filling of questionnaires, conduction of interviews, and formal and informal observations. It is a relatively lengthy process and can last from one day to multiple years. Since it’s a progressive research and requires long bouts of time, we get to observe developments in the process along the way. 

When evaluating the significance of case studies in light of clinical psychology, it can be asserted that several academic experts undervalue the procedure. A case study has the capacity to facilitate and highlight intricate knowledge regarding the subject that is primarily being studied. There are numerous means to attain this information. Some of them include structured and unstructured interviews, personal notes, journaling, questionnaires, observations, and maintenance of official documents. The unique trait that is similar in all the mentioned measures is that the results gathered from this research are qualitative in nature, i.e., they can’t be measured through conventional means. 

It is necessary to examine both the limitations and the strengths of case studies so as to get a clear idea of their purpose. Hence, the most crucial piece of information extracted through the conduction of case studies is that it facilitates rich and seasoned information that is qualitative. Therefore, the examiner can interpret, articulate, and understand the received information effectively. Furthermore, after the generation of this knowledge, you can also dive into further research as now you would have a specific direction rather than a general agenda. It will allow you to inspect the subject and understand the complexities involved. Thirdly, you can later compare and find contradictions between the contemporary and unconventional information. 

The Hawthorn Effect is a phenomenon in which people change their behaviour every time they realise that they are being watched or observed. Thus, the results collected can be intentional. Furthermore, the person conducting the investigation can also formulate a bias against or for the subject. In addition to this, the results obtained from this study cannot entirely be generalised. There are chances of errors and misinterpretation of cues and signals. Lastly, it is an extensive approach and can require a large amount of time, which is why patience is mandatory.

Institute of Professional Psychology (IPP),

Bahria University.

Strengths and Weaknesses of Case Studies

There is no doubt that case studies are a valuable and important form of research for all of the industries and fields that use them. However, along with all their advantages, they also have some disadvantages. In this article we are going to look at both.

Advantages of Case Studies

Intensive Study

Case study method is responsible for intensive study of a unit. It is the investigation and exploration of an event thoroughly and deeply. You get a very detailed and in-depth study of a person or event. This is especially the case with subjects that cannot be physically or ethically recreated.

This is one of the biggest advantages of the Genie case. You cannot lock up a child for 13 years and deprive them of everything. That would be morally and ethically wrong in every single way. So when the opportunity presented itself, researchers could not look away. It was a once in a lifetime opportunity to learn about feral children.

Genie was a feral child. She was raised in completed isolation, with little human contact. Because of the abuse she withstood, she was unable to develop cognitively. From infancy she was strapped to a potty chair, and therefore never acquired the physicality needed for walking, running and jumping.

If Genie made a noise, her father beat her. Therefore, she learned to not make a noise. Once she was found, researchers studied her language skills, and attempted to find ways to get her to communicate. They were successful. While she never gained the ability to speak, she did develop other ways to communicate. However, the public soon lost interest in her case, and with that, the funds to conduct the study.

However, her case was extremely important to child development psychology and linguistic theory. Because of her, we know that mental stimulation is needed for proper development. We also now know that there is a "critical period" for the learning of language.

Developing New Research

Case studies are one of the best ways to stimulate new research. A case study can be completed, and if the findings are valuable, they can lead to new and advanced research in the field. There has been a great deal of research done that wouldn't have been possible without case studies.

An example of this is the sociological study Nickel and Dimed. Nickel and Dimed is a book and study done by Barbara Ehrenreich. She wanted to study poverty in America, and did so by living and working as a person living on minimum wage.

Through her experiment, she discovered that poverty was almost inescapable. As soon as she saved a little money, she was hit with a crisis. She might get sick, or her car might break down, all occurrences that can be destructive when a person doesn't have a safety net to fall back on.

It didn't matter where she lived or what she did. Working a minimum wage job gave her no chances for advancement or improvement whatsoever. And she did the experiment as a woman with no children to support.

This study opened a lot of eyes to the problem of the working poor in America. By living and working as the experiment, Ehrenreich was able to show first-hand data regarding the issues surrounding poverty. The book didn't end with any solutions, just suggestions for the reader and points for them to think about.

Using this case study information, new studies could be organized to learn better ways to help people who are fighting poverty, or better ways to help the working poor.

Contradicting Established Ideas or Theories

Oftentimes there are theories that may be questioned with case studies. For example, in the John/John case study, it was believed that gender and sexual identity were a construct of nurture, not nature.

John-John focused on a set of twin boys, both of whom were circumcised at the age of 6 months. One of the twin's circumcisions failed, causing irreparable damage to the penis. His parents were concerned about the sexual health of their son, so they contacted Dr. John Money for a solution.

Dr. Money believed that sexuality came from nurture, not nature, and that the injured baby, Bruce, could be raised as a girl. His penis was removed and he was sexually reassigned to become a girl. Bruce's name was changed to Brenda, and his parents decided to raise him as a girl.

In this case, Dr. Money was dishonest. He believed that gender could be changed, which has since been proven false. Brenda's parents were also dishonest, stating that the surgery was a success, when in fact that wasn't the case.

As Brenda grew up, she always acted masculine and was teased for it at school. She did not socialize as a girl, and did not identify as a female. When Brenda was 13 she learned the truth, and was incredibly relieved. She changed her name to David, and lived the rest of her life as a male.

This case proved that the general theory was wrong, and is still valuable, even though the study author was dishonest.

Giving New Insight

Case studies have the ability to give insight into phenomena that cannot be learned in any other way. An example of this is the case study about Sidney Bradford. Bradford was blind from the age of 10 months old, and regained his sight at the age of 52 from a corneal transplant.

This unique situation allowed researchers to better learn how perception and motion changes when suddenly given sight. They were able to better understand how colors and dimensions affect the human process. For what it is worth, Bradford continued to live and work with his eyes closed, as he found sight too stimulating.

Another famous study was the sociological study of Milgram.

Stanley Milgram did a study from 1960 to 1974 in which he studied the effects of social pressure. The study was set up as an independent laboratory. A random person would walk in, and agree to be a part of the study. He was told to act as a teacher, and ask questions to another volunteer, who was the learner.

The teacher would ask the learner questions, and whenever he answered incorrectly, the teacher was instructed to give the learner an electric shock. Each time the learner was wrong, the shock would be increased by 15 volts. What the teacher didn't know was that the learner was a part of the experiment, and that no shocks were being given. However, the learner did act as if they were being shocked.

If the teachers tried to quit, they were strongly pushed to continue. The goal of the experiment was to see whether or not any of the teachers would go up to the highest voltage. As it turned out, 65% of the teachers did.

This study opened eyes when it comes to social pressure. If someone tells you it is okay to hurt someone, at what point will the person back off and say "this is not ok!" And in this study, the results were the same, regardless of income, race, gender or ethnicity.

This study opened up the sociological world of understanding the divide between social pressure and morality.

Disadvantages of Case Studies

Inability to Replicate

As demonstrated with the Genie case study, many studies cannot be replicated, and therefore, cannot be corroborated. Because the studies cannot be replicated, it means the data and results are only valid for that one person. Now, one could infer that that results of the Genie study would be the same with other feral children, without additional studies we can never be 100% certain.

Also, Genie was a white, American female. We do not know whether someone with a different gender, race or ethnicity would have a different result.

Key Term! Hawthorne Effect

The effect in which people change their behavior when they are aware they are being observed.

Researcher Bias

When conducting a case study, it is very possible for the author to form a bias. This bias can be for the subject; the form of data collection, or the way the data is interpreted. This is very common, since it is normal for humans to be subjective. It is well known that Sigmund Freud, the father of psychology, was often biased in his case histories and interpretations.

The researcher can become close to a study participant, or may learn to identify with the subject. When this happens the researcher loses their perspective as an outsider.

No Classification

Any classification is not possible due to studying a small unit. This generalization of results is limited, since the study is only focusing on one small group. However, this isn't always a problem, especially if generalization is not one of the study's goals.

Time Intensive

Case studies can be very time consuming. The data collection process can be very intensive and long, and this is something new researchers are not familiar with. It takes a long period of time to develop a case study, and develop a detailed analysis.

Many studies also require the authors to immerse themselves in the case. For example, in the Genie case, the lead researchers spent an abnormal amount of time with Genie, since so few people knew how to handle her. David Rigler, one of the lead researchers, actually had Genie live with him and his family for years. Because of this attachment, many questioned the veracity of the study data.

Possibility of Errors

Case study method may have errors of memory or judgment. Since reconstructing case history is based on memory, this can lead to errors. Also, how one person perceived the past could be different for another person, and this can and does lead to errors.

When considering various aspects of their lives, people tend to focus on issues that they find most important. This allows them to form a prejudice and can make them unaware of other possible options.

Ethical Issues

With small studies, there is always the question of ethics. At what point does a study become unethical? The Genie case was riddled with accusations of being unethical, and people still debate about it today.

Was it ethical to study Genie as deeply as she was studied?

Did Genie deserve to live out her life unbothered by researchers and academics trying to use her case to potentially further their careers?

At what point does the pursuit of scientific knowledge outweigh the right to a life free from research?

Also, because the researchers became so invested in the study, people questioned whether a researcher would report unethical behavior if they witnessed it.

Advantages and Disadvantages in Real-Life Studies

Two of these case studies are the Tylenol Scandal and the Genie language study.

Let's look at the advantages and disadvantages of these two studies.

Genie – Advantages

Uniqueness of study – Being able to study a feral child is a rare occurrence.

Genie – Disadvantages

Ethics - The lead researcher David Rigler provided a home for Genie, and was paid for being a foster parent. This is often seen as unethical, since Rigler had a financial interest in Genie and her case.

Tylenol – Advantages

Uniqueness of study – What happened to Tylenol was very unique and rare. While companies face crisis all the time, a public health crisis of this magnitude is very unique.

Tylenol – Disadvantages

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Case study definition

Case study, a term which some of you may know from the "Case Study of Vanitas" anime and manga, is a thorough examination of a particular subject, such as a person, group, location, occasion, establishment, phenomena, etc. They are most frequently utilized in research of business, medicine, education and social behaviour. There are a different types of case studies that researchers might use:

• Collective case studies

• Descriptive case studies

• Explanatory case studies

• Exploratory case studies

• Instrumental case studies

• Intrinsic case studies

Case studies are usually much more sophisticated and professional than regular essays and courseworks, as they require a lot of verified data, are research-oriented and not necessarily designed to be read by the general public.

How to write a case study?

It very much depends on the topic of your case study, as a medical case study and a coffee business case study have completely different sources, outlines, target demographics, etc. But just for this example, let's outline a coffee roaster case study. Firstly, it's likely going to be a problem-solving case study, like most in the business and economics field are. Here are some tips for these types of case studies:

• Your case scenario should be precisely defined in terms of your unique assessment criteria.

• Determine the primary issues by analyzing the scenario. Think about how they connect to the main ideas and theories in your piece.

• Find and investigate any theories or methods that might be relevant to your case.

• Keep your audience in mind. Exactly who are your stakeholder(s)? If writing a case study on coffee roasters, it's probably gonna be suppliers, landlords, investors, customers, etc.

• Indicate the best solution(s) and how they should be implemented. Make sure your suggestions are grounded in pertinent theories and useful resources, as well as being realistic, practical, and attainable.

• Carefully proofread your case study. Keep in mind these four principles when editing: clarity, honesty, reality and relevance.

Are there any online services that could write a case study for me?

Luckily, there are!

We completely understand and have been ourselves in a position, where we couldn't wrap our head around how to write an effective and useful case study, but don't fear - our service is here.

We are a group that specializes in writing all kinds of case studies and other projects for academic customers and business clients who require assistance with its creation. We require our writers to have a degree in your topic and carefully interview them before they can join our team, as we try to ensure quality above all. We cover a great range of topics, offer perfect quality work, always deliver on time and aim to leave our customers completely satisfied with what they ordered.

The ordering process is fully online, and it goes as follows:

• Select the topic and the deadline of your case study.

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• Leave the email address, where your completed order will be sent to.

• Select your payment type, sit back and relax!

With lots of experience on the market, professionally degreed writers, online 24/7 customer support and incredibly low prices, you won't find a service offering a better deal than ours.

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In psychology researches, several methods are used, for example experiment, observation and case studies. What are the strengths and weaknesses of case study method?

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• Relationships

3 Ways a Narcissist Will Show Their "Love" to You

Most people love to show love. narcissists, however, only love themselves..

Posted March 21, 2024 | Reviewed by Michelle Quirk

• Why Relationships Matter
• Find counselling to strengthen relationships
• The initial phases of a relationship with a narcissist often evoke intense euphoria.
• Gaslighting and manipulation are covertly employed by narcissists to assert dominance over their partners.
• Beyond exiting the toxic relationship, genuine healing requires rebuilding self-worth and self-esteem.

If you’ve ever been in a relationship with a person driven by a sense of self-importance, a constant craving for admiration, and a tendency to prioritize their own desires over the needs of others—you were possibly in the company of a narcissist.

People with narcissistic personality disorder (NPD) often engage in self-enhancement behaviors, seeking validation and admiration from their partners while displaying a lack of empathy. In doing so, they may treat their partners more as objects rather than equals.

Exploring the complexities of how a narcissist interacts with their partner can offer insight into the dynamic interplay between ego, validation, and emotional connection that unfolds in such a relationship.

How Does It Feel to Be a Narcissist’s Object of Love?

The narratives of being a narcissist’s love interest are rife with highly evocative and polarizing descriptors. The confusing see-saw of receiving love from an individual driven primarily by self-service can warp one’s view of what love is supposed to look and feel like.

There are, however, three common elements in most stories:

1. You Love Them; They Love Themselves

The initial phases of a relationship with a narcissist often evoke intense euphoria. Their charm, charisma , and seemingly genuine affection create a captivating whirlwind of passion and excitement. However, beneath this euphoria lies a fragile foundation, as the narcissist’s love is inherently self-serving. The narcissist perceives their partner as a means to fulfill their need for validation and bolster their brittle ego. Despite outward displays of affection, the relationship is fundamentally one-sided, with the narcissist prioritizing their own needs and desires.

Research confirms the notion that narcissists prioritize their sense of superiority over others, particularly marked by high concern regarding others’ reactions and a tenuous sense of existence. This stark contrast between the illusion of love created in the relationship and the reality of exploitation sets the stage for the tumultuous journey ahead.

2. Their Feelings Flip at the Drop of a Dime

As the relationship progresses, the emotional roller coaster intensifies, engulfing the narcissist’s partner in a vortex of uncertainty and instability. Recent research , spanning seven studies with a total of 3,560 participants, highlights that the short-term allure of narcissism is predominantly associated with admiration, while long-term relationship challenges stem from rivalry, marked by derogation of others and antagonistic self-protection.

The highs of being adored and cherished are quickly followed by the crushing lows of being discarded or devalued. This relentless cycle of idealization and devaluation corrodes the object’s self-worth and security, leaving them perpetually on edge, anticipating the next abrupt shift in the narcissist’s affections. The emotional toll is profound, leaving the object feeling lost, vulnerable, and emotionally drained, trapped in a perpetual state of turmoil and anxiety .

3. It’s All Smoke and Mirrors

Gaslighting and manipulation are covert tactics employed by narcissists to assert dominance over their partners. Through subtle psychological manipulation, they distort reality, sowing seeds of doubt and confusion. Gaslighting techniques may involve downplaying their partner’s concerns, distorting past events, or outright lying to shape the narrative in their favor.

A study published in The Journal of Sexual Aggression reveals that gaslighters often exhibit common personality traits such as emotional unavailability, withdrawal, irresponsibility, impulsiveness, distractibility, and a lack of self-awareness.

Over time, the victim of the narcissist’s affection may internalize these manipulative strategies, doubting their own sanity and perception. This erosion of self-trust leads to a deep loss of self-esteem and self-worth as the victim becomes increasingly reliant on the narcissist for validation and guidance. Once entangled in the manipulative web, breaking free from the narcissist’s grip becomes challenging.

What Steps Can You Take When Their Facade Begins to Crack?

The narcissist’s greatest weapon is also their greatest weakness—the inability to look beyond themselves. Here’s how you can take advantage of this blind spot and beat them at their own game:

• Gray rock them out of your life. The gray rock method is a strategy for dealing with narcissists by becoming emotionally unresponsive. Essentially, to disengage from manipulative or abusive conversations, responses should be intentionally uninteresting. This involves techniques such as minimizing emotional reactions, avoiding arguments, and keeping interactions brief and neutral. By doing so, individuals can deny the manipulator the emotional reaction or attention they seek, disempowering their tactics and protecting themselves from harm in the process.
• Poke holes in their stories. In the case of gaslighting, researcher Willis Klein from McGill University suggests paying close attention to their behavior. Despite a gaslighter’s convincing facade, they often reveal inconsistencies. “Compare their behavior towards you with how they treat others in your life. Hold them accountable for their narrative. You’ll likely notice discrepancies that will empower you to reclaim control over your own narrative,” says the author.

Beyond exiting the toxic relationship, genuine healing requires actively rebuilding self-worth and self-esteem. This involves introspection, self-reflection, and nurturing self-compassion. Establishing healthy boundaries and prioritizing personal well-being are paramount. Additionally, therapy can offer a valuable avenue to process difficult experiences, address trauma , and develop coping strategies to enhance resilience .

A version of this post also appears on Forbes.com.

Mark Travers, Ph.D., is an American psychologist with degrees from Cornell University and the University of Colorado Boulder.

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ORIGINAL RESEARCH article

Motivational variations in fitness: a population study of exercise modalities, gender and relationship status.

• 1 Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
• 2 Liberal Arts Department, American University of the Middle East, Egaila, Kuwait

Introduction: Motivation plays a crucial role in determining whether or not a person adheres to an exercise program. The present study aimed to determine the motivational differences between people exercising in fitness alone, in groups/aerobics and with a personal trainer by gender and relationship status.

Methods: The Exercise Motivations Inventory-2 (EMI-2) questionnaire was completed by 830 users of 20 largest fitness centers in Slovenia.

Results: The Kruskal-Wallis test followed by a Dunn post-hoc test revealed that health-related motives such as ill-health avoidance were most frequently associated with exercising with a personal trainer compared to other exercise modalities, especially among females ( p = 0.032, M = 4.88) and people in a relationship ( p = 0.020, M = 5.18). On the other hand, intrinsic motivations such as enjoyment and stress management were mostly associated with exercising alone ( p = 0.002, M = 4.98 and p = 0.021, M = 4.68, respectively). These results were also transferred to females and to some extent to people in a relationship (for enjoyment only). It is expected that intrinsic motivation is related to sustained exercise behavior.

Discussion: Future studies could implement a longitudinal design to test this statement and examine the proposed relationships over a longer period to better understand whether there may be causal relationships between motivation and different exercise modalities depending on different characteristics of participants.

1 Introduction

Physical inactivity remains a significant problem that negatively impacts the physical ( Haskell et al., 2007 ) and mental health of adults ( Spalter et al., 2015 ; Kajtna and Vučković, 2022 ). One of the fastest growing sectors in physical activity and exercise is the fitness industry ( Rodriguez, 2019 ; Yi et al., 2021 ), which is particularly popular among young people ( Ong et al., 2021 ). There are around 185 million members and 210,000 clubs worldwide ( Rothmann, 2022 ). In a study conducted by Fernandez (2022) , gym members had a lower prevalence of physical inactivity and a higher prevalence of vigorous physical activity than the general population, regardless of age and gender. However, less than 40% of gym members exercise regularly and the dropout rate is high ( Sperandei et al., 2016 ; Kopp et al., 2020 ; Rand et al., 2020 ; Gjestvang et al., 2021 ).

It is known that motivation plays a crucial role in determining whether or not a person adheres to an exercise program ( Teixeira et al., 2012 ). Nevertheless, research on the exercise behaviors of fitness club members is quantitatively and qualitatively limited ( Middelkamp and Steenbergen, 2015 ; Gjestvang et al., 2021 ). Frederick and Ryan (1993) found that people who engage in sports are driven by interest/enjoyment and competence motivation, whereas people who engage in fitness activities are driven by body-related motivation. Kilpatrick et al. (2005) also distinguish that intrinsic motives such as enjoyment and challenge are responsible for engaging in sport, while motivation for fitness training is more extrinsic and focuses on appearance, weight and stress management. Exercise behavior is determined more by health and fitness motives and also by appearance/weight concerns than by participation in sport. In contrast, social engagement and enjoyment motives were found to be less associated with fitness training, but more motivating for sport participation ( Cagas et al., 2015 ).

Regarding the different types of activities, it was demonstrated that the strongest discriminators were affiliation in team sports, enjoyment in individual racing sport and bowls players, mastery in racquet sports, psychological state in fitness exercisers, and competition/ego in martial artists ( Molanorouzi et al., 2015 ). The three most commonly cited motives for participants in fitness training and recreational activities were strength and endurance, weight management and stress management ( Ball et al., 2014 ; Rodrigues et al., 2022 ). Rodrigues et al. (2022) found differences between water activities and group fitness classes and cardio/strength activities. Few studies have been conducted with participants involved in extreme conditioning program training. Fisher et al. (2017) suggest that these participants were more likely to report higher scores for intrinsic motives such as enjoyment, challenge, and affiliation, while personal training clients reported higher scores for health-related motives such as positive health, ill-health avoidance, and weight management. The same authors suggest that individuals who exercise one-to-one with a personal trainer have higher health-related motives (e.g., positive health, health pressures, and ill-health avoidance). Similar results were found by Marin et al. (2018) , where participants involved in extreme conditioning program training had higher levels of enjoyment, stress management, social recognition, affiliation, competition and weight management. Conversely, resistance training participants indicated a higher motive for appearance.

Although some previous studies have found differences in motivation to participate in sport and fitness training ( Whaley, 2003 ; Kilpatrick et al., 2005 ), there is a gap in the literature when it comes to motivation to participate in the latter ( Ball et al., 2014 ). Recent studies also agree that future studies should analyze the motivational differences between different exercise activities in more detail ( Rodrigues et al., 2022 ). In a study by Tsitskari et al. (2017) , exercise motivation was used to segment gym-goers and conduct further analyses. However, there are no studies in which the motivation to participate in different types of exercise in fitness centers was investigated.

Very few studies compared extreme conditioning program training with group fitness exercise, training alone and also training with a personal trainer using the Exercise Motivations Inventory-2 (EMI-2) questionnaire ( Fisher et al., 2017 ). However, the design of the aforementioned study has some weaknesses. Firstly, the authors obtained the responses via social media. The fact that the authors were not personally present in the fitness centers could have an impact on the honesty of the participants and thus on the reliability and validity of the analyzed data. Although some authors claim that the presence of the researcher has no effect on performance ( Wood et al., 2006 ), there are some other studies that show that the virtual presence of the researcher had a significant positive effect in preventing careless responding ( Ward and Pond, 2015 ). Secondly, the criterion in the mentioned study was that all participants had been exercising for more than 6 months. The study by Maltby and Day (2001) has shown that this is a very important factor in determining motivation to exercise, so we believe that this could bias the results obtained. We believe that all participants should be assessed regardless of their training experience, as extrinsic motivation plays a decisive role, especially in the initial phases of training, while intrinsic motives are crucial for progress in later phases ( Dacey et al., 2008 ; Jones et al., 2020 ). Another study by Marin et al. (2018) used the EMI-2 questionnaire to assess motivational differences between resistance training and extreme conditioning program training. However, they used a similar approach by creating an online questionnaire and posting it on Facebook, where it remained for 2 months. In a study from China ( Rahman et al., 2019 ), the authors also used the EMI-2 questionnaire to assess the participants’ motivation for physical activity for three different group activities: fitness training, sports, and recreational and cultural activities. The drawback of this study was that the participants were predominantly middle-aged and older, mainly 55–64-year-olds and 65–74-year-olds (the inclusion criterion was age 35+). If we truly want to understand the motivational structure of exercisers, we should examine the entire age span and include youth as well. One of the reasons for this is that many studies have shown that the motivation for exercise varies according to age group ( Biddle et al., 2003 ; Trujillo et al., 2004 ; Caglar et al., 2009 ; Brunet and Sabiston, 2011 ; Egli et al., 2011 ; Molanorouzi et al., 2015 ; Jones et al., 2020 ; Box et al., 2021 ; Grajek et al., 2021 ; Gut et al., 2022 ; Rodrigues et al., 2022 ), so that the assessment of motivational structures between different exercise modalities would lead to biased results in older adults. Another advantage of including young adults in the study is the fact that they can be guided toward a more active lifestyle, if this is not already the case. Furthermore, there is ample evidence that the level of physical activity in adolescents continues into adulthood ( Telama et al., 2005 ; Telama, 2009 ). It is also worth noting that previous studies have shown that motivations related to weight control and physical appearance were prevalent in women, whereas all aspects related to competition were prevalent in men ( Kilpatrick et al., 2005 ; Pauline, 2013 ; Vuckovic et al., 2023 ). Furthermore, to our knowledge, there are no studies that consider relationship status when examining exercise motivation.

For the abovementioned reasons, we designed a study to investigate the differences in motivation for exercise between participants engaged in different fitness training modalities. We applied a direct and holistic approach that considered the gender and relationship status of the participants, thus significantly improving the methodological approach used previously. More specifically, the aim of the present study was to determine the differences in motivational structure between fitness, aerobics, and personal trainer adult clients.

2 Materials and methods

2.1 participants.

We collected data from members of 20 fitness centers in 9 major Slovenian cities (4 from the eastern region and 5 from the western region). The questionnaire was distributed to 2,060 participants. After removing incomplete answers (including attention test), the final number of fully and correctly completed questionnaires for further processing amounted to 830 questionnaires, which corresponds to a response rate of 40.29%.

Table 1 shows the demographic characteristics of the fitness center users.

Table 1. Sample characteristics.

2.2 Procedures

It is worth noting that all the major fitness centers in Slovenia that we have selected have relatively similar characteristics in terms of facilities, equipment, programs offered, membership conditions and prices. After the participants completed their workout and left the respective centers, we approached them with tablet computers. To encourage their participation, we offered them protein bars and asked them to complete the questionnaire. Before handing over the questionnaire, the procedure was explained in details to address any potential concerns or uncertainties the participants might have. All questionnaires were distributed from Monday to Sunday, in the morning, afternoon and evening. Participants signed a consent form before completing the questionnaires via an online cloud platform specifically designed for survey purposes. 1 This study was conducted in accordance with the Declaration of Helsinki. All participants gave written informed consent before participating in the study, and the Ethics Committee of the University of Ljubljana granted ethical approval for data collection (No. 2021-19).

2.3 Instruments

The Exercise Motivations Inventory-2 (EMI-2), developed by Markland and Ingledew (1997) was used to assess the exercise motivation of fitness center members. The EMI-2 scale consists of 51 items and each item is measured on a 6-point Likert scale from zero (does not apply to me at all) to five (applies to me very much), with higher scores indicating higher motivation to exercise. These items form 14 subscales, including: Affiliation, Appearance, Challenge, Competition, Enjoyment, Health Pressure, Disease Prevention, Agility, Positive Health, Revitalization, Social Recognition, Strength and Endurance, Stress Management, and Weight Management. Each subscale is determined by calculating the average of 3 to 4 appropriate items based on the EMI-2 scale scoring key. The EMI-2 is a factorially valid mean of assessing a wide range of motives for participation in sporting activities in adult men and women and is suitable for both athletes and non-athletes ( Markland and Ingledew, 1997 ). The EMI-2 has already been used in the Slovenian population, with Cronbach’s alpha ranging from 0.71 to 0.91 ( Vuckovic et al., 2023 ). However, we confirmed the reliability of the 51 EMI-2 items in this study by measuring the Cronbach’s Alpha coefficient (α = 0.801) and the 14 scales (α ranged from 0.665 to 0.903). In addition, the attention test questions were interspersed in the questionnaire to further increase the reliability and validity of the assessment. All participants who did not answer the attention test questions correctly were excluded from the study. In addition, participants answered questions about their personal life and the type of training they were participating in. For reasons of ecological validity, participants who took part in more than one type of training were also excluded from the study (see section “2.1 Participants”).

2.4 Statistical analysis

The Cronbach’s Alpha test was used to test the reliability of the EMI-2 scales. The mean scores of the 14 motivational scales were used as dependent variables, while the type of participant engagement (fitness, group training or personal trainer) and participant characteristics such as gender (males vs. females) and relationship status (single vs. in a relationship/married) were used as independent variables. Due to the ordinal and nominal nature of the data, the non-parametric Kruskal-Wallis test was used in this study. In the case of significant differences, the Dunn post-hoc test was used for pairwise comparisons. For each significant difference, the effect size was also reported as Pearson’s r, with r values of 0.10, 0.30, and 0.50 representing the thresholds for small, medium and large effects respectively ( Cohen, 1988 ). Descriptive statistics were presented as means, standard deviations, and χ 2 . All statistical tests were analyzed using the RStudio software (RStudio; Posit, PBC, Vienna, Austria). The alpha level was set at 0.05.

Table 2 contains descriptive statistics on the observed variables and the results of the Kruskal-Wallis test for the whole sample.

Table 2. Motivations of fitness center users by type of exercise.

Post-hoc tests revealed that individuals who exercise alone in the fitness center are significantly more motivated by stress management than personal trainer clients ( p = 0.008; r = 0.097). They are also more motivated by enjoyment compared to group exercise ( p = 0.025; r = 0.080) and personal trainer clients ( p = 0.003; r = 0.110). Similarly, fitness center users are significantly more motivated by challenge ( p = 0.006; r = 0.098) and social recognition ( p = 0.008; r = 0.096) than group exercise users. Users who participate in group classes exercise significantly more out of a sense of belonging than users who exercise in a fitness ( p = 0.004; r = 0.100) or with a personal trainer ( p = 0.002; r = 0.250). We also found that fitness center users are significantly more motivated by competition ( p = 0.001; r = 0.120) than those who attend group classes. We also demonstrated that fitness center users are more interested in their appearance than those attending group classes ( p = 0.010; r = 0.092) or training with a personal trainer ( p = 0.016; r = 0.089), but exercise less because for ill-health avoidance reasons than those attending group ( p = 0.010; r = 0.092) and personal training ( p = 0.030; r = 0.080). Finally, our results show that personal training clients exercise much more for nimbleness reasons than fitness participants ( p = 0.032; r = 0.079).

Table 3 shows the different motivations for exercise between the genders.

Table 3. Mean ranking scores on exercise motivation between male and female participants.

Using post-hoc tests, we found that affiliation ( p = 0.028; r = 0.103) and health pressures ( p = 0.020; r = 0.109) motivates males much more to go to group exercise classes than to fitness training. Completely opposite results were found for the motive appearance – males who exercise because of this go to fitness and do not prefer group exercise ( p = 0.029; r = 0.103).

Our results also demonstrate that female fitness center users who exercise alone are motivated by stress management ( p = 0.019; r = 0.140) or enjoyment ( p = 0.009; r = 0.156) are significantly more likely to work out alone in fitness than to go to a personal trainer. Those who exercise for challenge ( p = 0.015; r = 0.134) and competition ( p = 0.049; r = 0.108) are also more likely to exercise in a fitness than in a group, in contrast to those who are motivated with ill-health avoidance ( p = 0.031; r = 0.119). Finally, women who are motivated by affiliation are more likely to participate in group training than in fitness training alone ( p = 0.010; r = 0.142) or with personal trainer ( p = 0.002; r = 0.297).

Table 4 shows how the exercise motives of the single participants and the participants living in a relationship differ in relation to the type of training.

Table 4. Mean ranking scores on exercise motivation between single participants and participants in a relationship.

Post-hoc tests showed that singles prefer fitness ( p = 0.017; r = 0.123) or group exercise ( p = 0.041; r = 0.299) rather than training with a personal trainer to cope with everyday stress. They also exercise much more in a group than in a fitness ( p = 0.018; r = 0.120) or with a personal trainer ( p = 0.026; r = 0.324) because of affiliation. Singles also exercise more alone in a fitness than with a personal trainer because of their appearance ( p = 0.007; r = 0.141).

Members of fitness centers who are in a relationship or married enjoy fitness training more than training with a personal trainer ( p = 0.017; r = 0.126). They also exercise more in the fitness than in groups because they want to be socially recognized ( p = 0.020; r = 0.118). In addition, those who exercise because of affiliation, exercise more in groups than in the fitness ( p = 0.023; r = 0.115) and with personal trainer ( p = 0.037; r = 0.212). And those who exercise for competitive reasons exercise less in groups and more in the fitness area ( p = 0.006; r = 0.140) and with a personal trainer ( p = 0.028; r = 0.223). Finally, avoiding illness is a motive that is more common among users of group exercise ( p = 0.039; r = 0.105) and personal trainer clients ( p = 0.033; r = 0.113) than among users who only exercise in the fitness area.

4 Discussion

The aim of the study was to determine the motivational differences between people who train in fitness alone, in groups/aerobics, and those who train with a personal trainer. We also wanted to investigate whether the motivational structure of the participants differs according to gender and relationship status.

It is important to note that our analysis revealed no significant differences in the motivation scales for revitalisation, weight management, and strength and endurance, regardless of exercise type, gender, or relationship status. In the past, stress management has been shown to be a better motivation for exercise than sport activities ( Kilpatrick et al., 2005 ; Ball et al., 2014 ), especially for extreme conditioning program training participants ( Fisher et al., 2017 ; Marin et al., 2018 ). The results of our study show that the motive of coping with stress is more likely to be found among regular fitness center users than among group exercise and personal trainer clients. This was particularly pronounced in singles and females. We can only speculate about the reasons for the obtained results. One of the reasons could be that fitness center users prefer to train alone to cope with the stress rather than focusing on the personal trainer. Sometimes instructors can cause additional stress by requiring their practitioners to stay focused and follow instructions, especially if having a highly committed coach-athlete relationship ( Nicholls et al., 2016 ). Another explanation could be that single people, especially females, minimize their approachability by having the personal trainer work with them. It is known that one of the reasons of going to fitness is socialization ( Eriş et al., 2018 ). It is also known that physical activity can trigger the release of endorphins, which are natural mood boosters, and it can also help to lower levels of stress hormones such as cortisol ( Habibzadeh, 2015 ). Women tend to have higher stress levels due to a variety of factors ( Matud, 2004 ), which may make stress management a more compelling motivation. Finally, we can speculate that single men probably do not prefer to show their weaknesses by having someone tell them what and how to do in front of other people, especially potential “relationship candidates,” which is why they do not seek out personal trainer sessions but prefer to work out alone at the gym.

A strong motive for participants in sports ( Kilpatrick et al., 2005 ) such as individual racing ( Molanorouzi et al., 2015 ) and extreme conditioning program training ( Fisher et al., 2017 ; Marin et al., 2018 ) is to have fun. The results of our study show that enjoyment is a very important motivating factor for women and people in a relationship to exercise alone. If we consider the previously mentioned factor of approachability for females, we could assume that people who are in a relationship may simply want to enjoy time to themselves without having to deal with anyone, including personal trainer. In addition, individuals who pursue an independent fitness routine may place more emphasis on having fun because they have more autonomy in choosing the activities they really like. They can choose exercises that suit their personal interests and bring them pleasure. Personal trainers or group training programmes, on the other hand, may take a more structured approach that focuses less on individual enjoyment.

Another important reason for participating in an independent fitness routine is the challenge, especially for females. This can be explained by the fact that participants in group exercise classes perform the same exercises, which makes them less challenging. For some, the personal challenge of setting and achieving fitness goals for themselves is a source of recognition and self-satisfaction. They enjoy the sense of fulfilment that comes from overcoming individual challenges. A study by Rodrigues et al. (2022) has shown that group exercise is also known to be less challenging than some individual water activities.

People who are intrinsically motivated are more likely to participate in activities because they enjoy them or feel challenged. By contrast, in personal training or group exercise, extrinsic motives such as external goals or expectations may play more of a role, so the enjoyment or challenge may play a secondary role. Challenge and enjoyment are known to be intrinsic motives ( Markland et al., 1992 ; Frederick and Ryan, 1993 ; Markland and Ingledew, 1997 ; Maltby and Day, 2001 ; Egli et al., 2011 ; Fortier et al., 2012 ; Knowles et al., 2015 ) and generally have a positive influence on exercise participation ( Dacey et al., 2008 ; Teixeira et al., 2012 ), while some authors also include stress management among the intrinsic motives ( Markland and Ingledew, 1997 ; Maltby and Day, 2001 ).

Another important finding of our study is that participants, especially in a relationship/married, are more likely to participate in independent fitness activities rather than group activities due to social recognition. Previous studies suggest that social recognition is related to sport participation rather than exercise ( Kilpatrick et al., 2005 ; Ball et al., 2014 ). Our findings contradict the results of a study by Fisher et al. (2017) , which suggest that social recognition may be a motivating factor for participants in group exercise. However, in our case, the number of people who exercise individually is more than 7x times higher than the number of people who participate in group exercise. This means that people who exercise individually in the fitness have more contact with other people and automatically experience social recognition. On the other hand, the results of our study showed that group classes are very important for participants’ sense of belonging (affiliation) compared fitness and personal trainer sessions. This is in line with previous studies showing that aerobic exercise participants are primarily motivated by social-health factors ( Laverie, 1998 ; Fisher et al., 2017 ). Other studies showed that affiliation is a very important motivating factor in sports participants ( Kilpatrick et al., 2005 ; Ball et al., 2014 ), especially in team sports ( Molanorouzi et al., 2015 ) or even extreme conditioning program training ( Marin et al., 2018 ). In addition, a study from China showed that affiliation is very important when it comes to participating in cultural leisure activities ( Rahman et al., 2019 ). It is common knowledge that people who want to belong somewhere join a group.

The analysis revealed that males are much more motivated by competition than females, which is consistent with previous studies ( Morris et al., 1995 ; Morgan et al., 2003 ; Egli et al., 2011 ; Pauline, 2013 ; Boone and Brausch, 2016 ; Cho and Beck, 2016 ; Vučković et al., 2022 ; Vuckovic et al., 2023 ). However, there were no significant differences between the different exercise modalities. The results also showed that female fitness practitioners were more motivated by competition than female group exercisers. Previous research on this motive is inconclusive. In a study by Fisher et al. (2017) , the authors claim that competition is more important in group training than when training alone or with a personal trainer. At the same time, Rodrigues et al. (2022) argue that the competitive motive is more pronounced in water-based activities than in group training. However, the results obtained could also be explained by the same reason previously given for the challenge - same group exercises are less demanding than individually tailored exercises, so the scope for competition is minimal.

It is known that health-related exercise motives are less associated with sport and more with exercise ( Kilpatrick et al., 2005 ; Ball et al., 2014 ). Some studies have emphasized the importance of health motives specifically for aerobic exercise ( Laverie, 1998 ) and others for training with a personal trainer ( Fisher et al., 2017 ). The results of our study confirm both - that people who want to avoid poor health are more likely to exercise in a group and with a personal trainer than alone. This is in line with some previous studies, such as a study by Rodrigues et al. (2022) , which suggests that health motives are a more important motivational factor for resistance training compared to various water activities. Interestingly, our further analysis showed that this is particularly true for participants who are in a relationship or married. As can be seen, in addition to affiliation, health was also an important motivational parameter for the decision to participate in group training.

It has been shown that appearance is more important for individual fitness users than for those who train in groups or with a personal trainer. Even more interesting is that this motivational factor is more important for single men. Individual training can be more time efficient. They can structure their workouts to fit their schedule, and this time efficiency can be especially important for their work-life balance. Previous studies have shown that physical appearance is more important for participants in exercise than for sport participants ( Kilpatrick et al., 2005 ; Ball et al., 2014 ). However, the literature on this topic is inconsistent. A study by Marin et al. (2018) associates the motive of appearance with resistance training, while Fisher et al. (2017) argue that appearance is more important for individuals exercising with a personal trainer than for group, individual or extreme conditioning program training participants.

Finally, the results of our study showed that in addition to health-related motives, nimbleness was more important for participants who train with a personal trainer than for who train in fitness alone. This can be easily explained by the fact that personal trainer training sessions are usually conducted by highly qualified experts and are tailored to the specific needs, goals and fitness level of the clients.

4.1 Strengths and limitations

The main strength of our study is that the sample can be considered representative of the Slovenian population exercising in fitness centers. Our study included the 20 largest fitness centers in the country, which are evenly distributed throughout the country. For this reason, our results are significant and valuable for interpretation in the Slovenian population. Secondly, we were physically present during the assessment, so we are confident that the questionnaires were filled out by people who exercise regularly, so there is no room for misuse or misrepresentation. In addition, although we used the previously used reliable and valid EMI-2 questionnaire, to improve reliability and validity, we introduced “attention check” questions to ensure that the responses obtained were legitimate.

At the same time, some limitations of the study should be noted. Compared to regular fitness center members who exercised alone, a relatively small sample of participants attended group and personal trainer sessions. This finding is natural and was to be expected, but is still worth mentioning. One of the possible reasons for this could be that we surveyed the 20 largest fitness centers and the trend is toward exercising alone, while group and personal trainer sessions are more common in smaller gyms. General limitations also include the fact that this study was a cross-sectional study where data was collected all at once and there was no effective follow-up study. In addition, the intensity and frequency of exercise sessions were not recorded, although the participants exercised regularly. Furthermore, this study cannot be generalized globally due to the cultural and sociological characteristics of Slovenia. Future studies could introduce a longitudinal design to examine the proposed relationships at multiple time points over a longer period to better understand whether there may be causal relationships between motivation and different exercise modalities depending on different characteristics of the participants (gender, age, relationship status, etc.). The frequency and intensity of training as well as training experience should also be taken into account in future studies.

5 Conclusion

The results of our study showed that there are motivational differences between people who exercise in fitness alone, in groups/aerobics, and with a personal trainer, especially when gender and relationship status were taken into account.

Overall, fitness center members who exercised alone were motivated by stress management, enjoyment, challenge, social recognition, competition and appearance. Individuals who worked out in a group felt that affiliation was a very important reason for participating. People who exercised with a personal trainer did so primarily for reasons of disease prevention and nimbleness. These motivation scales were further translated to the participants according to gender and relationship status. Males exercised alone more than in groups, mainly because of their appearance. Females who exercised alone did so primarily for reasons of stress management, enjoyment, challenge and appearance compared to the other options. They also exercised with a personal trainer because they wanted to avoid illness, and in group classes for a sense of belonging (affiliation), just like single people. Individuals who were in a relationship, on the other hand, exercised alone for enjoyment and appearance, in a group for affiliation and with a personal trainer for competition and disease avoidance.

Health-related motives were most commonly associated with exercising with a personal trainer, especially among females and people in a relationship. Since nimbleness was also associated with personal training, this could be an indication of trust in the trainer as an expert in the field, especially when it comes to such serious matters as one’s health and physical performance. On the other hand, intrinsic motivations such as enjoyment and stress management were associated with exercising alone. These results were also transferred to females and, to a certain extent, to people in a relationship (enjoyment only). As mentioned earlier, this type of motivation is expected to be related to sustained exercise patterns ( McDonough and Crocker, 2007 ; Markland and Tobin, 2010 ). The question is whether these fitness center members exercise the longest compared to others because they are inspired by intrinsic motivation. Future research is needed, preferably longitudinal.

Data availability statement

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

Ethics statement

The studies involving humans were approved by the Ethics Committee of the University of Ljubljana. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

VV: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Validation, Writing – original draft, Writing – review and editing. SD: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – original draft, Writing – review and editing.

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 : motivation, group exercise, personal trainer, recreation, EMI-2 questionnaire, Slovenia

Citation: Vuckovic V and Duric S (2024) Motivational variations in fitness: a population study of exercise modalities, gender and relationship status. Front. Psychol. 15:1377947. doi: 10.3389/fpsyg.2024.1377947

Received: 30 January 2024; Accepted: 05 March 2024; Published: 21 March 2024.

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*Correspondence: Sasa Duric, [email protected]

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