T

t Test
▶ Mean Differences

T1D
▶ Type I Diabetes Mellitus and Quality of Life

Taiwan
Grace Yao
Department of Psychology, National Taiwan
University, Taipei, Taiwan, Republic of China

Definition
Taiwan is a small island that lies on the western
edge of the Pacific Ocean, between ▶ Japan and
the Philippines. It has an area of about
36,000 km2 (14,400 miles2).

Description
In June of 2011, Taiwan had 23,180,477 inhabitants, 50.2 % of which were males and 25.11 % of
which holding a bachelor’s or higher degree
(Directorate General of Budget, Statistics &
Executive Yuan, 2011). The age distribution

was 15.6 % aged 0–14, 73.4 % aged 15–64, and
10.9 % aged 65 and over (CIA World Fact Book,
2011a). In 2010, the GDP (PPP) was US
$35,800 per capita, ranked as 32nd in the world
(CIA World Fact Book, 2011b). The unemployment rate was 5.2 %, ranked as the 50th lowest in
the world (CIA World Fact Book, 2011b).
The ▶ WHOQOL-BREF was used in the 2001
▶ National Health Interview Survey (NHIS)
conducted by the National Health Research Institute and the Bureau of Health Promotion (BHP),
Department of Health, Taiwan (Shih et al., 2002).
13,008 respondents (aged between 20 and 69)
were randomly sampled and completely
answered the questionnaire. The sample was representative of the national population in age, gender, and in terms of the urbanization index (Hung,
2002). The ▶ WHOQOL-BREF uses a five-point
Likert-type scale for each item. The range of each
domain score was between 4 and 20. Table 1
shows the mean responses for each item and
domain of the questionnaire. In general, males
have better ▶ QOL on physical and psychological domains, while females have better ▶ QOL
on social domain. The scores of the four domains
decrease with age. However, the psychological
and environmental domain scores increase a bit
after 60 years old.
The ▶ SF-36 questionnaire was also used in
both of the 2001 and 2005 ▶ NHIS (Bureau of
Health Promotion, Health & Taiwan, 2011).
19,777 (aged between 11 and 98) and 17,769
(aged between 11 and 65) respondents were
included for the 2001 and 2005 studies,

A.C. Michalos (ed.), Encyclopedia of Quality of Life and Well-Being Research,
DOI 10.1007/978-94-007-0753-5, # Springer Science+Business Media Dordrecht 2014

8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

Item/Domain

Overall QOL
General Health
Pain & Discomfort
Dependency on Medication/Treatment
Positive Feelings
Spirituality/Religion/Per social Beliefs
Thinking, Learning, Memory, &
Concentration
Physical Safety & Security
Home Environment
Energy & Fatigue
Body Image & Appearance
Financial resources
Acquiring New Information
Recreation/Leisure
Mobility
Sleep & Rest
Activity of Daily Living
Work Capacity
Self-Esteem
Personal relationships
Sexual Activity
Practical Social Support
Physical Environment
Health & Social Care
Transport
Negative Feelings
Physical
Psychological
Social
Environment

#

1
2
3
4
5
6
7

3.31
3.12
3.37
3.67
2.82
3.31
2.95
3.92
3.41
3.65
3.63
3.66
3.59
3.52
3.67
3.54
3.42
3.55
3.54
15.11
13.66
14.38
13.01

3.30
3.39
4.08
4.38
2.70
3.52
3.40

Total
(n ¼ 13,008)

3.35
3.11
3.44
3.70
2.79
3.29
2.96
3.93
3.47
3.67
3.66
3.68
3.59
3.51
3.64
3.54
3.40
3.55
3.59
15.23
13.79
14.32
13.00

3.27
3.45
4.11
4.38
2.70
3.54
3.48

GENDER
Males
(n ¼ 6,586)

3.27
3.13
3.30
3.64
2.84
3.32
2.93
3.90
3.34
3.62
3.59
3.63
3.59
3.54
3.70
3.54
3.44
3.56
3.48
14.98
13.53
14.44
13.01

3.32
3.33
4.07
4.39
2.71
3.50
3.33

Females
(n ¼ 6,422)

3.35
3.12
3.42
3.69
2.96
3.42
3.12
4.07
3.40
3.69
3.64
3.70
3.65
3.50
3.75
3.60
3.44
3.53
3.55
15.37
13.83
14.54
13.27

3.36
3.46
4.14
4.53
2.86
3.55
3.40
3.30
3.11
3.41
3.74
2.84
3.35
2.88
4.01
3.40
3.68
3.68
3.68
3.59
3.60
3.68
3.49
3.39
3.57
3.55
15.30
13.80
14.49
12.97

3.27
3.44
4.12
4.46
2.70
3.57
3.47
3.31
3.12
3.36
3.66
2.73
3.24
2.87
3.86
3.44
3.63
3.63
3.64
3.56
3.55
3.63
3.54
3.43
3.57
3.54
15.05
13.59
14.32
12.90

3.28
3.37
4.08
4.35
2.61
3.52
3.41
3.26
3.09
3.26
3.53
2.69
3.15
2.88
3.64
3.37
3.56
3.53
3.57
3.53
3.42
3.60
3.52
3.41
3.53
3.50
14.57
13.26
14.05
12.76

3.27
3.29
3.99
4.15
2.59
3.40
3.30

3.32
3.18
3.17
3.54
2.65
3.10
2.96
3.51
3.36
3.52
3.47
3.60
3.58
3.36
3.57
3.58
3.45
3.52
3.56
14.19
13.34
14.00
12.88

3.22
3.18
3.88
3.91
2.66
3.40
3.25

20–29(n ¼ 3,592) 30–39(n ¼ 3,688) 40–49(n ¼ 3,403) 50–59(n ¼ 1,815) 60–69(n ¼ 510)

AGE

Taiwan, Table 1 The mean responses for the 26 items and 4 domains of the WHOQOL-BREF in the 2001 NHIS of Taiwan

T
6584
Taiwan

GENDER
Males
(n ¼ 8,326)
92.71
84.73
83.65
70.62
69.80
87.05
81.61
74.76
52.91
50.09

Females
(n ¼ 8,535)
88.84
78.99
77.73
66.27
64.36
84.95
77.54
70.55
50.92
48.49

AGE
20–29
(n ¼ 3,857)
97.27
89.99
86.47
75.79
70.18
84.44
79.93
72.88
55.63
48.70
30–39
(n ¼ 3,843)
96.11
89.12
83.48
73.44
68.96
87.60
81.11
72.58
54.58
48.95

40–49
(n ¼ 3,747)
93.56
85.44
81.79
69.48
68.67
88.09
83.21
74.06
52.70
50.14

50–59
(n ¼ 2,355)
89.76
78.84
78.36
63.90
66.00
85.85
79.93
72.65
50.49
49.56

60–69
(n ¼ 1,724)
79.44
66.14
72.39
56.29
61.31
81.89
74.75
70.41
46.04
49.08

70–79
(n ¼ 1,058)
68.24
56.19
68.45
54.02
58.08
78.52
68.75
71.46
42.31
49.47

*Since the factor scores of the eight scales for Taiwanese are not available, PCS and MCS were calculated by suing the US factor scores

1. PF
2. RP
3. BP
4. GH
5. VT
6. SF
7. RE
8. MH
PCS*
MCS*

Total
(n ¼ 16,862)
90.75
81.82
80.56
68.42
67.05
85.99
79.33
72.63
51.90
49.28

Taiwan, Table 2 The mean responses for the eight scales and physical/mental components of the SF – 36 in the 2001 NHIS of Taiwan
80–89
(n ¼ 261)
52.41
37.74
62.49
50.61
53.77
69.68
57.34
68.66
37.21
48.21

90–99(n ¼ 8)
22.5
21.88
47.38
38.00
42.50
67.19
33.33
71.50
27.32
48.55

Taiwan
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Taiwanese Women

Taiwan, Table 3 The mean responses for the eight scales and physical/mental components of the SF – 36 in the 2005
NHIS of Taiwan
Total
(n ¼ 14,843)
1. PF
94.88
2. RP
87.79
3. BP
84.85
4. GH
71.12
5. VT
68.36
6. SF
89.65
7. RE
83.30
8. MH
74.71
Physical 53.71
Mental 50.12

GENDER
Males
(n ¼ 7,570)
95.94
89.35
86.82
72.53
70.44
90.18
83.89
76.22
54.32
50.65

Females
(n ¼ 7,273)
93.77
86.16
82.80
69.65
66.19
89.10
82.69
73.13
53.08
49.57

AGE
20–29
(n ¼ 3,885)
97.49
91.48
86.64
73.76
67.26
88.97
80.52
72.74
55.53
48.53

30–39
(n ¼ 3,562)
97.17
91.12
85.55
73.87
68.52
89.95
83.13
74.01
55.01
49.56

40–49
(n ¼ 3,749)
94.87
88.04
84.86
70.91
69.25
90.40
84.80
75.83
53.50
50.80

50–59
(n ¼ 2,681)
91.41
82.72
82.87
66.70
68.92
89.79
85.47
76.46
51.39
51.61

60–65
(n ¼ 961)
85.49
73.70
80.56
63.26
67.16
87.99
83.32
75.93
56.83
49.01

*Since the factor scores of the eight scales for Taiwanese are not available, PCS and MCS were calculated by using the
US factor scores

respectively. In this entry, we selected the participants with ages above 20. Tables 2 and 3 show the
mean responses for the eight ▶ SF-36 scales as
well as the physical and mental components
(PCS and MCS) for both of the ▶ NHISs. In general, the physical component score is higher than
the mental score on both surveys. The scores of the
physical-related scales (e.g., PF, RP, BP, and GH)
decrease with age. On the other hand, higher scores
on the mental-related scales (e.g., SF, RE, and
MH) were noted for middle-aged people.

CIA World Fact Book. (2011a). Retrieved August 12,
2011, from https://www.cia.gov/library/publications/
the-world-factbook/geos/tw.html.
CIA World Fact Book. (2011b). Retrieved August 12,
2011, from https://www.cia.gov/library/publications/
the-world-factbook/geos/tw.html.
Directorate General of Budget, Accounting and Statistics,
Executive Yuan, R. O. C. (2011). Retrieved August 12,
2011 from http://sowf.moi.gov.tw/stat/month/m1-01.xls.
Hung, Y. T. (2002). Sampling design of the National
Health Interview Survey. NHIS Brief Communication
No. 2, June 2002.
Shih, Y. T., Chang, H. Y., & Le, K. H., et al. (2002).
Introduction to the National Health Interview Survey
(NHIS). NHIS Brief Communication No. 1, June 2002.

Cross-References
▶ Japan, Quality of Life
▶ National Health Interview Survey (NHIS)
▶ Physical Functioning (PF)
▶ Quality of Life (QOL)
▶ SF-36 Health Survey
▶ Symptomatic Gallstone Disease and Quality of
Life in Taiwan
▶ World Health Organization Quality of Life
(WHOQOL) Assessment

Taiwanese Women

References

Tangible Support

Bureau of Health Promotion, Department of Health,
Taiwan (2011). Retrieved August 12, 2011, from
http://nhis.nhri.org.tw/2001nhis.html.

▶ Chinese Health-Promoting Lifestyle Profile

Talent
▶ Creative Class (Richard Florida)

▶ Social Support and Self-Worth Among
African-American Youth

Task Discretion

Target Hardening and Crime
▶ Impact of Housing Design on Crime

Tariffs
▶ Taxes

Task Discretion
Ying Zhou
Surrey Business School, University of Surrey,
Surrey, UK

Synonyms
Decision latitude; Job autonomy

Definition
Task discretion refers to the extent to which
employees are able to exercise independent
initiative and judgment over their job tasks.

Description
The “participative management” paradigm that
emerged in the late 1980 emphasizes giving
employees higher levels of job autonomy as
a means of unleashing employee creativity and
improving organizational efficiency (Aoki, 1990;
Lowin, 1968; Miller & Monge, 1986; Walton,
1985). For instance, Appelbaum, Bailey, Berg,
and Kallenberg (2000) analyzed the relationship
between participative workplace practices and
the performance of plants in steel, apparel, and
medical electronic instruments and imaging
industries in the US and found that employee
autonomy and shop floor participation had
a significantly positive impact on organizations’

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competitive advantage. Explanations for the positive impact of employee empowerment include
that it improves the quality of job decisions
(Levine & Tyson, 1990; Miller & Monge,
1986), reduces industrial conflict (Delaney,
Fiorito, Jarley, & Schwochau, 1993) and facilitates the development of new work skills
(Osterman, 1995).
From the psychosocial perspective, the scope
for decision-making in the job has important
implications for the ▶ quality of working life.
It has been suggested that employees’ task
discretion and broader participation in organizational decision-making help satisfy their
nonpecuniary needs and protect their physical
and mental well-being (Gardell, 1987; Johnson
& Johansson, 1991; Karasek & Theorell, 1990;
Marmot, 2006). The need to have a voice
over how one carries out his or her work is important because it contributes to a sense of competence and self-actualization. In support of
the argument, American and British investigations with psychosocial job characteristics
have consistently found positive correlations
between employee task discretion and general
▶ job satisfaction (Blumberg, 1968; Coburn,
1978; Patchen, 1970).
Further, a lack of control over the job can lead
to higher levels of job stress and deteriorated
health. The influential theoretical model developed by Karasek and Theorell (1990) treats work
strain as a function of the joint effects of job
demands and employees’ decision latitude over
their work. It postulates that excessive workload
produces long-term adverse effects on employee
health only when it is accompanied by low decision latitude. When employees are allowed to
exercise discretion over their work, heavy job
demands can transform into positive challenges
that facilitate cognitive growth, which will
inhibit fatigue from developing into stress.
Karasek and Theorell (1990)’s analysis of the
Swedish Level of Living Survey and the US
Health Examination Survey showed that
workers’ risk of developing coronary heart disease (CHD) symptoms was strongly correlated
with the interaction of their work demands and
decision latitude.

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6588

The findings were replicated by Hahn’s (1986)
study of the psychosocial work conditions of
male Finnish industry workers, which also
revealed a clear association between the interaction of high work demands and low decision
latitude on the one hand and elevated risk
for workers to develop myocardial infarction
or angina pectoris on the other hand. Similar
findings were reported by more recent research
on British workers (Kuper & Marmot, 2003).
More skeptical writers, however, have pointed
out the theoretical and practical limits to
the effectiveness of employee empowerment
practices. These include management resistance
to power-sharing, inequality of skills among
employees and inauthentic empowerment
programs used by employers to reassert managerial control and intensify the work process (Grant,
1999; Heller et al., 1998; Legge, 1995; Purcell,
1993; Willmott, 1993). Despite the plausibility of
such arguments, the majority of empirical
evidence to date based on analysis of large-scale
employee surveys tends to support the view
that higher level of employee task discretion is
associated with improved physical and mental
well-being.

References
Aoki, M. (1990). Toward an economic model of the Japanese firm. Journal of Economic Literature, 28(1),
1–27.
Appelbaum, E., Bailey, T., Berg, P., & Kallenberg, A.
(2000). Manufacturing advantage: Why highperformance work systems pay off. Ithaca, NY: Cornell
University Press.
Blumberg, P. (1968). Industrial democracy: The sociology
of participation. London: Constable.
Coburn, D. (1978). Work and general psychological and
physical well-being. International Journal of Health
Services, 8, 415–435.
Delaney, J., Fiorito, J., Jarley, P., & Schwochau, S. (1993),
‘Employee cooperation programme structures and
organizational flexibility’, Unpublished Paper,
University of Iowa.
Gardell, B. (1987). Work organization and human nature.
Stockholm: The Swedish Work Environment Fund.
Grant, D. (1999). HRM, rhetoric and the psychological
contract: A case of ‘easier said than done’. International Journal of Human Resource Management, 10,
327–350.

Task Measures
Hahn, M. (1986), Psychosocial work conditions and
risk of coronary heart disease. Academic Thesis,
Department of Sociology, University of California,
Berkeley.
Heller, F., Pusic, E., Strauss, G., & Wilpert, B. (Eds.).
(1998). Organizational participation: Myth and
reality. Oxford, UK: Oxford University Press.
Johnson, J. V., & Johansson, G. (Eds.). (1991). The
psychosocial work environment: Work organization,
democratisation and health. Essays in memory
of Bertil Gardell. Amityville, NY: Baywood
Publishing.
Karasek, R., & Theorell, T. (1990). Healthy work, stress,
productivity and the reconstruction of work life.
New York: Basic Books.
Kuper, H., & Marmot, M. (2003). Job strain, job demands,
decision latitude, and risk of coronary heart disease
within the Whitehall II Study. Journal of Epidemiology and Community Health, 57, 147–153.
Legge, K. (1995). Human resource management:
Rhetorics and realities. Basingstoke, England:
Macmillan.
Levine, D. I., & Tyson, L. D. (1990), ‘Participation, productivity, and the firm’s environment’. In A. S. Blinder
(Eds.). Paying for productivity (pp. 183–237).
Washington, DC: Brookings Institution.
Lowin, A. (1968). Participative decision making:
A model, literature critique, and prescriptions for
research. Organizational Behavior and Human Performance, 3(1), 68–106.
Marmot, M. (2006). Tackling social factors to improve
health. Bulletin of the World Health Organization, 84,
267–268.
Miller, K., & Monge, P. (1986). Participation, satisfaction
and productivity: A meta-analytical review. Academy
of Management Journal, 29, 727–753.
Osterman, P. (1995). Skill, training, and work organization in American establishments. Industrial Relations,
34(2), 125–146.
Patchen, M. (1970). Participation, achievement
and involvement on the job. New Jersey, USA:
Prentice-Hall.
Purcell, J. (1993). The challenge of human resource
management for industrial relations research and practice. International Journal of Human Resource
Management, 4(3), 511–527.
Walton, R. (1985). From ‘control’ to ‘commitment’ in
the workplace. Harvard Business Review, 63(2),
77–84.
Willmott, H. (1993). Strength is ignorance; slavery is
freedom: Managing culture in modern organizations.
Journal of Management Studies, 30(4), 515–552.

Task Measures
▶ Activity Assessment

Taxes

Taxes
J€urgen Faik
FaMa-Neue Frankfurter Sozialforschung,
Frankfurt/Main, Germany

Synonyms
Tariffs; Tribute fees

Definition
Taxes are certain payments from private persons
and enterprises directed to the state authorities
without claims for special compensation. On the
one hand, taxes are often seen as a burden, which
lessen private resources of wealth. On the other
hand, taxes are an important source of income for
the state to provide public goods.

Description
Historically, taxes exist since early antiquity.
Although their traditional authorization was
caused by the satisfaction of societal wants,
some remarkable, creative justifications for generating public revenue were given. In this sense,
Emperor Vespasian argued: “Pecunia non olet!”
(“Money does not smell!”) in order to justify a tax
on public conveniences.
From a welfare perspective, Adam Smith, the
father of economics, postulated four, nowadays,
well-known principles of taxation in (see Smith,
1776/1977): the regularity of taxation, the firmness
of tax laws, and the convenience as well as the
cheapness of tax collection. Based on these principles, in the nineteenth century – during the
period of classical liberalism (see, e.g., Dickerson,
Flanagan, & O’Neill, 2009, pp. 129–136) – tax
legislation emerged in the sovereign states. For
modern tax systems especially the following
aspects are relevant: (1) fiscal purposes (in order
to realize governmental targets), (2) governance
aspects (in order to influence socially undesirable

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behavior of society’s members like smoking by
levying a relatively high cigarette tax), and
(3) redistribution purposes (in order to achieve a
politically desired distribution of personal
incomes) (see, e.g., Musgrave & Musgrave,
1989). State authorities use tax revenue for providing public goods in the fields of infrastructure,
education, health, etc.; furthermore, to some
degree, taxes are needed to erase public debts.
The balance of private and public goods is
a reasonable goal and the incongruity of private
wealth and public poverty was noticed especially
in the sixties (Galbraith, 1967).
In general, several variants for constructing
tax systems exist. They vary concerning the tax
base, the relationship between tax payments and
tax base, the level of the tax rate, the amount of
tax exemptions, and the taxed target groups. For
instance, in Germany income and value-added
taxes exist (among others). While the German
income tax system is primarily addressed to the
entire population and is characterized by
a progressive tax scale, the German value-added
tax is based on consumption, it is levied on entrepreneurs, and it has a proportional tax scale
(currently: usually 7 % for subsistence commodities and 19 % for all other commodities).
In Germany, e. g., more than 70 % of overall tax
revenue stems from only four sources: income tax,
value-added tax, mineral oil tax, and (local) business
tax. Related to the German gross domestic product,
the share of tax revenue – without social security
contributions – amounts to approximately 20 %
(see, e.g., Statistisches Bundesamt, 2011 with
respect to the third quarter of 2010). Including social
security contributions, this share of total tax revenue
increases up to 37 % in 2010 (see OECD, 2011).
For individuals, the tax burden creates negative consequences with respect to private wellbeing because it reduces the disposable income
level, but this point of view neglects the provision
of public goods (like streets and education) which
increases individual well-being (for more details,
see Mankiw, 2009). Thus, two opposing effects
on the relation between individual satisfaction
and taxes exist. For example, in a study for the
US state of Minnesota, it was found that residents
of Minnesota “(. . .) tend to be slightly more

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6590

dissatisfied than satisfied with the amount of taxes
they pay” (Minnesota Department of Revenue,
2005:1). In a study of Feldman and Steenbergen
(2001), US citizens were asked if they consider the
amount of income taxes they pay are too high,
somewhat too high, about right, somewhat too
low, or much too low. The result was that only
a few people thought that they were paying too
little in taxes. In a study of Schmölders (1960),
Germans were asked to tell what they associate
with taxes. Twenty-nine percent of the people associated negative aspects, e. g., like unpleasant feelings (13 %) and too many or too high taxes (8 %).
The so-called Laffer curve postulates a concave
connection between tax revenue and average tax
rate. Supply-side economists claim that the optimal tax rate of the Laffer curve is exceeded in
practice, and, thus, supply-side economists
demand diminishments of business and income
taxes in order to evolve entrepreneurial dynamics.
Concerning the financing of such tax diminishments, supply-side economists typically plead for
cutbacks of transfers (see in this context, e.g.,
Bartlett, 2003). This point of view is often accompanied by a deep distrust in the productivity and
the management qualities of the public sector,
compared with the private sector. It is assumed
that public organizations would waste tax revenue
to a high degree. Nowadays, this would be
documented by high public debts which generated
a need for state authorities to save money, i.e., to
restrict the provision of public goods.
The sketched position of supply-side economists is by no means undisputed. For instance,
Haavelmo’s theorem asserts that the kind of
usage of tax revenue is decisive for an assessment
of growth/well-being effects. In brief, that means
that the diminishment of taxes can reduce
growth/well-being if it is accompanied by
a reduction of public expenditures (et vice
versa). Another counterargument against the
supply-side economists’ position is also inspired
by the Keynesian theory which assumes higher
marginal consumption rates in the lower-income
region compared to the upper-income classes
(for such fundamental macroeconomic aspects,
see, e.g., Mankiw, 2010). Against this background, income redistribution by a progressive

Taxes

tax system can cause a higher macroeconomic
consumption level and, therefore (at least short
termed), a stimulation of overall output and
income which might be a successful economic
strategy especially during a recession (see, e.g.,
Faik, 2010, pp. 390–394).
The redistribution effects of taxes (which are
connected with well-being categories as a tax base,
like income, wealth, and consumption) depend on
the functional relationship between the amount of
money a taxpayer has to give to the state and the
variable which represents the tax base. A progressive function reveals a greater amount of redistribution than, e.g., a flat tax. Besides the concrete
functional relation, for redistributive purposes, the
kind of tax exemptions and their location in several
well-being regions are relevant (for corresponding
fundamental considerations see, e.g., Musgrave &
Musgrave, 1989). In total, taxes are fundamental
for our quality of life because it depends on
the provision of public goods and their financing
through taxes and, additionally, on the redistribution effects in the economy and society.

Cross-References
▶ Consumption
▶ Consumption Taxes
▶ Economic and Social Indicators
▶ Happiness
▶ Household Disposable Personal Income
▶ Household Expenditure
▶ Life Satisfaction Judgments
▶ Needs Assessment
▶ Objective Quality of Life
▶ Personal Well-Being
▶ Quality of Life

References
Bartlett, B. (2003). Supply-side economics: “Voodoo Economics” or Lasting Contribution? In: Laffer Associates.
Supply-Side Investment Research, November. http://
web.uconn.edu/cunningham/econ309/lafferpdf.pdf.
Dickerson, M. O., Flanagan, T., & O’Neill, B. (2009). An
introduction to government and politics: A conceptual
approach (8th ed.). Toronto: Nelson Education.
Faik, J. (2010). Grundlagen der Volkswirtschaftslehre
(3rd ed.). Berlin: Logos.

Taylor and Aspinwall Psychosocial Stress Model
Feldman, S., & Steenbergen, M. (2001). Social welfare
attitudes and the humanitarian sensibility. In
J. H. Kuklinski (Ed.), Citizens and politics: Perspectives
from political psychology (pp. 366–400). Cambridge:
Cambridge University Press.
Galbraith, J. K. (1967/1972). The new industrial state
(2nd ed.). Harmondsworth: Penguin.
Mankiw, N. G. (2009). Principles of economics (5th ed.).
Mason: South-Western College Pub.
Mankiw, N. G. (2010). Macroeconomics (7th ed.). New
York: Worth Publishers.
Minnesota Department of Revenue. (2005). Taxpayer
satisfaction with the state’s tax system,
St. Paul. http://taxes.state.mn.us/legal_policy/Documents/other_supporting_content_systemsurvey.pdf.
Musgrave, R. A., & Musgrave, P. B. (1989). Public Finance
in Theory and Practice. New York: McGraw-Hill.
OECD. (2011). http://www.oecd-ilibrary.org/taxation.
Schmölders, G. (1960). Das Irrationale in der öffentlichen
Finanzwirtschaft. Probleme der Finanzpsychologie.
Hamburg: Rowohlts deutsche Enzyklop€adie.
Smith, A. (1776/1977). An inquiry into the nature and
causes of the wealth of nations. Chicago: The University of Chicago Press.
Statistisches Bundesamt. (2011). https://www-genesis.
destatis.de/genesis/online.

“Taxing the Rich”
▶ Progressive Taxation

Taxonomy of Measurement
Properties
▶ COSMIN: Consensus-Based Standards for the
Selection of Health Status Measurement
Instruments

Taylor and Aspinwall Psychosocial
Stress Model
Konstantinos Kafetsios
Department of Psychology, University of Crete,
Rethymno, Greece

Definition
A conceptual framework derived from research
in social cognition, coping and stress that details

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the paths and processes through which personality (e.g., optimism, mastery, social support perceptions) and social (e.g., time, money, gender,
status) resources influence stress levels and psychological and health outcomes. Central to the
model is the identification of appraisal, coping
and resistance/vulnerability to stress as key moderators or mediators of personality and social
resources’ effects on stress levels, psychological
health and well-being giving the model
a dynamic, multilevel character.

Description
The model (Taylor & Aspinwall, 1996 see Fig. 1)
explains stress and its effects on health and psychological well-being in a multilevel fashion
with proximal processes of stress appraisal, coping styles and strategies and stress vulnerability
nested within more distal social and personality
resource factor effects. At the distal level, the
model outlines how personality and environmental resources may influence psychological outcomes directly or indirectly through affecting
appraisal, coping and vulnerability to stress.
Conceptualizing personality characteristics and
social conditions as psychological resources,
Taylor and Aspinwall adhere to social and psychological resource models that consider stress as
the potential or actual loss of resources (see
Hobfoll, 2002). Individual/personality resources
that influence stress appraisal, selection and use
of coping strategies, and ultimately vulnerability
to stress include socio-emotional learning,
genetic underpinnings of support tendencies and
negative affectivity, dispositional affectivity,
pessimism, hardiness, optimism, psychological
control, self-esteem, and social support perceptions. Environmental resources include time,
money, education, standard of living, and structural aspects of social support. Building on the
then available personality and sociopsychological research, the model identified direct effects
of those personal and external resources on
vulnerability or resistance to stress.
At the proximal level, Taylor and Aspinwall’s
model builds on Lazarus and Folkman’s (1984)

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6592

Taylor and Aspinwall
Psychosocial Stress
Model, Fig. 1 Taylor and
Aspinwall psychosocial
stress model

Taylor and Aspinwall Psychosocial Stress Model

External
Resources

Stressor

Personal
Resources

distinction between primary and secondary
appraisal to threat and Carver and Scheier’s
(1994) theory of approach-avoidance coping
styles and coping strategies to explain the moderating and mediating effects of cognitive and
motivational regulatory processes for psychosocial resources relationships with stress levels and
well-being. For example, personality resources
such as optimism may influence stress appraisal,
a key moderator, in that low levels of optimism
may exacerbate stress by rendering it higher or
even intolerable for the individual (e.g.,
Aspinwall & Brunhart, 1996). Coping styles,
strategies and vulnerabilities can mediate psychosocial resources’ effects on stress and wellbeing. Equally, the availability of financial
resources may dampen down stress vulnerability
with palliative effects on psychological wellbeing (Taylor & Seeman, 1999). Dispositional
optimism may interact with situational optimism,
as a result of availability of environmental
resources (e.g., time, money).
The model has influenced conceptualizations
of how environmental factors interact with personality capacities to influence social support
(Thoits, 2011), well-being, and mental and
physical health (e.g., Taylor & Boffman, 2011;
Taylor, Repetti & Seeman, 1997). Central ideas
regarding the combination of cognitive and motivational moderators and mediators were later

Appraisal

Coping

Psychosocial
outcomes

Social Support

developed into Aspinwall and Taylor’s (1997)
influential model of proactive coping as anticipatory efforts to a potentially stressful event to
prevent it or modify its form before its occurrence. The model also informed research on
social support and psychosocial resources in
older adults (e.g., Martin, Gr€unendahl, & Martin,
2001) or special populations (e.g., Van der Veek,
Kraaij, & Garnefski, 2009).
Discussion
Taylor and Aspinwall’s multilevel framework is
particularly effective in pointing to sociocognitive and motivational processes that mediate and moderate stress level outcomes and how
these relate to personality and social resources
(and their interaction).
Although aspects of the model have informed
related research and theorizing, empirical tests of
the full model and its effects on well-being and
quality of life have been rare. In one such test,
a cross-sectional study of a sizeable working
sample (Michielsen, Croon, Willemsen et al.
2004) confirmed part of the model especially
paths linking external and internal resources
(relationships between external resources and
social support levels). Part of the model was not
supported in this dataset, the part that had to do
with the direct effect of external resources (i.e.,
gender) on stressors and coping strategies

Technocratic Knowledge

mediating stress levels’ relationships with psychological outcomes (i.e., emotional exhaustion).
Another attempt to apply the model to predict the
quality of life of a sample of psychiatric outpatients (Masthoff et al., 2007) failed to support the
full model, although some parts of the model
were verified in further exploratory analyses in
the same sample.
The model integrates empirically established
contextual and individual difference predictors of
psychosocial stress outcomes, thus integrating
process-oriented and individual difference perspectives in psychosocial stress outcomes. The
utility of such an approach was further exemplified in Aspinwall and Taylor’s (1997) model of
proactive coping.

Cross-References
▶ Negative Affect
▶ Optimism
▶ Social Support
▶ Stress

References
Aspinwall, L. G., & Brunhart, S. M. (1996).
Distinguishing optimism from denial: Optimistic
beliefs predict attention to health threats. Personality
and Social Psychology Bulletin, 22, 993–1003.
Aspinwall, L. G., & Taylor, S. E. (1997). A stitch in time:
Self-regulation and proactive coping. Psychological
Bulletin, 121, 417–436.
Carver, C. S., & Scheier, M. F. (1994). Situational coping
and coping dispositions in a stressful transaction. Journal of Personality and Social Psychology, 66,
184–195.
Hobfoll, S. R. (2002). Social and psychological resources
and adaptation. Review of General Psychology, 6(4),
307–324.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal,
and coping. New York: Springer.
Martin, M., Gr€unendahl, M., & Martin, P. (2001). Age
differences in stress, social resources, and well-being
in middle and older age. Journals of Gerontology –
Series B Psychological Sciences and Social Sciences,
56, P214–P222.
Masthoff, E. D., Trompenaars, F. J., Van Heck, G. L.,
Michielsen, H. J., Hodiamont, P. P., & De Vries, J.
(2007). Predictors of quality of life: A model based
study. Quality of Life Research, 16(2), 309–320.

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Michielsen, H. J., Willemsen, T. M., Croon, M. A., De
Vries, J., & Van Heck, G. L. (2004). Determinants of
general fatigue and emotional exhaustion:
A prospective study. Psychological Health, 19,
223–235.
Taylor, S. E., & Aspinwall, L. G. (1996). Mediating and
moderating processes in psychosocial stress:
Appraisal, coping, resistance, and vulnerability. In
H. B. Kaplan (Ed.), Psychosocial stress: Perspectives
on structure, theory, life course, and methods
(pp. 71–110). New York: Academic Press.
Taylor, S. E., & Broffman, J. I. (2011). Psychosocial
resources: Functions, origins, and links to mental and
physical health. In J. M. Olson & M. P. Zanna (Eds.),
Advances in experimental social psychology
(pp. 1–57). New York: Academic Press.
Taylor, S. E., Repetti, R. L., & Seeman, T. (1997).
Health psychology: What is an unhealthy environment
and how does it get under the skin? Annual Review of
Psychology, 48, 411–447.
Taylor, S. E., & Seeman, T. E. (1999). Psychosocial
resources and the SES-health relationship. In N.
Adler, M. Marmot, B. McEwen, & J. Stewart (Eds.),
Socioeconomic status and health in industrial nations:
Social, psychological, and biological pathways
(pp. 210–225). New York: New York Academy of
Sciences.
Thoits, P. A. (2011). Mechanisms linking social ties and
support to physical and mental health. Journal of
Health and Social Behavior, 52(2), 145–161.
Van der Veek, S. M. C., Kraaij, V., & Garnefski, N.
(2009). Cognitive coping strategies and stress in parents of children with down syndrome: A prospective
study. Intellectual and Developmental Disabilities,
47(4), 295–306.

Team Efficacy
▶ Collective Efficacy

T
Technical Quality of Government
▶ Good Governance and Happiness in Nations

Technocratic Knowledge
▶ Democracy and Development in Mexico and
Chile

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6594

Technological Capabilities
▶ Capability and the Middle-Income Trap in
Chile

Teen Drug Abuse
▶ Adolescent Substance Use

Teen Drug Use
▶ Adolescent Substance Use

Teen Motherhood in Canada
Hala Tamim, Ban Al-Sahab and
Jennifer Connolly
York University, Toronto, ON, Canada

Synonyms
Adolescent motherhood in Canada; Girls’ motherhood in Canada

Description
Teen pregnancy and childbirth is associated
with lifelong physical, emotional, and socioeconomic risks for both the adolescent mother and
her child. Despite widespread recognition of the
multiple hazards of adolescent pregnancy and
motherhood, the World Health Organization
(WHO) estimates the global rate of live births
delivered by teenage girls aged 15–19 years to
be approximately 11 % (World Health Organization [WHO], 2012). In Canada, 30,000 adolescent girls became pregnant in 2005. About
14,000 girls gave birth, while 16,000 of the
girls had an abortion (Statistics Canada, 2005).

Technological Capabilities

These figures are alarming given the highly
adverse effects on the mother and infant as
well as the ▶ healthcare system.
Adverse Effects of Teen Motherhood on
Mothers, Infants, and Healthcare System
Maternal Effects. Adolescent pregnancy has
been associated with poor maternal weight
gain, pregnancy-induced hypertension, anemia,
sexually transmitted diseases (STD), and
prolonged and difficult labor (Community
Action Program for Children and the Canada
Prenatal Nutrition Program [CAPC/CPNP],
2007; Klein, 2005). Studies have shown that
maternal mortality rate is twice as likely
among adolescent mothers as among adult pregnant women (Klein, 2005). Teenage mothers are
also confronted with the double challenge of
becoming a parent while at the same time
becoming an adult, which limits their acquisition of child-focused parenting skills (CAPC/
CPNP, 2007). Moreover, a majority of adolescent parents do not complete their education and
hence are faced with constricted employment
choices and poor economic opportunities
(CAPC/CPNP). In fact, homelessness by the
age of 33 years was reported to be twofold
more among teenage mothers than their older
counterparts (CAPC/CPNP).
Child Effects. In addition to the adverse
maternal effects of teen motherhood, children of
adolescent mothers have poor neonatal outcomes. Having a low birth weight baby is twice
more likely to occur among adolescents than
adults (Klein, 2005). Prematurity is also more
evident among adolescent mothers. The percentage of preterm birth is approximately 14 %
among girls 17 years as compared to 6 % for
women aged 25–29 years (Klein). Moreover, the
neonatal death rate (within 28 days of birth) is
almost three times higher among adolescent
mothers (Klein). The children of teen mothers
have also been shown to have greater developmental, cognitive, attachment, and behavioral
problems than those born to adult mothers. The
American Notre Dame Adolescent Parenting
Project (Whitman, Borkowski, Keogh, & Weed,
2001) revealed that by age 3, internalizing

Teen Motherhood in Canada

problems (i.e., low ▶ self-esteem, helplessness,
self-loathing, depression) were common among
37 % of the children of adolescent mothers, while
35 % had externalizing problems (i.e., delinquency, acting out, ▶ anger). Moreover, adolescent mothers’ children have shown to perform
poorly on cognitive tests and measures of school
achievement as compared to children of older
mothers (Baldwin & Cain, 1980; Ha, Osofsky,
& Culp, 1996; Spieker, Larson, Lewis, White, &
Gilchrist, 1997). Besides behavioral and cognitive problems, the Notre Dame Longitudinal
Parenting Project found that by age 3, around
75 % of children born to teen mothers experienced a delay in one domain of development
and around 50 % of the children had delays in
two domains of development (Whitman et al.,
2001). Finally, studies have shown that children
of adolescent mothers are at greater risk for
becoming victims of ▶ child abuse (McCullough
& Scherman, 1998).
Healthcare System Effects. Adolescent parenthood comes at a great cost to the healthcare
system. Health problems associated with teen
pregnancy and motherhood result in increased
rates of hospital admittance, highlighted in
numerous Canadian studies. A Manitoba study
found that the risk of postnatal readmission was
higher for infants whose mothers were 17 years of
age or younger than for older mothers (Martens,
Derksen, & Gupta, 2004). Similarly, an Ottawabased study concluded that young maternal age
was linked to both obstetric complications and
risk of readmission (Liu et al., 2002). Cargill and
Martel (2007) added to these findings by showing
that young single women are most likely to return
to emergency departments with their neonates.
Finally, increased hospital admissions have
been noted after the neonatal period as children
of adolescent mothers are more likely to be
admitted to hospital for accidents, injuries, and
illnesses than children of older mothers (Offord,
1987). Teen mothers, moreover, often experience
a loss of productivity related to their health risks,
and the cost of their low earnings is passed on to
society (Hoffman, 2006). Based on a national
Canadian study, adolescent mothers were found
to have decreased participation in the labor

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market and low earnings, with hourly wages of
teenage mothers found to be $10.93, while they
were $13.29 for adult mothers (Luong, 2008).
In view of these disadvantages, it is not surprising
to learn that adolescent mothers are more likely to
use ▶ welfare and government assistance
programs than older mothers (Maynard, 1997).
Epidemiology of Teenage Pregnancy and
Births Around the World and in Canada
The prevalence of teen motherhood varies greatly
from country to the other. The highest adolescent
birthrates are in the developing countries of
Africa, followed by India, Bangladesh, Latin
America, and the Caribbean. The percentage of
women who have their first child before 20 years
of age in these countries ranges from 30 % to 50 %
(WHO, 2006). In industrialized Europe, the rates
are markedly lower. According to the WHO
(1999), Italy, along with the Netherlands, has the
lowest teen mother rate (2.3 %). Portugal and the
United Kingdom are Western European countries
with the highest number of live births to adolescents, 7.8 % and 6.4 %, respectively. Countries in
Eastern Europe report even higher proportions of
births to teen mothers: 21 % for Georgia, 20.5 %
for Bulgaria, and 19.5 % for the Ukraine (Singh &
Darroch, 2000). Therefore, it is estimated that one
in five or one in six of the births was to adolescent
mothers in these nations (Singh & Darroch, 2000).
As for other countries, Japan reported the rates of
live births to 15–19-year-old girls as 1.4 % (Singh
& Darroch, 2000) in 1995, while it was reported as
4.9 % in Taiwan in 1994 (Lee, Yen, Wu, & Lee,
2007). Around the same time period, 12.6 % of all
births in the United States were attributed to adolescents (Singh & Darroch, 2000).
In Canada, it has been estimated by Statistics
Canada that the live birthrate of adolescent girls
(15–19 years) among all 2006 births was 4.1 %
(Statistics Canada, 2006a). The ▶ prevalence rates
in Quebec, Ontario, and British Columbia, however, were lower than the national average (2.7 %,
3.3 %, and 3.5 %, respectively). Nunavut (24.0 %)
and the Northern Territories (10.6 %), on the other
hand, had much higher teen motherhood rates than
the general Canadian average. As for pregnancy
rates among Canadian adolescents, it was found to

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be 24.6 per 1,000 adolescent under 20 years of age
in 2005 (Statistics Canada, 2005). The rate is lower
than the 72.2 pregnancies per 1,000 adolescents
reported in 2004 in the United States (Ventura,
Abma, Mosher, & Henshaw, 2008).
With regard to characteristics of teen moms,
international studies have shown that adolescent
▶ childbearing is more common among
women with low levels of income and education
(Singh, Darroch, & Frost, 2001). Girls with good
self-esteem and a sense of responsibility also tend
to avoid adolescent pregnancies (Ruusuvaara,
1997). Furthermore, although these differences
vary across countries, levels of childbearing are
strongly associated with race, ethnicity, and
even immigrant status (Singh et al., 2001). In
the United States, at least, African-American adolescents are at a higher risk of early childbearing in
comparison to other ethnicities (Chang, O’Brien,
Nathanson, Mancini, & Witter, 2003). Pregnant
adolescents are also more prone to take part in
dangerous activity. An American study found
that those who had done cocaine (4.88 times
more likely), carried a weapon (4.06 times more
likely), or had a history of STD (3.50 times more
likely) were more likely to become pregnant
(Rome, Rybicki & Durant, 1998). There is also
some information on predictors and characteristics
of Canadian pregnant adolescents. In a rather old
study, adolescent mothers demonstrated higher
rates of substance, tobacco, and dietary abuse
during pregnancy than older mothers (Jacono,
Jacono, St Onge, Van Oosten, & Meininger,
1992). In a more recent study, adolescents with
a history of sexual abuse (Bowman, 2007) and
sexual abuse involving penetration were 13 times
as likely to become pregnant (Cinq-Mars, Wright,
Cyr, & McDuff, 2003). Moreover, about one quarter of the adolescent mothers’ partners were 6 or
more years older (Millar & Wadhera, 1997).
Study on Teen Births in Canada
While teen motherhood and pregnancy are
reasonably well documented in other countries,
this is less the case for Canada. Only limited data
are available about teen motherhood and the
characteristics of teen mothers (Cinq-Mars et al.,
2003; Dryburgh, 2000; Jacono et al., 1992;

Teen Motherhood in Canada

Millar & Wadhera, 1997). The authors in
a previously published article (Al-Sahab, Heifetz,
Tamim, Bohr, & Connolly, 2012) examined the
prevalence and characteristics of adolescent
mothers throughout the provinces of Canada,
using a recent Canadian survey, the Maternity
Experience Survey (MES).
The MES was sponsored by the Public Health
Agency of Canada and conducted by Statistics
Canada in 2006. It aimed to assess pregnancy,
delivery, and postnatal experiences across the
Canadian provinces and territories. The study
recruited women aged 15 years and above, who
had singleton live births, and who lived with their
baby at the time of data collection. Women were
selected from the 2006 Canadian Census of
Population. Out of 8,244 women estimated to
have met the eligibility criteria, 6,421 women
responded to the survey. The data were collected
during the 5th and 9th month postpartum through
telephone interviews using computer-assisted
telephone interviews. The MES questionnaire
lasted for 45 min on average and was available
in 15 different languages. To increase participation rate, up to 25 calls were attempted for each
study participant on different times of the week
and day. The MES project was presented to
Health Canada’s Science Advisory Board, Health
Canada’s Research Ethics Board, and the
Federal Privacy Commissioner and was approved
by Statistics Canada’s Policy Committee. For
more information about the MES, please refer to
other references (Dzakpasu, Kaczorowski,
Chalmers, Heaman, & Duggan, 2008; Statistics
Canada, 2006b).
Based on the recommendation of the Royal
College of Obstetricians and Gynecologists in the
United Kingdom on optimal maternal age for
childbearing, maternal age, the main dependent
variable for the study, was grouped as teen mothers
(<20 years), average-aged mothers (>=20 years
and <35 years), and older mothers (>=35 years)
(Al-Sahab et al., 2012). The analysis of the study
compared teen mothers to average-aged mothers
across different independent variables. Among
these variables were sociodemographic characteristics including total household income, place of
residence (urban vs. rural), ▶ immigration status,

Teen Motherhood in Canada

marital status, and province of residence. Maternal characteristics, including previous history
of teen pregnancy and mother’s perceived
health, were also examined. A list of pregnancy-related factors such as alcohol drinking
during pregnancy, smoking during pregnancy,
mother’s intention on planned pregnancy, and
attendance of prenatal/childbirth education
classes during the pregnancy was included in
the analysis. Finally, experience of violence
in the past 2 years was explored. All of the
above independent variables were included in
a logistic regression analysis comparing teen
mothers to average-aged mothers. To account
for the complex sampling design, bootstrapping
was performed to calculate all the 95 %
confidence interval (CI) estimates.
Due to small sample sizes, the Al-Sahab et al.
(2012) study excluded from the analysis women
living in the northern territories. The study
sample, thus, totalled 6,188 women and was
weighted to represent 76,110 Canadian women.
The mean age of the study participants was 29.6
years (Standard Deviation (SD) ¼ 5.2). The mean
age for teen, average-aged, and older mothers
were 18.1 years (SD ¼ 1.1), 28.3 years
(SD ¼ 3.7), and 37.4 years (SD ¼ 2.3), respectively. Based on MES data for current births,
2.9 % of the births (95 % CI: 2.7–3.1) were
among mothers aged 20 years or younger,
79.5 % (95 % CI: 78.6–80.4) among averageaged mothers, and 17.6 % (95 % CI: 16.7–18.5)
among older mothers. The teen motherhood prevalence was higher than the MES calculated
national average among women residing in the
provinces of the Western Prairies (4.8 %) and
Eastern Atlantic (4.8 %). Teenage deliveries
ranged between 2.0 % and 2.3 % among women
living in British Columbia, Ontario, and
Quebec. Among all study participants, 14.1 %
reported to have had experienced teen pregnancy
and 6.2 % have had a childbirth during their
teenage years. The teen motherhood rate in
MES might be slightly underreported since the
sample was only restricted to mothers who were
residing with their infants at the time of the survey. Teen mothers whose children were under
foster care were not included in the study.

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Based on the logistic regression analysis, all the
sociodemographic variables were significantly
associated with being an adolescent mother except
for the place of residence (Al-Sahab et al., 2012). As
compared to average-aged mothers (20–35 years),
teen mothers were more likely to have low household income. As the household income decreased,
the odds of being a teen mom increased. Teen
motherhood was also more common among
nonimmigrant (Odds Ratio (OR) ¼ 3.10, 95 % CI:
1.14–8.42) and single mothers (OR ¼ 2.66, 95 %
CI: 1.69–4.18). According to the multivariate logistic regression analysis, none of the maternal
characteristic variables proved to be significantly
associated
with
adolescent
motherhood.
On the other hand, of the health-related variables,
attendance at prenatal classes and intention of
planned pregnancy were both found to be significantly associated with age at delivery. Mothers
attending prenatal classes were two and a half
times (OR ¼ 2.54, 95 % CI: 1.74–3.71) more likely
to be teen mothers. Moreover, mothers who wanted
their pregnancy to happen at a later stage in their life
were more at odds of being teen mothers
(OR ¼ 4.49, 95 % CI: 2.93–6.87). Finally, experience of abuse in the past 2 years was significantly
associated with maternal age at delivery. The odds
of experiencing physical and/or sexual abuse was
higher among adolescent mothers (OR ¼ 2.24,
95 % CI: 1.53–3.29) than other mothers.
Conclusion and Future Directions
Teenage childbearing and birth has negative
implications on the health and well-being of the
mother and the child, as well as financial costs to
the healthcare system. In Canada, the prevalence
of teen motherhood was reported to be 4.1 % by
Statistics Canada and 2.9 % by the Maternity
Experiences Survey. Both rates, while relatively
low, are still higher than the rates reported by some
European countries. Other than the burden of child
rearing at a young age, Canadian teen mothers are
disadvantaged by their low socioeconomic status,
single motherhood status, and experiences of
▶ violence and abuse. Policy makers should therefore aim to provide intervention programs and
assistance for these young women, in terms of
financial support, violence prevention and

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control, and access to sympathetic health services.
Since adolescent moms are more likely to attend
prenatal classes, there is evidence that Canadian
teen mothers demonstrate characteristics of
▶ resilience despite the risks and challenges they
face. Further, in-depth understanding of what
mitigates the risks associated with adolescent
childbearing and what protective factors may be
available to adolescents at risk is highly warranted.
Studying resilience to these adverse outcomes in
Canada will build a comprehensive body of
information on which to base policy and intervention that are specific to this country.

References
Al-Sahab, B., Heifetz, M., Tamim, H., Bohr, Y., &
Connolly, J. (2012). Prevalence and characteristics of
teen motherhood in Canada. Maternal and Child
Health Journal, 16(1), 228–234.
Baldwin, W., & Cain, V. (1980). The children of teenage
parents. Family Planning Perspectives, 12, 34–43.
Bowman, K. G. (2007). When breastfeeding may be
a threat to adolescent mothers. Issues in Mental Health
Nursing, 28(1), 89–99.
Cargill, Y., & Martel, M. J. (2007). Postpartum maternal
and newborn discharge. Journal of Obstetric Gynaecology in Canada, 29(4), 357–363.
Chang, S. C., O’Brien, K. O., Nathanson, M. S., Mancini, J.,
& Witter, F. R. (2003). Hemoglobin concentrations
influence birth outcomes in pregnant African-American
adolescents. Journal of Nutrition, 133(7), 2348–2355.
Cinq-Mars, C., Wright, J., Cyr, M., & McDuff, P. (2003).
Sexual at-risk behaviors of sexually abused adolescent
girls. Journal of Child Sexual Abuse, 12(2), 1–18.
Community Action Program for Children and the
Canada Prenatal Nutrition Program (CAPC/CPNP).
(2007). On the move: Mobilizing community and
engaging youth to reduce rates of teen pregnancy in
Canada. Retrieved September, 2012, from
http://www.phac-aspc.gc.ca/hp-ps/dca-dea/prog-ini/
funding-financement/npf-fpn/tp-ga/pdf/tp-ga-engl.pdf
Dryburgh, H. (2000). Teenage pregnancy. Health Reports,
12(1), 9–19.
Dzakpasu, S., Kaczorowski, J., Chalmers, B., Heaman, M.,
Duggan, J., & Neusy, E. (2008). Maternity experiences
study group of the Canadian perinatal surveillance system. Public Health Agency of Canada. The Canadian
maternity experiences survey: Design and methods.
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207–216.
Ha, D. M., Osofsky, J. D., & Culp, A. M. (1996). Relating
the adolescent mother-child relationship to preschool
outcomes. Infant Mental Health Journal, 174, 302–309.

Teen Motherhood in Canada
Hoffman, S. D. (2006). By the numbers: The public costs
of teen childbearing. Washington, DC: National
Campaign to Prevent Teen Pregnancy.
Jacono, J. J., Jacono, B. J., St Onge, M., Van Oosten, S., &
Meininger, E. (1992). Teenage pregnancy: A reconsideration. Canadian Journal of Public Health, 83(3),
196–199.
Klein, J. D. (2005). Adolescent pregnancy: Current trends
and issues. Pediatrics, 116, 281–286.
Lee, S. H., Yen, C. H., Wu, W. Y., & Lee, M. C. (2007).
A review on adolescent childbearing in Taiwan: Its
characteristics, outcomes and risks. Asia-Pacific
Journal of Public Health, 19(1), 40–42.
Liu, S., Heaman, M., Kramer, M. S., Demissie, K., Wen,
S. W., & Marcoux, S. (2002). Length of hospital stay,
obstetric conditions at childbirth, and maternal
readmission: A population-based cohort study. American Journal of Obstetric Gynecology, 187(3), 681–687.
Luong, M. (2008). Life after teenage motherhood.
Perspectives on Labour and Income, 9, 5–13.
Martens, P. J., Derksen, S., & Gupta, S. (2004). Predictors
of hospital readmission of Manitoba newborns within
six weeks postbirth discharge: A population-based
study. Pediatrics, 114(3), 708–713.
Maynard, R. (1997). Kids having kids: Economic costs
and social consequences of teen pregnancy. Washington, DC: The Urban Institute Press.
McCullough, M., & Scherman, A. (1998). Family-of-origin
interaction and adolescent mothers’ potential for child
abuse. Adolescent, 33(130), 375–384.
Millar, W. J., & Wadhera, S. (1997). A perspective on
Canadian teenage births, 1992–94: Older men and
younger women? Canadian Journal of Public Health,
88(5), 333–336.
Offord, D. (1987). Ontario child health study. Archives of
General Psychiatry, 44, 832–836.
Rome, E. S., Rybicki, L. A., & Durant, R. H. (1998).
Pregnancy and other risk behaviors among adolescent
girls in Ohio. Journal of Adolescent Health, 22(1),
50–55.
Ruusuvaara, L. (1997). Adolescent sexuality: An educational and counseling challenge. Annals of the
New York Academy of Science, 816, 411–413.
Singh, S., & Darroch, J. E. (2000). Adolescent pregnancy
and childbearing: Levels and trends in developed countries. Family Planning Perspectives, 32(1), 14–23.
Singh, S., Darroch, J. E., & Frost, J. J. (2001). Socioeconomic disadvantage and adolescent women’s sexual
and reproductive behavior: The case of five developed
countries. Family Planning Perspectives, 33(6),
251–258, 289.
Spieker, S. J., Larson, N. C., Lewis, S. M., White, R. D., &
Gilchrist, L. (1997). Children of adolescent mothers:
Cognitive and behavioral status at age six. Child and
Adolescent Social Work Journal, 14(5), 335–364.
Statistics Canada. (2005). Pregnancy outcomes.
Retrieved September, 2012, from http://www5.statcan.
gc.ca/bsolc/olc-cel/olc-cel?catno=82-224-XWE&
lang=eng#formatdisp

Telecommuting
Statistics Canada. (2006a). Canadian vital statistics,
birth database. Accessed May 19, 2010, http://
cansim2.statcan.ca/cgi-win/cnsmcgi.pgm?Lang¼E&
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Maternity experiences survey, 2006. Accessed May
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document/5019_D1_T1_V1-eng.pdf
Ventura, S. J., Abma, J. C., Mosher, W. D., & Henshaw,
S. K. (2008). Estimated pregnancy rates by outcome
for the United States, 1990–2004. National Vital Statistics Reports, 56(15), 1–25.
Whitman, T., Borkowski, J., Keogh, D., & Weed, K.
(2001). Interwoven lines: Adolescent mothers and
their children. Mahwah, NJ: Lawrence Erlbaum
Associates.
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in the 21st century. Accessed May 19, 2010, http://www.
euro.who.int/Document/Hms/itahfa21/omsindice.htm.
World Health Organization (WHO). (2006). Pregnant
adolescents: Delivering on global promises of hope.
Geneva, Switzerland: WHO Document Production
Services.
World Health Organization (WHO). (2012). Maternal,
newborn, child and adolescent health: Adolescent pregnancy. Retrieved September, 2012,
from http://www.who.int/maternal_child_adolescent/
topics/maternal/adolescent_pregnancy/en/index.html

Teen Substance Abuse
▶ Adolescent Substance Use

Teen Substance Use
▶ Adolescent Substance Use

Telecommuting
E. Jeffrey Hill and Kaylene J. Fellows
School of Family Life, Brigham Young
University, Provo, UT, USA

Synonyms
Telework; Work-at-home; Working remotely

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Definition
Telecommuting is an alternative work arrangement in which employees perform tasks elsewhere that are normally done in a primary or
central workplace, for at least some portion of
their work schedule, using electronic media to
interact with others inside and outside the
organization (Gajendran & Harrison, 2007).
Telecommuting is a form of teleworking and is
often done at home.

Description
Jack Nilles is thought to have coined the word
telecommuting in 1973, and he defined it as “the
substitution of telecommunications and/or
computers for commuting work” (Nilles, 1994,
p. 109). The emphasis is on the reduction or
elimination of the daily commute to and from
the workplace. Although telecommuting has traditionally been associated with work-at-home,
the term is also applied to a broader range of
virtual work options, such as working from satellite work offices, hotels, and so forth (Siha &
Monroe, 2006).
Theoretically, telecommuting is thought to
enhance quality of life because it meets the
needs of individuals, companies, and societies
by (1) providing individuals flexibility and autonomy to better meet life demands; (2) reducing the
time spent commuting and making that time
available for personal/family life; (3) helping
organizations attract key talent and lower overhead costs associated with offices (including
adding accommodations for those with disabilities); (4) providing employees a way to work
during times when working from the office is
inconvenient or impossible (e.g., during nonstandard hours or severe weather that might otherwise
interfere with the commute); and (5) improving
society by reducing traffic and pollution that
result from vehicular commuting (McCloskey &
Igbaria, 1998).
Individual studies and meta-analyses have
unambiguously documented that telecommuting
is associated with many positive quality of life

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outcomes including higher perceived autonomy,
lower work-family conflict, higher job performance, lower job turnover intent, greater job
satisfaction, and less role stress (see Gajendran
& Harrison, 2007). These positive outcomes are
magnified when telecommuting is coupled with
schedule flexibility (Hill, Erickson, Holmes, &
Ferris, 2010). In addition, the relationship
between telecommuting and job satisfaction
may be curvilinear based on the number of
hours spent telecommuting per week (Golden &
Veiga, 2005). Many have speculated that
telecommuting would be detrimental to coworker relationships. However, this relationship
has only been substantiated for high-intensity
telecommuting (more than 2.5 days per week).
Those engaging in extensive telecommuting may
also perceive reduced career advancement opportunities (McCloskey & Igbaria, 1998).
Telecommuting has become more common in
recent years. The number of employee telecommuters in the United States (those who work from
home or remotely at least one full day per month)
increased from 9.9 million in 2005 to 17.2 million
in 2008, an increase of 74 % (WorldatWork,
2009).

Cross-References
▶ Home-Based Work
▶ Telework
▶ Virtual Work
▶ Work-at-Home
▶ Workplace Flexibility

References
Gajendran, R. S., & Harrison, D. A. (2007). The good, the
bad, and the unknown about telecommuting: Metaanalysis of psychological mediators and individual
consequences. Journal of Applied Psychology, 92,
1524–1541.
Golden, T. D., & Veiga, J. F. (2005). The impact of extent
of telecommuting on job satisfaction: Resolving
inconsistent findings. Journal of Management, 31,
301–318.
Hill, E. J., Erickson, J. J., Holmes, E. K., & Ferris, M.
(2010). Workplace flexibility, work hours, and

Television and Leisure
work-life conflict: An extra day or two. Journal of
Family Psychology, 24, 349–358. doi:10.1037/
a0019282.
McCloskey, D. W., & Igbaria, M. (1998). A review of the
empirical research on telecommuting and directions
for future research. In M. Igbaria & M. Tan (Eds.),
The virtual workplace (pp. 338–358). Hershey, PA:
IGI Global.
Nilles, J. M. (1994). Making telecommuting happen:
A guide for telemanagers and telecommuters. New
York: Van Nostrand Reinhold.
Siha, S. M., & Monroe, R. W. (2006). Telecommuting’s
past and future: A literature review and research
agenda. Business Process Management Journal, 12,
455–482.
WorldatWork (2009). Telework trendlines 2009.
Retrieved January 19, 2012 from http://www.
worldatwork.org/waw/adimLink?id¼31115

Television and Leisure
▶ Television and Quality of Life

Television and Quality of Life
Paul S. N. Lee
School of Journalism and Communication,
The Chinese University of Hong Kong,
Hong Kong, People’s Republic of China

Synonyms
Television and leisure; Television consumption;
Television impact

Definition
Television technology appeared in the 1920s. Its
heyday was in the 1970s and 1980s. With the rise
of the Internet and other forms of information
and communication technologies, the pervasiveness of television has declined in most parts of
the world since the turn of the century. Nevertheless, television viewing still remains a major
leisure activity taking up a considerable amount

Television and Quality of Life

of time. Studies have shown that television
viewing has both positive and negative impact
on people’s well-being.

Description
Television technology appeared in the 1920s.
In mid-1930s, Germany, France, the United
Kingdom, and the United States started broadcasting, mostly on an experimental basis.
The world’s first high-definition television
broadcasting service using 405-line standard
was launched in 1936 by the BBC in London.
The growth was slow at the beginning. When the
Second World War broke out in 1939, only
20,000 television receivers were registered in
the UK. The television service was suspended
during the war. When the service was resumed
in 1946, growth was still slow. By 1949, less than
2 % of adult population in the United Kingdom
had television sets (Belson, 1967).
In the USA, television service was not
completely stopped by the war. Six experimental
stations continued their broadcasting service
throughout the war years although the growth
was slow (Whitehouse, 1986). By 1949, only
about 9 % US homes had television sets.
The penetration of television accelerated in the
1950s. By the end of 1963, the penetration
rate of television in the US was 93 %, while that
of the UK was 91 % in 1964 (Belson, 1967).
A UNESCO study in 1965 on people’s time
expenditure on various daily activities in 12
countries in Western Europe, Eastern Europe,
and America showed that nearly 90 min of free
time were devoted to television in these countries
including the Soviet Union, France, West
Germany, Bulgaria, the USA, and Peru (Szalai,
1972). Except for some poor and war-torn
countries like Ethiopia, Liberia, Malawi, Niger,
Rwanda, Somalia, and Uganda, television has
reached more than 90 % homes all over the
world in the twenty-first century.
The heyday of television was in the 1970s and
1980s. With the rise of the Internet and
other forms of information and communication
technology such as mobile phones, MP3, video

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games, and video discs, the pervasiveness of
television has declined in most parts of the
world since the turn of the century. Nevertheless,
television viewing still remains a major leisure
activity taking up a considerable amount of time.
A recent study on time use in 23 countries
showed that in 2005, with the exception of the
Netherlands (19 %), television viewing took
up almost one-third of people’s leisure time or
more (Robinson, 2011). The time spent on television viewing just lags behind sleep and paid
work (Fisher & Robinson, 2011).
In general, television viewing is taken as a passive leisure. With conservative, noncontroversial
and least objectionable program contents, television is considered to be a medium cultivating an
inactive, unchallenging, and unimaginative
mind in its audience. Many studies have found
a correlation between television viewing and
various negative aspects of life. The heavier the
viewing, the more serious is the problem. However,
some studies found positive experiences in
television viewing among the audience. Overall,
television studies since the 1950s have shown that
the impact of television on quality of life varies
with different levels of analysis and socioeconomic
categories.
There are three levels of analysis in the impact
of television on life quality, namely, individual,
family, and societal. The variables which
mediate the impact of television on life quality
include age, education, marital status, psychological state/mood, interpersonal relationship, and
family orientation.
Impact on Individual
In general, analysis at the individual level has
found many negative aspects of television viewing. Much attention has been given to the effect
of television on children. This is not surprising
since television was the first time in history an
audiovisual medium sitting in people’s home,
having close and easy contact with children.
There are three landmark studies on television’s effects on children. They are Television
and the Child (Himmelweit, Oppenheim, &
Vince, 1958), Television in the Lives of Our
Children (Schramm, Lyle, & Parker, 1961), and

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Television and Growing Up (Surgeon General’s
Scientific Advisory Committee, 1972).
Both Himmelweit and Schramm’s research
teams found that the amount of viewing is
a function of age, intelligence, and social class.
The older, more intelligent and lower class
children tended to watch more. Television
appears to have had a minor effect on schoolwork. For the very young, television viewing
results in an increase in vocabulary especially
the words frequently used on television. Reading
decreases in recent viewers, but reestablishes
later with a change in type, with a reduction in
comic reading and escapist fare in general. When
intelligence is taken into account, there is little
relationship between viewing amount and school
performance.
However, insecure middle-class children,
particularly those who have difficulty in making
friends, tend to watch much more television than
the typical middle-class children. But children of
lower socioeconomic status do not exhibit a link
between insecurity and heavy viewing
(Himmelweit et al., 1958; Schramm et al.,
1961). An explanation is that children of lower
socioeconomic status, like their parents, watch
a lot more television than children of upper or
middle class. Insecurity or frustration does not
differentiate the children who watch a lot of television all the time. But middle-class children who
usually watch less television will increase
their amount of viewing due to frustration or
insecurity, and the result stands out in statistical
analysis (Maccoby, 1954).
Children are found to use television for three
main reasons. First, it gives an excuse for them
to get together and share common topics in
conversations. Second, television serves as an
important source for information about the
outside world. Third, it is used for entertainment.
Television provides contents from casual
relaxation to escape. In Schramm et al.’s study,
they found entertainment the main function of
television, and the chief needs television meets
are those under the heading of fantasy. In the
researchers’ view, the fantasy-seeking behavior
has positive and negative consequences. On the
one hand, fantasy behavior may drain off some of

Television and Quality of Life

the discontent resulting from the hard blows of
socialization and provide insights and analogies
that may help the viewer to see himself better.
On the other hand, it may lead a child into
withdrawal from the real world, encourage the
confusion of real situations with fantasy, and
thereby cause him more trouble than he should
have in learning the rules of the real world. It may
also build up aggression and make socially
acceptable adjustment more difficult (Schramm
et al., 1961).
A decade later, another large-scale study
found a more negative picture about television.
Despite controversies around the researchers’
conflict of interest with television networks and
numerous qualifications made to the findings
of the report (Comstock, 1980), the 5-volume
Surgeon General’s report on televised violence
provided a basis for the Surgeon General to
conclude in the US Senate Commerce Subcommittee hearing that “televised violence . . .. does
have an adverse effect on certain members of our
society. . .. a causal relationship between
televised violence and anti-social behavior is
sufficient to warrant appropriate and immediate
remedial action. . .” (US Government, 1972).
A combination of evidence from laboratory-type
experiments, field experiments, and surveys in
the Surgeon General study provides evidence of
real-life connection between viewing of violent
television programs and aggressiveness among
young viewers.
The finding of televised violence’s adverse
impact on children in the early 1970s was probably due to the fact that commercial television had
gradually turned away from providing educational and informational contents since the
1960s. A study in New York in 1947 showed
that the most popular television programs at that
time was first, sports; second, live drama; third,
feature films; and fourth, children shows
(Siepmann, 1950). In the early 1970s, however,
it was observed that television contents were
dominated by violence, then sex, seminudity,
vulgarity, smoking, drinking, and drugs. All
these contents were on the rise (Bower, 1973).
The link between undesirable social behaviors
and television viewing is not limited to children.

Television and Quality of Life

Adult viewers are also susceptible to negative
influences of television. A longitudinal study
combining content analysis and surveys found
that heavy viewers are more likely to
overestimate the frequency of violent and criminal acts and the likelihood of their falling victim
to an act of crime or violence. These viewers
obtain a distorted view from television and
become fearful of the neighborhood and the
outside world (Gerbner & Gross, 1976; Gerbner,
Gross, Morgan, & Signorielli, 1980). Although
the causal link between viewing and audience
behavior is questioned (Hirsch, 1980, 1981), the
role of television in constructing social reality
received support in some studies (Hawkins &
Pingree, 1983; Rosengren & Windahl, 1989).
The series of so-called cultivation studies have
indicated that heavy television viewers tend to
be more mistrustful, alienated, and apprehensive
(Gerbner, Gross, Morgan, Signorielli, &
Jackson-Beeck, 1979; Gerbner et al., 1980).
The link between television viewing and some
negative attributes is however subject to interpretation. Although heavy viewers are found to be
stressed, unhappy, lonely, bored, and see their
own lives as less fulfilling and more depressing
(Anderson, Collins, Schmit, & Jacobvitz, 1996;
Morgan, 1984), television viewing is at the same
time conceived by viewers as relaxing, entertaining, satisfying, and peaceful (Csikszentmihalyi &
Kubey, 1981; Steiner, 1963). Despite
a continuing decline of television’s dominance
in daily life, a study in 2003 in three Chinese
cities showed that television was still conceived
to be the third most important medium in raising
quality of life after the Internet and mobile
phone (Lee, Leung, Lo, & Xiong, 2008). It is
found that the typical viewing experience is characterized by moderate cheerfulness and high
relaxation (Csikszentmihalyi & Kubey, 1981).
The contrast between viewers’ television
experience and the characterization of their lives
can be explained by the variation between immediate and long-term effect, as well as the duration
of time spent on watching television. In the short
run, television viewing may provide relaxation
and escape, but in the long run, the messages
and reality derived from the screen may bring

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negative consequences. Greater viewing may
cultivate the sense that one’s own life is less
glamorous and exciting than the lives of most
television characters. In addition, only heavy
viewing seems to be a problem. Moderate viewing, i.e., 2 or 3 hours a day, is indeed found to
have an effect of pleasant relaxation
(Csikszentmihalyi & Kubey, 1981; Morgan,
1984). This discrepancy between heavy and moderate viewers in viewing experience is probably
due to the fact that heavy viewers have some
“unhappy” psychological moods which drive
them to watch a lot more television than usual,
while moderate or light viewers are usually
“more happy” people.
Relatively poor people have been found to be
the most enthusiastic viewers. It can be explained
by the fact that television is a form of “going
places” without incurring expenditure; it brings
the world to people’s doorsteps without the need
to pay (Siepmann, 1950). The relationship
between heavy viewing and feeling of “lousy”
in life is found to hold stronger among nonwhites,
the unemployed, and older people – all have
a gloomy outlook compared with other social
groups (Morgan, 1984).
Summarizing the findings of their study as
well as those of others, Kubey and
Csikszentmihalyi (1990) point out six factors
for heavy viewing on individuals. They are loneliness, availability of free time, emotional difficulties, youth, low income, and lack of education.
Quite often, when people are deprived and marginalized, they are more likely to be lonely, emotionally difficult, have abundant free time, low
income, low education, and little guidance or
support from family or friends. These characteristics point to certain socially and psychologically disadvantaged groups, including the
unemployed, divorced, widowed, older people
who are widowed and/or retried, seriously ill,
depressed and stressed, “empty nest” parents or
children, poor, and people with low level of
symbolic skills.
In short, television viewing is associated with
low quality of life among disadvantaged groups
of people who tend to watch a lot more television
than normal. For light and moderate viewers,

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television is more likely to enhance life quality in
providing relaxation, escape, information, and
opportunities for social interaction. Parker
(1976) observes that television and other media
are both a leisure interest in themselves and also
a catalyst for other interests.
Impact on Family
Television viewing is always a family activity
particularly in early years when most families
had only one television set. Findings generally
show that television viewing harmonizes with
family life. Many studies have found that television viewing is associated with greater family
interactions and solidarity (Brody, Stoneman, &
Sanders, 1980; Faber, Brown, & McLeod, 1979;
Friedson, 1953; Glick & Levy, 1962; Katz &
Foulkes, 1962; Katz & Gurevitch, 1976; Lull,
1980; Robinson, Converse, & Szalai, 1972). It is
reported that married adults, especially those
with children, watch significantly more television, stay at home more, and spend less time
with friends than adults who are single or without
children. Similar trends are found in adolescents.
More frequent use of television by teenagers is
associated with more time spent with the family
and with better feelings with the family. The
groups for whom heavier viewing is not generally
associated with positive familial experiences are
those adults who are single, divorced, or separated (Kubey & Csikszentmihalyi, 1990). The
downside of heavy viewing with family members
seems to lie mainly in spending too much time
passively instead of engaging more actively in
other non-television activities.
Lull (1980) examines the difference in
attitudes and uses of television between sociooriented and concept-oriented families. He
found that families which stress harmonious
social relations at home consider television
a useful tool to facilitate communication among
family members. For social-oriented family
members, television viewing serves to structure
their activities and talk patterns as well as accomplish some complex interpersonal objectives.
On the other hand, for families which emphasize
individual expression, discussion of ideas, and
personal achievement, television viewing is less

Television and Quality of Life

used as a communication facilitator. The concept-oriented family members have a guarded
attitude toward television and exercise control
over viewing. They watch more for information
than for fantasy. This study shows that whether or
not television viewing is a rewarding experience
depends on the cultural orientation of the family.
If the family emphasizes individual members’
achievement more than harmonious family relationship, heavy television viewing will not
enhance members’ satisfaction as much as
families which emphasize members’ solidarity
and harmony.
Impact on Society
Much less attention is given to television’s
impact on society than on individuals and families. Empirical studies are even less. Most studies
on television’s societal impact are based on
personal observation or historical analysis.
There are more theories than empirical evidence
on this part.
McLuhan’s conception on television’s influence on society is most noteworthy. He conceives
that the invention of writing has “detribalized”
humans by taking them out a closely knit oral
culture and put them into a private and isolated
setting because writing and reading are essentially private activities. With the invention of
electronic media, especially, television, humans
become “retribalized” into a “global village” in
which they will come into close contact with each
other again. This is due to the fact that electronic
media can convey the wholeness of communication though a combination of sound, text, and
image. Television will restore the good balance
of the senses and deprivatize, encouraging participation, and relationship building. It will bring
humans back to the communal experiences of
an oral culture (McLuhan, 1962, 1964).
Similarly, Meyrowitz (1985) argues that television breaks the barriers set up by printed materials which separate people into very different
experiential world. By bringing many different
types of people to the same “place,” electronic
media have fostered a blurring of many formerly
distinct social roles. Some behaviors that were
once kept in the “backstage” of each performance

Television and Quality of Life

world emerge into the enlarged “onstage” of each
performance world. Many traditionally perceived
differences including different social groups, different stages of socialization, and different levels
of authority are dismantled by a collapse of distinctions between people’s “onstage” and “backstage” behaviors. The widespread use of
electronic media has contributed to many positive social developments including integration
movements for blacks, women, elderly, children,
disabled, prisoners, and mentally ill.
The grand theories of McLuhan and
Meyrowitz are not subject to empirical tests.
However, the general social trends in the past
several decades have made crossing boundaries
of various kinds by humans, including national,
ethnic, hierarchical and gendered, obvious, and
no longer surprising. The popularization of
values like free choices, equal opportunities,
elimination of hierarchy, fair play, individual
rights, and the like through television has contributed to the social and cultural changes around
the world in the past few decades.
Apart from the grand theories, Schramm
(1973) points out some obvious impact of
television on social changes. He observes that
television’s presence alone already changed people’s living patterns and knowledge base. Since
television absorbs more time than the average
individual gives to any activity other than work
or sleep, it is bound to have an effect on the way
a family arranges its living patterns. The late
afternoon’s children programs, the daytime
women’s programs, the favorite prime-time
entertainment, and special events like election
night reports are all likely to be fixed points
around which individuals organize their leisure
and families arrange their schedule. Television’s
immediate effect was found to be modifying
previous leisure time avocations of people.
There was a decline in moviegoing, in attendance
at sporting events, in reading, and most
seriously in radio listening (Robinson, 1981;
Siepmann, 1950).
It was a common experience for people who
had witnessed the heyday of radio to get together
with family members in the evening to listen to
radio dramas. After television came, family radio

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listening was replaced by television viewing.
A study on the change of life styles from 1925
to 1966 in the USA shows that in urban Minnesota in 1936, 52 % of families possessed encyclopedia and 61 % had piano, but in the Detroit
sample in 1966, only about 10 % of the families
had encyclopedia and 10 % had piano, while
77 % had a television set (Felson, 1976). The
data indicate that people’s home activities have
changed dramatically since the introduction of
television.
Schramm (1973) also points out the fact that
nowadays we get most of our information about
the outside world from television although the
information may be superficial and in lack of
details. Without television, we certainly know
less than what we know now. Schramm does not
mean to say that television has great educational
values, what he means is lots of information and
knowledge about public affairs, and entertainment come to us via television. Some information
from television must have been retained although
much has been forgotten. The society’s general
level of knowledge is raised because of
television.
Conclusion
Television viewing is generally considered to be
a passive leisure activity which implies mental
and cognitive inactivity (Bickham, Wright, &
Huston, 2001). It is regarded as most useful for
three needs, i.e., to kill time, to spend time with
family, and to be in a festive mood (Katz,
Gurevitch, & Hass, 1973). In their study on television and children, Schramm, Lyle, and Parker
(1961) noted that television chiefly meets children’s fantasy needs as opposed to reality needs.
Television is always associated with nonpositive
notions of passivity, fantasy, escape, vicarious
experience, thrills, withdrawal, etc. It is generally
assumed that television viewing cannot do much
to increase quality of life.
But empirical studies show that only “heavy”
viewing is problematic. Moderate and light viewing may indeed be beneficial for viewers’ entertainment, information, and social needs. Heavy
viewing is found to be associated with unhappy
people’s psychological state and mood,

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socioeconomic position, marital status, life cycle,
or a combination of some or all of these. Heavy
television viewers are more likely to be stressed,
lonely, unemployed, poor, uneducated, divorced,
widowed, or old aged without job, family, or
friends, and insecure particularly with regard to
the outside world. However, the direction of causality is not determined. It is possible that people
are unhappy and deprived at first and then turn to
television for relaxation, comfort, or escape. In
this case, television is not a contributor to low
quality of life. Rather, it serves an important
function for unhappy people to seek refuge and
escape, albeit temporarily, from the hardship of
real life. For the deprived and unhappy viewers,
although television may not enhance their life
quality, it helps make them forget their troubles
and unhappy state at least for a while.
At the family and societal levels, researchers
tend to find an essentially positive influence of
television on family interaction and social development. Television serves as a catalyst for family
members to build solidarity or to seek information for individual growth. Although it is difficult
to empirically test the notion of a “global village”
being built by television or a leveling of hierarchy
due to blurring of distinction between back stage
and on stage, the conception of television as
a benign technology in human society can hardly
be challenged with empirical evidence either. We
cannot point out a major harm done by television
to humans since its appearance. Even for those
who live in a most totalitarian society where
television and other mass media are centrally
controlled, they still have a choice not to use
and trust the media contents.
In retrospect, despite the fact that televised
violence was found to have strong influence on
children’s aggression, the actual incidence of
violence due to television seldom occurs.
Television is rarely accused by society as the
major culprit of real-life crimes either. On the
other hand, children learn a lot of knowledge
from television before and after schooling.
Adults get lots of information about their society
and other countries from television. More important, television still remains a major leisure
activity for most people in the modernized

Television and Quality of Life

world. It provides relaxation, entertainment, and
topics for social interactions. Based on the findings and observations of previous studies, it is
quite clear that television has a positive influence
on quality of life most of the time for most
people.

Cross-References
▶ Leisure
▶ Violence

References
Anderson, D., Collins, P., Schmit, K., & Jacobvitz, R.
(1996). Stressful life events and television viewing.
Communication Research, 23(3), 243–260.
Belson, W. (1967). The impact of television. Connecticut,
USA: Archon Books.
Bickham, D., Wright, J., & Huston, A. (2001). Attention,
comprehension, and the educational influences of
television. In D. Ginger & J. Singer (Eds.), Handbook
of children and the media (pp. 101–119). Thousand
Oaks, CA: Sage.
Bower, R. (1973). Television and the public. New York:
Holt, Rinehart & Winston.
Brody, G., Stoneman, Z., & Sanders, A. (1980). Effects of
television viewing on family interactions: An observational study. Family Relations, 29, 216–220.
Comstock, G. (1980). Television in America. Beverly Hill,
CA: Sage.
Csikszentmihalyi, M., & Kubey, R. (1981). Television and
the rest of life: A systematic comparison of subjective
experience. Public Opinion Quarterly, 45, 317–328.
Faber, R., Brown, J., & McLeod, J. (1979). Coming of age
in the global village: Television and adolescence. In E.
Wartella (Ed.), Children communicating: Media and
development of thought, speech, and understanding
(pp. 215–249). Beverly Hill, CA: Sage.
Felson, M. (1976). The differentiation of material
life styles: 1925–1966. Social Indicators Research, 3
(3/4), 397–421.
Fisher, K., & Robinson, J. (2011). Daily life in 23
countries. Social Indicators Research, 101, 295–304.
Friedson, E. (1953). The relation of the social situation of
contact to the media in mass communication. Public
Opinion Quarterly, 17, 230–237.
Gerbner, G., & Gross, L. (1976). Living with television:
The violence profile. Journal of Communication,
26(2), 173–199.
Gerbner, G., Gross, L., Morgan, M., & Signorielli, N.
(1980). The “mainstreaming” of American: Violence
profile no. 11. Journal of Communication, 30(1),
10–29.

Telework
Gerbner, G., Gross, L., Morgan, M., Signorielli, N., &
Jackson-Beeck, M. (1979). The demonstration of
power: Violence profile no. 10. Journal of Communication, 29(2), 177–196.
Glick, I., & Levy, S. (1962). Living with television.
Chicago: Aldine.
Hawkins, R., & Pingree, S. (1983). Television’s influence
on social reality. In E. Wartella et al. (Eds.), Mass
communication review yearbook (Vol. 5, pp. 53–76).
Beverly Hills, CA: Sage.
Himmelweit, H., Oppenheim, A., & Vince, P. (1958).
Television and the child. London: Oxford University
Press.
Hirsch, P. (1980). The “scary world” of the non-viewer
and other anomalies – a reanalysis of Gerbner et al.’s
findings in cultivation analysis, Part I. Communication
Research, 7(4), 403–456.
Hirsch, P. (1981). On not learning one’s mistakes, Part II.
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Katz, E., & Foulkes, D. (1962). On the use of mass media
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Katz, E., & Gurevitch, M. (1976). The secularization of
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Cambridge, MA: Harvard University Press.
Katz, E., Gurevitch, M., & Hass, H. (1973). On the use of
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Lee, P., Leung, L., Lo, V., & Xiong, C. (2008). The
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Hall.

Television Consumption
▶ Television and Quality of Life

Television Impact
▶ Television and Quality of Life

T
Telework
E. Jeffrey Hill and Kaylene J. Fellows
School of Family Life, Brigham Young
University, Provo, UT, USA

Synonyms
Telecommuting;
remotely

Virtual

work;

Working

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Telework

Definition

come to a consensus on how this dimension relates
to the overall definition of telework, with some
researchers including contract or self-employed
individuals in the population, while others maintain that just regular employees should be included
(Garrett & Danziger, 2007).
Teleworking is becoming more and more
common, perhaps because of technological
advances which enable working, communication,
and interaction similar to those experienced in
a traditional office (Mello, 2007) and due to less
fear and mistrust on the part of managers (Lister
& Harris, 2011). Despite the difficulties associated with getting an accurate picture of the population of teleworkers, extant research does
suggest that teleworking seems to be a relatively
common experience – a 2001 random telephone
sample suggested that approximately 20 % of
working Americans were teleworkers (Davis &
Polonko, 2001). The population of teleworkers
appears to be fundamentally different than the
average worker in that they are more likely to
be highly educated and highly paid males who
work as independent contractors rather than fullfledged employees (Bailey & Kurland, 2002).
They are also more likely to work for larger
companies (Lister & Harris, 2011) and are far
more likely than the average worker to work in
a professional or management capacity (Bailey &
Kurland, 2002; Lister & Harris, 2011).
Research corroborates that different types of
telework are associated with different work and
personal/family outcomes. Telecommuting is
related to greater job motivation, improved job
retention, increased work-life balance, and greater
personal/family success when compared to the
traditional office. Working in the virtual office is
also associated with greater job motivation, but
with less work-life balance and lower personal/
family success (Hill, Ferris, and Martinson 2003).

Any use of information technologies (such as
telecommunications and/or computers) to perform work outside the conventional workplace
(Nilles, 1994). Telework is a broad term which
encompasses telecommuting – working electronically from a fixed location away from the office
(often at home) – and the virtual office – working
electronically from a variety of locations
away from the office (Hill, Miller, Weiner, &
Colihan, 1998).

Description
Telework was foreseen as early as 1950 but did
not become practical until the advent of personal
computers and portable modems in the early
1970s (Hill, Hawkins, & Miller, 1996). Until the
1990s, almost all teleworkers were telecommuters who worked from home to accommodate
personal and/or family needs. However, with the
diminishing cost and size of telecommunications
equipment, as well as increased portability,
a much broader group of teleworkers emerged
(Hill et al., 1998).
Teleworkers of this type electronically from
a variety of ever-changing remote locations such
as libraries, Internet cafes, hotel rooms, client
offices, and even on trains and in automobiles
(Mello, 2007). These employees are said to pertain to the virtual office.
Some researchers suggest that there are four
qualifications which must be in order for
a situation to be called telework. First is the work
location – this could include one’s home, a satellite
office, a field site, etc., but the employee must
work from a non-office location at least some of
the time. Second is the reliance on information and
communication technologies. The third dimension
is the locational time distribution. Although early
research focused on those workers that worked
away from the office full-time, most researchers
now acknowledge that teleworkers can spend any
portion of their time away from the office. The
fourth and final dimension is the contractual relation to the company. Researchers have not yet

Cross-References
▶ Home-Based Work
▶ Telecommuting
▶ Work-at-Home
▶ Workplace Flexibility

Temporal Satisfaction with Life Scale (TSWLS)

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References

Definition

Bailey, D. E., & Kurland, N. B. (2002). A review of
telework research: Findings, new directions, and
lessons for the study of modern work. Journal of
Organizational Behavior, 23, 383–400.
Davis, D. D., & Polonko, K. A. (2001). Telework in the
United States: Telework America Survey 2001.
International Telework Association and Council.
Garrett, R. K., & Danziger, J. N. (2007). Which telework?
Defining and testing a taxonomy of technologymediated work at a distance. Social Science Computer
Review, 25, 27–47.
Hill, E. J., Ferris, M., & Martinson, V. (2003). Does it
matter where you work?: A comparison of how three
work venues (traditional office, virtual office and home
office) influence aspects of work and work/family balance. Journal of Vocational Behavior, 63, 220–241.
Hill, E. J., Hawkins, A. J., & Miller, B. C. (1996). Work
and family in the virtual office: Perceived influences of
mobile telework. Family Relations, 45, 293–301.
Hill, E. J., Miller, B. C., Weiner, S. P., & Colihan, J.
(1998). Influences of the virtual office on aspects of
work and work/life balance. Personnel Psychology,
51, 667–683.
Lister, K. & Harris, T. (2011). The state of telework in the
U.S.: How individuals, business, and government benefit. Retrieved from http://www.workshifting.com/
downloads/downloads/Telework-Trends-US.pdf
Mello, J. A. (2007). Managing telework programs effectively. Employee Response Rights Journal, 19, 247–261.
Nilles, J. M. (1994). Making telecommuting happen:
A guide for telemanagers and telecommuters. New
York: Van Nostrand Reinhold.

The Temporal Satisfaction with Life
Scale (TSWLS; Pavot, Diener, & Suh, 1998) is
a 15-item self-report instrument intended to
assess the respondent’s overall life satisfaction
(sometimes referred to as global satisfaction).
The TSWLS incorporates a temporal framework;
respondents are asked to make ratings pertaining
to past, present, and future satisfaction.

Tele-working
▶ Work, Alternative/Flexible Arrangements

Temporal Satisfaction with Life Scale
(TSWLS)
William Pavot
Social Science, Southwest Minnesota State
University, Marshall, MN, USA

Description
Rationale
The influence of goals on human ▶ motivation,
and the effect of progress toward goals on
▶ subjective well-being (SWB) and behavior
have been well established empirically. Behavior
is often “pushed by the past. . .” or “pulled by the
future. . .” as well as influenced by one’s current
experiences and situation (Karniol & Ross, 1996,
p. 593). More specifically to happiness and ▶ life
satisfaction, our ongoing subjective sense of
well-being is likely to be at least partially determined by recalled events in the past or anticipated
future circumstances (Diener, 1984; Diener, Suh,
Lucas, & Smith, 1999). Some of these experiences have a general influence, such as the effect
that age differences tend to have on how we view
past life satisfaction and anticipate future
life satisfaction (Lachman, Rocke, Rosnick, &
Ryff, 2008). Other factors, such as personality
and unique life experiences, are also likely to be
important determinants of our interpretation of
the past or anticipation of the future, and represent more unique influences on our sense of
well-being and life satisfaction. The addition of
a temporal dimension in the assessment of life
satisfaction allows investigators the opportunity
to examine these influences separately, which is
not possible with many existing measures of life
satisfaction and subjective well-being.

Synonyms
Global Life Satisfaction; Happiness; Quality
of life, subjective; Satisfaction with Life;
Time-related quality of life; Well-being, subjective

Scale Development
The TSWLS was developed as an adjunct to the
▶ Satisfaction with Life Scale (SWLS; Diener,
1985). The original five-item SWLS was

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modified and expanded to a 15-item measure.
Each of the five items from the original SWLS
appears three times in the TSWLS, with revised
wording representing past, present, and future
satisfaction with life. For example, the item
from the original SWLS “I am satisfied with my
life” was reworded to “I am satisfied with my
current life,” and two additional items worded
“I am satisfied with my life in the past” and “I
will be satisfied with my life in the future” have
been added to the measure. The respondent is
instructed to indicate his/her agreement or disagreement with each item, using a seven-point
▶ Likert scale (1 ¼ strongly disagree,
7 ¼ strongly agree). The items are presented to
the respondent grouped according to the indicated time-frame in temporal order; the respondent is asked to indicate agreement/disagreement
with five statements regarding life satisfaction in
their past life, five statements focused on their
present level of life satisfaction, and finally five
statements oriented toward expected future life
satisfaction.
Scoring the TSWLS
Using the same structure as the SWLS, the items
of the TSWLS are all worded in a positive
direction; none of the items are reverse-keyed.
The unidirectional structure was maintained for
reasons of consistency, clarity of presentation,
and simplicity (Pavot et al., 1998). Subsequent
analysis (McIntosh, 2001) has indicated
only modest effects for response bias for the
scale. Thus, the scoring rubric involves
a straightforward summation of the responses.
Overall mean scores for the TSWLS would
be expected to fall in a range roughly three
times the typical mean scores for the original
scale; generally, this outcome has been
observed. For example, Pavot & Diener (1993)
reported a composite mean score on the SWLS
for several large student samples of 23.9. The
mean scores on the TSWLS for the college
student sample reported in Pavot et al. (1998)
were 63.61, 69.39, and 69.96 across three separate administrations of the scale. The subscales
formed by the groups of past, present, and future
directed items can be analyzed separately to

Temporal Satisfaction with Life Scale (TSWLS)

consider the variation in response that each specific temporal focus may introduce.
▶ Reliability and Validity
As an indicator of internal reliability, Pavot et al.
(1998) reported Alpha reliabilities for the
TSWLS of .92, .92, and .93 across three
administrations of the scale to the same sample.
Test-retest reliabilities of .83 (for a 4-week interval), .88 (5-week interval), and .82 (9-week interval) indicate that the scale has good temporal
stability; these reliabilities also indicate some
variation in responses over time.
The TSWLS has shown good ▶ convergent
validity with other measures of SWB (McIntosh,
2001; Pavot et al., 1998), including other
self-reported measures and informant reports.
Conversely, the ▶ discriminant validity of the
TSWLS is indicated by consistent negative correlations with variable such as neuroticism,
depression, and loneliness (Pavot et al., 1998).
Factor Structure
The results of a principal components analysis of
the TSWLS are presented in Pavot et al. (1998).
Using varimax rotation, a three-factor solution
was obtained for the scale. The three subsets of
future, present, and past items formed Factor 1,
Factor 2, and Factor 3, accounting for percentages
of scale variance of 45.2, 19.3, and 9.3, respectively. McIntosh (2001), using a covariance structure analysis approach, also presented data
supporting a three-factor structure.
Cross-Cultural Research
The TSWLS has not been used extensively in
cross-cultural research, unlike the original
SWLS, which has been translated to more than
25 languages (for a complete listing, see the following webpage: http://internal.psychology.illinois.edu/ediener/SWLS.html), and has been
used in a number of cross-cultural studies.
Researchers anticipating using the TSWLS
for cross-cultural research should be aware
that some evidence exists (based upon the original SWLS) for differential response patterns
across cultural groups, when sophisticated
item response analysis is applied to the data

Temporary Employment

(Oishi, 2006; Vitterso, Biswas-Diener, & Diener,
2005). Cross-cultural research with the TSWLS
therefore will require caution and careful analysis.
Additional Measurement Concerns
The TSWLS was developed as a measure of
overall or global life satisfaction, which represents a cognitive judgment. Although it generally
correlated with the affective components of
SWB, it is not intended as a complete assessment
of all aspects of SWB. Researchers intending to
assess “SWB” should incorporate specific
measures of the affective components as well as
measures of life satisfaction in order to capture
the primary components of the construct.
Previous research has shown that the affective
and cognitive context of a SWB assessment can,
under some circumstances, influence an individual’s response to such a measure (Pavot, 2008;
Pavot & Diener, 1993). Potential users of the
TSWLS are encouraged to be mindful of these
contextual influences as they design their research.

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McIntosh, C. N. (2001). Report on the construct validity of
the temporal satisfaction with life scale. Social Indicators Research, 54, 37–56.
Oishi, S. (2006). The concept of life satisfaction across
cultures: An IRT analysis. Journal of Research in
Personality, 40, 411–423.
Pavot, W. (2008). The assessment of subjective wellbeing: Successes and shortfalls. In M. Eid &
R. J. Larsen (Eds.), The science of subjective
well-being. New York: Guilford Publications.
Pavot, W., & Diener, E. (1993). The affective and cognitive context of self-reported measures of subjective
well-being. Social Indicators Research, 28, 1–20.
Pavot, W., Diener, E., & Suh, E. (1998). The temporal
satisfaction with life scale. Journal of Personality
Assessment, 70, 340–354.
Vitterso, J., Biswas-Diener, R., & Diener, E. (2005). The
divergent meanings of life satisfaction: Item response
modeling of the satisfaction with life scale in
Greenland and Norway. Social Indicators Research,
74, 327–348.

Temporary Agency Work
▶ Temporary Employment

Cross-References
▶ Motivation
▶ Satisfaction with Life Scale Adapted for
Children
▶ Satisfaction with Life Scale (SWLS), an
Overview
▶ Subjective Well-Being (SWB)

References
Diener, E. (1984). Subjective well-being. Psychological
Bulletin, 95, 542–575.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S.
(1985). The satisfaction with life scale. Journal of
Personality Assessment, 49, 71–75.
Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L.
(1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 276–302.
Karniol, R., & Ross, M. (1996). The motivational impact
of temporal focus: Thinking about the future and the
past. Annual Review of Psychology, 47, 593–620.
Lachman, M. E., Rocke, C., Rosnick, C., & Ryff, C. D.
(2008). Realism and illusion in Americans’ temporal
views of their life satisfaction: Age differences in
reconstructing the past and anticipating the future.
Psychological Science, 19, 889–897.

Temporary Contracts
▶ Temporary Employment

Temporary Employment
Nele De Cuyper and Hans De Witte
Research Group Work, Organizational and
Personnel Psychology, Faculty of Psychology
and Educational Sciences, KU Leuven,
Leuven, Belgium

Synonyms
Alternative/flexible work arrangements; Casual
employment; Contingent work; Contractual
flexibility; Fixed-term contracts; Nonpermanent
employment;
Nontraditional
employment;
Precarious employment; Temporary agency
work; Temporary contracts

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Temporary Employment

Definition

characteristics?; “objective” aspects of their
jobs, quality of work, and employment) and
(b) employee work-related attitudes, health, and
▶ well-being at work (subjective consequences
of temporary work).

The Organisation for Economic Co-operation
and Development (OECD, 2002) defines temporary employment as “dependent employment of
limited duration.” Lack of permanency is inherent to temporary contracts. Temporary contracts
come in many forms (De Cuyper, Isaksson, & De
Witte, 2005), from short term (daily and on-call
contracts) to limited term (fixed term, seasonal,
specific tasks, replacement, trainees, probation,
and job creation schemes), temporary agency
work (both permanent and nonpermanent with
the agency), and subcontractors.

Description
Facts and Figures
In 2009, temporary employment, as defined
above, accounted for about 14 % of the workforce
in Europe, 13 % in Canada, and 8 % in North
America (see www.oecd.org). The incidence of
temporary work varies considerably between
countries, from about 6 % in the United Kingdom
(UK) to 22 % in Portugal and 25 % in Spain, for
example. It furthermore fluctuates with economic
conditions, so that the proportion of temporary
contracts decreases during economic recession.
Temporary contracts are overrepresented among
the youngest age group, and their proportion
decreases with educational level and among
jobs requiring high skills. Gender differences
are less outspoken and strongly dependent on
the particularities of national labor markets (see,
e.g., De Cuyper, Isaksson, & De Witte, 2005).
There is general agreement regarding the
benefits of temporary work for employers,
among them cost-cutting in the short term and
efficiency in adapting to shifts in demand and
supply (e.g., Sverke, Hellgren, & N€aswall,
2000). Policy-makers, researchers, and trade
unions however expressed concern regarding
the consequences of temporary employment for
employees. These concerns relate to the consequences of temporary employment for (a) the
quality of the work (e.g., is temporary employment
characterized
by
specific
job

Quality of Work
The “flexible firm” model of Atkinson (1984) is
a dominant perspective in research on temporary
employment. The theory assumes that companies
are characterized by two categories of workers,
namely, core and peripheral workers. Temporary
workers are part of the peripheral category and
are assumed to be less important for the core
business, as these workers can be easily replaced.
This echoes segmentation theory, which distinguishes between a primary and secondary segment in the labor market (Kalleberg, 2003), again
with temporary workers being part of the secondary labor market. Jobs of workers in the periphery
of the organization and/or in the secondary labor
market are assumed to be inferior in terms of
wages and job quality. Part of the explanation
relates to assumptions of Human Capital Theory
(Becker, 1993): employers are less likely to
invest in peripheral workers or in employees
from the secondary labor market, because they
will not stay in the organization for long. A return
on the employer’s investment is thus less likely
for temporary workers compared to core (e.g.,
permanent) workers.
Research tends to confirm the assumption of
lower quality of work among temporary workers,
even though not all findings are unequivocal (for
overviews, see, e.g., Connelly & Gallagher,
2004; De Witte & N€aswall, 2003; De Cuyper
et al., 2008; Goudswaard & Andries, 2002;
Kalleberg, Reskin, & Hudson, 2000). The job
content of workers with a temporary contract is
poorer. A variety of surveys point towards less
autonomy and control over the job for temporary
workers. Their tasks are more monotonous, offering fewer possibilities for skill utilization and
development. According to the European Dublin
survey, the working conditions of temporary
workers are also inferior. They more often work
in painful and tiring positions, are exposed to
intense noise, and perform repetitive movements

Temporary Employment

or short repetitive tasks. These workers also often
lack information regarding safety issues on the
job. Their employment conditions are characterized by lower wages, less fringe benefits, and
lower promotion and training opportunities.
Finally, temporary workers have fewer possibilities to participate in decision making and are not
consulted to the same extent as permanent
workers. Note that temporary workers also consistently perceive more job insecurity
(▶ Employment Insecurity, ▶ Fear of Job Loss,
▶ Job Security) in their job, a known job stressor
(Sverke, Hellgren, & N€aswall, 2002). Not all
findings point towards an inferior job quality for
temporary workers, however. Studies also typically reveal that temporary workers report lower
levels of workload (Parker, Griffin, Sprigg, &
Wall, 2002), whereas they sometimes experience
less role conflicts and greater role clarity. Taken
together, however, most studies point towards
a less advantageous position, which is also
reflected in the finding that temporary workers
less often work in the occupation or workplace
of choice (Aronsson & Göransson, 1999).
Health and Well-Being
The lower quality of work of temporary workers
leads to the hypothesis that their health and wellbeing will be poorer compared to permanent
workers. Various theoretical perspectives have
been advanced to underpin this assumption.
First of all, job stress theories (▶ Work Stress)
result in this expectation, as the jobs of temporary
workers contain more stressors which are known
to result in heightened levels of job strain
(De Witte & N€aswall, 2003). Next, based on
▶ social comparison and social exchange theories, one can assume that temporary worker will
feel deprived (▶ Relative Deprivation Theory)
when comparing themselves with permanent
workers, which will likely result in the perception
of being treated unfairly (▶ Perceived Fairness)
(Beard & Edwards, 1995).
The results of empirical studies to date are
much less equivocal and even inconclusive, however (for overviews, see, e.g., De Cuyper et al.,
2008; Quinlan, Mayhew, & Bohle, 2001;
Virtanen et al., 2005). This is illustrated by the

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findings regarding ▶ job satisfaction. Some
studies found permanent workers to score higher
on job satisfaction, whereas others found the
opposite pattern, or no differences at all. In their
review, Quinlan et al. (2001) show that most (but
not all) studies suggest a negative relationship
between temporary contracts and ▶ occupational
health and safety. With respect to general health,
temporary workers report better or comparable
health as permanent workers. In the metaanalysis of (Virtanen et al.), the association
between temporary employment and general
health was not significant. Finally, also the
results concerning psychological well-being
(Psychological Health, Mental Health, ▶ Subjective Well-Being) are mixed. The meta-analysis of
(Virtanen et al.) reveals a lower level of psychological well-being among temporary workers.
This association was dependent on the type of
contract and the specific well-being indicator
and ranged from weak to moderate. The pattern
of results of the large scale European
PSYCONES project deviates from this picture
(Guest, Isaksson, & De Witte, 2010). In this
study, the life satisfaction of temporary workers
did not differ from permanent workers. The temporary workers in this study even reported lower
irritation, depression and ▶ anxiety, and higher
job satisfaction than permanent workers.
Psychological Contract Theory and
Impression Management as Explanations of
Inconsistencies
Some explanations have been advanced for the
inconsistency between the (less advantageous)
quality of work of temporary workers and their
health and well-being. After all, the latter is not
unequivocally negative, as could be expected
based on their work quality. One explanation
relates to the psychological contract, or the “the
idiosyncratic set of reciprocal expectations held
by employees concerning their obligations and
their entitlements” (McLean Parks, Kidder, &
Gallagher, 1998). The promise of job security is
part of the relational psychological contract,
more often offered to permanent workers than to
temporary workers (De Cuyper & De Witte,
2006). The perception of job insecurity violates

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the relational psychological contract and leads to
negative outcomes, such as lower job satisfaction
and irritation. This means that job insecurity will
be problematic for permanents but not for temporary workers. Since no relational psychological
contract is offered to temporary workers, job
insecurity does not violate their expectations
and does not lead to negative reactions or lower
well-being. Another explanation relates to the
idea that temporary employment can be perceived as a stepping stone towards a permanent
contract. This could motivate temporary workers
to engage in impression management strategies,
to promote the image of being an excellent and
healthy worker, thus increasing the probability
of getting the desired permanent contract
(De Cuyper & De Witte, 2010).

Cross-References
▶ Alternative/Flexible Work Arrangements
▶ Anxiety
▶ Casual Employment
▶ Employment Insecurity
▶ Fear of Job Loss
▶ Human Capital
▶ Job Satisfaction
▶ Job Security
▶ Occupational Health
▶ Perceived Fairness
▶ Relative Deprivation Theory
▶ Social Comparison Theory
▶ Subjective Well-Being
▶ Work and Employment, Quality of
▶ Well-Being at Work
▶ Work Stress

References
Aronsson, G., & Göransson, S. (1999). Permanent employment but not in a preferred occupation: Psychological
and medical aspects, research implications. Journal of
Occupational Health Psychology, 4, 152–163.
Atkinson, J. (1984). Manpower strategies for flexible
organizations. Personnel management, August, 28–31.
Beard, K. M., & Edwards, J. R. (1995). Employees at risk:
Contingent work and the psychological experience of

Temporary Employment
contingent workers. In C. I. Cooper & D. M. Rousseau
(Eds.), Trends in organizational behavior (pp. 109–126).
Chichester, UK: Wiley. Vol. 2.
Becker, G. (1993). Human capital: A theoretical and
empirical analysis with special reference to education
(3rd ed.). Chicago: The University of Chicago Press.
Connelly, C. E., & Gallagher, D. G. (2004). Managing
contingent workers: Adapting to new realities. In R. J.
Burke & C. L. Cooper (Eds.), Leading in turbulent
times (pp. 143–164). Malden, MA: Blackwell.
De Cuyper, N., de Jong, J., De Witte, H., Isaksson, K.,
Rigotti, T., & Schalk, R. (2008). Literature review of
theory and research on the psychological impact of
temporary employment: Towards a conceptual
model. International Journal of Management Reviews,
10, 25–51.
De Cuyper, N., & De Witte, H. (2006). The impact of job
insecurity and contract type on attitudes, well-being
and behavioural reports: A psychological contract perspective. Journal of Occupational and Organizational
Psychology, 79, 395–409.
De Cuyper, N., & De Witte, H. (2010). Impress to become
employable. The case of temporary workers. Journal
of Career Development, 37, 635–652.
De Cuyper, N., Isaksson, K., & De Witte, H. (Eds.).
(2005). Employment contracts and Well-being among
European Workers. Hampshire, UK: Ashgate
Publishing.
De Witte, H., & N€aswall, K. (2003). ’Objective’ vs ’subjective’ job insecurity: Consequences of temporary
work for job satisfaction and organizational commitment in four European countries. Economic and Industrial Democracy, 24, 149–188.
Goudswaard, A., & Andries, F. (2002). Employment status
and working conditions. Luxembourg: European
Foundation for the Improvement of Working and
Living Conditions, Office for Official Publications of
the European Community.
Guest, D., Isaksson, K., & De Witte, H. (2010). Employment contracts, psychological contracts, and employee
well-being. An international study. Oxford, UK:
Oxford University Press.
Kalleberg, A. (2003). Flexible firms and labour market
segmentation. Work and Occupations, 30(2), 154–175.
Kalleberg, A. L., Reskin, B. F., & Hudson, K. (2000). Bad
jobs in America: Standard and nonstandard employment relations and job quality in the United States.
American Sociological Review, 65, 256–278.
McLean Parks, J., Kidder, D. L., & Gallagher, D. G.
(1998). Fitting square pegs into round holes: Mapping
the domain of contingent work arrangements onto the
psychological contract. Journal of Organizational
Behavior, 19, 697–730.
OECD. (2002). Employment Outlook. Paris: Organisation
for Economic Co-operation and Development.
Parker, S. K., Griffin, M. A., Sprigg, C. A., & Wall, T. A.
(2002). Effect of temporary contracts on perceived
work characteristics and job strain: A longitudinal
study. Personnel Psychology, 55, 689–717.

Terrorism
Quinlan, M., Mayhew, C., & Bohle, P. (2001). The global
expansion of precarious employment, work disorganization and consequences for occupational health: Placing the debate in a comparative historical context.
International Journal of Health Services, 31, 507–536.
Sverke, M., Gallagher, D. G., & Hellgren, J. (2000). Alternative work arrangements: Job stress, well- being, and
work attitudes among employees with different
employment contracts. In K. Isaksson, L. Hogsted,
C. Eriksson, & T. Theorell (Eds.), Health effects of
the new labour market. New York: Plenum.
Sverke, M., Hellgren, J., & N€aswall, K. (2002). No security: A meta-analysis and review of job insecurity and
its consequences. Journal of Occupational Health Psychology, 7(3), 242–264.
Virtanen, M., Kivim€aki, M., Joensuu, M., Virtanen, P.,
Elovainio, M., & Vahtera, J. (2005). Temporary
employment and health: A review. International Journal of Epidemiology, 34, 610–622.

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Territorialization
▶ Defining Urban Areas, Quality of Life

Terror Management Theory
▶ Objective and Subjective Nearness to Death

Terrorism
Jonathan Barker
Department of Political Science, University of
Toronto, Toronto, ON, Canada

Temporary Urban Practices
▶ Sharing Space in the Contemporary City

Synonyms
Extreme political violence

Tension
▶ Anxiety

Terminology Concerning
Relationship Satisfaction
▶ Relationship Satisfaction

Territorial Grouping Using Quality of
Life Criteria
▶ Defining Urban Areas, Quality of Life

Territoriality and Crime
▶ Impact of Housing Design on Crime

Definition
Terrorism is illegitimate violence directed at
civilians for political purposes.

Description
The two major kinds of terrorism are state terrorism and oppositional terrorism. State terrorism is
directed by government agencies, while oppositional terrorism is carried out by non-state
groups. Each of these subdivides into domestic
and international categories. Domestic terrorism
is planned and performed within one country,
while international terrorism is orchestrated in
one country and accomplished in another
(Ganor, 2002).
The connections between terrorism and
▶ quality of life are fourfold. Terrorist attacks
may cause changes in quality of life. Aspects of
quality of life may make terrorist attacks more or
less likely. Quality of life may shape the way

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people think about terrorism. The experience of
terrorism may affect the way people assess their
quality of life.
State terrorism far surpasses oppositional terrorism in its impact on quality of life. It kills and
harms far more people. Beyond its sheer lethality,
it represents the government’s betrayal of its fundamental responsibility to protect the people
under its authority. Governments use official
branches to carry out terrorism, but they may
also employ unofficial agents and often act without the niceties of legal justification. Police-led
death squads, government-organized pogroms,
large-scale killings, extraordinary renditions,
and systematic torture of political detainees are
examples. Through painstaking research R.
Rummel (1994) demonstrates that “during the
first eighty years of this [20th] century, almost
one hundred and seventy million men, women
and children have been shot, beaten, tortured,
knifed, burned, starved, frozen, crushed, or
worked to death; buried alive, drowned, hung,
bombed, or killed in any other of the myriad
ways governments have inflicted death on
unarmed helpless citizens and foreigners.” One
hundred and thirty million of these were killed by
their own governments. By contrast, he found
that just over half a million people were killed
by terrorists and guerrilla fighters. That is a ratio
of about one killed by non-state groups to two
hundred fifty killed by governments.
Domestic state terrorism has a direct impact
on the quality of life of at least some citizens, and
in the case of large-scale state terrorism, its effect
is very powerful and widespread. Those who
control the government through agencies of the
state may inflict violence against civilians for
many different political purposes: to prevent
expression of dissent, to eliminate opposition
groups, to expunge a category of people, to
extract labor and property from certain groups,
to change the pattern of economic activity, to
alter the distribution of population, and to demonstrate impunity and invincibility. The people
who are the target of state violence or who
fear they may become a target lose all sense of
security, and many lose their freedom or
their lives. Fear may pervade much of society.

Terrorism

When a government attacks a named group, it
usually launches a propaganda campaign to
make others fear and hate that group. Physical
security suffers, the psychological sense of safety
is diminished, and many experience trauma
(Agger & Jensen, 1996).
Domestic state terrorism also harms other
aspects of quality of life such as income, health,
and education. Targeted groups may suffer in
almost all dimensions of quality of life, while
others may hardly be affected and may, in some
instances, benefit, for example, from the transfer
of property from a targeted group or from a sense
that a domestic danger is under surveillance.
State terrorism may enforce economic exploitation of a class, region, or cultural grouping to the
immediate benefit of other classes, regions, or
cultural groupings. Some state terrorist episodes
are so disruptive that the whole economy suffers.
Each situation has its own complex ramifications. In some cases, government officials play
upon existing social tensions to orchestrate
violence. In others, they may lack the will or
capacity to resist being used by non-state groups
for their violent agendas (Menjiı̀var &
Rodriguez, 2005).
Does quality of life cause state terrorism?
Political autocracy and the absence of civil and
political rights make domestic state terrorism
more likely. Negative aspects of quality of life
such as severe regional economic disparities,
interethnic conflict, and economic crisis may be
precursors of state terrorism, but their effect is not
direct, and their presence is neither necessary nor
sufficient for state terrorism. Two political conditions that do not figure in measures of quality of
life often have a quite direct influence on the
development of domestic state terrorism: the
emergence or creation of political identities that
the government sees as enemies of the state
(Heryanto, 2006) and international pressure to
enforce an unpopular neoliberal economic program (Blakeley, 2009). The cases of Stalin’s
Soviet Union and Hitler’s Germany demonstrate
the power of a government ideology that values
ethnic nationalism or economic industrialization
far above human rights and that devalues a group
or class for reasons of ethnicity, religion, or

Terrorism

political beliefs. A government with such an ideology may see violence against civilians as
a political tool to use in pursuit of its political
goals (Duvall & Stohl, 1983).
The impact of international state terrorism,
although smaller than its domestic counterpart,
is significant. Governments undertake or assist
terrorist action in other countries for several different reasons. They sometimes extend their
domestic terrorist action abroad by targeting
domestic enemies who have fled abroad.
A government agency may attack citizens in
another country as part of a larger interstate conflict. All these actions have a direct impact on the
quality of life in a country that is the target of
terrorist attack, especially on the groups or individuals who may be targeted.
A government, whether or not it engages in
domestic state terrorism, may support the domestic terrorist action of another government with the
aim of strengthening a friendly regime or weakening a threatening oppositional group.
A government may also support the terrorist
capacities of oppositional groups in another
country. The consequence of both actions is to
increase the impact on quality of life. Quality of
life variables seem to play little systematic role in
bringing about these kinds of transnational support for terrorism. However, rich and powerful
countries may be tempted to use terrorism to
control political dangers in weaker and poorer
countries, particularly those perceived as failed
states. The government of a poor country may
resort to terrorism in a conflict with a richer country that it would never attack militarily. Certainly,
richer countries have been known to fear such
attacks (Byman, 2005).
One kind of international state terrorism in the
nineteenth and twentieth centuries related
strongly to quality of life and had an enormous
impact around the world: modern colonialism.
The European powers and Japan made frequent
use of terrorism in creating and maintaining their
empires. The termination of colonial rule sought
by nationalist movements (that sometimes themselves employed terrorism) was opposed in many
cases with a final barrage of state terrorism
(Elkins, 2005).

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Domestic and international oppositional terrorism are usually more episodic and localized,
and less deadly than state terrorism. Yet they are
widespread, and some episodes of domestic
oppositional terrorism persist for decades (Ireland, Spain, Sri Lanka, and Colombia). Research
on the consequences of oppositional terrorism
has touched upon several aspects of quality of
life including economic performance, sense of
well-being, and incidence of psychological
trauma. Broadly, the findings are that oppositional terrorism, especially where it is intense
and long lasting, shrinks or slows the economy,
reduces the subjective level of life satisfaction,
and increases the experience of psychological
trauma (Frey, Luechinger, & Stutzer, 2009;
Holan & Silver, 2011). However, the consequences are not uniform, and there are exceptions
to the general trend (Gaibulloev & Sandler,
2011). Statistical studies of whole economies
often show little economic effect of localized
terrorism or episodes of short duration (Krueger,
2007). However, in cases where group terrorism
has become widespread and frequent, economic
welfare and sense of security can be severely
compromised (Abadie & Gardeazabal, 2001).
The situation may devolve into a broad crisis of
authority and civil war that does great harm to
quality of life for the whole country.
In addition to the effects of the terrorism itself,
counterterrorist measures taken by the government attacked may alter quality of life. Many
people may be reassured, but the typical increase
in surveillance and official calls to report suspicious behavior may raise the level of public anxiety and restrict the freedom of the many nonterrorists subjected to surveillance measures
(Donohue, 2008). Shifts of government spending
into surveillance, intelligence, education, and
research about terrorism may draw funding
away from other government programs that support quality of life (M€uller, 2011).
Research on causes of oppositional terrorism,
both domestic and international, energized by
the hope of finding keys to stopping and
preventing it, has reflected strong preexisting
hypotheses about the power of possible motivators like economic status, religious belief, and

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6618

cultural identity. The research yields a mixed
picture. There are connections, but the forces at
work differ from case to case, and they do not
always point in the same direction. Especially
relevant to issues of quality of life are the
attempts to discover the structural or root causes
of terrorism. The social variables that are often
cited as possible root causes are poverty, low
levels of education, severe economic inequality,
high youth unemployment, and rapid urbanization. Comparative statistical studies of large
numbers of cases fail to find the strong correlations that justify speaking of root causes. Much
stronger relationships are found between oppositional terrorism and political variables.
A history of political violence, political dictatorship, foreign occupation, or ethnic discrimination is found to make oppositional terrorism
more common. A current government lacking
territorial control, democratic practices, civil
liberties, rule of law, or political inclusion is
also more likely to generate oppositional terrorism (Piazza, 2011).
Terrorism undoubtedly changes the way people judge quality of life. State terrorism may
induce some to fear the designated enemies of
the state and to value authoritarian rule while
others may gain an enhanced valuation of peace,
security, and civil rights. Experience of oppositional terrorism may increase the value many
people place on security at the expense of liberty,
while for others, human rights remain the priority. It is plausible that aspects of quality of life
such as education and income generally affect the
importance people attribute to terrorism, but that
relationship appears not to have received useful
research.

Discussion
These findings are consistent with the idea that
terrorism is a political activity that (by definition)
requires the terrorists to act with two intentions:
to pursue a political purpose and to do so by
means of violence against civilians. Political
intentions are notably various, and although
they do bear some relation to the economic and

Terrorism

social context in which they are formed, the effect
must pass through the process by which political
intentions are formed. Terrorist political intentions are much more closely related to political
history, experience, and tensions than they are to
economic and social aspects of quality of life.
Therefore, it is the political aspects of quality of
life that are most closely connected with
terrorism.

Cross-References
▶ Democracy
▶ Educational Inequality
▶ Inequality in Quality of Life
▶ Political Empowerment
▶ Political Trust
▶ Poverty
▶ Social Change
▶ Social Inequalities
▶ Unemployment
▶ War

References
Abadie, A. & Gardeazabal, J. (2001). A case–control study
for the Basque country. Working Paper 8478 National
Bureau of Economic Research.
Agger, I., & Jensen, S. (1996). Trauma and healing under
state terrorism. London: Zed Books.
Blakeley, R. (2009). State terrorism and neoliberalism:
The North in the South. London: Routledge.
Byman, D. (2005). Deadly connections: States that sponsor terrorism. Cambridge: Cambridge University
Press.
Donohue, L. (2008). The cost of counterterrorism: Power,
politics, and liberty. Cambridge: Cambridge University Press.
Duvall, R., & Stohl, M. (1983). Governance by terror. In
M. Stohl (Ed.), The politics of terrorism (pp. 179–219).
New York: Marcel Dekker.
Elkins, C. (2005). Imperial reckoning: The untold story of
Britain’s gulag in Kenya. New York: Henry Holt.
Frey, B. S., Luechinger, S., & Stutzer, A. (2009). The life
satisfaction approach to valuing public goods: The
case of terrorism. Public Choice, 138(3), 317–345.
Springer.
Gaibulloev, K., & Sandler, T. (2011). The adverse effect
of transnational and domestic terrorism on growth in
Africa. Journal of Peace Research, 48(3), 355–371.
SAGE Publications.

Test Bias
Ganor, B. (2002). Defining terrorism. Media Asia, 29(3),
123–133.
Heryanto, A. (2006). State terrorism and political identity
in Indonesia: Fatally belonging. London/New York:
Routledge.
Holman, E. A., & Silver, R. C. (2011). Health status and
health care utilization following collective trauma:
A 3-year national study of the 9/11 terrorist attacks in
the United States. Social Science & Medicine, 73,
483–490. Elsevier.
Krueger, A. (2007). What makes a terrorist: Economics
and the roots of terrorism. Princeton, NJ: Princeton
University Press.
Menjiı̀var, C., & Rodriguez, N. (2005). When states kill:
Latin America, the U.S., and technologies of terror.
Austin: University of Texas Press.
M€
uller, C. (2011). The economics of terrorism from
a policy-maker’s perspective. Defence and Peace Economics, 22(2), 125–134. Taylor & Francis.
Piazza, J. A. (2011). Poverty, minority economic discrimination, and domestic terrorism. Journal of Peace
Research, 48(3), 339–353. SAGE Publications.
Rummell, R. (1994). Death by government. New Brunswick, NJ: Transaction.

Tertiary Education
▶ Higher Education: Institutional Effects
▶ Postsecondary Education

Test Bias
Brian F. French
College of Education, Washington State
University, Pullman, WA, USA

Synonyms
Bias, statistical; Invariance

Definition
Test bias refers to the differential validity of test
scores for groups (e.g., age, education, culture,
race, sex). Bias is a systematic error in the measurement process that differentially influences

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scores for identified groups. Bias can be internal
(psychometric properties, test structure) or
external (differential prediction/selection) to
the test.

Description
Test bias, defined as a systematic error is the
measurement, captures the idea that there are
construct-irrelevant components that result in
systematically higher or lower scores on the
measurement
for
the
groups
under
examination (American Educational Research
Association [AERA], American Psychological
Association [APA], & National Council on Measurement in Education [NCME], 1999; Berk,
1982). Bias, as describe here, is used in a
technical sense. This description does not entangle social fairness, equality, and prejudice in
with bias. Bias may lead to issues in fairness
and equality but that is beyond the technical
definition discussed here. Investigations of test
bias generally include studies of (a) unequal
psychometric properties and (b) differential prediction of performance or selection between
groups. Researchers in the quality of life domain
and working with patient reported outcomes, for
example, may ask questions about if the Early
Development Inventory has a similar factor
structure across Aboriginal and non-Aboriginal
children to support the claim that the measure
assesses the same facets in each group
(Muhajarine, Puchala, & Janus, 2011). In the
field of educational and psychological measurement there is general agreement that investigations of bias are an essential component of
high-quality testing practice and development
at all stages.
Evidence to support the absence of bias is critical, no matter the purpose, as the scores
measurements yield will be used to draw
inferences about a person’s ability, and thus used
to make a variety of selection or diagnostic
decisions. Thus, scores and their inferences directly
impact the quality of lives of individuals, be it for
acceptance to a university, placement in a job, or a
cognitive diagnosis of a student or patient.

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6620

To avoid unfavorable social consequences,
Messick (1989) suggests that the measurement
process must keep construct-irrelevant variance
and construct under-representation to a minimum.
Taken one step further, the measurement process
must hold differences in test properties at
a minimum across identified subgroups in the population. It is not sufficient to provide evidence of
construct validation for a majority group.
The issues of test bias have received much
attention from the legal system, policy makers,
test consumers, test developers, and the general
public. In the United States, the 1960s marked the
first attempts to define test bias in technical terms
(Croker & Algina, 1986). Many regulations, for
example, that concern the misuse of psychological tests, especially in employment decisions,
were developed in part, as a result of the United
States Title VII of the Civil Rights Act of 1964.
This Act provided government regulations to
ensure that employment decisions were not
based on a person’s ethnicity, race, sex, color,
or religion. The desired outcome was economic
equality for African Americans. In 1966, official
guidelines for employment testing were released
with the intent of defining test bias related to in
employment decisions (Wigdor & Garner, 1982).
Educational testing received legal attention in
the United States as well around this time.
Improper classroom placement based on test
scores was brought to the court’s attention in
Larry P. v. Riles in California. The case centered
on the misuse of intelligence test scores to place
African American students in special education
classes. This was the first case at the federal level
to demand validity evidence of tests used
to place students in certain classes (Wigdor &
Garner). Tests without such validation were not
to be used. Some court decisions were based on
a subjective review of the test by the judge
(Wigdor & Garner). This method of validation,
especially by a non-expert in the field of intelligence tests, was not sufficient evidence to claim
that the test is unbiased (Plake, 1980; Sandoval
& Whelan-Miille, 1980). Indeed, these were not
the last of the legal battles concerning test bias.
These continue today and will likely increase
with the increase of accountability models

Test Bias

based on test scores. What this legal attention
did assist with was moving researchers to begin
to technically define what type of evidence was
needed to detect the absence or presence of
test bias.
Researchers and practitioners have pointed
to various ways to examine tests for bias (e.g.,
AERA, APA, & NCME, 1999) including (a)
content-related sources, (b) response-related
sources, (c) differences in internal test structure,
and (d) differential predication or selection across
groups. A combination of methods including
statistical techniques and judgmental review can
be used to identify potential bias. A few of the
major statistical techniques used in this endeavor
at the test level are highlighted below. See other
encyclopedia entries for information on item
level methods for detecting bias (i.e., differential
item functioning; ▶ measurement invariance).
Differences in the internal structure (e.g.,
factor structure) of the test can be examined
through multi-group confirmatory factor analysis
to assess the degree of factorial invariance
(Bollen, 1989; Byrne, Shavelson, & Muthén,
1989; Millsap, 2011). This type of evidence
begins with examination of the unrestricted
theoretical model of the test to assess if
a general model fits well between the identified
groups. If this model does not fit between groups,
test constructs are said to be measured differently
and no additional testing is needed. If the model
adequately fits between groups, progressively
more restrictive models are tested for invariance.
More restricted models may be tested by adding
one additional constrained matrix of: (a) factor
loadings, (b) error variances and (c) factor
variances and covariances. If any matrix is
found to lack invariance, steps can be taken to
test one matrix element at a time to identify the
location of the lack of invariance. Models
are typically compared using the chi-square
difference test and changes in fit indices
(e.g., French & Finch, 2006). Other variations
of factor models can be used to test for
factor similarity under various assumptions
including the multiple indicator, multiple cause
(MIMIC) model (e.g., Finch, 2005; French &
Mantzicopoulos, 2007; Muthén, 1988).

Test Bias

The second main area studied in test bias is
differential ▶ predictive validity, or prediction
and selection bias. This bias occurs when associations with other variables (i.e., validity coefficients) significantly differ between groups or
when a test systematically over or underestimates
a criterion for a given group. Differential
prediction is investigated by comparing
regression lines for criterion and predictor scores
between groups. Please note that a lack of
differential prediction does not guarantee that
a test will not be biased (Croker & Algina,
1986). With regard to differential selection,
especially in the employment arena, various
models have been defined (e.g., Croker & Algina)
and continue to be researched and refined (e.g.,
Meade & Fetzer, 2009) to ensure accurate
outcomes for identified groups.
Researchers currently have a plethora of quality examples of empirical applied research which
demonstrates attempts to locate test bias. There
also is excellent methodological work to support
the methods and statistical techniques employed
to detect bias. Moreover, entire books on the
technical aspects of measurement invariance
(Millsap, 2011) are available and point to
the successes as well as needs for improvements
in the area. The models employed are becoming
increasingly sophisticated. Models are taking
into account complex data collection and structures (e.g., multilevel data) as well as allowing
researchers to work within a latent variable
modeling framework (e.g., Sawatzky, Ratner,
Kopec, & Zumbo, 2011) to take advantage of
that variable system. In the decades that follow,
there is no doubt that the field will continue to
make technical advances in accurately identifying bias. Certainly the biggest challenges that
remain for the study of test bias is identifying
the sources of bias and explaining why bias
occurs from a non-statistical viewpoint.
Researchers continue to make progress in moving
from an exploratory analysis framework to
a confirmatory analysis framework to assist with
this identification process. No matter how sophisticated and accurate the statistical methods
become, the fundamental questions persons ask
will be is the test bias and why.

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Cross-References
▶ Differential Item Functioning (DIF)
▶ Item Response Theory [IRT]
▶ Measurement Invariance
▶ Response Shift

References
American Educational Research Association, American
Psychological Association, & National Council on
Measurement in Education. (1999). Standards for
educational and psychological testing. Washington,
DC: American Educational Research Association.
Berk, R. A. (1982). Handbook of methods for detecting
test bias. Baltimore: Johns Hopkins University Press.
Bollen, K. A. (1989). Structural equations with latent
variables. New York: Wiley.
Byrne, B. M., Shavelson, R. J., & Muthén, B. (1989).
Testing for the equivalence of factor covariance and
mean structures: The issue of partial measurement
invariance. Psychological Bulletin, 105, 456–466.
Croker, L., & Algina, J. (1986). Introduction to classical
and modern test theory. Philadelphia: Harcourt.
Finch, H. (2005). The MIMIC model as a method for
detecting DIF: Comparison with Mantel-Haenszel,
SIBTEST, and the IRT likelihood ratio. Applied
Psychological Measurement, 29(4), 278–295.
French, B. F., & Finch, W. H. (2006). Confirmatory factor
analytic procedures for the determination of measurement invariance. Structural Equation Modeling, 13,
378–402.
French, B. F., & Mantzicopoulos, P. Y. (2007). An
examination of the first/second-grade form of the
pictorial scale of perceived competence and social
acceptance: Factor structure and stability by grade
and gender across groups of economically disadvantaged children. Journal of School Psychology, 45,
311–331.
Meade, A. W., & Fetzer, M. (2009). Test bias, differential
prediction, and a revised approach for determining the
suitability of a predictor in a selection context.
Organizational Research Methods, 12, 738–761.
Messick, S. (1989). Meaning and values in test validation:
The science and ethics of assessment. Educational
Researcher, 18, 5–11.
Millsap, R. E. (2011). Statistical approaches to
measurement invariance. New York: Routledge.
Muhajarine, N., Puchala, C., & Janus, M. (2011). Does the
EDI equivalently measure facets of aboriginal and
non-aboriginal children? Social Indicators Research,
103, 299–314.
Muthén, B. O. (1988). Some uses of structural equation
modeling in validity studies: Extending IRT to
external variables. In H. Wainer & H. Braun (Eds.),
Test validity. Hillsdale, NJ: Lawrence Erlbaum.

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Plake, B. S. (1980). A comparison of a statistical and
subjective procedure to ascertain item validity: One
step in the validation process. Educational and
Psychological Measurement, 40, 397–404.
Sandoval, J., & Whelan-Miille, M. P. (1980). Accuracy of
judgments of WISC-R item difficulty for minority
groups. Journal of Consulting and Clinical
Psychology, 48, 249–253.
Sawatzky, R., Ratner, P. A., Kopec, J. A., & Zumbo, B.
(2011). Latent variable mixture models: A promising
approach for the validation of patient reported
outcomes. Quality of Life Research. doi:10.1007/
s11136-011-9976-6.
Wigdor, A. K., & Garner, W. R. (Eds.). (1982). Ability
testing: Uses, consequences, and controversies, Pt. 1.
Washington, DC: National Academy Press.

Test Statistic
▶ Hypothesis Testing

Test Statistic

Description
Test-retest reliability measures the stability of the
scores of a stable construct obtained from the
same person on two or more separate occasions.
▶ Reliability concerns the degree to which scores
can be distinguished from each other, despite
▶ measurement error. In the case of test-retest
assessment, intraindividual response variability
is used to estimate measurement error (Hays,
Anderson, & Revicki, 1993).
Evaluation of the Test-Retest Reliability of
a Continuous Variable
The Classical Test Theory Approach
According to classical test theory (CTT), reliability (R) is defined as the ratio of true score variance
ðst 2 Þ to total score variance, which is the sum of
the true score variance and the error variance
ðse 2 Þ.
R¼

Testing Students
▶ Student Achievement

Test-Retest Reliability
Gemma Vilagut
IMIM (Hospital del Mar Medical Research
Institute), Barcelona, Spain

Synonyms
Coefficient of stability; Repeatability; Reproducibility of test results

Definition
Test-retest reliability is the degree to which test
scores remain unchanged when measuring
a stable individual characteristic on different
occasions.

s2t
s2t þ s2e

It can be shown that, under CTT assumptions
about measurement error, this ratio equals the
Pearson product-moment correlation (r) of two
parallel forms of a questionnaire, i.e., two different sets of items (X and X0 ) that address the same
constructs and have identical true scores and linearly independent errors with equal variances.
Given the difficulties of designing parallel
forms, Guttman (1945) suggested that two consecutive and independent test applications in
a stable population would be parallel. Therefore,
the Pearson correlation between them would be
equal to their reliability. Notice that the use of
Pearson correlation requires testing parallelism.
If the two applications of the test were tauequivalent (i.e., having the same true scores but
possibly different error variances) or congeneric
(i.e., having measures with linearly related true
scores), parallelism assumptions would be violated. In this situation, the Pearson correlation
would yield biased estimates of reliability
because, as a linearity index, it cannot discern
between two identical true scores or true scores
that are linearly related (T1 ¼ aT2 + b).

Test-Retest Reliability

To solve these limitations, the intraclass correlation coefficient (ICC) has been proposed as an
alternative method for determining test-retest
reliability (Hays et al., 1993; Streiner & Norman,
1989). The general form of the ICC is a ratio of
variance due to differences between subjects
(true score variance) to the total variance of the
data (observed score). In a test-retest design, the
ICC can be calculated from mean squared errors
derived from a repeated measures ▶ ANOVA.
Among the wide range of available forms of the
ICC (McGraw & Wong, 1996; Shrout & Fleiss,
1979), the distinction between a measurement of
consistency or absolute agreement is especially
relevant for the assessment of test-retest reliability. ICCs measuring absolute agreement are sensitive to systematic variations in different
applications of the same test, because betweentrial variance is included in the denominator as
part of the total variance, and thus, measurements
that differ in absolute value, regardless of the
reason, are considered as disagreements. Another
advantage of the ICC is that, unlike Pearson correlation, it allows more than two assessments of
the test to be easily summarized.
In test-retest situations, trials are crossed with
subjects and therefore follow the appropriate
design for analysis by means of two-way models.
A two-way random effects model to measure
agreement, which assumes that the different assessments are randomly selected, is appropriate for
most test-retest evaluations in HRQOL studies.
According to the Shrout and Fleiss notation system
(Shrout & Fleiss, 1979), this definition corresponds
to the ICC(2,1) or ICC(2,k), depending on whether
the reliability of a single trial or the reliability of the
average of multiple trials is estimated, respectively.
In this model, the main effect of multiple
assessments is incorporated into the estimate of
total variability (Hays et al., 1993).
ICCð2;1Þ ¼

MSB  MSE
MSB þ ðk  1ÞMSE þ kðMST  MSE Þ=n

where MSB ¼ mean square between subjects;
MSE ¼ mean square error; MST ¼ mean square
between trials; and k is the number of assessments
per respondent.

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The Spearman-Brown prophecy formula can
then be used to obtain the ICC estimate of the
average of multiple trials:
ICCð2; kÞ ¼
¼

ICCð2; 1Þ
1 þ ðk  1ÞICCð2; 1Þ
MSB  MSE
MSB þ ðMST  MSE Þ=n

The ICC has been criticized because its magnitude depends on between-subject variability. If
subjects differ little from one another, a low ICC
can be found even if trial-to-trial variability is
small. If subjects differ from each other a lot,
the ICC can be large even if trial-to-trial variability is large. However, other authors (Streiner &
Norman, 1989) perceive this characteristic of the
ICC as an asset rather than a drawback, arguing
that it actually reflects the fact that small differences between individuals are more difficult to
detect than large ones.
Model-Based Approach

Several authors have proposed model-based
approaches for the assessment of test-retest
data. McArdle et al. (McArdle & Woodcock,
1997) proposed ▶ structural equation models
for longitudinal data in which the sample is
subdivided into multiple groups with different
test-retest intervals. These models allow for the
structural separation of some potentially important components, such as reliability, stability,
and change. Similarly, Tisak et al. (Tisak &
Tisak, 1996) proposed a ▶ latent growth curve
modeling approach that allows measurements to
be decomposed into separate sets of parameters
representing reliability and the function of
change, thus permitting a wide variety of
submodels that include models of change and
constancy to be statistically tested.
Graphical Methods

Bland and Altman (1986) suggested a graphical
approach to examine the agreement between two
different methods or to assess the reproducibility
of a single measure. It consists of plotting the
individual differences of two administrations

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6624

Test-Retest Reliability,
Fig. 1 Example of Bland
and Altman plot with limits
of agreement

Test-Retest Reliability

Score Differences (Test-Retest)

T

6

Mean + 1.96SD

4
2
Mean

0
−2
−4

Mean − 1.96SD

−6

20

30

40

50

60

70

Average score of both applications

against their average. If the differences are normally distributed, 95 % of them are expected to lie
between d  1.96s and d + 1.96s, known as the
limits of agreement (LOA), where d is the mean
difference and s is the standard deviation of the
differences. This method has become increasingly
popular over the last few years. Unlike the ICC, it
is independent of the true variability of
the observations, and it can potentially alert the
researcher to systematic differences in scores.
Effects such as monotonic drift in the agreement
related to the value of measurement or a systematic
increase in error (evaluated with the differences
between assessments) related to the value of the
measurement (i.e., the mean of the two assessments) can be easily detected. An example of
a Bland and Altman plot is presented in Fig. 1.
More recently, Luiz, Costa, Kale, and
Werneck (2003) proposed a new graphical
method, the survival-agreement plot, wherein
the Kaplan-Meier method is used to plot the absolute difference of two assessments from the same
individual |A – B| in the x-axis against the proportion of individuals with differences equal to or
greater than the observed difference (xi) in the yaxis. One limitation of this approach is that it
cannot detect systematic differences (or bias).
Another similar graphical strategy that has been
proposed to assess agreement is the mountain plot
(Monti, 1995), also known as the folded empirical
cumulative distribution plot, which is obtained by
computing a percentile for each ranked difference
between two measurements.

Assessment of Reproducibility of
a Categorical Variable
The methods described so far apply to continuous
variables. When the variable to be evaluated is
categorical, the use of Cohen’s kappa coefficient
(k) or an extension of this, the weighted kappa
(kw), is generally recommended (Streiner & Norman, 1989; Terwee et al., 2007). Both statistics
are designed to take into account the effects of
agreement by chance. The k is appropriate only in
cases in which the categorical variable is
unordered, and it is calculated as follows:
k¼

P o  Pe
1:0  Pe

where Po is the observed proportion of agreements and Pe is the proportion of agreements
expected by chance. For ordinal variables with
more than two categories, the weighted kappa
should be used instead, as it considers partial
agreement when responses differ by only one or
two categories. In weighted kappa, the diagonal
cells of total agreement have a weight of zero and
the two opposite corners have the maximum
weight and it is calculated as a sum of the
weighted frequencies corrected for chance:
P
wij Poij
kw ¼ 1:0  P
wij Peij
where wij is the weight assigned to cell (i,j) and
Poij and Peij are the observed and expected

Test-Retest Reliability

proportions in cell (i,j). The most commonly used
weighting system makes use of quadratic
weights, which correspond to the square of the
amount of discrepancy. If this weighting scheme
is used, then the weighted kappa is equal to one
form of the ICC: the ICC(2,1).
Cautions and Recommendations for the TestRetest Interval
Under the valid assumption of stability and the
independence of trials, the two administrations
can be considered parallel and the test-retest correlation would be an adequate reliability index
(Cronbach, 1947). However, these two conditions for parallel forms compete with one
another: short time intervals are required to prevent changes in true scores, but intervals that are
too short would lead to the violation of independence between applications because the memory
of the former application would still be fresh in
the subject’s mind. For the evaluation of HRQOL
measurements, a retest interval of 1 or 2 weeks is
common, but there could be situations in which
a longer period might be required (Streiner &
Norman, 1989; Terwee et al., 2007). Donald G.
Morrison (1981) explicitly modeled forgetting and
change in true score processes through a stochastic
model to determine the optimal time between two
administrations when reliability is assessed
through test-retest correlation. In any case, the
time interval used in obtaining the coefficient of
stability should be reported and justified.
Standards for Test-Retest Reliability
As with internal consistency reliability, a test-retest
reliability estimate of 0.90 is considered to be the
minimum standard for scales that are interpreted at
the individual level (Nunnally & Bernstein, 1994).
This recommendation stems from the fact that the
▶ standard error of measurement would be about
one-third of the measure’s standard deviation with
a reliability of 0.90. However, this value may be too
stringent in some situations. For this reason,
reliabilities exceeding 0.70 have been suggested
as acceptable for group comparisons (Nunnally &
Bernstein, 1994), given that the sample size
will serve to reduce the degree of measurement
error compared to group differences.

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Cross-References
▶ ANOVA
▶ Intraclass Correlation Coefficient (ICC)
▶ Latent Growth Curve Modeling
▶ Measurement Error
▶ Reliability
▶ Standard Error of Measurement
▶ Structural Equation Models

References
Bland, J. M., & Altman, D. G. (1986). Statistical methods
for assessing agreement between two methods of
clinical measurement. Lancet, 1, 307–310.
Cronbach, L. (1947). Test “reliability”: Its meaning and
determination. Psychometrika, 12, 1–16.
Guttman, L. (1945). A basis for analyzing test-retest
reliability. Psychometrika, 10, 255–282.
Hays, R. D., Anderson, R., & Revicki, D. (1993).
Psychometric considerations in evaluating healthrelated quality of life measures. Quality of Life
Research, 2, 441–449.
Luiz, R. R., Costa, A. J., Kale, P. L., & Werneck, G. L.
(2003). Assessment of agreement of a quantitative variable: a new graphical approach. Journal of Clinical
Epidemiology, 56, 963–967.
McArdle, J. J., & Woodcock, R. W. (1997). Expanding
test-retest designs to include developmental time-lag
components. Psychological Methods, 2, 403–435.
McGraw, K. O., & Wong, S. P. (1996). Forming inferences about some intraclass correlation coefficients.
Psychological Methods, 1, 30–46.
Monti, K. (1995). Folded empirical distribution function
curves-Mountain plots. The American Statistician, 49,
342–345.
Morrison, D. (1981). A stochastic model for test-retest
correlations. Psychometrika, 46, 143–151.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric
theory (3rd ed.). New York: McGraw-Hill.
Shrout, P. E., & Fleiss, J. L. (1979). Intraclass
correlations: Uses in assessing rater reliability.
Psychological Bulletin, 86, 420–428.
Streiner, D. L., & Norman, G. R. (1989). Health measurement scales: A practical guide to their development
and use. Oxford: Oxford University Press.
Terwee, C. B., Bot, S. D., De Boer, M. R., van der Windt,
D. A., Knol, D. L., Dekker, J., et al. (2007). Quality
criteria were proposed for measurement properties of
health status questionnaires. Journal of Clinical
Epidemiology, 60, 34–42.
Tisak, J., & Tisak, M. S. (1996). Longitudinal
models of reliability and validity: A latent curve
approach. Applied Psychological Measurement, 20,
275–288.

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Test-Retest Reliability Coefficient
▶ Inter-item Correlations
▶ Reliability Coefficient

Textiles
▶ Arts in British Columbia, Canada

Theater
▶ Arts and Quality of Life
▶ Arts in British Columbia, Canada

Thematic Analysis
Victoria Clarke1 and Virginia Braun2
1
Department of Psychology, University of the
West of England, Bristol, UK
2
School of Psychology, The University of
Auckland, Auckland, New Zealand

Definition
Thematic analysis (TA) is a method for identifying and interpreting patterns of meaning across
qualitative data.

Description
TA as a method was first developed by Gerald
Holton, a physicist and historian of science, in the
1970s (Merton, 1975). In the social sciences, TA
has been extensively used for analyzing qualitative data, but until recently, there has been little
discussion of TA as a method or guidance provided for its use (Aronson, 1994; Boyatzis, 1998;
Patton, 1990, provide early exceptions). In 2006,

Test-Retest Reliability Coefficient

Braun and Clarke (2006) proposed a “systematic”
and “sophisticated” (Howitt & Cramer, 2008,
p. 341) approach to TA, which has subsequently
been widely adopted. Although TA is often used
(within a realist or essentialist framework)
merely to describe or summarize key patterns in
data, for Braun and Clarke, a good TA involves
more than simply reporting what is in the data; it
involves telling an interpretative story about the
data in relation to a research question.
Braun and Clarke’s (2006, 2012) approach
involves a (recursive) six-phase process:
1. Familiarizing yourself with the data and identifying items of potential interest
2. Generating initial codes
3. Searching for themes
4. Reviewing potential themes
5. Defining and naming themes
6. Producing the report
The first phase of TA, something common to
all forms of qualitative analysis, is familiarization with the data. This involves the researcher
immersing themselves in their dataset by reading
and rereading each and every data item (and
listening to any audio data at least once), to
learn the content of the dataset “inside out.”
Familiarization also involves starting to identify,
and record, potentially interesting features of the
data, relevant to the research question.
Familiarization is followed by the process of
systematically coding the data to generate initial
codes. A code is a pithy label that captures something interesting about the data (codes in TA are
very similar to initial codes in grounded theory;
see Charmaz, 2006), and the aim here is to identify potentially meaningful bits of the data, at the
smallest level (Boyatzis, 1998). Codes either
summarize the (surface) meaning of the data
(called semantic codes, similar to grounded
theory’s “in vivo” codes (Charmaz, 2006) and
interpretative phenomenological analysis’s
(IPA) “descriptive comments” (Smith, Flowers,
& Larkin, 2009)) or dig deeper into the data to
identify “hidden meanings” (called latent codes),
such as assumptions underpinning the semantic
content. Latent codes prioritize the researcher’s
analytic framework; they are often deductive, and

Thematic Analysis

the data are examined through existing theoretical lenses. Semantic codes are more inductive
and grounded in the data and prioritize the meanings provided in the data. This phase ends with
the compilation of a list of the codes and collation
of all the data relevant to each code.
In the phase searching for themes, the analysis
shifts to a wider focus. A theme identifies
a meaning patterned across the dataset, which is
important for illuminating the research question
(Braun & Clarke, 2006). Despite the word
“searching,” it should not be assumed that themes
are hidden in the data waiting to be discovered by
the intrepid researcher or that if the researcher is
patient enough, themes will simply “emerge”
from the coded data fully formed (Ely et al.,
1997). The process of constructing themes is an
active one (Taylor & Ussher, 2001)! Theme
development involves looking for broader patterns of meaning across the coded data; coded
data can be organized into a theme by “promoting” a particularly large and complex code to
a theme (Charmaz, 2006) or clustering similar
codes together. There is no one (ideal) way to
do this; researchers rely on their own analytic
judgment about what is meaningful and important for answering the research question. A good
theme is stand-alone and distinctive, yet themes
need to work together to form a coherent whole –
an analytic story. Some codes (and themes) will
inevitably be discarded, because they do not fit
the developing analytic narrative. This phase
ends with a set of candidate themes; some sense
of the relationship between themes (perhaps figuratively represented in the form of a thematic
map (see Braun & Clarke, 2006, 2013, for examples)) and the collation of the coded data relevant
to each theme.
There are two levels of reviewing potential
themes: (1) checking that the themes “work” in
relation to the coded data (do they capture the
most important features of the coded data relevant to the research question?) and (2) checking
that they work in relation to the whole dataset
(which involves a final read through of the whole
dataset to check). Throughout the reviewing process, the researcher checks that each theme is

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coherent and substantial, with clear boundaries
and a distinct central organizing concept (Braun
& Clarke, 2013). The process of reviewing potential themes is especially important for novice
qualitative researchers and when working with
large datasets. The researcher ends this process
with a final set of themes.
The process of defining and naming is the
phase where the most substantive, interpretive
analytic work is done, and where the researcher
produces detailed and complex definitions of
each theme, which capture its shape and texture
and how it relates to other themes. In this phase,
the researcher selects the data extracts that will be
used in the final report, and develops and builds
the analysis into its final form, with each theme
(and the analysis overall) clearly addressing the
research question. Ideally, as noted above, the
analysis must go beyond simply summarizing or
paraphrasing the data, to tell a rich, nuanced,
conceptually-informed interpretative story about
the meanings embedded in and beyond the surface of the data (see Braun & Clarke, 2006, for
a checklist of quality criteria for TA). Another
seemingly trivial but important part of this stage
is naming each theme. Good theme names are
informative and engaging (short data quotes that
capture the “essence” of a theme can be used).
Producing the report is the last phase of
a Braun and Clarke’s (2006) version of TA. However, as in all other qualitative analytic
approaches, writing is integral to the analytic
process, so the analysis will usually be close to
fully drafted before this phase. This phase provides the final opportunity for refining the analysis, such as through the integration of literature,
or determining the order in which the themes are
to be presented. The researcher’s goal is to tell the
rich and complex story of their analysis, situated
within the relevant field of scholarship, in a way
that convinces the reader of the validity of their
interpretations.
In many ways, the procedures and principles
of TA are similar to other forms of pattern-based
qualitative analytic methods, such as IPA (Smith
et al., 2009) and grounded theory (Charmaz,
2006). However, unlike these approaches, it is

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not tied to a particular theoretically framework
and provides just a method, rather than
a methodology, for qualitative research. This
gives it unique flexibility and the potential for
researchers to use it in a range of different ways.
It is highly flexible in relation to the types of
research questions and appropriate forms of
data. So, it can be used to answer a wide variety
of research questions: about experiences or perspectives, practices and behaviors, influencing
factors, or the representation or construction of
particular social objects or processes. It can also
be used with almost any type of qualitative data:
data generated through a researcher interacting
with participants (e.g., face-to-face or virtual
interviews or focus groups), data generated by
participants writing responses to questions or
prompts (e.g., qualitative surveys, story completion tasks, vignettes, researcher-directed diaries),
or secondary sources of data (e.g., women’s magazines, TV talk shows, parliamentary proceedings). And it can be used for both smaller and
larger datasets.
TA is also flexible in how it can be used to
analyze and theorize data. As it is not tied to
a particular theoretical or epistemological
framework, it can be used within an essentialist
or experiential framework, where language is
treated as a window on reality or people’s experiences (Hall, 1997), or a constructionist or critical framework, where language is treated as
constructing and creating the meanings and
“reality” evident in the data (Burr, 2003). In
terms of analysis, TA can be used inductively,
where the analysis is driven by the content of the
data, by the participants’ language and concepts,
or deductively, where the data are analyzed
through the lens of preexisting theories and concepts (Boyatzis, 1998). TA is often used to summarize and provide a rich description of
a dataset, identifying key themes and patterns
of meaning at the surface (semantic) level of the
data; it can also be used to interrogate the “hidden” or latent meanings in a dataset, the assumptions underpinning, and the implications of,
particular patterns of meaning, and to provide
an interpretative and conceptual analysis of
a dataset (Braun & Clarke, 2006).

Theoretical Framework

Overall, TA provides an accessible, flexible,
foundational method for qualitative data analysis,
with clear guidelines for conducting analysis. It
offers a comparatively easy entry into qualitative
research and can be used to answer many different types of research questions.

References
Aronson, J. (1994). A pragmatic view of thematic analysis. The Qualitative Report. http://www.nova.edu/ssss/
QR/BackIssues/QR2-1/aronson.html.
Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. Thousand Oaks, CA: Sage.
Braun, V., & Clarke, V. (2006). Using thematic analysis in
psychology. Qualitative Research in Psychology, 3(2),
77–101.
Braun, V., & Clarke, V. (2012) Thematic analysis. In
H. Cooper (Ed.), Handbook of research methods in
psychology. (Vol. 2: Research Designs, pp. 57–71).
Washington, DC: APA Books.
Braun, V. & Clarke, V. (2013). Successful qualitative
research: A practical guide for beginners. London:
Sage.
Burr, V. (2003). Social constructionism (2nd ed.). London: Psychology Press.
Charmaz, K. (2006). Constructing grounded theory:
A practical guide through qualitative analysis. Thousand Oaks, CA: Sage.
Ely, M., Vinz, R., Downing, M., & Anzul, M. (1997). On
writing qualitative research: Living by words.
London: Routledge/Falmer.
Hall, S. (1997). Representation: Cultural representations
and signifying practices (pp. 223–279). London: Sage.
Howitt, D., & Cramer, D. (2008). Introduction to research
methods in psychology (2nd ed.). Harlow, UK: Prentice Hall.
Merton, R. K. (1975). Thematic analysis in science: Notes
on Holton’s concept. Science, 188(4186), 335–338.
Patton, M. Q. (1990). Qualitative evaluation and research
methods (2nd ed.). Newbury Park, CA: Sage.
Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method
and research. London: Sage.
Taylor, G. W., & Ussher, J. M. (2001). Making sense of
S&M: A discourse analytic account. Sexualities, 4(3),
293–314.

Theoretical Framework
▶ Person-Environment Fit Theory

Theory-Driven Interventions

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Theoretical Sampling

Theory-Driven Interventions

▶ Purposive Sampling

Wouter Vanderplasschen1 and
Jessica De Maeyer2
1
Orthopedagogics, Ghent University, University
College Ghent, Gent, Belgium
2
Ghent University College, Faculty of Education,
Health and Social Work (E-QUAL), Gent,
Belgium

Theoretical Synthesis
▶ Metatheory

Synonyms

Theory of Causal Effects (TCEs)
▶ Causal Inference on Total, Direct, and Indirect
Effects

Knowledge-driven interventions; Quality of
Life (QoL); Randomized controlled trial (RCT);
Theory-driven
evaluation;
Theory-driven
implementation

Definition
Theory-driven interventions can be defined as

Theory of Goal-Striving Stress (TGSS) practices or interventions which are based on an
▶ Expectation-Reality Discrepancy and Quality
of Life Assessments of Chinese Migrants

explicit theoretical model including an articulation of the causal link between an intervention
and its outcomes. A clear description is provided
how and why the intervention leads to specific
outcomes such as improved Quality of Life
(QoL).

Theory of Low Self-Control
Description
▶ Risky Lifestyles and Self-Control

Theory-Driven Evaluation
▶ Theory-Driven Interventions

Theory-Driven Implementation
▶ Theory-Driven Interventions

The Cochrane Database of Systematic Reviews (or
“Cochrane Library”) has been established by the
Cochrane Collaboration as a widely accessible tool
to identify and spread accurate and up-to-date
information about evidence-based interventions in
health care. Similarly, the Campbell Collaboration
aims at preparing, maintaining, and disseminating
systematic reviews of effective practices in the field
of education, crime and justice, and social welfare.
Both influential organizations regard the “randomized controlled trial (RCT)” as the gold standard for
evaluating interventions and determine evidence
based on the number of RCTs that have demonstrated significant outcomes in favor of the

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experimental condition. Although this experimental approach appears highly valuable for evaluating
short-term and clear-cut (medical) interventions,
it has been less successful for evaluating
more comprehensive and long-term (psychosocial)
interventions such as therapeutic communities
or case management (Broekaert, Autrique,
Vanderplasschen, & Colpaert, 2010). Moreover,
published systematic reviews often stick to the
conclusion that “the intervention works (or not),”
but why or how an intervention works remains
unaddressed. Therefore, several authors have
emphasized the importance of a theory-driven
approach to evaluation, where the links between
an intervention and its intended outcomes are set
out a priori and are observed prospectively. By
doing so, more appropriate and for the individual
relevant personal outcome indicators such as QoL
can be selected to judge the effectiveness of an
intervention, instead of using generic and socially
desirable outcome measures (De Maeyer,
Vanderplasschen, & Broekaert, 2009).
Theory-Driven Approach
Irrespective of whether an intervention works or
not according to evidence-based criteria, programs
intended to help or support individuals need to be
legitimized by ethical, legal, practical, methodological, and theoretical principles. However, an
underlying theoretical rationale for providing
a specific intervention does not guarantee per se
the provision of a theory-driven intervention nor
of evidence-based practice. The theory-driven
approach and the evidence-based paradigm
are compatible and complementary, and
a combination of both approaches may be the
best way to address the evaluation of interventions
(Broekaert et al., 2010). Researchers are increasingly encouraged to move beyond the simplistic
outcome-focused approach (determining that it
works by demonstrating the causal connection
between an intervention and the intended
outcomes) in favor of a more informative, phenomenological approach to examine the processes
underlying program effects (Sidani & Sechrest,
1999). These processes explain how the program
exerts its influence on the anticipated effects and
identify what makes a program work. This

Theory-Driven Interventions

emphasis on understanding how an intervention
works and what makes it work, in addition to
simply knowing whether or not it works, has led
to the development of the theory-driven approach
to program implementation and evaluation.
A theory can be defined as a broad attempt to
organize and explain phenomena occurring. It
contains a consistent group of statements that present a systematic view about phenomena, which
identify, define, and describe the phenomena
involved, as well as specify the nature of the
relationships among the phenomena (Sidani &
Sechrest, 1999). Theory does not necessarily
refer to the grand psychological or sociological
theories, though these comprehensive theories
may be helpful in understanding why one outcome
leads to another. Consequently, more specific
“practical” theories are needed for explaining the
behavior of specific groups of individuals, e.g.,
children with autism, or for understanding standardized interventions like cognitive behavioral
therapy (Van Strien, 1984). The most specific
type of theory is the theory of a specific case
(n ¼ 1 theory). The latter type of theory is most
closely related to the concept “theory-driven
interventions” since such an approach allows
a way of understanding interventions and of
predicting their effects (Greenhalgh, 2009).
Program or intervention theories consist of
a set of statements that describe a particular program, explain why, how, and under what conditions the program effects occur, predict the
outcomes of the program, and specify what
needs to be done to bring about the desired
program effects (Sidani & Sechrest, 1999).
A program theory defines the problem for which
a program is set up, specifies the causal processes
through which the program is expected to produce the desired outcomes, predicts the outcomes
expected of the program, and identifies the conditions under which the causal processes arise
(Chen, 1990). It further specifies the nature,
intensity, and duration of the activities that
should be performed in order to achieve the
intended program outcomes, the human and
material resources needed for delivering the program, and the procedures to be followed when
delivering the program.

Theory-Driven Interventions

Quality of Life as Outcome Indicator
One of the core elements of a program theory is
the expected output (Lipsey, 1993). The expected
output represents the effects or outcomes anticipated as a result of the program. A program theory
specifies the nature of the outcomes, the timing at
which the changes are expected to occur, the
expected pattern of change in the outcomes after
implementation of the program, and any interrelationships among the outcomes (Sidani & Sechrest,
1999). Output reflects the expected output and
consists of the ultimate outcomes that are intended
with an intervention. Outcomes constitute the reasons for which the program is set up and are used
as the criteria indicating the effectiveness or successes of the program. Outcome indicators are also
useful for monitoring the implementation of an
intervention and for improving the quality of care
(Van Loon, Claes, Vandevelde, Van Hove, &
Schalock, 2010). By starting from the expected
personal outcomes (QoL), transparency and
clarity are created for the goals that need to be
met, starting from an assessment of individuals’
needs and aspirations (input) and an adequate plan
and strategy to realize these objectives (throughput). This is what Schalock and Bonham (2003)
have called “right to left thinking.”
According to Schalock, Verdugo, and Gomez
(2011), outcomes can be measured from an individual, organizational, and societal perspective.
From an individual perspective, objective and
measureable indicators need to be developed
that can be used to determine whether the practice
in question leads to positive personal outcomes.
Change indicators are preferably targeted to individuals’ behavioral, physical, psychological, or
subjective well-being since this gives a better
indication of individuals’ situations than dichotomous outcome measures such as employment,
abstinence, or cure (De Maeyer et al., 2009).
Also, at organizational level personal outcomes
can be used to measure global benefits to program
recipients, which are the result of program activities, services, and supports. Finally, societal
perspectives determine social policy and its
guiding concepts and principles (e.g., inclusion,
self-determination, empowerment) (Schalock
et al., 2011).

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As many diseases or disorders disturb individuals’ well-being and tend to be of chronic nature,
QoL has become an important outcome indicator,
defined as a subjective sense of well-being and
satisfaction with life (Katschnig, 2006). Moreover, growing dissatisfaction with the medical
treatment model was a driving force behind the
development of a movement for self-advocacy,
participation, and social inclusion, which stresses
the individual needs of persons in their daily lives
(Greenhalgh, 2009). As a consequence, the
importance of client self-management and their
involvement in care is increasingly emphasized
in most Western countries. The use of concepts as
QoL has brought clients’ desired outcomes on the
clinical agenda (Higginson & Carr, 2001). It
alerts professionals to the clients’ concerns
about their QoL, clarifies clients’ priorities for
care, and prompts a discussion between client
and professional about these issues. This is very
important since clients and professionals do not
always agree on which outcomes of care are most
important. Discussion about intended personal
outcomes may lead to greater involvement in
decisions about their care and increase clients’
self-efficacy to manage their own health
(Greenhalgh, 2009). This may in turn affect treatment compliance and satisfaction.
QoL is an overarching concept, which has often
been applied in health care research, particularly
in the fields of disability studies and mental health
care. Nevertheless, there is controversy about the
meaning of this concept, and there is no consensus
about its definition (Carr & Higginson, 2001).
The WHO Quality of Life Group has defined
QoL as “individuals’ perceptions of their position
in life in the context of the culture and value
systems in which they live and in relation to their
goals, expectations, standards and concerns”
(WHOQOL Group, 1998, p. 551). Various professions have created their own interpretations of
QoL, with little resemblance and much fragmentation in-between disciplines. Still, there is
a growing recognition of QoL as an important
indicator for the impact of treatment, the need for
health care, the evaluation of interventions, and
the cost-benefit analyses. In general, QoL is seen
as a subjective and multidimensional phenomenon

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that starts from an individual’s own perspective.
Today, there is an overall consensus that QoL
consists of both objective and subjective components of life, although the subjective component of
QoL tends to prevail (Cummins, 2000). Also, it is
a dynamic construct that changes throughout the
life cycle, influenced by individuals’ expectations.
QoL may vary substantially between individuals
and will be affected by someone’s specific life
situation. Some dimensions in life (e.g., physical
health) will have a universal character, but these
dimensions can vary between individuals and cultures (De Maeyer et al., 2009).
Toward a Theory-Driven Evidence-Based
Client-Centered Practice
Besides scientific evidence and theoretical
modeling, professionals’ experience and input
are a third important component of a sound present-day practice. Practice-driven evaluations are
needed, which involve researchers and providers
who work jointly to gather information about the
effects of an intervention. This is what Veerman
and van Yperen (2007) refer to as “practice-based
evidence”. However, theory, practice, and evidence cannot function without their most crucial
partner: the client. A humanistic, client-centered
approach, which starts from clients’ needs and
assets, should guide treatment and support
(Broekaert et al., 2010). As most disorders are
chronic and cannot be cured, clients’ subjective
well-being should be(come) the most important
outcome indicator. One of the biggest challenges
in measuring QoL is trying to capture the uniqueness of this concept for each individual, which
means that it is not always desirable to start from
an objective standard of QoL. By making explicit
reference to theory, theory-driven interventions
and evaluations contribute to the generalizability
of interventions and its components that
enhance QoL.

Cross-References
▶ Metatheory
▶ Personal Outcomes Scale
▶ Subjective Well-being

Theory-Driven Interventions

References
Broekaert, E., Vanderplasschen, W., Colpaert, K., &
Autrique, M. (2010). The human prerogative:
A critical analysis of evidence-based and other paradigms of care in substance abuse treatment. Psychiatric Quarterly, 81(3), 227–238.
Carr, A. J., & Higginson, I. J. (2001). Measuring quality of
life: Are quality of life measures patient centred?
British Medical Journal, 322, 1357–1360.
Chen, H. T. (1990). Theory-driven evaluations. Newbury
Park, CA: Sage.
Cummins, R. A. (2000). Objective and subjective quality
of life: An interactive model. Social Indicators
Research, 52, 55–72.
De Maeyer, J., Vanderplasschen, W., & Broekaert, E.
(2009). Exploratory study on drug users’ perspectives
on quality of life: More than health-related quality of
life? Social Indicators Research, 90(1), 107–126.
Greenhalgh, J. (2009). The applications of PROs in clinical practice: What are they, do they work, and why?
Quality of Life Research, 18(1), 115–123.
Higginson, I. J., & Carr, A. J. (2001). Measuring quality of
life: Using quality of life measures in the clinical
setting. British Medical Journal, 322(7297),
1297–1300.
Katschnig, H. (2006). How useful is the concept of quality
of life in psychiatry. In H. Katschnig, H. Freeman, &
N. Sartorius (Eds.), Quality of life in mental disorders
(pp. 3–17). Chichester, UK: Wiley.
Lipsey, M. W. (1993). Theory as method: Small theories
of treatments. New Directions for Program Evaluation, 57, 5–38.
Schalock, R., & Bonham, G. S. (2003). Measuring
outcomes and managing for results. Evaluation and
Program Planning, 26, 229–235.
Schalock, R. L., Verdugo, M. A., & Gomez, L. E. (2011).
Evidence-based practices in the field of intellectual
and developmental disabilities: An international
consensus approach. Evaluation and Program
Planning, 34(3), 273–282.
Sidani, S., & Sechrest, L. (1999). Putting program theory
into operation. American Journal of Evaluation, 20(2),
227–238.
van Loon, J., Claes, C., Vandevelde, S., Van Hove, G., &
Schalock, R. L. (2010). Assessing individual support
needs to enhance personal outcomes. Exceptionality,
18(4), 193–202.
Van Strien, P. J. (1984). De verwetenschappelijking van
de praktijk. Tijdschrift voor Orthopedagogiek, 23,
162–180.
Veerman, J. W. & van Yperen, T. A. (2007). Degrees of
freedom and degrees of certainty: a developmental
model for the establishment of evidence-based
youth care. Evaluation and Program Planning, 30(2),
212–221.
WHOQOL Group (1998). Development of the World
Health Organization WHOQOL-BREF quality of life
assessment. Psychological Medicine, 28, 551–558.

Thermometer Scale (Feeling Thermometer)

Therapy
▶ Counseling

Thermometer Scale
▶ Thermometer Scale (Feeling Thermometer)

Thermometer Scale (Feeling
Thermometer)
Diana Zavala-Rojas
Research and Expertise Centre for Survey
Methodology, Department of Political and Social
Sciences, Universitat Pompeu Fabra,
Barcelona, Spain

Synonyms
Rating scale; Thermometer scale

Definition
The feeling thermometer, or thermometer scale,
is a rating procedure to measure respondents’
feelings about an issue using a scale that
corresponds or makes a metaphor to temperatures
in the thermometer.

Description
A feeling thermometer, or a thermometer scale, is
a procedure used in survey research to measure
feeling. Respondents are given instructions to
express their feelings in numbers using the
thermometer for temperatures as a reference or
an analogy. Positive feelings are labelled as warm
feelings and negative feelings are equivalent to
cold feelings. It aims to measure the direction of
the attitude and also to assess the degree or intensity of the feeling (Alwin, 2007, p. 188).

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The underlying assumption of thermometer
scales is based in information theory: more precise information can be obtained if respondents
can give their answer in a continuum or in a large
number of categories (Alwin, 1992, 1997, 2007;
Saris, 1988, 1998; Saris, Bruinsma, Schoots, &
Vermeulen, 1977; Saris & Gallhofer, 2007).
The first survey to introduce this scale was the
▶ American National Election Studies survey
(ANES) in 1964. Since its formulation in the
ANES, feeling thermometer scales are quite
popular to measure attitudes towards politicians,
groups, and public figures. In the ANES, a large
set of items asks about feelings towards political
leaders and groups using a 0–100 scale
making a visual and an oral reference and
metaphor to a temperature thermometer.
Alwin (2007) reported the reliability of the
ANES feeling thermometer used in 1970. It
spans in a quite large range. The “respondent’s
feeling thermometer rating of people on welfare”
had the minimum reliability of 0.425 (N ¼ 504)
and the “respondent’s feeling thermometer rating
of Christian fundamentalists” got the highest
reliability of 0.856 (N ¼ 1,082). The mean
reliability of the items was 0.6385 and the
standard deviation was 0.11252.
Alwin (1997) analyzed a multi-trait
multi-method experiment (MTMM) conducted
in the ▶ Quality of Life Survey in 1978. The
experiment compared the quality of two forms
of a “7-point scale” and a “feeling thermometer”
of 17 domains of life satisfaction measured in the
survey. For all the indicators included in the
experiment, that thermometer scales reported
larger ▶ reliability, and they also provided more
validity. However, Alwin (1992, 1997) found that
only 3–5 % of respondents used other numbers of
the scale than the ones presented in the labels;
then he concludes that the scale is indeed reduced
to a 9-point scale instead of a 100-point scale as
the real temperature thermometer.
Wilcox, Sigelman, and Cook (1989) studied
the propensity of thermometer scales in producing a tendency for people to answer consistently in a positive or negative way about political
issues. For their study, they used the data
collected in the ANES in 1979. They showed

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Third World

that “some respondents are simply ‘warmer’ than
others to the broad range of groups they rate with
feeling thermometers” (p. 251). They also found
that some respondents use only a narrow range of
the thermometer while others use the whole scale.
The best predictors for the use of the scale were
“measures of attachment to and involvement in
political groups” (p. 251). This poses a problem
because part of the variance in the scale is not
explained by differences in attitudes to groups,
but by systematic behavior of respondents.
Moderately liberal respondents seemed to have
“positivity biases” (p. 256).
The item in the ANES questionnaire is: “Please
look at page 3 of the booklet. I would like to get
your feelings toward some of our political leaders
and other people who are in the news these days.
I will read the name of a person and I would like
you to rate that person using something we call the
feeling thermometer. Ratings between 50 and
100 mean that you feel favorable and warm
toward the person. Ratings between 0 and 50
mean that you do not feel favorable toward the
person and that you do not care too much for that
person. You would rate the person at the 50 mark
if you do not feel particularly warm or cold toward
the person. If we come to a person whose name
you do not recognize, you do not need to rate that
person. Just tell me and we will move on to the
next one” (ANES Datacenter webpage 2012).

Alwin, D. F. (1997). Feeling thermometers versus 7-point
scales: Which are better? Sociological Methods &
Research February, 25, 318–340.
Alwin, D. F. (2007). Margins of error: A study of
reliability in survey measurement. Hoboken, NJ:
John Wiley & Sons.
ANES Datacenter webpage 2012. Accessed February 13,
2012, from http://electionstudies.org/studypages/
download/datacenter_all.htm
Saris, W. E. (1988). A measurement model for psychophysical scaling. Quality and Quantity, 22, 417–483.
Saris, W. E. (1998). Words are sometimes not enough to
express the existing information. In M. Fenema, C. van
der Eyck, & H. Schijf (Eds.), In search of structure:
Essays in social science and methodology
(pp. 98–115). Amsterdam: Het Spinhuis.
Saris, W. E., Bruinsma, C., Schoots, W., & Vermeulen, C.
(1977). The use of magnitude estimation in large
scale survey research. Mens en Maatschappij, 52,
369–359.
Saris, W. E., & Gallhofer, I. N. (2007). Design, evaluation
and analysis of questionnaires for survey research.
Hoboken: Wiley.
Wilcox, C., Sigelman, L., & Cook, E. (1989). Some like
it hot: Individual differences in responses to group
feeling thermometers. The Public Opinion Quarterly,
53(2), 246–257.

Cross-References

Thought

▶ American National Election Studies
▶ Measurement Methods
▶ Multi-indicator Measures
▶ Quality of Life
▶ Reliability
▶ Response Bias(es)

▶ Cognitive Function

References
Alwin, D. F. (1992). Information transmission in the
survey interview: Number of response categories and
the reliability of attitude measurement. In P. V.
Marsden (Ed.), Sociological methodology 1992
(Vol. 22, pp. 83–118). Washington, DC: American
Sociological Association.

Third World
▶ Developing Countries

Three Italies
▶ Italy, Quality of Life

Thresholds
▶ Tipping Points

Thurstone Rescaling

Thurstone Rescaling
Wim Kalmijn
Erasmus Happiness Research Organization
EHERO, Erasmus University Rotterdam,
Rotterdam, The Netherlands

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e.g., “very happy” ! “code 4,” “pretty happy” !
“code 3,” “not too happy” ! “code 2,” and
“unhappy” ! “code 1.” Moreover, a confusion of
codes with cardinal numbers unintentionally introduces unjustified equidistance between successive
ratings. A final problem is demonstrated by the
above examples, where “very happy” is replaced
with “4” when first in the row but with “3” when
second, even if both scales are four-step scales.

Definition
Thurstone rescaling is a method of rescaling verbal (textual) primary ratings to a corresponding
numerical secondary rating on a predefined common continuum. These secondary Thurstone ratings are based on the opinions of a number of
individuals about the meaning of this label,
expressed as its average appropriate position
within this continuum.

Description
Problems in Measuring Quality of Life
Quality of life is commonly measured using survey
questions such as: Taking all things together, how
would you say things are these days – would you
say you are . . . ? “very happy,” “pretty happy,”
“not too happy,” or “unhappy”? See ▶ Rescaling.
Questions with respect to happiness differ in
“wording,” i.e., the text of the response options.
Another set of labels to be used with the same
question could have been “fully happy,” “very
happy,” “happy,” “unhappy.” Moreover, the
numbers of response options used are different;
some researchers present 3 options and others 7.
Next to questions using verbal response options,
survey researchers increasingly use numerical
response scales, such as a rating on a range
0 (most unhappy) to 10 (most happy). All this
variety in response options greatly reduces the
comparability of the available survey data.
One more problem particular to questions using
verbal or pictorial response scales is that computation of average values and standard deviations
requires that options are represented with numbers.
Commonly, see ▶ Linear Scale Transformation,
this is done using rank numbers as codes,

Rescaling as a Solution
Most of these problems can be addressed
using “rescaling procedures.” Rescaling of the
original verbal response options involves a
transformation of each response option on the
primary scale into a corresponding number on
a secondary scale in such a way that all secondary
scales cover a common interval, for which [0, 10]
is the usual standard.
The traditional rescaling method is the linear
scale transformation, e.g., stretching a 1–4 scale
to 0–10. See ▶ Linear Scale Transformation. This
method has serious methodological shortcomings. One is that difference in meaning of labels
is ignored, e.g., if in two different four-step questions “fully happy” and “very happy” are the first
options on the list of its question, their meaning is
defined to be identical for the researcher, but
presumably not in the eye of the respondent.
Another shortcoming is the assumed equidistance
of successive ratings, e.g., that the difference
between “very happy” and “fairly happy” is
equally large as the one between “not too
happy” and “unhappy.” The Thurstone transformation is an alternative rescaling method, which
is focused on the labels of the response options.

T
Background of the Thurstone Method
Jones and Thurstone (1955) presented 51
“phrases,” i.e., qualifications, used to judge consumer products to 905 US respondents together
with a nine-interval questionnaire. These intervals were presented as a row of nine contiguous
boxes. The left hand box was anchored as
“greatest dislike,” the right-hand one as “greatest
like”; the neutral middle box was marked as
“neither like nor dislike.” The respondents had
to tick one of the nine boxes when presented with

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each of the 51 qualifications, e.g., “poor” or “like
a bit.” Later, integer numbers were assigned to
the middle of each box, from 4 to +4; these
numbers were kept hidden from the respondents.
The judgments of the “accepted” respondents
on the appropriate position of, e.g., the qualification
“poor” appeared to be scattered around a central
value 1.55 with a standard deviation 0.87. These
statistics for the qualification “like a bit” were
+2.32 and 0.52, respectively. In this way all
51 qualifications were positioned on the “meaning
continuum,” which were applied as their scale
values. Respondents were ignored if they did not
understand the task, ignored too many phrases or
produced clearly inconsistent combinations.
Incidentally, a phrase would be disqualified, if the
distribution of its individual responses was bimodal
or if a large value of the standard deviation revealed
poor consensus among respondents with respect to
the meaning of this particular phrase.
Application in the World Database of
Happiness
The rescaling of the original response options
implies a transformation of each verbal response
option on the primary scale into a corresponding
number on a secondary scale in such a way that
all secondary scales cover a common interval, for
which [0, 10] is the usual standard.
Veenhoven and his team selected a number of
verbal response options to questions about happiness and rated the value of each with a number
between 0 and 10 (Veenhoven, 1993). They used
common survey questions in English language.
The average ratings connected to these labels are
presented in the list below.
Thurstone ratings for 14 frequently used happiness response options in surveys have been
collected in Table 1 (Veenhoven, 2013).
These ratings are referred to in the World Database of Happiness (WDH) as “Thurstone values.”
They are used to compute “transformed” means
and standard deviations, which are presented in the
collection of distributional findings on “Happiness
in Nations.” When comparing these transformed
statistics across time and nations, Veenhoven
got some odd results, which brought several
weaknesses of this rescaling method to the light.

Thurstone Rescaling
Thurstone Rescaling, Table 1 Thurstone Ratings for
14 frequently used labels in verbal happiness rating scales
Label
Very happy
Quite happy
Happy
Pretty happy
Fairly happy
Rather happy
Neither happy nor unhappy
Not too happy
Rather unhappy
Not very unhappy
Fairly unhappy
Not happy
Not at all happy
Very unhappy

Rating
9.3
7.2
7.0
6.7
6.5
6.0
5.1
4.1
4.0
3.7
3.4
2.7
1.0
0.6

Weak Points of the Thurstone Rescaling
Method
• The method ignores both the number of alternative categories on the same scale and their
labels.
• It also ignores the scale position as compared
to those of the alternatives.
• Although the judges in the Erasmus University
Rotterdam Happiness Research group were
a relatively homogeneous group in this respect,
the standard deviation of Thurstone rating estimates within this group, reflecting the (lack of)
consensus about the position of the same rating
on the same [0, 10] scale, was substantial: it
varied between 0.3 and 1.5. Among a more
heterogeneous group of respondents, a larger
▶ dispersion is to be expected.
• The number of judges is not taken into
account. In practice, Thurstone ratings are
treated incorrectly as if they were error-free,
as is also the case with the secondary ratings
after linear scale transformation, giving rise to
a flattered precision of the estimated mean
value in the case of both rescaling methods.
• If Thurstone ratings are based on expert judgments, these do not necessarily reflect the
views of typical respondents in a survey.
• These judgments may be time dependent,
which effect has not yet been investigated.

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)

Therefore, scientists working in this area have
been looking for an alternative. Most of the
above problems vanish when happiness in the
population is considered to be a continuous
▶ latent happiness variable, and this view is
used as the basis for the happiness population
estimation parameters procedure.
This may make the Thurstone rescaling
method obsolete for future application.

Cross-References
▶ Happiness Population Distribution Parameter
Estimates
▶ Latent Happiness Variable
▶ Linear Scale Transformation
▶ Rescaling

References
Jones, L. V., & Thurstone, L. L. (1955). The psychophysics of semantics: An experimental investigation.
Journal of Applied Psychology, 39(1), 31–36.
Veenhoven, R. (1993). Happiness in nations (p. 110).
Rotterdam: RISBO, Erasmus University.
Veenhoven, R. (2013). Happiness in nations. World Database of Happiness, Erasmus University Rotterdam.
Available at http://www.worlddatabaseofhappiness.
eur.nl/hap_nat/introtexts/intronat7.pdf

Thyroid-Specific Patient-Reported
Outcome Measure (ThyPRO)
Torquil Watt
Department of Medical Endocrinology,
Copenhagen University Hospital Rigshospitalet,
Copenhagen, Denmark

Description
Introduction
Located in the junction between the head and the
body, the thyroid gland may be envisioned as
a meeting point between psyche and soma.
Somatic diseases within the thyroid have major

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impact on the psyche of the patient and vice
versa. Previously, a blunted response by
thyroid-stimulating hormone (TSH) to externally
administered TSH-releasing hormone was used
in the diagnosis at that time termed “endogenous
depression” – the somatic function of the thyroid
is affected in the depressed patient (Hein & Jackson, 1990; Kirkegaard & Faber, 1981;
Kirkegaard, Korner, & Faber, 1990). In the recent
quest within psychiatry for the biological correlates of psychiatric diseases, the thyroid axis has
gained renewed focus (Rush et al., 1997).
Another line of research has focused on the
consequences for the thyroid of psychological
stress. The results from this methodologically
challenging research indicate a possible relationship between psychological stress and
subsequent onset of autoimmune thyroid disease
(Harris, Creed, & Brugha, 1992; Lee et al., 2003;
Matos-Santos et al., 2001; Sonino et al., 1993).
Evidence regarding the opposite etiological
pathway, leading from thyroid disease to
psychological distress and psychiatric disease
and ultimately reduced ▶ quality of life, is more
readily obtained and more clinically relevant, and
is indeed the focus for this entry. A large amount
of studies have found thyroid diseases to be
a major risk factor for such impairments
(summarized in Watt et al. (2006)). Based on
the well-documented high impact of psychological distress on quality of life one might expect,
that thyroid diseases pose substantial impact on
quality of life.
Diseases related to the thyroid gland are very
common, affecting individuals of all ages, mainly
women. Thyroid hormones target all cells/organs
in the body, mainly as a promoter of metabolism,
and under- or overproduction of hormones
therefore affects a broad range of human functions. Two major disease mechanisms are
involved in thyroid diseases, leading to a wide
spectrum of clinical manifestations: enlargement
of the gland, termed goiter, and autoimmunity,
where the immune system falsely targets thyroid
structures. Goiter without accompanying
dysfunction (termed nontoxic goiter) may cause
neck discomfort and/or cosmetic concerns, but
goiter may also be associated with autonomous

T

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Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)

function, resulting in overproduction of
hormones (hyperthyroidism, in this case termed
toxic nodular goiter). Autoimmunity can be
associated with enlargement of the gland
(diffuse goiter), but most often leads to disturbed
function, with either decreased secretion of thyroid hormones (autoimmune hypothyroidism) or
increased secretion (hyperthyroidism, termed
Graves’ disease). A subgroup of patients with
Graves’ disease has affection of the eyes,
yielding a characteristic protrusion and irritation
of the eyes (termed thyroid-associated
ophthalmopathy (TAO) or Graves’ orbitopathy
(GO)). The classical symptoms of hypothyroidism are unspecific, but well described, with tiredness, slow cerebration, constipation, weight gain,
and depression as core elements. The typical
symptoms of hyperthyroidism are rapid heartbeats, tremor, weight loss, ▶ anxiety, and
increased sweating.
The importance of involving quality of life
aspects in the evaluation of thyroid patients is
increasingly recognized (Abraham, Avenell,
Watson, Park, & Bevan, 2004; Ladenson, 2002;
Romijn, Smit, & Lamberts, 2003). This is well
motivated, since benign thyroid disorders are
common and rarely life-threatening. Thus, their
treatment mainly deals with optimizing the
quality of life of the patients who can be treated
by, e.g., thyroid hormone supplementation, antithyroid drugs, radioiodine, or surgery. The scientific documentation about how these common,
well-known diseases affect people’s lives is
very limited, as is the knowledge about how
various treatments moderate these effects. Some
questionnaires have been developed for and have
been used in specific thyroid subpopulations
(Fahrenfort, Wilterdink, & van der Veen, 2000;
Jaeschke et al., 1996; Jaeschke, Guyatt, Cook,
Harper, & Gerstein, 1994; McMillan, Bradley,
Woodcock, Razvi, & Weaver, 2004; Saravanan
et al., 2002; Tehrani et al., 2004; Terwee et al.,
1999, 2001; Terwee, Gerding, Dekker, Prummel,
& Wiersinga, 1998),but prior to the development
of the ThyPRO, no validated, thyroid-specific
patient-reported outcome instrument was available for use across different thyroid diseases
(Watt et al., 2006). The nature of thyroid diseases

necessitates such an approach to HRQLmeasurement in these patients: These diseases
are characterized by a substantial overlap
between various disease entities (e.g., coexistence of goiter and hyperthyroidism) and a shift
between diseases (e.g., hyperthyroid patients
becoming hypothyroid through ablative therapy).
If a quality of life questionnaire was confined to
cover only one of these entities, the results of
longitudinal studies may be misleading, because
important quality of life aspects were not
measured.
The purpose of ThyQoL project was therefore
to develop a questionnaire for measurement of
quality of life in patients with benign thyroid
diseases – the ThyPRO.
Development of the ThyPRO
As outlined in Fig. 1, the development process
was rather complex, in order not only to ensure
appropriate measurement properties, including
▶ content validity, but also to coordinate the
development of two parallel versions in Danish
and English.
Issue Generation

Content validity was ensured by tapping three
sources: a literature review (Watt et al., 2006),
interviews with experienced clinicians and with
thyroid patients (Watt et al., 2007). As shown in
Table 1, patients and clinicians offered
complementary perspectives on what was
relevant, where patients focused more on psychological aspects of their diseases and clinicians
focused more on what was specific for thyroid
diseases.
Based on these analyses, a theoretical model
of quality of life impairment within thyroid
diseases was constructed, which is shown
in Fig. 2.
Pilot Testing

Comprehensibility, applicability, and acceptability of the questionnaire were tested using iterative
rounds of cognitive interviewing. We adopted
a probing technique which in our opinion was
better suited for self-completed questionnaire,
i.e., “immediate retrospective probing.” This

Currently ongoing:
Longitudinal validation
Abbreviated version,
cross-culturally equilibrated

Swedish version

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO), Fig. 1 Development process, including translation

Third Danish version:
the Danish ThyPRO

Item reduction
reflected in
English version
Third English version:
the English ThyPRO

‘Second’ reconciled English
version of the questionnaire

‘Second’ reconciled Danish
version of the questionnaire

Scale validation
Clinical validation
Reliability testing
(i.e. internal consistency
and test-retest)
Resulting item reduction

Iterative rounds of
cognitive interviews

Iterative rounds of
cognitive interviews

Harmonization

First English version
of the quesionnaire

Standard (forward-backward)
translation procedure

Interviews
with 80 patients

First Danish version
of the quesionnaire

List of relevant
issues

Interviews with
15 expert clinicians

Standard (forward-backward)
translation procedure,
including cognitive interviews

Literature
review

Versions in:
French
Dutch
Italian
Portoguese
German
Hebrew
Serbian
Hindi

Standard (forward-backward)
translation procedure,
including cognitive interviews

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)
6639

T

T

1
3
5
7
9
12

4
5
8
1
12
13

23
18
25
24
26

6
8
10
11
13

Dry grittiness in eyes
Swollen eyelids
Blurred vision
Pressure in the eyes

Feeling of unrest
Dyspnea
Palpitations
General fatigue
Getting upset*
Easily getting stressed*
Swollen face
Emotional lability
Restlessness

Watery eyes*
Bags under the eyes*

TAO

4
9
11
12

3
5
6
7
8
10
13
14
15

1
2

P

Toxic nodular goiter
P
E
Most relevant to patients only
Dyspnea
1
21
Bothered by patient
2
*
role*
Cancrophobia
6
61
Globulus sensation
8
22
Physical fatigue
9
30
Weight dissatisfaction 10 45
Swollen hands or feet 11 84
Sadness
13 66
General fatigue
Clearing throat often*

Nontoxic goiter

44
Sleeplessness
84
Hypersomnia
87
Feeling like suffocating*
30
Weight dissatisfaction
*
Weight increase
*
Physical fatigue
61
Feeling of unrest
31
Pruritus
62
Most relevant to both patients and experts
1 Palpitations
3
4 Neck swelling
2 Neck swelling
4
5 Globulus sensation
8 Feeling of unrest
5
6 Anxiety
3 Emotional lability
7
8 Cancrophobia
General fatigue
12 9 Hoarseness
Increased sweating
14 2

*
*

E

1
3
9
14
15

5
6
7
8
10
11
12
13

2
4

P

1
2
14
5
9

25
36
*
32
37
38
39
105

23
-

E

P

General fatigue
Gold intolerance
Physical fatigue
Hypersomnia
Weight increase
Weight
dissatisfaction

Getting upset*
Palpitations
Globulus sensation
Dyspnea
Clearing throat often*

3
3
5
6
7
8

9
10
11
13
14

Being slow*
1
Bags under the eyes* 4

Hypothyroidism

1
11
6
4
9
13

*
91
46
63
*

*
*

E

6640

Palpitations
Emotional lability
Feeling of unrest
Hand tremor
Restlessness
Easily irritated or
angry

*
*

2
4

Getting upset*
Easily getting
stressed*
Dyspnea
Physical fatigue
Tension
Nervousness
Attention problems

E

P

Graves’ disease

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO), Table 1 Patient clinician agreement about which issues are relevant (Adapted from Watt et al. (2007))

T
Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)

16 14 Photophobia
34 15 Red eyelids
Limit daily activities
Impaired general health
Social problems
Anxiety

Mental fatigue
Diarrhea

15

13

Increased appetite

Heat intolerance

11 Pain in the throat

Unsatisfied with
appearance
10 Mask visible aspects

7

Difficulty breathing
Discomfort swallowing
6

3
4

19
130
131
132
16

10
11
12
13
15

129 8

112 7

39

83
22

Dry skin
Attention problems

Difficulty
concentrating
Depression

Hoarseness

46 14
31 15

33 12

24 10

76 8

16 2
53 7

15 3

Constipation
Impaired memory
Limit daily activities

12 5

Mental fatigue

Issues among the 15 most relevant according to both patients and experts are listed in the middle part of the table. Issues in the upper part of the table were among the 15 most
relevant according to patients but not to experts; issues in the lower part of the table were among the 15 most relevant according to experts but not to patient. Issues marked with
asterisks (*) were added to the list of issues by the patients after the expert interviews had been conducted. TAO thyroid-associated ophthalmopathy, P relevance rank according
to patients (the most relevant ranked as #1), E relevance rank according to experts

42 12 Worry
100 14 Pain when moving head
28 15 Weaker voice
Neck stiffness
Dyspnea

18

39

42

Most relevant to experts only
Hand tremor
75 1
Weight loss
65 3

Impaired memory

Difficulty
concentrating
38 10 Nervousness
116 11 Diarrhea
17 12 Sleeplessness
38 13
58 14
50 15

9

45

24 11 Red eyes

Sleeplessness

7

75

Double vision

19 9

Increased appetite

6

24

26 7

Heat intolerance

4
5

30
22

37 2
18 3

Increased sweating
Weight loss

Pain in the eyes
Unsatisfied with
appearance
Reduced vision

15 6

14 10

Difficulty
concentrating
General fatigue

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)
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Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)

ThyQoL model of thyroid
pathophysiological variables and
affected dimensions of quality of life
Thyroid
pathophysiology
Goitre
– thyroid volume
Hyperthyroidism
– low TSH, high
fT4 and fT3

Physical
symptoms:
Goitre
Hyperthyroid
Hypothyroid
Eye

Hypothyroidism
– high TSH, low
fT4 or low fT3
Autoimmunity
– TPO-Ab and
TSHR-Ab
Orbithopathy
– CAS and
NOSPECS

Function and
well-being:
Tiredness
Cognition
Emotional
susceptibility

Psychological
symptoms:

Participation
Social life
Daily life
Sex life
Cosmetic
complaints

Depression
Anxiety

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO), Fig. 2 Theoretical model. Each dimension is
measured by a separate multi-item scale

technique proved very effective in reducing the
number of errors occurring during each completion of the questionnaire (Watt et al., 2008), as
shown in Table 2.
Quantitative, Psychometric, and Clinical
Validation

Based on multitrait scaling and internal
consistency analyses, a final, comprehensive
questionnaire possessing appropriate measurement properties was developed, which was
designated the thyroid-specific patient-reported
outcome, ThyPRO (Watt et al., 2009).
Analyses of ▶ known-groups validity, where
expected high-score and low-score groups were
defined for each of the 13 scales (cf. Fig. 2), showed
excellent discriminative power of this new instrument (Fig. 3). The same study showed excellent
▶ test-retest reliability in a clinical sample of
patients with thyroid diseases (Watt et al., 2010).

Internationalization

Partly parallel to the development described
above, versions in 10 other languages have been
developed (cf. Fig. 1 and Table 3). The instrument is already in use in several clinical studies
worldwide, and data from these will be used to
develop a cross-culturally equilibrated abbreviated version, based on selection of items with best
measurement properties in terms of fit to
a structural equation model and of best clinical
properties (i.e., discriminative power and responsiveness) as well as lack of ▶ differential item
functioning according to language.
Current and Future Projects

Currently, the ThyPRO is in use in several
studies. Some of those are further methodological studies evaluating further the longitudinal
measurement properties of the instrument, but
also clinical studies exploring impact of thyroid

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)

6643

T

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO), Table 2 Number of problems identified within
each of six rounds of cognitive interviews (Adapted from Watt et al. (2008))
Questionnaire version:
Number of interviews:
Number of identified problems
(average per interview)
Separately for each component
Comprehension
Retrieval
Judgment
Responding
Logical
Acceptability
Coverage

1
n¼5
30 (6.00)

2
n¼4
21 (5.25)

3
n¼4
27 (6.75)

4
n¼4
13 (3.25)

5
n¼5
16 (3.20)

6
n¼9
19 (2.11)

All
versions
n ¼ 31
126 (4.06)

17
1
2
4
5
1
0

10
0
6
4
1
0
0

7
0
7
8
1
2
2

5
0
2
2
1
1
2

5
0
4
4
2
0
1

10
0
2
6
1
0
0

54
1
23
28
11
4
5

The number of problems identified within the cognitive interviews are presented separately for each cognitive
component involved in the problem and separately for each interview round, ultimately resulting in a revised version

Thyroid-Specific PatientReported Outcome
Measure (ThyPRO),
Fig. 3 Mean scale scores
for the expected high-score
groups versus the low-score
groups for the 13 ThyPRO
scales. Vertical lines
indicate 95 % confidence
intervals of the means

diseases on quality of life in greater detail, as
well as evaluating various treatment modalities
including randomized clinical trials. Among
these is a study recently published in European
Thyroid Research (Watt et al., 2012) which indicates, that pathophysiological mechanisms not
previously considered of importance to the clinical state and quality of life of the patients may

T
indeed play a role for the well-being of these
patient: When evaluating quality of life of
patients with autoimmune hypothyroidism,
using this comprehensive instrument and analyzing data within the theoretical model
presented in Fig. 2, autoimmunity, as measured
by thyroid peroxidase antibodies, appeared to
have greater influence on quality of life than

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Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO)

Thyroid-Specific Patient-Reported Outcome Measure (ThyPRO), Table 3 Languages in which linguistically
validated versions of the ThyPRO are available
Danish
English
Portuguese
German
Italian
French
Dutch
Serbian
Hindi

Spørgeskema om livskvalitet ved sygdomme i skjoldbruskkirtlen
Quality of Life Questionnaire for Patients with Thyroid Disease
Questionário da Qualidade de Vida para Pacientes com Doença da Tiroide
Lebensqualit€at Fragebogen f€
ur Patienten mit Schilddr€
usenerkrankungen
Questionario sulla qualità della vita per pazienti con malattia della tiroide
Questionnaire qualité de vie pour patients avec maladie thyroı̈dienne
Vragenlijst kwaliteit van leven voor patiënten met een schildklieraandoening
Upitnik o kvalitetu života pacijenata sa bolešću štitaste žlezde

Swedish
Hebrew

Frågeformul€ar om livskvalitet vid sköldkörtelsjukdomar

levels of thyroid hormones did. This is indeed an
exploratory finding, which needs confirmation in
longitudinal studies.

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Bevan, J. S. (2004). Antithyroid drug regimen for
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(2000). Long-term residual complaints and psychosocial sequelae after remission of hyperthyroidism.
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Nogueira, P. J., Macedo, A., Galvao-Teles, A.,
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McMillan, C. V., Bradley, C., Woodcock, A., Razvi, S., &
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response,
thyrotropin-releasing

Time Budget(s)
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Saravanan, P., Chau, W. F., Roberts, N., Vedhara, K.,
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Dick, H. B., & Kahaly, G. J. (2004). Disease-specific
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M. N., Baldeschi, L., Kalmann, R., et al. (2001). Interpretation and validity of changes in scores on the
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Bonnema, S. J., Heged€
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Watt, T., Groenvold, M., Rasmussen, A. K., Bonnema,
S. J., Heged€us, L., Bjorner, J. B., et al. (2006). Quality
of life in patients with benign thyroid disorders. A
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Watt, T., Heged€
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Bonnema, S. J., Bjorner, J. B., et al. (2007). Which
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Watt, S. H., Bonnema, S. J., et al. (2008). Improving
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Tibet
▶ Ethnic Tibetans: Application of the Personal
Well-being Index (PWI)

Time Budget(s)
Seoyong Kim
Department of Public Administration, Ajou
University, Suwon, South Korea

Synonyms
Time use(s)

Definition
Time budgets in a strong sense refer to activityspecific aggregated time used over the entire day
like a money budget (Harms & Gershuny, 2009).

Description
The time budgets are patterns of time use to
which people have usually accustomed every
day. Time budget studies have been empirically

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conducted by social scientists since 1959, when
an international group of social scientists in
UNESCO formed the study of time budgets.
Time use research has developed with respect to
methodological as well as to substantive issues.
Meanwhile, there are a number of comprehensive
studies about the concern and the international
development of time use research: Kramer (2005)
has recently provided an historic overview,
Harms and Gershuny (2009) focus on time budgets and time use issues, Gershuny (2001) covers
time use methods, and Harvey (1999, 2004), Harvey, Szalai, Elliott, Stone, and Clark (1984),
Andorka (1987), or the volume on “Time Use—
Research, Data and Policy” (Merz & Ehling,
1999) give a general and recent overview about
the field (recited from Merz, 2009).
The patterns of time use and allocation are key
elements in influencing one’s ▶ quality of life
(QOL). The researches about time use have shifted
their focus from just pattern of time use or determinant of it (Andorka, 1987; Clark, Harvey, &
Shaw, 1990; Shaw, 1986) to the outcome of it.
The latter mainly concerned with the work performance in organization or QOL in personal life
(Cho et al., 2009; Galay, 2007; Jia & Lubetkin,
2009; Labianca, Moon, and Watt, 2005).
After analyzing the patterns of time use and
▶ happiness in Bhutan, Galay (2007) reported
that respondents who had longer work hours or
very short work hours express lower happiness
than those who worked an appropriate amount of
time. He also confirmed that the nonwork activities,
such as sociocultural activities and sports and leisure, have a positive impact on the level of happiness. Also, in the simple descriptive statistics,
▶ community participation and religious activities
reveal the positive impact on the happiness.
The time use pattern is a critical factor for
patients to influence the QOL. By analyzing
time use and life satisfaction, Cho et al. (2009)
compare the quality of life of the poor farming
households with the nonpoor one. They found
that nonpoor farming household members spent
more time in social participation and voluntary
activities, while the poor ones spent more time in
social gathering and leisure. However, the impact
of such difference on subjective well-being is

Time Budget(s)

mixed: A general life satisfaction levels between
the poor and the nonpoor shows no significant
difference for individual life, but the second
reveals a higher satisfaction with family life.
Also, based on data from 375 women with
rheumatoid arthritis (RA), Jia and Lubetkin
(2009) tested hypothesis that time use imbalances
would be associated with psychological distress.
They found that spending 2 hours per day in
obligatory activities was not significantly related
with poor psychological status, but spending no
time in committed and discretionary activities
was related with lower life satisfaction and higher
depressive symptoms.
Moreover, the European Quality of Life Survey of 2003 reported a strong correlation between
time use and ▶ subjective well-being: People
who had long work hours generally had low subjective well-being (Böhnke, 2005).
In measuring the time budget, the respondents in sample are usually asked to record the
durations and moments of specific events within
given period of time. Most of time studies used
the diary method. For example, in adopted diary
method in the 12-nation time budget survey of
1965–1966, Szalai (1972) collected the data
about the times of beginning and finishing the
daily activities from midnight to midnight in
two ways: (1) by diaries written by the respondents or (2) by interviews with the sampled
persons. There are variants in methods of
collecting data about time budget according to
covered period and targeted information. The
quality of time information decreases when the
scope of covered time expands: For example,
yearly based time data appeared less exact than
daily based ones, even if the former could collect more information about activities than the
latter did.

References
Andorka, R. (1987). Time budgets and their uses. Annual
Review of Sociology, 13, 149–164.
Böhnke, P. (2005). First European quality-of-life survey:
Life satisfaction, happiness and sense of belonging.
Luxembourg, UK: Office for Official Publications of
the European Communities.

Time Needed to Travel to Work
Cho, H. K., Lee, K. Y., Lee, Y. S., Kim, O. S., Lee, S. M.,
Hong, D. S., et al. (2009). Time use and quality-of-life
of the Korean rural poor. Social Indicators Research,
93, 223–227.
Clark, S. M., Harvey, A. S., & Shaw, S. M. (1990). Time
use and leisure: Subjective and objective aspects.
Social Indicators Research, 23, 337–352.
Galay, K. (2007). Patterns of time use and happiness in
Bhutan: Is there a relationship between the two? V.R.F.
Series, 432. Institute of Development Economies, Japan
External Trade Organization. http://www.ide.go.jp/
English/Publish/Download/Vrf/pdf/432.pdf.
Gershuny, J. (2001). Time use research methods.
In P. Baltes & N. Smelser (Eds.), International encyclopedia of the social & behavioral sciences. Amsterdam: Elsevier Science Limited.
Harms, T., & Gershuny, J. (2009). Time Budgets and
Time Use, German Council for Social and Economic
Data (Rat f€ur Sozial- und WirtschaftsDaten) Working
Paper No. 65, Berlin. http://www.ratswd.de/download/
RatSWD_WP_2009/RatSWD_WP_65.pdf.
Harvey, A. S. (1999). Time use research: The roots to
the future. In J. Merz & M. Ehling (Eds.), Time
use—research, data and policy (pp. 123–150).
Baden-Baden, Germany: FFB-Schriftenreihe Band
10, Nomos Verlagsgesellschaft.
Harvey, A. (2004). Welcome address of the IATUR president: eIJTUR and time-use: Past, present and future.
International Journal of Time Use Research, 1-1,
I–IV. eIJTUR.org.
Harvey, A. S., Szalai, A., Elliott, D. H., Stone, P. J., &
Clark, S. (1984). Time budget research: An ISSC
workbook in comparative analysis. New York:
Campus.
Jia, H., & Lubetkin, E. I. (2009). Time trends and
seasonal patterns of health-related quality-of-life
among U.S. adults. Public Health Reports, 124(5),
692–701.
Kramer, C. (2005). Zeit f€
ur Mobilit€
at—R€
aumliche
Disparit€
aten der individuellen Zeitverwendung f€
ur
Mobilit€
at in Deutschland, Reihe Erdkundliches
Wissen, Band 138. Stuttgart, Germany: Franz Steiner
Verlag.
Labianca, G., Moon, H., & Watt, I. (2005). When is an
hour not 60 minutes? Deadlines, temporal schemata,
and individual and task group performance. The Academy of Management Journal, 48(4), 677–694.
Merz, J. (2009). Time use and time budgets: Improvements, future challenges and recommendations. IZA
Discussion Paper No. 4358. http://mpra.ub.unimuenchen.de/16304/
Merz, J., & Ehling, M. (1999). Time use—research, data
and policy. Baden-Baden, Germany: FFBSchriftenreihe Band 10, Nomos Verlagsanstalt.
Shaw, S. M. (1986). Leisure, recreation on free time?
Measuring time usage. Journal of Leisure Research,
13, 177–189.
Szalai, A. (Ed.). (1972). The use of time. The Hague, The
Netherlands: Mouton.

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Time Budgeting
▶ Time Trade-Off

Time Competition
▶ Time Pressure

Time Distance
▶ Inter-temporal Aspect of Well-Being

Time Distance to Death
▶ Objective and Subjective Nearness to Death

Time Needed to Travel to Work
Margo Hilbrecht
Faculty of Applied Health Sciences, University
of Waterloo, Waterloo, ON, Canada

Synonyms
Commute time

Definition
Time needed to travel to work refers to both the
quantity and quality of time spent travelling
between a person’s place of residence and his or
her workplace.

Description
The relationship between time needed to travel to
work and quality of life is influenced not only by

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the amount of time allocated to travelling but also
the quality of that time, including simultaneous
activities like listening to music and external
factors such as traffic congestion and predictability. The amount of time spent travelling to work
varies according to several factors. Those who
need the most time are more likely to be male,
highly educated, earn a higher than average
income, spend longer hours working for pay,
and live in urban centers (Besser, Marcus, &
Frumkin, 2008; Hansson, Mattisson, Björk,
Östergren, & Jakobsson, 2011; Lyons &
Chatterjee, 2008). Robinson and Godbey (1997)
note that about 30 % of daily travel time is spent
commuting, with the remaining travel time
allocated to leisure activities, and personal and
family care.
Time needed to travel to work is most often
considered in terms of time trade-offs. With only
24 h each day, more time needed to travel to work
means less time is available for other activities.
More specifically, longer travel times to work
have been associated with less time for leisure,
sleep, and other subsistence activities. Furthermore, when more time is spent travelling to work,
less time is allocated to travel for the purpose of
maintaining social relationships (Kitamura et al.,
1992). More recently, Besser et al. (2008) found
similar results when examining the effect of time
required to travel to work on access to social
capital. Those who spent 90 min or more commuting had significantly fewer socially oriented
trips, such as going out to dinner with friends or
attending school activities, which suggests
a travel time threshold that can have a limiting
effect on personal relationships.
The inability to fulfill commitments and obligations in other life spheres because of time
needed to travel to work can lead to role conflict,
especially among women who generally have
a disproportionate responsibility for caregiving
and domestic activities (Roberts, Hodgson, &
Dolan, 2011). For Canadian women, long commute times rank among the five most important
predictors of role overload (Duxbury, Lyons, &
Higgins, 2008), perhaps due to different travel
experiences from men, including the following:
less access to flexible work hours to help avoid

Time Needed to Travel to Work

peak traffic times, different use of public transit,
or the expectation of integrating household
responsibilities with commuting, which necessitates multiple trip interruptions and lengthens
travel time.
Much of the concern about health effects associated with time needed to travel to work is
related to longer periods of sedentary activity
for those who use cars or public transit as their
primary mode of transportation. Longer amounts
of time required for travelling to work are linked
to health issues such as hypertension, obesity, and
decreased cardiovascular fitness (Hoehner,
Barlow, Allen, & Schootman, 2012), and can
contribute to low energy, everyday stress, and
illness-related absence from work (Hansson
et al., 2011). In a recent US poll, employees
requiring more than 90 min to travel to work
reported a higher incidence of back and neck
pain, obesity, and high cholesterol compared to
workers whose travel time was 10 min or less
(Crabtree, 2010). Traffic congestion and lengthy
commutes are associated with higher stress levels
among full-time workers (Turcotte, 2011). Traffic congestion has a particularly negative effect
on the quality of travel time. As the
unpredictability associated with traffic congestion and other factors beyond drivers’ control
increases, so do perceptions of stress (Evans,
Wener, & Phillips, 2002; Gottholmseder,
Nowotny, Pruckner & Theurl, 2009).
The adverse effects of time needed to travel
to work on well-being are part of the burden
discourse. In contrast, the gift perspective
suggests that time spent travelling to work can
potentially enhance quality of life. When viewed
as a gift, travel time allows a transition time for
individuals to focus their thoughts as they shift
between different spheres of activity. It can also
create a time out from other commitments and
responsibilities (Jain & Lyons, 2008). Moreover, by equipping for the journey with mobile
technologies and reading materials, social-, leisure-, and work-related activities can occur
simultaneously with travel. Lyons and Urry
(2005) envision a continuum of productivity
during travel time to work, ranging from
unproductive or wasted time to ultra productive

Time Poor

time, where more is accomplished during
the journey than may have been otherwise.
The level of productivity and ensuing benefits
depend largely on equipping appropriately but
can be influenced by other factors such as life
stage, health status, and travel conditions. In
other words, depending on individual characteristics, travel circumstances, transportation
mode, and preparation for the journey, time
spent travelling to work has the potential to
enhance daily life.
It is possible, too, for both the gift and burden
discourses to exist simultaneously. Transition
time and leisurely moments during travel time
may contribute to enhanced quality of life, but if
time needed to travel to work precludes other
activities related to well-being or contributes to
poor health outcomes, it can be detrimental. As
such, considering both time trade-offs and the use
and experience of time needed to travel to work is
important in order to understand the relationship
to quality of life.

Cross-References
▶ Commuting
▶ Health
▶ Obesity, an Overview
▶ Quality of Life
▶ Sleep, an Overview
▶ Stress
▶ Time Trade-Off
▶ Traffic Mobility
▶ Transit Systems and the Quality of Life
▶ Transportation and the Quality of Life
▶ Work Time

References
Besser, L. M., Marcus, M., & Frumkin, H. (2008). Commute time and social capital in the U.S. American
Journal of Preventive Medicine, 34(3), 207–211.
doi:10.1016/j.amepre.2007.12.004.
Crabtree, S. (2010). Wellbeing lower among workers with
long commutes. Gallup Poll Briefing. Retrieved
September 12, 2012, from http://www.gallup.com/
poll/142142/wellbeing-lower-among-workers-longcommutes.aspx

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Duxbury, L., Lyons, S., & Higgins, C. (2008). Too much
to do, and not enough time: An examination of role
overload. In D. S. Lero, K. Korabik, & D. L. Whitehead (Eds.), Handbook of work-life integration
(pp. 125–140). London: Elsevier.
Evans, G. W., Wener, R. E., & Phillips, D. (2002). The
morning rush hour: Predictability and commuter
stress. Environment and Behavior, 34(4), 521–530.
doi:10.1177/00116502034004007.
Gottholmseder, G., Nowotny, K., Pruckner, G. J.,
& Theurl, E. (2009). Stress perception and
commuting. Health Economics, 18(5), 559–576.
doi:10.1002/hec.1389.
Hansson, E., Mattisson, K., Björk, J., Östergren, P.-O., &
Jakobsson, K. (2011). Relationship between commuting and health outcomes in a cross-sectional population survey in southern Sweden. BMC Public Health,
11(1), 834. doi:10.1186/1471-2458-11-834.
Hoehner, C. M., Barlow, C. E., Allen, P., & Schootman, M.
(2012). Commuting distance, cardiorespiratory fitness,
and metabolic risk. American Journal of Preventive
Medicine,
42(6),
571–578.
doi:10.1016/j.
amepre.2012.02.020.
Jain, J., & Lyons, G. (2008). The gift of travel time.
Journal of Transport Geography, 16(2), 81–89.
doi:10.1016/j.jtrangeo.2007.05.001.
Kitamura, R., Robinson, J., Golob, T., Bradley, M.,
Leonard, J., & van der Hoorn, T. (1992). A comparative analysis of time use data in the Netherlands
and California. Retrieved August 25, 2012,
from http://repositories.cdlib.org/itsdavis/UCD-ITSRR-92-09
Lyons, G., & Chatterjee, K. (2008). A human perspective
on the daily commute: Costs, benefits and trade-offs.
Transport Reviews, 28(2), 181–198. doi:10.1080/
01441640701559484.
Lyons, G., & Urry, J. (2005). Travel time use in the
information age. Transportation Research Part A,
39(2), 257–276. doi:10.1016/j.tra.2004.09.004.
Roberts, J., Hodgson, R., & Dolan, P. (2011). “It’s driving
her mad”: Gender differences in the effects of commuting on psychological health. Journal of Health
Economics, 30(5), 1064–1076.
Robinson, J. P., & Godbey, G. (1997). Time for life: The
surprising ways that Americans use their time.
University Park: Pennsylvania State Press.
Turcotte, M. (2011). Commuting to work: Results
of the 2010 General Social Survey. Canadian
Social Trends, 92. Retrieved August 3, 2012,
from http://www.statcan.gc.ca/pub/11-008-x/2011002/
article/11531-eng.htm#tphp

Time Poor
▶ Time Poverty Thresholds in the USA

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Time Poverty Thresholds in the USA
Charlene Marie Kalenkoski1 and
Karen S. Hamrick2
1
Department of Economics, Ohio University,
Athens, OH, USA
2
U.S. Department of Agriculture, Economic
Research Service, Washington, DC, USA

Synonyms
Discretionary time indicators; Time poor; Time
scarcity; Time stress; Time-adjusted income
poverty; Time–pressure illusion

Definition
Time poverty is the concept that individuals do
not have enough discretionary time – the time
available after engaging in necessary activities
like sleep and in the committed activities of
paid and unpaid work – to engage in activities
that build their social and ▶ human capital. Time
poverty thresholds define a level of discretionary
time below which individuals are considered to
be “time poor.” Such thresholds are often defined
relative to a population distribution although
absolute thresholds can be defined based on the
minimum amount of time required to perform
certain tasks.

Description
Time constraints, like money constraints, affect
individuals’ well-being. Everyone has 24 h in
a day, but some individuals have more control
or flexibility over their time than others.
People who are “time poor” do not have
enough discretionary time to engage in activities
that improve their social and ▶ human capital.
Yet, the focus of policy discussions is ▶ income
poverty. Indeed, when time poverty was initially
suggested as a social problem in the 1970s,
Vickery (1977) modified existing income poverty

Time Poverty Thresholds in the USA

thresholds to define time-adjusted income
poverty thresholds for the United States (US).
She based the thresholds on her estimate of the
minimum amount of time that would be needed to
complete household tasks, based on the average
amount of time non-employed homemakers spent
on household tasks according to US time budget
data and on other assumptions regarding how
much time was necessary for certain activities.
Vickery calculated different thresholds based on
▶ household composition – the number of adults
and the number of children in the household – to
account for differences in household time
resources and needs. Similar time-adjusted
income poverty measures were constructed by
Douthitt (2000) for the United States using 1985
data and by Harvey and Mukhopadhyay (2007)
for Canada using 1998 data. However, it is important to measure time poverty separately from
income poverty as the relationship between time
poverty and income is not clear a priori.
Rather than use ad hoc assumptions about
how much time is needed for various tasks,
other researchers have constructed time poverty
thresholds as relative measures. These thresholds
are defined as some percentage of median
discretionary time. Bittman (2002), Bardasi and
Wodon (2006), and Burchardt (2008) constructed
relative thresholds for Australia, Guinea, and the
United Kingdom, respectively.
Because such relative time poverty thresholds
were lacking for the United States, Kalenkoski,
Hamrick, and Andrews (2011) constructed
several sets of thresholds using nationally representative data on individuals’ actual activities
from the American Time Use Survey (ATUS).
The ATUS is a continuous survey that the US
Bureau of Labor Statistics began in 2003
(http://stats.bls.gov/tus/). The time-diary component of the ATUS is a 24-h diary such that
individuals’ own descriptions of their activities
are coded into standardized activities. The
questionnaire portion of the ATUS provides
information on the respondent’s ▶ household
composition as well as demographic and labor
force participation for the respondent and the
respondent’s household members. The timediary method of collecting information on

Time Poverty Thresholds in the USA

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Time Poverty Thresholds in the USA, Table 1 Time poverty thresholds for the total population and by household
composition, 2003–2006

Total population
One adult, no children
One adult, one child
One adult, 2 or more
children
Two adults, no children
Two adults, one child
Two adults, two or
more children
Three or more adults,
no children
Three or more adults,
one child
Three or more adults,
two or more children

Group percent of
population
100.0
14.4
1.5
1.7

Median discretionary
minutes
483
583
408
390

Median discretionary
hours
8.1
9.7
6.8
6.5

60 % of median
discretionary minutes
289.8
349.8
244.8
234.0

32.5
8.8
15.9

535
418
382

8.9
7.0
6.4

321.0
250.8
229.2

14.1

525

8.8

315.0

5.9

480

8.0

288.0

5.2

440

7.3

264.0

Source: Kalenkoski et al. (2011)

individuals is considered a neutral method of
collecting activity information, less subject
to social desirability bias than a questionnaire
asking about specific activities (Stinson, 1999).
Time-diary data can be used to develop an
objective measure of time poverty; a subjective
measure would use survey data that asked respondents whether they felt ▶ time pressure or time
stress.
Kalenkoski et al. (2011) first defined an
individual’s daily discretionary minutes to be
1,440 min (the total number of minutes in a day)
minus minutes spent in necessary and committed
activities. The authors defined necessary
activities to be those activities that an individual
must perform for himself or herself, such as
sleeping and grooming. They defined committed
activities as those activities that an individual
must perform given prior commitments, such as
market work, childcare, and household work:
Necessary activities [ATUS major activity code]:
• Personal care (sleeping and grooming) [01]
Committed activities [ATUS major activity
code]:
• Household activities [02]
• Caring for and helping household members
[03]
• Work and work-related activities [05]

A person’s remaining activities were then
defined as discretionary activities, and the total
duration of time spent in these activities was
defined as discretionary time. What might be
referred to as recreational time or free time was
included in discretionary time, but activities such
as caring for non-household members, education,
and civic obligations were also included.
Kalenkoski et al. (2011) defined alternative
thresholds at 50 %, 60 %, and 70 % of the
population median of this discretionary time.
For example, 289.8 min was the threshold
calculated at 60 % of the median population
discretionary minutes. They then defined similar
alternative thresholds based on the median of
discretionary time for various subgroups in the
population based on household composition and
employment status. They adopted 60 % of the
median as the time poverty threshold (Table 1).
After defining these thresholds and calculating
time poverty rates for various groups in the
population, Kalenkoski et al. (2011) performed
multivariate regression analysis using the ATUS
data to determine the correlates of discretionary
time and time poverty. The authors found that,
controlling for other factors, an additional household child substantially decreased a person’s
daily discretionary time and increased the

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probability of being time poor. However, an additional household adult did not affect a person’s
daily discretionary time or his or her probability
of being time poor. Being employed for pay,
however, was the most significant factor determining a person’s daily discretionary time and
whether or not the person was time poor. Income
was not associated with discretionary time or
time poverty, supporting the creation of time
poverty measures apart from income poverty
measures.
Other Approaches
Goodin, Rice, Parpo, and Eriksson (2008)
developed a time–pressure measure defining discretionary time to be the minimum time
necessary for paid work, household tasks, and
personal care. They defined time–pressure
illusion as the time difference between the actual
time spent on these activities and the minimum
amount of time necessary.
The Organisation for Economic Co-operation
and Development (OECD) included time-use
measures in its Better Life Initiative report on
measuring ▶ well-being across its member
counties (OECD, 2011). However, instead of
using time poverty thresholds, the OECD used
a group of indicators to assess ▶ work-life
balance. The indicators were working more than
50 h per week, time in leisure and personal care,
commuting time, satisfaction with work-life
time allocation, and employment rate of mothers
with school-age children.
Davis and You (2011) used a cost difference
approach to create money-time thresholds for
food production, where household production
time was valued at a market rate. They found
that, for single-headed households, time is more
of a constraint than money in reaching the
nutritional recommendations of the US Department of Agriculture Thrifty Food Plan.
Discussion
Researchers can apply time poverty thresholds to
a variety of questions to see if lack of discretionary time is a determining factor to an observed
outcome. For example, time poverty may be
a determinant of energy balance behaviors,

Time Poverty Thresholds in the USA

that is, physical activity levels and food intake.
Traditionally, policymakers have used income
poverty measures to identify individuals and
households lacking sufficient material resources.
However, time is also a scarce resource that
affects individuals’ well-being. Lack of time to
exercise or eat healthily may lead to obesity and
its associated health problems. Recognition of the
importance of time poverty could further improve
analysis and policymaking in a wide variety of
public assistance and public welfare contexts.

Cross-References
▶ Gender and Poverty
▶ Poverty
▶ Poverty Lines
▶ Poverty Measurement
▶ Relative Poverty Rate
▶ Social Indicators
▶ Time Budget(s)
▶ Time Trade-Off

References
Bardasi, E., & Wodon, Q. (2006). Measuring time poverty
and analyzing its determinants: Concepts and application to Guinea. In C. Mark Blackden & Quentin
Wodon (Ed.), Gender, time use, and poverty in
Sub-Saharan Africa (World Bank Working Paper No.
73, pp. 75–95). Washington, DC: World Bank.
Bittman, M. (2002). Social participation and family
welfare: The money and time costs of leisure in Australia. Social Policy & Administration, 36(4),
408–425.
Burchardt, T. (2008). Time and income poverty (Case
Report 57). York, UK: Centre for Analysis of Social
Exclusion, Joseph Rowntree Foundation.
Davis, G. C., & You, W. (2011). Not enough money or not
enough time to satisfy the Thrifty Food Plan? A cost
difference approach for estimating a money-time
threshold. Food Policy, 36(2), 101–107.
Douthitt, R. A. (2000). Time to do the chores?’ Factoring
home-production needs into measures of poverty.
Journal of Family and Economic Issues, 21, 7–22.
Goodin, R. E., Rice, J. M., Parpo, A., & Eriksson, L.
(2008). Discretionary time: A new measure of freedom. Cambridge, UK: Cambridge University Press.
Harvey, A. S., & Mukhopadhyay, A. K. (2007). When
twenty-four hours is not enough: Time poverty of
working parents. Social Indicators Research, 82,
57–77.

Time Pressure
Kalenkoski, C. M., Hamrick, K. S., & Andrews, M.
(2011). Time poverty thresholds and rates for the US
population. Social Indicators Research, 104, 129–155.
OECD (2011). How’s Life?: Measuring well-being,
OECD Publishing, Paris, France. http://dx.doi.org/
10.1787/9789264121164-en.
Stinson, L. L. (1999). Measuring how people spend their
time: A time-use survey design. Monthly Labor
Review, 122(8), 3–6.
Vickery, C. (1977). The time-poor: A new look at poverty.
Journal of Human Resources, 12, 27–48.

Time Preference
▶ Inter-temporal Aspect of Well-Being

Time Pressure
Tanja van der Lippe
Department of Sociology, Utrecht University,
Utrecht, The Netherlands

Synonyms
Combination pressure; Scarcity of time; Time
competition

Definition
There are only 24 h in a day, which means that, by
definition, the time devoted to one activity leaves
less time for other activities. The scarcity
argument, which is commonly used for real
time, can also be applied to time as experienced.
If someone puts in more hours at work, he or she
will perceive a reduction in the number of hours
which are available for family obligations.
This can cause someone to feel pressed for time
(van der Lippe, Jager, & Kops, 2006).

Description
These days people often feel busy and hurried
(Gleick, 1999). For many women and men in

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paid employment, balancing work and family
obligations has grown into a major problem,
which is hard to solve. In families where both
spouses are active in the labor market, difficulties
may arise as to who should bear the responsibility
of domestic and caring duties (van der Lippe,
2007). Running the household does not just
mean that competing responsibilities have to be
juggled: parenting standards and job expectations
have risen as well (Jacobs & Gerson, 2004). With
respect to the latter, employers seem to demand
an ever greater willingness of their employees to
be permanently available.
All in all, then, the scarcity of time appears to
have grown more urgent in both the family and
the workplace, with people frequently feeling
torn between the two. As Schor (1992) states,
the modern employee faces a serious distortion
in the allocation of time between paid work and
the private sphere; Hochschild (1997) notes
that, in the USA, work has become home, and
home has become work. Although Gershuny
(2000) argues that, in the past 50 years, the
amount of leisure time in Western society has
increased, in actual practice, people seem to be
running out of time. Employed couples tend to
feel they have to make the most of the amount of
time there is available and experience ever more
and greater pressure. As a consequence, a growing number of people suffer from ▶ stress due to
work-home interference, with fatigue or even
serious health problems, such as ▶ burnout, as
a result.
In particular when work cannot be finished at
the office and must be completed at home, such
problems might arise. The work-family conflict is
sometimes thought to have become more similar
for men and women. However, it is a well-known
fact that the amount of time spent in the labor
market varies less for men than women. In
addition, more hours of paid employment tends
to put greater time pressure on women as compared to men. And not only the actual number of
hours spent at the office will be of influence on
the time pressure experienced, the amount of
overtime is a contributing factor as well.
Flexible work schedules, for instance, can pose
a serious threat to maintaining stable relations

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at home (Presser, 2000). If someone needs to
work evenings or weekends instead of just office
hours, stress and tension in the private sphere
may result, because ordinary family activities,
such as eating together or leisure, have to be
canceled or postponed. This means that working
overtime can increase the time pressure experienced by women as well as men.
Apart from the number of hours actually
spent on work, job content will also influence
whether someone experiences work-related
strain or not. The more demanding a job is in
terms of responsibility and supervision, the more
likely it is that time pressure will arise. In particular managerial jobs often lead people to complain that work never seems to be finished. Even
if they put in the maximum number of hours,
people in such jobs often continue to feel burdened by the sheer intellectual demands that are
made on them.
With regard to home and family, the demand
hypothesis states that the more care is needed at
home, the more time is invested in the household.
The demand for care depends, first of all, on
whether there are any children present in the
household and, if so, how old these are. The
younger a child is, the more care he/she needs,
which leads to higher experienced time pressure
on the main carer in the household. As is often
observed, women usually devote relatively more
time to household and caring tasks. An explanation for this division of labor can be found by
applying an exchange perspective. In the
exchange framework, the division of household
tasks results from implicit negotiations between
spouses about input (earnings or financial
resources) and output (who performs household
and caring tasks).
Another contributing factor to the common
perception that time is scarce and flying by
which is often mentioned is that of the diffusion
of new forms of information and communication
technology (ICT). Yet research has shown that it
is not necessarily true that the option of keeping
in continuous contact offered by mobile phones
has accelerated the pace of life beyond people’s
perceived capacity to cope comfortably with
this. For example, an analysis of phone logs

Time Pressure

(Bittman, Brown, & Wajcman, 2009) has provided no indication that more frequent use of
mobile phones leads to an increase in the feeling
of being pressed for time: in itself, using
a mobile phone does not put a strain on people.
Quite the contrary, it seems likely that the
mobile phone has provided a new means for
solving time dilemmas, as arrangements can be
made and rescheduling can be done directly and
on the spot.
Time pressure is not only caused by household
and work-related factors, for the country
someone lives in is of influence as well. Countries
vary in their social policies and how these are
institutionalized, and several typologies have
been developed for describing international
differences between welfare states in ideology,
functioning, and the practical outcome of this for
citizens. Family-friendly government policies, in
particular, can make a big positive difference to
citizens’ work and family lives. Supportive measures such as the supply of sufficient childcare
facilities and paid maternity and parental leave
can greatly facilitate the combination of work and
care responsibilities. In countries with a more
family-friendly climate, households are expected
to experience less time pressure (van der Lippe
et al., 2006).
To conclude, the exact relation between
experienced time pressure and the level of happiness of citizens in different countries remains
somewhat unclear. Garhammer (2002) speaks
about the time pressure-happiness paradox in
modern West European societies. The feeling
of being stressed because of role conflict and
simultaneous tasking, and the sense of being
overstimulated by all kinds of novel experiences, is a common phenomenon in Western
Europe. At the same time, though, the Danish,
the Dutch, and the Swedish are ranked among
the happiest people in the world. Happiness is
generated by making progress in life, a sense
of flow, being able to mobilize resources, and
taking an active part in society. Feeling pressed
for time is the flip side of this golden coin – an
adverse effect with which, according to
Garhammer (2002), people in modern society
have learned to cope.

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References

Time Trade-Off
Bittman, M., Brown, J. E., & Wajcman, J. (2009). The
mobile phone, perpetual contact and time pressure.
Work, Employment and Society, 23, 673–691.
Garhammer, M. (2002). Pace of life and enjoyment of life.
Journal of Happiness Studies, 3, 217–256.
Gershuny, J. (2000). Changing times: Work and leisure in
post-industrial society. Oxford: Oxford University
Press.
Gleick, J. (1999). Faster: The acceleration of just about
everything. New York: Pantheon Books.
Hochschild, A. R. (1997). The time bind. When work
becomes home and home becomes work. New York:
Metropolitan Books.
Jacobs, J. A., & Gerson, K. (2004). The time divide: Work,
family, and gender inequality. Cambridge: Harvard
University Press.
Presser, H. B. (2000). Nonstandard work schedules and
marital instability. Journal of Marriage and the
Family, 62, 93–110.
Schor, J. B. (1992). The overworked American. The
unexpected decline of leisure. New York: Basis Books.
van der Lippe, T. (2007). Dutch workers and time
pressure: Household and workplace characteristics.
Work, Employment and Society, 21, 693–711.
van der Lippe, T., Jager, A., & Kops, Y. (2006).
Work-family balance in European countries. Acta
Sociologica, 49, 303–319.

William Michelson
Department of Sociology, University of Toronto,
Toronto, ON, Canada

Synonyms
Fixed resource allocation and time; Time
budgeting

Definition
In a system in which people are all allocated
a fixed and equal amount of time in the day or
week, marginally more time devoted to one or
more activities will take time then not available
for other activities. Time is hence traded from
some potential activities to others, either explicitly or implicitly.

Description

Time Reference
▶ Reference Period

Time Scarcity
▶ Time Poverty Thresholds in the USA

Time Spent with Children by Parents
▶ Parental Time and Child Well-Being

Time Stress
▶ Time Poverty Thresholds in the USA

The conceptual model of the zero-sum game is
a fundamental reference point in the analysis of
time use. As applied by Staikov, (1973), this
model posits that time is a fixed resource, as
everyone is allocated 24 h in the day and 168 h
in the week. Time withdrawn from this sum for
one or more activities debits the total time available by exactly that much, leaving less time for
other potential activities during the stated period
of time. The day and week are surely long enough
for multiple activities to occur, but the total
amount of time to be disposed is finite and impervious to expansion. Thus, the choice of what to do
and how long to do it presents limitations on what
else a person might do within the same time
period. Devoting marginally more time to particular activities, whether by choice or by fiat,
leaves less time for others. Hence, people are
said to trade-off their time, putting more of their
fixed time resources into some activities while
leaving less for others. In some situations,

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this trade-off is voluntary and rational, while
in others, it may reflect external obligations
and pressures such as employment contexts,
cultural traditions, religious prescriptions, gender
roles, and more. Whether or not the trade-off is
desired, it is a function of fixed time resources.
(Michelson, 2005; Robinson, 1977).
This model is also implicitly the foundation
for a field of study commonly called Time Geography, developed by the late Swedish geographer,
Torsten H€agerstrand. H€agerstrand examined the
contexts in which people carry out activities
during specific periods of time, from single days
to a lifetime. His underlying point of view was
that, in the limited time of these periods, what
people do at the start of these periods and what
they are also committed to do limit the time
available for alternative and successive activities.
As a geographer, he emphasized how tangible
factors that come to bear on timing and
time consumption in human communities exercise constraints on human activity. This has
become the basis for widespread research activity
pertinent to decision making in the public realm.
(Carlstein, 1978; Carlstein, Parkes, & Thrift,
1978; Parkes & Thrift, 1980).
In the study of time use, trade-offs between
activities are a focus of interest. Time devoted to
paid work is highly variable in the population,
but when pursued, accounts for a substantial
proportion of the waking minutes of the day.
Thus, it is not surprising that its trade-offs with
other activities are considerable. For example,
Harvey’s analysis of data from Halifax, Nova
Scotia, in the 1970s showed that time devoted
to the general category of paid work was
strongly correlated in an inverse direction with
time devoted to each of the other general categories of activity, such as household work, childcare, shopping, personal needs, education,
and recreational activities (Harvey et al., 1984,
p. 106).
More current correlation analysis of
representative American national time use data,
from the American Time Use Study, focuses on
a selection of specific activities among adults
between 25 and 64 years of age on weekdays
only. Figure 1 shows the correlation coefficients

Time Trade-Off

of time devoted to paid employment to 27 other
common daily activities. It supports Harvey’s
earlier, more general analysis in that 24 of the
27 correlations are inverse. Sleep has the
greatest inverse correlation with time spent in
paid work. Two activities, however, are directly
correlated with paid work time: time spent on
commuting and on grooming. One use of time,
travel for family care, does not vary in one
direction or the other with paid work time
(Michelson, 2011).
While the logic underlying time trade-offs and
empirical evidence of trade-offs are highly supportive, there are circumstances that offer exceptions to their absolute applicability.
The zero-sum game, as applied to time
resources, suggests that devoting time to activities is mutually exclusive-that you cannot do two
things at once. You can only do one activity at
a time, thus consuming time that might be used
for another activity. Although this is true for
much activity, there are common exceptions.
Doing more than one activity at a time is known
as multitasking. Not all time use creates an
inherent need for trade-offs. Much of child care
is multitasked: keeping an eye on children
while cleaning, cooking, watching television,
shopping, and much else. Estimates are that
about 60 % of child care is performed as a secondary activity, while also doing something else
considered as the primary activity at the time.
(Bittman & Pixley, 1997; Mattingly & Bianchi,
2003). The pioneering multinational time use
study in the mid-1960s had also documented
from 12 nations how much of radio and
television consumption, reading, and conversation were occurring as simultaneous activities
(Szalai, 1972).
Another strategy to deal with activities that are
potentially mutually exclusive, in view of limited
available time, is to cut down the duration
of each, resulting in more but shorter episodes
of activity in the day. This is known as intensification (Hargreaves, 1990) and sometimes
fractionation (Gunthorpe, 2003; Mattingly &
Bianchi, 2003).
Both multitasking and intensification/fractionation have been observed as adaptations

Time Trade-Off

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T

0.6

Pearson Correlation with Time Spent
in Paid Employment

0.5
0.4
0.3
0.2
0.1
0
−0.1
−0.2
−0.3
−0.4
1

2

3

4

5

6

7

8

9

10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Main Daily Activities

Time Trade-Off, Fig. 1 Main Daily Activities: 1. Commuting, 2. Grooming, 3. Travel for family care, 4. Leisure
travel, 5. Relaxing/thinking, 6. Travel for household
activities, 7. Leisure computing, 8. Travel caring for non
household adults, 9. Games, 10. Travel for eating and
drinking, 11. Playing with children, 12. Travel grocery
shopping, 13. Eating and drinking, 14. Physical care for

children, 15. Travel for socializing, 16. Reading,
17. Travel for other shopping, 18. Grass cutting and
landscaping, 19. Religious services, 20. Kitchen
cleanup, 21. Laundry, 22. Shopping other than for
groceries, 23. Socializing, 24. Food preparation,
25. House cleaning, 26. TV and movies, 27. Sleep

employed more frequently by women than by
men, in view of gender-based roles in an everyday life that increasingly involves paid employment. (Bittman & Wajcman, 2000; Peters &
Raaijmakers, 1998; Sullivan, 1997). Such
adaptations are not just objective adjustments
but are frequently experienced as subjectively
stressful. Thus, when the correlation of paid
work duration to time spent in other daily
activities among husbands and wives with
full-time employment resulted in results comparable to Fig. 1 (and to Harvey et al. (1984)
correlations for both genders), it was also the
case that the trade-offs, accompanied by gender-related intensification/fragmentation, were
experienced as having many more sources of
stress for the wives than for their husbands
(Michelson, 1986).
Time trade-offs are therefore not only fundamental dynamic elements in time use but are the
basis for adaptative responses that are themselves
affectively experienced.

Cross-References
▶ Time Needed to Travel to Work
▶ Time Pressure

References
Bittman, M., & Pixley, J. (1997). The double life of the
family. St. Leonards, NSW: Allen and Unwin.
Bittman, M., & Wajcman, J. (2000). The rush hour: The
character of leisure time and gender equity. Social
Forces, 79(1), 165–189.
Carlstein, T. (1978). A time-geographic approach
to time allocation and socio-ecological systems.
In W. Michelson (Ed.), Public policy in temporal
perspective (pp. 69–82). The Hague: Mouton
Publishers.
Carlstein, T., Parkes, D., & Thrift, N. (Eds.). (1978).
Human activity and time geography. New York:
Halstead Press.
Gunthorpe, W. (2003). Over the edge: severe time pressure in Australia. Paper presented to the International
Association of Time Use Conference, Brussels,
Belgium, September 17–19.

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Hargreaves, A. (1990). Teachers’ work and the politics
and time and space. Qualitative Studies in Education,
3, 303–320.
Harvey, A., Szalai, A., Ellioff, D., Stone, P., & Clark, S.
(1984). Time budget research. Frankfurt: Campus
Verlag.
Mattingly, M., & Bianchi, S. (2003). Gender differences
in the quantity and quality of free time: The
U.S. experience. Social Forces, 91(3), 999–1030.
Michelson, W. (1986). Divergent convergence: the daily
routine of employed spouses as a public affairs agenda.
Public Affairs Report, 26(4): full issue.
Michelson, W. (2005). Time use: Expanding explanation in
the social sciences. Boulder, CO: Paradigm Publishers.
Michelson, W. (2011). Activity trade-offs in the perspective of economic recession. Paper presented to the
International Association of Time Use Research Conference, Oxford, United Kingdom, August 3.
Parkes, D., & Thrift, N. (1980). Times, spaces, and places:
A chronogeographic perspective. New York: Wiley.
Peters, P., & Raaijmakers, S. (1998). Time crunch and the
perception of control over time from a gendered
perspective: The Dutch case. Society and Leisure,
21(2), 417–433.
Robinson, J. (1977). How Americans use time: A socialpsychological analysis of everyday behavior.
New York: Praeger.
Staikov, Z. (1973). Modelling and programming of timebudgets. Society and Leisure, 5(1), 31–47.
Sullivan, O. (1997). Time waits for no (wo)man: An
investigation of the gendered experience of domestic
time. Sociology, 31(2), 221–239.
Szalai, A. (1972). The use of time. The Hague: Mouton
Publishers.

Time Trends and Their QOL
Implications
John Robinson
Department of Sociology, University of
Maryland, College Park, MD, USA

Synonyms
Time-diary trends in time use, and their QOL
implications; Time, subjective; Time use activity
patterns

Description
Time figures prominently in the structure
and quality of people’s lives. Not only is it

Time Trends and Their QOL Implications

experienced in terms of Ben Franklin’s familiar
equation, “time is money,” but in terms of the
increased years of ▶ life expectancy, decreased
hours in the workweek, and the decreased days of
work layoffs and strikes that analysts have used to
argue for improvements in the ▶ quality of life
(QOL) in society over the last 100 years.
Reflecting time’s importance, government and
academic researchers from most Western
countries are now collecting full 24-h time-diary
data to monitor and understand how daily life
differs across demographic groups, across
decades, and across countries. For that reason,
extensive national diary data are now being
collected on an ongoing basis by the American
Time Use Survey [ATUS], as can be accessed by
googling “ATUS-X.” Diary data from more than
25 other counties have been collected via the
Multinational Time Use Survey (MTUS), as
archived at the University of Oxford via its
website www.timeuse.org.
Time trends have been monitored in two
basic ways:
1. Objective time: Documentation and accounting of the hours spent on various daily
activities, like paid work, TV viewing, and
time alone. While the QOL or positive benefits
of engaging in particular daily activities
are often not obvious, social observers seem
to concur that increases in daily activities
like child care, ▶ volunteering, and other
potentially altruistic behaviors, as well
as (voluntary) free time, represent improvements in a person’s or society’s QOL,
while increases in time spent on routine
▶ housework, repair activities, and TV
viewing are seen as less desirable. Empirical
support for many of these assumptions is
provided in Table 1 below.
2. Subjective time: Survey questions asking how
people perceive their time use and how they
feel about and value the way they spend their
time. Subjective time measures fall into three
categories:
1. Affect: ▶ Enjoyment and ▶ satisfaction,
with questions about how much ▶ pleasure
respondents obtain from specific activities
or their lives more generally, as in Table 1.

Time Trends and Their QOL Implications
Time Trends and Their QOL Implications,
Table 1 Enjoyment ratings from diary activities vs. in
general (on a scale from 10 ¼ enjoy a great deal to
0 ¼ dislike a great deal) (1985 and 1975 national data,
from Robinson & Godbey, 1999, Appendix O)
1985 DIARY
(average ¼ 7.0)
10 – ENJOY A GREAT
DEAL
9.3 Sex
9.2 Play sports
8.7 Playing/reading with
children
8.5 Church, religion
8.5 Sleep
8.2 Meals away
8.2 Socialize, visit others
8.0 Socialize with family
8.0 Work breaks
7.9 Reading
7.8 Meals at home
**7.8 TV
7.4 Hobbies, crafts
7.2 Exercise
7.2 Baby care
7.2 Organizations
*7.0 Work
7.0 Bathing
6.6 Cooking
6.6 Other shopping
6.4 Child care
6.4 Help others
6.3 Work commute
6.1 Dressing
5.8 Other housework
5.5 Grocery shopping
5.5 Home repairs
5.2 Pay bills, financial, etc.
5.0 Yardwork
4.9 Clean house
4.9 Laundry
4.8 Health care, doctor
4.7 Car repair
0 – DISLIKE A GREAT
DEAL

1975 GENERAL
(average ¼ 6.8)
10 – ENJOY A GREAT
DEAL

8.9 Child care

8.6 Play with children
8.0 Socializing, talking
8.0 Work

7.5 Sleep
7.4 Eating
7.4 Washing, dressing
7.3 Church, religion
7.0 Reading

6.8 Hobbies
6.5 Play sports
6.5 Cultural events
6,2 Cooking

**5.9 TV
5.1 Home repairs
5.0 Organizations
4.6 Grocery shopping
4.3 Other shopping
4.2 Clean house
0 – DISLIKE A GREAT
DEAL

2. Time pressure: Perceptions of ▶ time
pressure and ▶ stress, with questions
about feeling rushed, time crunch and personal stress, or spending enough time with
one’s spouse or children.

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Among the long-term US trends
observed in these diary studies for the
working-age population 18–64 are:
1. A decline in paid-work time by men
(mainly due to more years of education
and earlier effective retirements)
coupled with an increase in paid-work
hours of women (mainly due to their
higher employment rates, not hours
worked per week)
2. Declines in the unpaid work (family
care) by women, coupled with increased
unpaid work by men
3. Slight increases in hours of sleep
coupled with decreases in eating meals
and grooming
4. Increases in free time, particularly in TV
viewing time, IT use and fitness activity
Documentation of these trends can be
found in Robinson and Godbey (1999),
Robinson and Land (2008), Aguiar and
Hurst (2009), Robinson (2009), and
Robinson and Martin (2012). Lack of
increases in arts and sex participation, two
activities not adequately measured in diary
studies are described in Robinson (2010).
3. Output: Questions related to outputs from
time inputs, such as being more satisfied
with house cleanliness and how well one’s
children are doing in life. These have
supplemented with more objective measures of output, like grades in school,
house cleanliness, or obesity.
Turning to each of these subjective topics
in more detail
1. Affect: As reflected in Table 1, activity
satisfaction can be obtained
(a) As rated in “real time,” that is, integrated
as part of the time diary, by follow-up
questions after each reported activity
in a time diary (Krueger et al., 2009;
Robinson & Godbey, 1999)
(b) As rated in general, as in the survey question “On a scale from __ to __ how much
do you enjoy doing _______(activity)?”
Interestingly, these diary ratings of some
activities in the first column of Table 1 differ

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significantly from the responses derived from the
general survey questions in the second column.
For example, respondents rated their diary work
time enjoyed an average of about one point lower
on these 0–10 scales than when asked about their
work in general, and the particular TV programs
they watched as one point higher than TV viewing in general.
Nonetheless, there was much more convergence on other activities, such as ratings of child
care and socializing being toward the most enjoyable end of the scale vs. housework and repair
activities being at the bottom. Kahneman,
Krueger, Schkade, Schwarz, and Stone (2004)
and Krueger et al. (2009) argue for using the realtime subjective ratings in the diary as supplemental
measures to the gross domestic product (GDP) to
more fully reflect a country’s QOL. At the same
time, the general ratings did perform well in a 1975
panel study in being a major predictor of diary
times, providing an important example of attitudes
predicting behavior (activity).
The ▶ General Social Survey (GSS) has been
regularly asking time-estimate questions on
several activities since 1972, also asking these
same respondents several QOL questions, especially on ▶ happiness. Robinson and Martin
(2008) found that GSS respondents who more
often attend religious services, read newspapers,
and socialize with relatives, neighbors, and
friends report being progressively more happy
(after major demographic predictors of happiness
are taken into account). This suggests that there is
something involved in doing these activities that
makes people happier or that happy people enjoy
them more or both. The one exception was for
watching TV, with heavier viewers reporting
themselves as significantly less happy (Kubey
and Czikszentmihalyi 1990).
2. Time Pressure: A separate issue regarding the
time-QOL connection involves feelings of
time pressure, of being rushed or under stress,
with the general assumption that the less of
this in one’s life, the better (Mack 1925).
These mainly have come in the form of single
questions asked about:
Feeling Rushed: Asked first in the 1965
American time-diary study and more than 10

Time Trends and Their QOL Implications

national surveys in the interim (Robinson &
Godbey, 1999, Chap. 15), the question showed
a significant increase in those “always” feeling
rushed between 1965 and early 1990s.
A companion question from 1965 asks the
opposite – how often respondents “. . . .have
time on their hands you don’t know what with?”
with those saying “almost never” rising
from 48 % in the 1960s and 1970s to about 60 %
in the 1990s.
However, that situation changed significantly
in 2010, when the proportion feeling always
rushed dropped seven percentage points and
those feeling almost never having tome on their
hands about five points. At the same time, that
10 % of the public subscribing to both positions
reported about a 50 % level of being “very
happy” compared to less than 25 % in the rest of
the population (Robinson 2012).
Stress: Given the great medical concern
and societal attention paid to the stressful lifestyles in America, it is surprising that there are so
few data using standardized trend questions on
stress. The National Center for Health Statistics
did include a direct question on perceived stress
in its very large 1985 and 1995 surveys, and it
did find a significant rise from 50 % to 56 %
between 1986 and 1993, but then a surprising
decline to 48 % in 1995 (paralleling the 1995
decline in feeling always rushed).
Other Measures: Robinson and Godbey (1999)
report results on a 10-item measure of “time
crunch” scale that has since been used in several
other countries. As with the rushed and
stress questions, women and those aged 25–44
were most likely to respond being under more
time crunch.
Another single item asked respondents
whether they would be willing to give up a
day’s pay to get a day off from work. Only
18 % of workers in both 1975 and in 1998
reported being “very tired” at the end of
a workday. Time pressure concerns are also
evident in questions asking respondents whether
they have more or less free time than 5 years
previously, or whether they spend enough
time with their children, or how well balanced
their work and family lives are.

Time Trends and Their QOL Implications

3. Outputs from Time Inputs: Here, there are
concerns about the productivity or consequences of various ways of spending time.
Thus, one set of survey questions has asked
parents about how well their children are
doing in life, about their satisfaction with
the amount of time the family spends together,
or about awareness of where their children are
at times when they are not with them (Bianchi,
Robinson, & Milkie, 2006). Other survey
items have asked how satisfied respondents
are with the cleanliness of their homes
(Robinson & Milkie, 1998) or the quality of
the family meals (Juster & Stafford, 1985).
A few studies have examined more objective
measures of output, such as Schuman, Walsh,
Olson, and Etheridge (1985), finding little
relationship between study time and grades in
school, and Robinson and Godbey (1999), little
relation between time spent on housework and
respondent satisfaction with household cleanliness, as rated either by the respondent or by the
survey interviewer – nor by the presence of
household appliances. Similarly, respondents
who reported longer work hours were slightly
more likely to attend arts events or to engage in
sex. In general, these analyses support
Parkinson’s (1962) most insightful observation
that “work expands to fill the time available for
its completion.”
Some more promising advances in linking time
to output and welfare have been recently proposed
by economists. Bittman and Ironmonger (2011)
have presented a typology outlining options to
simply placing monetary values on work, unpaid
work, and free time, one that moves beyond the
initial strategy of valuing time in terms of the
implicit wage rate of the individual. Goodin,
Rice, Parpo, and Eriksson (2008) assert that time
is an inherently superior metric than money,
reversing the usual process of valuing time in
dollars and instead expressing money in terms of
the time required to earn it. Discretionary time
thus represents an advance over the more conventional category of “free time” as a new metric of
welfare.
On the negative end of the ▶ welfare scale, there
is the concern about the possible negative impacts

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of time spent eating (Janes, Hamrick, & Lacey,
2011; Zick & Stevens, 2011). Brown, Nicholson,
Broom, and Bittman (2011) present evidence that
TV viewing is accompanied by increased consumption of high-calorie snack foods.
Policy Issues: Time diaries provide clear
evidence of several ▶ social inequalities. In the
case of the division of housework between men
and women, Table 1 shows that both men and
women rate housework as quite low in terms of
enjoyment. Yet women continue to do twice as
much of it. The “Take back your time” movement
(DeGraff, 2003) has proposed that American
workers stop all paid work after mid-October, so
that their total annual work hours would be made
equivalent to those of European workers. The “Turn
off your TV” movement has designated 1 week
a year for people to leave their sets off and to instead
participate in more potentially gratifying activities
(although Table 1 suggests that, although people
rate TV in general as relatively low on the Table 1
enjoyment meter, the programs they watched on the
diary day rated far higher in enjoyment).
Of all the potential policy issues related to time
use, possibly the most impressive is the lack of
solid data on the marginal outputs that workers
produce and obtain for their inputs of work time.
Some data suggest that the same work productivity
can be achieved with 20–50 % less time spent on
the job (Parkinson, 1962; Schor, 1992; Schuman
et al., 1985) and that many workers put in simple
“face time” to impress their employers.

References
Aguiar, M., & Hurst, E. (2009). A summary of trends in
American time allocation. Social Indicators Research,
92, 70–80.
American Time-Use Survey (ATUS). Retrieved from
www.bls.gov/atus
Bianchi, S., Robinson, J., & Milkie, M. (2006). Changing
rhythms of American family life. New York: Russell
Sage Foundation: Rose Monograph Series.
Bittman, M., & Ironmonger, D. (2011). Conference overview. Social Indicators Research, 101, 1–15.
Brown, J., Nicholson, J., Broom, D., & Bittman, M.
(2011). Television viewing by school-age children:
Associations with physical activity, snack food consumption and unhealthy weight. Social Indicators
Research, 101, 20–23.

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Csikszentmihalyi, M. (1991). Flow: The psychology of
optimal experience. New York: Harper Collins.
DeGraff, J. (2003). Take back your time. New York:
Berrett-Koehler.
Goodin, R. E., Rice, J. M., Parpo, A., & Eriksson, L.
(2008). Discretionary time: A new measure of freedom. Cambridge: Cambridge University Press.
Janes, M., Hamrick, K., & Lacey, J. (2011). Exercise,
eating patterns, and obesity: Evidence from the
ATUS and its eating & health module. Social Indicators Research, 101, 27–34.
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well being (pp. 33–62). Ann Arbor, MI: Institute for
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Kahneman, D., Krueger, A. B., Schkade, D. A., Schwarz, N.,
& Stone, A. A. (2004). A survey method for characterizing daily life experience: The day reconstruction
method. Science, 306(5702), 1776–1780.
Krueger, A., et al. (2009). Time use and subjective
well-being in the US and France. Social Indicators
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Kubey, R., & Csikszentmihalyi, M. (1990). Television and
the quality of life. Hillsdale, NJ: Lawrence Erlbaum.
Parkinson, C. N. (1962). Parkinson’s law. New York:
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Issue
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social indicators research, Special Issue 93.
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further indicators of how American life has not
improved. Social Indicators Research, 99(1), 1–12.
Robinson, J. (2012). Less rushed, but no happier. Social
Indicators Research. Springer Science (online
November 2012).
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surprising ways Americans use their time (2nd ed.).
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of life. In W. Donsbach & M. Traugott (Eds.), Handbook
of public opinion research. Thousand Oaks, CA: Sage.
Robinson, J., & Martin, S. (2008). What do happy people
do? Social Indicators Research, 89, 565–571.
Robinson, J., & Martin, S. (2012). Time use as a social
indicator. In K. Land (Ed.), Handbook of social
indicators research. New York: Springer.
Robinson, J., & Milkie, M. (1998). Back to the basics:
Trends in and role determinants of women’s attitudes
toward housework. Journal of Marriage and the
Family, 60(1), 205–218.
Schor, J. (1992). The Overworked American Basic Book:
New York.
Schuman, H., Walsh, E., Olson, C., & Etheridge, B. (1985).
Effort and reward: The assumption that college grades
are affected by quantity of study. Social Forces, 945–66.
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Indicators Research, 101.

Time Use Activity Patterns

Time Use Activity Patterns
▶ Time Trends and Their QOL Implications

Time Use(S)
▶ Time Budget(s)

Time, Subjective
▶ Time Trends and Their QOL Implications

Time-Adjusted Income Poverty
▶ Time Poverty Thresholds in the USA

Time-Diary Trends in Time Use, and
Their QOL Implications
▶ Time Trends and Their QOL Implications

Time-Location Sampling
John Karon1 and Cyprian Wejnert2
1
The Centers for Disease Control and Prevention,
Albuquerque, NM, USA
2
DHHS/CDC/OID/NCHHSTP/DHPSE/BCSB,
Atlanta, GA, USA

Synonyms
Time-space
sampling

sampling;

TLS;

Venue-based

Definition
TLS (also known as time-space sampling and
venue-based sampling) is used to collect data

Time-Location Sampling

from hard-to-reach populations, such as men who
have sex with men (MSM), who can be found at
identifiable locations. Locations are selected at
random from the ▶ sampling frame of candidate
locations, and persons are enrolled by sampling at
these locations. Because the probability of being
sampled varies among enrolled persons and persons enrolled at the same location may have
similar characteristics, TLS data should be analyzed using sample-survey methods in order to
make inference to the population of persons
attending these locations.

Description
Most analyses of TLS data have regarded
the persons sampled as an independent, identically distributed sample chosen with equal probability from an infinite population. These
assumptions are appropriate for a simple random
sample; we call the corresponding analysis
a naive analysis. If frequency of attendance at
locations in the ▶ sampling frame varies
(resulting in variation among sampling probabilities) and is associated with an outcome of interest, point estimates from such an analysis will
be biased. In addition, clustering of persons with
similar characteristics and variation among
sampling probabilities causes the naı̈ve analysis
to underestimate standard errors of estimates.
We assume that the population of interest is the
population of persons attending locations.
We obtain a sample using a multistage sampling
procedure. The first stage sampling frame consists
of all locations (identified using formative
research, also known as venues) at which enough
persons from the population of interest can be
found on some day during a specified duration
(such as 4 h) to make recruitment worthwhile.
This sampling frame can be redefined periodically.
At the start of each specified calendar period (such
as each month), investigators choose a random
sample of locations (a simple random sample without replacement) of a specified size from this sampling frame. For each location selected, the
investigators choose a day and then a time period
for sampling at that location. Finally, the

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investigators count the number of persons seen at
the location who appear to meet the eligibility
criteria and obtain data from a sample of those
persons (MacKellar et al., 2007).
To make inference to the population of
persons attending these locations, the appropriate analysis is that of a multistage cluster
sample survey. The first stage is the locations
(the primary sampling units, PSUs). If we group
the sampling events at a location, the sampling of
persons within the PSUs is a second stage. The
probability of being sampled depends on
many factors, including whether a person goes
to any location in the sampling frame, whether he
goes to such a location when sampling takes
place there, and the proportion of eligible persons
sampled at that location. We define weights
which approximately reflect the differential
probability of enrollment in the study; we include
the effect of all factors that affect the sampling
probability in these weights, so that the data
can be analyzed as a two-stage rather than
a three-stage sample (software for analyzing
a two-stage sample is more readily available
than for a three-stage sample). Using these
weights and the location from which a person
was enrolled (the cluster) in an analysis accounts
for the effects of variation among the weights
and of clustering on point estimates and the
standard errors of these estimates (Karon &
Wejnert, 2012).
In a sample-survey analysis, a weight w, the
inverse of the probability of being sampled, is
defined for each person. Let xj and wj be the
observed quantity of interest and the weight,
respectively, for the jth person in the sample.
Then the estimated mean value in the sample is
the sum of the wj xj divided by the sum of
the weights wj. Note that the mean is unchanged
if all the weights are multiplied by a constant. The
variance of an estimate based on a sample survey
is a sum of the variances for each PSU. Each of
these variances is an expression times 1  fpc,
where fpc (the finite population correction factor)
is the probability that the PSU was sampled.
Without this correction, the estimated variance
is too large if a substantial proportion of the PSUs
are sampled.

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Time-Location Sampling

The sampling probability p for a person
enrolled in a TLS is similar to the cumulative
probability from a negative binomial distribution,
as shown by Eq. 1 below. Let si be the probability
that the person is enrolled during the ith sampling
event, given the person’s behavior (how often
the person attends locations in the sampling
frame, which location the person attends, and
when he attends these locations). Then,
p ¼ s1 þ ð1 s1 Þs2 þ ð1 s1 Þð1 s2 Þs3 þ . . . (1)

That is, the person could be enrolled during
the first sampling event, or not enrolled during
that event but enrolled during the second, or not
enrolled during the first two events but enrolled
during the third, etc. If the si are constant, the
summands of Eq. 1 are the successive terms of
the negative binomial probability distribution.
The probability that a person is sampled
during the ith sampling event is the product of
four probabilities: gi, the probability that a person
attends any location in the sampling frame on
the day when that sampling event takes place;
ai, the probability of attending the location at
which sampling takes place given that the person
attends some venue on that day; bi, the proportion
of potential venue sampling time on that day
during which sampling took place; and fi, the
sampling fraction at that sampling event. Thus,
s i ¼ gi ai bi f i

(2)

If fi is computed as the number who participate
divided by the number believed eligible, and
if we do not stratify the response probability and
the sampling fraction by personal characteristics,
then fi includes the effect of nonresponse.
To obtain a simple approximation to
a person’s sampling probability, we assume
that, for a person in the sample, si is constant
and equal to s (s may vary among persons).
This will be true if, for that person, gi, bi, and
the ai are constant during the study period
(i.e., the person’s attendance pattern is
unchanged during the study), and the sampling
fractions are equal at all locations the person

attended. Assume that there are k sampling
events. Since the probability of not being
sampled at each event is 1  s, the probability
of being sampled is:
p ¼ 1  ð1sÞk ¼ ks  kðk1Þs2 =2 þ . . .
using the power expansion of (1 + x)k; the
omitted terms contain terms of at least order
k3s3. Because gi and bi are at most 1, because
sampling fractions will be substantially less than
1 at the larger locations at which many persons
can be sampled, and because ai will be small
if the venue sampling frame is large enough, we
expect the si to be much less than 1. If the number
of sampling events is not too large, ks is small,
and the remaining terms are of order (ks)2 or
smaller. Because the higher order terms are
small compared to ks, p is approximately equal
to ks, and p is approximately proportional to s,
provided that the person attends locations in
the sampling frame throughout the study period.
The information necessary to obtain approximate estimates of a and g can be obtained in
interviewing a person who is sampled. The value
of b for the day on which a person is sampled is
known. The mean or overall sampling fraction at
a location is computed from the numbers sampled
and estimated to be eligible at each sampling
event. If sampling fractions at larger locations
remain small near the end of the study, ks will be
is small enough that p is approximately proportional to s. Therefore, we use 1/s as our weight, wj.
The variance of an estimate from a sample
with unequal probabilities of sampling or clustering compared to that from a simple random
sample (SRS) from an infinitely large population
is quantified as the design effect (DE), defined as
the variance computed based on the sampling
design, divided by the variance that would be
obtained if the sample were from a SRS. Assume
we want to estimate a proportion p. The denominator of the DE can be calculated as p(1  p)/n if
we our observed value is p from a sample of size
n and ignore the finite population correction
factor. If all weights are equal, then DE is approximately 1 + (m  1)r where m is the mean

Time-Location Sampling

cluster size and r is the intracluster (or
intraclass) correlation coefficient (ICC) (Kish,
1965). The ICC measures the variability
among clusters compared to the variability in
the entire population. The ICC is 1 if p is 0 or 1
within each cluster; in this case, the DE is
approximately m. If p is constant across clusters, then the ICC is negative and is equal to 1/
(n  1) if all clusters are of size n (this is the
minimum value for the ICC; in this case, the DE
is approximately 0 – the effective sample size is
the number of clusters). Zou and Donner (2004)
give three estimators (one of which is a kappatype estimator) of the ICC and their variances
for binary data x under the hypotheses that the
probability Pr (x ¼ 1) is constant across clusters,
and that observations from different clusters are
independent.
Using our proposed weights to analyze data on
MSM collected by the Centers for Disease
Control and Prevention (CDC) using TLS illustrates the effects of weighting, variation among
the weights, and clustering on prevalence estimates, on estimates of the association between
prevalence and a risk factor, and on the standard
errors of estimates (Karon & Wejnert, 2012).
This analysis estimates the proportions with
HIV, with hepatitis B, and reporting unprotected
anal intercourse (UAI) within the last 6 months in
four of the six metropolitan areas in which the
study was conducted. The analysis considers
weights both including and excluding the
sampling fractions at the locations at which men
were recruited. For most analyses, weighting had
at most modest effects on the estimates of
prevalence (clustering has no effect on these estimates) but substantial effects on the observed
DEs (for weighted analyses of the prevalence of
HIV, observed DEs were 3.5–5.2). The observed
DEs for these prevalences are greater than those
predicted from the kappa-like DE estimator. The
analysis also uses logistic regression to evaluate
UAI as a risk factor for HIV and hepatitis B in
two metropolitan areas. Again, observed DEs for
clustered weighted analyses are substantially
greater than 1. With hepatitis B as the outcome
in one metropolitan area, the p-values for the

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naı̈ve and clustered unweighted analyses are
small (at most 0.01) but are at least 0.12 for the
clustered weighted analyses.
Discussion
Special methods are required for sampling hardto-reach populations (those for which there is
neither a list of the population members nor
a list of where they can be found). Kalton
(2009) reviewed methods for sampling these
populations. The most popular methods for sampling populations such as men who have sex with
men and injection drug users are time-location
sampling, respondent-driven sampling, and
snowball sampling. Two recent reviews contain
substantial discussions of time-location and
respondent-driven sampling (Marpsat &
Razafindratsima, 2010; Semaan, 2010).
Reports of TLS data analyses should clearly
state the population to which the estimates apply.
If the data are analyzed as a simple random
sample, the results apply to a population resembling the persons actually sampled, rather than
the population from which the sampled persons
are drawn. If only the sampling fractions f in
equation (1) are used to compute weights for
prevalence (frequency of attendance at venues
and the proportion of potential time used in
sampling [g,a, and b in Eq. 1] are not used), or
if the analysis is unweighted but the sampling
fractions are approximately constant, then prevalence point estimates refer to the population of
visits to the locations in the sampling frame,
ignoring the fact that there is variation in the
frequency with which persons appear at those
locations and the sample is biased toward more
frequent attendees. Unless the possibility of
clustering within locations is accounted for,
the confidence interval for a prevalence estimate
from such an analysis may be too narrow,
provided that we can ignore the finite population
correction factor for the sampling of locations
(the primary sampling units). Analyses of
the CDC TLS study of MSM show that using
weights and accounting for clustering can yield
point estimates that are somewhat different from
those obtained and standard error estimates that

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6666

are substantially different from those obtained if
the data are regarded as arising from a simple
random sample.
Our proposed weights are proportional to the
inverses of estimated sampling probabilities for
the study. These estimated probabilities rely on
assumptions that would be hard to verify using
self-reported data, resulting in weights that can
only be approximations to the correct weights.
CDC is currently working with consultants to
develop weights based on the stages of sampling
(selection of locations from the sampling frame,
selection of the day and period when sampling
will occur at a location, selection of persons
attending the location, and frequency with
which a sampled person attends locations);
these weights may be closer approximations to
correct weights based on the probabilities that
persons are sampled.
To evaluate the potential for biased estimates
as a result of incorrect weights, the data analysis
should include an evaluation of associations
between weights and both outcomes of interest
and important covariates. If there are clear
associations, appropriate care should be used in
drawing conclusions from the study. More
robust analyses (such as using trimmed weights)
should be considered if some persons are
assigned relatively large weights (Karon &
Wejnert, 2012). Because weights are approximations to the correct weights, the true standard
errors of estimates are likely to be larger than the
computed standard errors. As a result of the
possible bias in a point estimate and underestimation of its standard error, conclusions from
analyses of TLS data should be made cautiously.
For example, an analysis with a p-value not very
much less than the nominal significance level
(such as 0.05) or a confidence interval excluding
but not very far from the null value should be
considered to give at best weak evidence for
a significant result.
Sample sizes for a TLS must take into account
possible large design effects. These design
effects probably cannot be estimated in advance;
analyses of the CDC MSM TLS data show that
design effects may be large. Variation in the
weights increases the design effects. To our

Time-Location Sampling

knowledge, the importance of DEs in the analysis
of TLS data has rarely been considered.
The primary alternative to TLS is respondentdriven sampling (RDS) (Heckathorn, 1997). Two
studies in Brazil found substantial differences
between the estimates from these two sampling
methods, possibly as a result of yielding
samples with very different distributions of
a characteristic that may be associated with an
outcome of interest (Kendall et al., 2008;
McKenzie & Mistiaen, 2009). Inference from
TLS is limited to the population of persons
attending locations in the sampling frame;
a report on a TLS study should summarize
characteristics of locations at which no persons
could be recruited and assess whether individuals
attending these locations are systematically
different from individuals who can be recruited
at reachable locations to assess possible differences between the reachable population of location attendees and the complete population of
location attendees. TLS is also likely to be slower
and more expensive than RDS (Kendall et al.,
2008). We have outlined the assumptions
required to compute valid analysis weights for
a sample-survey analysis of TLS data. Theory
for RDS depends on assumptions concerning
respondents’ knowledge of their network, the
way respondents recruit others, the character
of the network, and the recruitment process
(Gile & Handcock, 2010; Volz & Heckathorn,
2008). See Semaan (2010) for further discussion
of software and evaluation. Two studies have
shown that current RDS theory may not estimate
uncertainty properly (Geol & Salganik, 2010;
Wejnert, 2009). Current RDS theory does not
cover fitting linear and logistic regression
models.
The choice between TLS and RDS should
consider ease of implementation, time needed
to complete the study, cost of the study, coverage of the population of interest, assumptions
required for the analysis to be valid, data
required for the analysis, and difficulty and feasibility in doing the analysis. Compared to RDS,
a TLS analysis based on sample-survey methods
has the advantages of a firmer theoretical basis,
the ability to fit models, and the use of widely

Tipping Points

available software. Both methods have design
effects greater than one; further research is
needed to determine which, if either, method
has a consistently smaller design effect than the
other.

Cross-References
▶ Representative Sample
▶ Sample Survey
▶ Sampling Error

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Semaan, S. (2010). Time-space sampling and respondentdriven sampling with hard-to-reach populations. Methodological Innovations Online, 5, 60–75.
Volz, E., & Heckathorn, D. D. (2008). Probability based
estimation theory for respondent driven sampling.
Journal of official statistics, 24, 79–97.
Wejnert, C. (2009). An empirical test of respondentdriven sampling: Point estimates, variance, degree
measures, and out-of-equilibrium data. Sociological
Methodology, 39, 73–116.
Zou, G., & Donner, A. (2004). Confidence interval estimation of the intraclass correlation coefficient for
binary outcome data. Biometrics, 60, 807–811.

Time–Pressure Illusion
References
Geol, S., & Salganik, M. J. (2010). Assessing respondentdriven sampling. Proceedings of the National
Academy of Sciences, 107, 6743–6747.
Gile, K. J., & Handcock, M. S. (2010). Respondent-driven
sampling: An assessment of current methodology.
Sociological Methodology, 40, 285–327.
Heckathorn, D. D. (1997). Respondent-driven sampling:
A new approach to the study of hidden populations.
Social Problems, 44, 174–199.
Kalton, G. (2009). Methods for oversampling rare
subpopulations in social surveys. Survey Methodology,
35, 125–141.
Karon, J. M., & Wejnert, C. (2012). Statistical methods for
the analysis of time-location sampling data. Journal of
Urban Health, 89, 565–586. doi:10.1007/s11524-0129676-8.
Kendall, C., Kerr, L. R. F. S., Gondim, R. C., Werneck, G.,
Macena, R., Pontes, M., et al. (2008). An empirical
comparison of respondent-driven sampling, time location sampling, and snowball sampling for behavioral
surveillance in men who have sex with men, Fortaleza,
Brazil. AIDS and Behavior, 12(Supplement 1),
97–104.
Kish, L. (1965). Survey sampling (p. 258). New York:
Wiley.
MacKellar, D. A., Gallagher, K. M., Finlayson, T.,
Sanchez, T., Lansky, A., & Sullivan, P. S. (2007).
Surveillance of HIV risk and prevention behaviors of
men who have sex with men – A national application
of venue-based, time-space sampling. Public Health
Reports, 122(Supplement 1), 39–47.
Marpsat, M., & Razafindratsima, N. (2010). Survey
methods for hard-to-reach populations: Introduction
to the special issue. Methodological Innovations
Online, 5, 3–16.
McKenzie, D. J., & Mistiaen, J. (2009). Surveying migrant
households: A comparison of census-based, snowball
and intercept point surveys. Journal of the Royal
Statistical Society: Series A (Statistics in Society),
172, 339–360.

▶ Time Poverty Thresholds in the USA

Time-Related Quality of Life
▶ Temporal Satisfaction with Life Scale
(TSWLS)

Time-Space Sampling
▶ Time-Location Sampling

Tipping Points
Ren Thomas
Department of Geography, Planning, and
International Development Studies, University of
Amsterdam, Amsterdam, The Netherlands

T
Synonyms
Points of no return; Thresholds; Trigger events;
Turning points

Definition
Tipping points are moments in time signaling
periods of rapid and intense change in behaviors,

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perceptions, actions, or conditions. Depending on
the context, these points in time can mark
irreversible changes (as in the natural sciences
or complexity theory), or those that are so significant that they could be said to mark paradigm
shifts (as in political regime change).

Description
In the bestselling book The Tipping Point: How
Little Things Can Make a Big Difference (2000),
Malcolm Gladwell defined a tipping point as
“the moment of critical mass, the threshold, the
boiling point.” Gladwell explored the diffusion
of ideas, products, and messages, proposing
that they can spread “infectiously” under
three conditions: they are supported and
spread through people with specific social connections (categorized as connectors, mavens, or
salesmen); they use language that sticks in the
memory; and the social context facilitates their
use or adoption. In Gladwell’s case studies,
which include the surge in popularity of Hush
Puppies shoes in the mid-1990s, the adoption of
hybrid corn by Iowa farmers in the 1930s, and
a recent drop in the New York City crime rate,
small changes turned out to have major effects
which then catalyzed rapid change.
Although Gladwell popularized the use of
the phrase, the concept of the tipping point predates his work by several decades and crosses
disciplinary boundaries. The concept can be
found in fields as diverse as physics, climatology (Lenton, 2012; Russill, 2008), and sociology (e.g., Giles, Cataldo & Gatlin, 1975;
Meyerson & Banfield, 1955; Schwab & Marsh,
1980). In physics, a tipping point is “the point at
which an object is displaced from a state of
stable equilibrium into a new equilibrium state
qualitatively dissimilar from the first” (The Free
Dictionary). Several iterations of this definition
can be found in other scientific fields: in a study
of abrupt changes in arctic climates, Lenton
(2012, 11) wrote that “the tipping point
(or threshold) is the corresponding critical
point–in forcing and a feature of the system–at
which the future state of the system is

Tipping Points

qualitatively altered.” Urry (2008, 244) cites
complexity theory: “If a system passes
a particular threshold with minor changes in
the controlling variables, switches may occur
and the emergent properties turn or tip over.”
In epidemiology, epidemics such as influenza
start slowly with a few cases, tipping at
a certain point then rising sharply as the majority of cases are recorded and falling away as the
few remaining cases are recorded. While
scholars seem to agree that tipping points signal
periods of significant change, there is disagreement on whether the changes mark points of no
return; whether the tipping point is indeed “the
time at which a change or an effect cannot be
stopped” (Cambridge Dictionaries). Lenton
(2012) noted that not all climate tipping points
are bifurcations leading to irreversible change;
in the social sciences, tipping points are associated with major sociopolitical or paradigm
shifts which can be enduring, but are hardly
irreversible.
Some of the earliest uses of the term
“tipping point” in the social sciences were
in sociological research (e.g., Meyerson &
Banfield, 1955), where the tipping point concept
became established as a way in which to frame
discourse on residential concentrations (Schwab
& Marsh, 1980) and school desegregation based
on race (Giles et al., 1975). Researchers examined whether there was a point at which
the percentage of African American residents
in a neighborhood, or school children in
desegregated schools, had increased enough to
affect increased out-migration of whites.
According to Schwab and March (1980, 386),
“The reluctance of whites to share residential
areas is reflected in such popular terms for neighborhood change as ’block busting’, ’invasion’,
’tipping’, ’resistance’, and ’encroachment.” The
tipping point model of neighborhood change was
vigorously challenged; Schwab and Marsh
(1980) and Giles et al. (1975) found that the
model did not operate uniformly across neighborhoods or over time and that out-migration did not
increase above a certain threshold. Although
there was a change in concentration of racial
groups in the neighborhoods they studied, the

Tipping Points

pattern did not follow the epidemiological model
of rapid change above a certain threshold.
Researchers have also used the tipping point
concept to study rapidly changing social events
such as political regime change (Pelling &
Dill, 2010) and shifts in ▶ public opinion or
perception (Bentley & Ormerod, 2010; Russill,
2008; Wood, 2006). In many cases, researchers
examine historical events to try to determine
what specific actors, policies, or agents caused
rapid change: in Bentley and Ormerod’s exploration of public knowledge on the avian flu and
swine flu epidemics, the authors analyzed realtime online data to examine the search intensity
of these topics on the internet. They found that
a specific political event “brought public awareness past the tipping point” (2010, 485). Pelling
and Dill (2010) examined whether natural disasters had determined the direction and significance
of political change. They wrote that in any
political regime the balance between citizens
and the state contributes to a sort of social
contract; at critical historical moments such as
the post-disaster period (potential tipping points),
regime instability allows the terms of the social
contract to be tested and renegotiated. Similarly,
Wood (2006) tried to determine whether
a specific political settlement between the
tobacco industry and several US states was
a significant enough event to be considered
the tipping point (or “focusing event”) that forced
smoking into the public agenda. Urry
(2008) discussed several small developments in
governance and technology that might topple the
current car-dominant paradigm into one of “postautomobility.”
The definition of tipping points in the
sociopolitical context, then, is far more subjective than in the scientific context. Tomalty (2009)
describes a tipping point in urban planning in the
early twentieth century, when declining ▶ public
health, increased ▶ poverty, and unsanitary
building conditions led to planning initiatives
such as ▶ zoning and building regulations.
However, when he compares this period of
intense activity to the current emphasis on
sustainable ▶ community planning, he writes
that “the movement has gradually gathered

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momentum as the public exerts pressure on
elected officials and administrators to adopt policies and plans that will promote economic and
social development, while respecting environmental limits” (Tomalty, 2009, 15). He does
not distinguish between a point beyond which
rapid policy shift takes place and a gradual
increase in awareness over time. However,
Wood (2006) distinguishes between “triggering” events (those with the potential to catapult
an issue from relative obscurity on the systemic
agenda to a place of prominence on the
institutional agenda) and “focusing events”
(large-scale, dramatic events intuitively recognized as a potential catalyst for major policy
action, which upset the balance of power and
continue to affect policy for many years).
One characteristic of these focusing events or
tipping points is that they become known to
policymakers and the public almost simultaneously; Wood made the case that public and
policy awareness of smoking (and its health
and quality of life effects), on the other hand,
had been gradually rising for decades. Russill
(2008) traced the use of the tipping point concept
in discussions of climate change and suggested
that the use of this concept among high-profile
individuals “signals a broader trend towards
epidemiological models of explanation likely
to activate public health styles of intervention
for addressing climate change impacts” (2008,
133). He wrote that the tipping point is an example of a set of metaphors, images, and cultural
references that evoke a sense of viral contagion.
Reformulating problems as epidemics to facilitate solutions and using epidemiological inquiry
in the narrative form helped popularize public
health perspectives in the media (e.g., Berton
Rouche, Richard Preston, and Malcolm
Gladwell, all staff writers for New Yorker
magazine). Examples include recasting obesity
as a disease in the 1980s and cigarette smoking
as an addiction in the 1990s (Wood, 2006). In
Russill’s view, the use of the tipping point concept “signals the potential relevance of epidemiological reasoning in conditions or urgency and
uncertainty” (2008, 140); in climate change
discussions, he believes that increasing use of

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Tiredness

the term among representatives of public agencies has shifted concern from erratic weather
patterns to human health and quality of life
dimensions.
Although tipping points evoke the imagery of
rapid and irreversible change in contexts of
national or international significance, the term is
sometimes used to describe much smaller, more
gradual, or localized shifts. For example, Mabry,
Olster, Morgan and Abrams (2008) argued that
our ability to understand the causes of preventable common diseases has reached a threshold
beyond which achieving optimal health and
▶ well-being is inevitable; Ramirez (2006) used
the tipping concept to describe the increase in
consumers’ tastes for healthy foods.
The power of the tipping point as a metaphor is
the intrinsic notion that ideas, concepts, and
behaviors can take hold within a very small
group of people; if these are the “right” people,
broadly connected to others in a variety of fields
and at different spheres of influence, they can
catalyze major change. In scientific terminology,
“a key feature of complexity thinking is
that, although there are long-term irreversibilities, nothing is fixed forever. . .” (Urry,
2008, 345). Understanding this can help professionals in many fields spread targeted concepts or
behaviors, such as encouraging drug addicts to
exchange clean needles, increasing awareness of
diabetes, or politicizing climate change to affect
action. Of course, the concept can also be used by
advertisers, political figures, and social media to
sell products or advance ideas that may or may
not improve quality of life or be in the ▶ public
interest. In Gladwell’s words, “Tipping Points are
a reaffirmation of the potential for change and the
power of intelligent action. Look at the world
around you. It may seem like an immovable,
implacable place. It is not. With the slightest
push–in just the right place–it can be tipped”
(2000, 259).

References

Cross-References

Tiredness

▶ Social Change

▶ Fatigue

Bentley, R. A., & Ormerod, P. (2010). A rapid method for
assessing social versus independent interest in health
issues: A case study of “bird flu” and “swine flu”.
Social Science & Medicine, 71, 482–485.
doi:10.1016/j.socscimed.2010.03.042.
Giles, M. W., Cataldo, E. F., & Gatlin, D. S. (1975).
White flight and percent Black: The tipping point
re-examined. Social Science Quarterly, 56(1),
85–92.
Gladwell, M. (2000). The tipping point: How little things
can make a big difference. New York: Back Bay
Books/Little, Brown.
Lenton, T. (2012). Arctic climate tipping points. Ambio,
41, 10–22. doi:10.1007/s13280-011-0221-x.
Mabry, P. L., Olster, D. H., Morgan, G. D., &
Abrams, D. B. (2008). Interdisciplinarity and systems
science to improve population health – A view
from the NIH office of behavioral and social
sciences research. American Journal of Preventive
Medicine,
35(2),
S211–S224.
doi:10.1016/j.
amepre.2008.05.018.
Myerson, M., & Banfield, E.C. (1955) Politics, Planning
and Public Interest. Glencoe, Ill.: The Free Press.
Pelling, M., & Dill, K. (2010). Disaster politics: Tipping
points for change in the adaptation of sociopolitical
regimes. Progress in Human Geography, 34(1),
21–37. doi:10.1177/0309132509105004.
Ramirez, J. C. (2006). Tipping point: As consumers learn
more about food’s impact, yogurt makers are taking
the opportunity to boost the healthfulness of their
offerings. Dairy Field, 189(6), 14.
Russill, C. (2008). Tipping point forewarnings in climate
change communication: Some implications of an
emerging trend. Environmental Communication:
A Journal of Nature and Culture, 2(2), 133–153.
doi:10.1080/17524030802141711.
Schwab, W. A., & Marsh, E. (1980). The tipping-point
model: Prediction of change in the racial composition
of Cleveland, Ohio, neighbourhoods, 1940–1980.
Environment and Planning A, 12, 385–398.
Tomalty, R. (2009). Urban tipping point. Alternatives,
35(5), 14–16.
Urry, J. (2008). Governance, flows, and the end of the car
system? Global Environmental Change, 18, 343–349.
doi:10.1016/j.gloenvcha.2008.04.007.
Wood, R. S. (2006). Tobacco’s tipping point: the Master
Settlement Agreement as a focusing event. The Policy
Studies Journal 34(3), 419–436.

Tobit Models

TLS
▶ Time-Location Sampling

Tobit Models
Oriol Cunillera
Health Services Research Unit, IMIM-Hospital
del Mar, Barcelona, Spain

Synonyms
Heckit, sample selection models (type II Tobit);
Normal censored data, regression model

Definition
Family of statistical regression models that
describe the relationship between censored or
truncated continuous dependent variables and
some independent variables.

Description
The Tobit models are a family of statistical
regression models that describe the relationship
between a censored (or truncated, in an even
broader sense of this family) continuous dependent variable yi and a vector of independent variables xi. The model was originally proposed by
James Tobin (1958) to model nonnegative continuous variables with several observations taking value 0 (household expenditure).
Generally, the Tobit models assume there is
a latent continuous variable yi , which has not
been observed over its entire range. It can happen
due to truncation or censoring.
When truncation occurs, individuals on certain range of the variable yi are not included in
the dataset. In the database we only observe individuals taking values on the variable in

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a restricted range; individuals out of that range
have been excluded of the dataset or in fact do not
exist.
When censoring occurs, there is no exclusion
of individuals in certain ranges of yi , but yi is not
observed over its entire range anyway; instead of
observing this variable, we only observe yi ,
which is a censored observation of yi . Unlike in
the case of truncation, the variable takes (or hypothetically would take) values all over its entire
range in the individuals of the database; however,
for some ranges, it is not correctly observed,
taking a different given value. For example, measuring heights with a 2-m tape measure could
lead to individuals higher than 2 m being censored to that value; taller individuals would be in
the database but all we know is they are censored
(so their “2” value indicates they are at least 2
m tall).
Tobit models carry the idea of the censored
normal distribution into regression models,
assuming that this latent variable yi linearly
depends on xi via a parameter (vector) b.
Tobit in HRQoL
In the area of quality of life, Tobit models are
used to model measures suffering from ▶ ceiling
effect (proportion of individuals reporting the
best health status describable by the instrument),
usually in order to model preference-based
indexes, such as EQ-5D, HUI, or 15D. Utility
scores are anchored in values 0 (corresponding
to death) and 1 (perfect health). These indexes
tend to present a common problem of ceiling
effect at 1 in certain populations (Guo et al.,
2008; Luo et al., 2009; Moock & Kohlmann,
2008; Vainiola et al., 2010), which is especially
marked in general population, where, for example, the EQ-5D index shows ceiling effects
around 47–65 % (Bharmal & Thomas, 2006;
Johnson & Pickard, 2000; McDowell, 2006;
Petrou & Hockley, 2005). The presence of
a relevant ceiling effect supposes the violation
of the normality assumption ordinary least
squares models are based on, which has motivated the use of different alternatives, such as
Tobit, two-part, or censored least absolute

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6672

Tobit Models

Tobit Models,
Fig. 1 Formulation and
likelihood function of Type
I Tobit model

yi*=bxi + ui
a
yi =

yi *
b

Φ

L=

l – b ′xi
s

yi = a

deviations (CLAD) models. Tobit models assume
these indexes are a right-censored observation of
quality of life at 1.
Although Tobit models are applicable to all
kind of censored data, they have been classically
developed for left-censored data. In the area of
quality of life, though, Tobit models are, in most
cases, applied for right-censored data (ceiling
effect).

if yi* ≤ l
if l < yi* < r
if yi* ≥ r
1
y – b ′ xi
j i
s
s

•

a<yi<b

Φ

•

b ′ xi – r
s

yi= b

Types of Tobit
Depending on the type of limited data (censored
or truncated) and according to similarities in the
likelihood function, we can define at least 5 different types of Tobit models.

its likelihood function is shown in the same figure, whose Hessian has been proven, with some
reparametrization, to be negative definite (Olsen,
1978; Iwata, 1993). The parameters b of the
model can then be obtained by maximum likelihood. This estimation has been proven to be
consistent (Amemiya, 1973). bs must be
interpreted as the marginal effect (effect on the
conditional mean of the dependent variable of
a change in one of the regressors) of x~ on the
latent unobserved variable and so have a direct
effect on the observed variable as well as on the
probability of being censored.
Type I Tobit is the model usually used for
health measures with presence of ceiling effect.

Type I Tobit

Type II to V Tobits

In 1958, Tobin presented a model considering
a limited dependent variable with a lower limit
L that has a concentration of individuals in the
limiting point (left censored, with values for the
censored individuals equal to the limiting point,
a ¼ l), with residuals ui assumed to be normally
distributed. Despite this, further work has defined
the specific case of the data Tobin used in his
article (left censored at zero, a ¼ l ¼ 0, ui 
Nð0; s2 Þ) as the standard normal Tobit model
(or type 1 Tobit), which simplifies a lot all formulation, but type I Tobit models are
widespreadly conceived in a more general way
as shown in Fig. 1, where y is assumed to be
a latent partially observed variable that can take
values beyond the limiting points. Under the
assumption of normality and homoscedasticity,

Although other types of Tobit models have not
received much attention in the quality of life area,
they can easily be found in econometrics. Apart
from type II Tobit (aka Heckit), which can be
a valid alternative to type I Tobit for variables
with ceiling effect as a kind of two-part model,
other types of Tobit models generally appear too
complex for usual purposes in quality of life
research.
Following the summary of the different types
of Tobit models given by Amemiya (1984), these
can be summarized in the attached table, III to
V responding to their classical presentation in the
case of left censoring at 0, and where the number
and the type (C ¼ Censored, B ¼ Binary) of
dependent variables vary across Tobit types.
Type II Tobit presents a censored continuous

Tobit Models

T

6673
∂E yi xi
∂xij

= bj • Φ

r – xi′ b
σ

−Φ

l – xi′ b
σ

+

l – xi′ b
l–a
j
σ
σ

−

r – xi′ b
r–b
j
σ
σ

Tobit Models, Fig. 2 Marginal effect on the observed variable in the Type I Tobit model

E yi xi = a • Φ

l – xi′ b
+ xi′ b
s

Tobit Models,
Fig. 3 Expected value of
the observed variable in the
Type I Tobit model

variable for which its censoring is modeled separately as a binary variable. Type III Tobit
models two variables, adding to type I Tobit
a second variable observed censored for the
same cases as for the first variable. Types IV
and V add a third variable in more complex
relations.
More detail on validity of these models and
their likelihood functions can be found in
Schnedler (2005).
From Latent to Observed
For many psychometric scales with presence of
ceiling effect, it would be acceptable to use a type
I Tobit model and assume that the underlying
latent variable represents real quality of life.
When using Tobit models to model utilities, this
is not acceptable as researcher is interested in the
interpretation as utilities (0 and 1 representing
death and perfect health, respectively). In that
case, the main interest is on estimating the marginal effect of x~ on the observed variable y, more
~ coefficient of the model on
than the obtained b
the latent variable y . This is important when the
goal is to interpret results on utilities or on
▶ QALYs that can be derived from these indexes,
not on quality of life in a more general sense.
Estimations on latent variables of models for
censored variables cannot be interpreted as utilities and cannot be used to derive ▶ QALYs.
Different approaches have been proposed to
transform estimations on the latent variable into
estimations on the observed variable, for either
marginal effects of explanatory variables or the
expected value of the dependent variable.

s

•

j

Φ

•

l – xi′ b
s

r – xi′ b
s
−j

−Φ
r – xi′ b
s

l – xi′ b
s

+b

+

•

Φ

xi′ b – r
s

The exact marginal effect of x~ on the observed
variable y can be seen in Fig. 2. This theoretical
exact marginal effect, though, is not onedimensional for each b; by applying this formula,
one estimation of the effect for each variable is
obtained for each individual. Different
approaches can be carried out to obtain a unique
estimation for each explanatory variable.
Although the mean of these individual effects
is recommended as the estimation of the marginal
effect (Greene 1997), it is far more frequent to
evaluate this function at the mean values of x~.
In some articles (Clarke, Gray, & Holman,
2002; Hasan, Subhani, & Osman, 2011), marginal effects on the dependent variable have
been obtained by multiplying the coefficients on
the latent variable by the probability of a nonlimit observation. In the case of left censoring at
zero l ¼ 0 with l ¼ a, the individual marginal
effect is simplified to b multiplied by the individual probability (given the covariates) of having
a latent value beyond zero; McDonald and
Moffitt (1980) omitted in their notation that
“individual” nature of this non-limit probability,
which led to Clarke’s extrapolation and establishment of this rough procedure, which can be
a simple approximation but it is not theoretically
justified Greene (1999).
In order to obtain estimations of the expected
values for the observed variable, some
researchers aggregate the expected values for
the latent variable beyond the limit points to
the limit values (i.e., expected values for the
EQ5D index above the limiting point below 1
get value 1). Although intuitively sensible, it

T

–

–

C

C

C

C

C

C

B

C

C

B

2

3

4

5
cens

obs

P( y1 observed, y2)

P( y1 censored , y3) .
obs

obs

P( y1, y2)

P( y1, y2)

P( y1 observed, y2)

P( y1 censored , y3) .

cens

obs

P( y1 censored) .

P( y1 censored) .

obs

P( y1)

cens

cens

cens

P( y1 censored) .

Likelihood

y3i* = b 3 x3i + u 3i

y 2i* = b 2 x 2i + u2i

y1i* = b1x1i + u1i

y3i* = b 3x 3i + u3i

y 2i* = b 2 x 2i + u 2i

y1i* = b1 x1i + u1i

y2i* = b2x2i + u2i

y1i* = b1x1i + u1i

y2i* = b2x2i + u2i

y1i* = b1x1i + u1i

y1i* = b1x1i + u1i

y 3i =

y2i =

y 3i =

y2i =

y1i =

y2i =

y1i =

y2i =

y1i =

if y 1i* ≤ 0
0

if y 1i* > 0
if y 1i* ≤ 0
if y 1i* > 0
if y 1i* ≤ 0

0
0
y 3i *

y3i *
y2i *

if y 1i* > 0
if y 1i* ≤ 0

0

if y 1i* ≤ 0
0

if y 1i* > 0

if y 1i* > 0
y 1i *

y 2i *

if y 1i* ≤ 0
0

if y 1i* ≤ 0
if y 1i* > 0

if y 1i* > 0

y 1i *
0
y2i *

if y 1i* > 0

if y 1i* > 0
if y 1i* ≤ 0

y 1i *
a
y2i *

if y 1i* ≤ 0

a

Formulae

6674

Tobit Models, Fig. 4 Amemiya’s summary of the different types of Tobit models

–

–

C

1

y3

y2

y1

Type

Dependent variables

T
Tobit Models

Tobit Models

ignores the construction of the model, in which
the expected value of the latent variable is implicitly conditioned to be observed.
With the estimation obtained from the model,
0
being xi b the expected value for the latent variable, the expected value for the observed variable
is correctly calculated by the formula in Fig. 3.
Assumptions
Standard Tobit assumptions hold on normality
and homoscedasticity of residuals, and Tobit
models have shown poor robustness to their
violation.
The Tobit models have been found to be nonconsistent and inefficient in the case of heteroscedasticity (Arabmazar & Schmidt, 1981; Hurd,
1979; Maddala & Nelson, 1975). In this case,
CLAD models are generally accepted as
a robust alternative to regress censored variables
(Clarke et al., 2002; Payakachat et al., 2009;
Petrou & Kupek, 2009; Pullenayegum et al.,
2010; Saarni et al., 2006; Sullivan & Ghushchyan
2005, 2006). While CLAD models present a valid
alternative to type I Tobit models, they do not
allow any exact post-estimation on observed variables; approximations used for Tobit for that
objective, mentioned in last section, have been
used in the literature for CLAD models as well
(Clarke et al., 2002; Sullivan & Ghushchyan,
2006); however, these approximations have no
basis to be applied with these models, so the use
of CLAD models for utilities/▶ QALYs should
be carefully studied (Fig. 4).

Cross-References
▶ Ceiling Effect
▶ Quality Adjusted Life Years (QALY)
▶ Utility

References
Amemiya, T. (1973). Regression analysis when the dependent variable is truncated normal. Econometrica,
41(6), 997.
Amemiya, T. (1984). Tobit models: A survey. Journal of
Econometrics, 24, 3–61.

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Arabmazar, A., & Schmidt, P. (1981). Further evidence on
the robustness of the Tobit estimator to heteroskedasticity. Journal of econometrics, 17(2), 253–258.
Bharmal, M., & Thomas, J. (2006). Comparing the EQ-5D
and the SF-6D descriptive systems to assess their ceiling effects in the US general population. Value in
Health, 9(4), 262–271.
Clarke, P., Gray, A., & Holman, R. (2002). Estimating
utility values for health states of type 2 diabetic
patients using the EQ-5D (UKPDS 62). Medical Decision Making, 22(4), 340–349.
Greene, W. (1997). Econometric analysis (3rd ed.). Saddle River: Prentice Hall.
Greene, W. (1999). Marginal effects in the censored
regression model. Economic Letters, 64(1), 13–49.
Guo, N., Marra, C. A., Marra, F., Moadebi, S., &
Elwood, R. K. (2008). Health state utilities in latent and
active tuberculosis. Value in Health, 11(7), 1154–1161.
Hasan, S. A., Subhani, M. I., & Osman, A. (2011). Marketing is all about taking money from customers (an
application of Tobit model). International Research
Journal of Finance and Economics, 81, 30–37.
Hurd, M. (1979). Estimation in truncated samples when
there is heteroscedasticity. Journal of Econometrics,
11, 247–258.
Iwata, S. (1993). A note on multiple roots of the Tobit log
likelihood. Journal of Econometrics, 56, 441–445.
Johnson, J. A., & Pickard, A. S. (2000). Comparison of the
EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Medical Care, 38(1),
115–121.
Luo, N., Johnson, J. A., Shaw, J. W., & Coons, S. J.
(2009). Relative efficiency of the EQ-5D, HUI2, and
HUI3 index scores in measuring health burden of
chronic medical conditions in a population health survey in the United States. Medical Care, 47(1), 53–60.
Maddala, G.S., Nelson, F.D. (1975). Specification errors
in limited dependent variable models. NBER Working
Paper Series, Vol. w0096.
McDonald, J. F., & Moffitt, R. A. (1980). The uses of
Tobit analysis. The Review of Economics and Statistics, 62(2), 318–321.
McDowell, I. (2006). Measuring health: A guide to rating
scales and questionnaires (3rd ed.). New York: Oxford
University Press.
Moock, J., & Kohlmann, T. (2008). Comparing preference-based quality-of-life measures: Results from
rehabilitation patients with musculoskeletal, cardiovascular, or psychosomatic disorders. Quality of Life
Research, 17(3), 485–495.
Olsen, R. J. (1978). Note on the uniqueness of the maximum likelihood estimator for the Tobit model.
Econometrica, 46, 1211–1215.
Payakachat, N., Summers, K., Pleil, A., Murawski, M.,
Thomas, J., Jennings, K., & Anderson, J. (2009).
Predicting EQ-5D utility scores from the 25-item
National Eye Institute Vision Function Questionnaire
(NEI-VFQ 25) in patients with age-related macular
degeneration. Quality of Life Research, 18(7), 801–813.

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Petrou, S., & Hockley, C. (2005). An investigation into the
empirical validity of the EQ-5D and SF-6D based on
hypothetical preferences in a general population.
Health Economics, 14(11), 1169–1189.
Petrou, S., & Kupek, E. (2009). Estimating preferencebased health utilities index mark 3 utility scores for
childhood conditions in England and Scotland. Medical Decision Making, 29(3), 291–303.
Pullenayegum, E. M., Tarride, J. E., Xie, F., Goeree, R.,
Gerstein, H. C., & O’Reilly, D. (2010). Analysis of
health utility data when some subjects attain the upper
bound of 1: Are Tobit and CLAD models appropriate?
Value in Health, 13(4), 487–494.
Saarni, S. I., H€ark€anen T., Sintonen, H., Suvisaari, J.,
Koskinen, S., Aromaa, A., & Lönnqvist, J. (2006).
The impact of 29 chronic conditions on health-related
quality of life: A general population survey in finland
using 15D and EQ-5D. Quality of Life Research, 15(8),
1403–1414.
Schnedler, W. (2005). Likelihood estimation for censored
random vectors. Econometric Reviews, 24(2),
195–217.
Sullivan, P. W., & Ghushchyan, V. (2005). A national
catalog of preference-based scores for chronic conditions in the United States. Medical Care, 43(7),
736–749.
Sullivan, P. W., & Ghushchyan, V. (2006). Preferencebased EQ-5D index scores for chronic conditions in
the United States. Medical Decision Making, 26(4),
410–420.
Tobin, J. (1958). Estimation of relationships for limited
dependent variables. Econometrica, 26(1), 24–36.
Vainiola, T., Pettil€a, V., Roine, R. P., R€as€anen, P.,
Rissanen, A. M., & Sintonen, H. (2010). Comparison
of two utility instruments, the EQ-5D and the 15D, in
the critical care setting. Intensive Care Medicine,
36(12), 2090–2093.

Tolerance
Allison Carter
Department of Sociology and Anthropology,
Rowan University, Glassboro, NJ, USA

Definition
Tolerance, the attitude, and toleration, the practice, are associated with liberal philosophies of
inclusion (Brown, 2006, 13). While tolerance
does not necessarily imply complete acceptance
or assimilation into the social order, it does imply
the refusal of complete rejection (p. 27).

Tolerance

Tolerance can be practiced by governments
toward their citizenry, by individuals toward
others’ diverse modalities of worship and lifestyle, and by citizens toward the abusive actions
taken by their government. As part of liberal
discourse, tolerance is associated with freedom
from bigotry and impartiality (p. 25). For neoMarxists such as Marcuse, tolerance as practiced
has turned into its opposite and is associated with
a repressive society.

Description
Two exemplars of the liberal espousal of tolerance are Jeffrey Alexander and Gustav Niebuhr.
Alexander sees the solidarity of the civil sphere
of society “as exhibited and sustained by
public opinion, deep cultural codes, distinctive
organizations – legal, journalistic and
associational—and such historically specific
interactional practices as civility, criticism, and
mutual respect” (Alexander, 2006, p. 31). Alexander believes that justice in democratic societies
derives from the civil sphere’s “ambition” for
universality, inclusiveness, and a balance
between collective obligation and individual
autonomy (p. 34).
Gustav Niebuhr, writing from a liberal, religious perspective, sees tolerance as a beginning.
“Simply tolerating people is not likely to make you
know them any better” (Niebuhr, 2008, p. 43).
Despite the limits of merely coexisting in the
same space, the interactions that result can lead
to knowledge and hopefully mutual appreciation.
“To reach beyond tolerance is to open oneself to
getting to know others, to appreciate their role in
the world. In that sense, it’s an activity that
involves recognizing (with some humility)
that one can actually learn from others” (p. 28).
Niebuhr cites the mainstream Christian (Presbyterian, Methodist, Episcopalian, Congregationalist)
churches’ repudiation of the doctrine of
supercessionism, according to which the New
Testament negated the Jewish covenant with God
(p. 135). For example, the Alliance of Baptists,
splitting from the conservative Southern Baptist
Convention, issued a statement acknowledging

Tolerance

that the “dehumanizing attitudes that lead to the
events collectively known as the Holocaust did not
occur overnight or within the span of a few years,
but were the culmination of centuries of Christian
teaching and church-sanctioned action directed
against the Jews…” (p. 137). In the wake of the
events of September 11, 2001, it is Muslims who
are subject to the possibility of stereotyping and
violence (pp. 5–11). For Niebuhr, what is needed is
an “era of conversation”; he advocates the practices of the interfaith movement which brings
together Christians, Jews, and Muslims to explore
their divergent traditions and develop an appreciation not only for one anothers’ beliefs, but for the
particularity of their own (p. 134).
Tolerance is a feature of political discourse.
As a political term tolerance is understood in
different ways. It is famously associated with
the liberal political philosophy of John Stuart
Mill. In On Liberty, published in 1859, tolerance
is seen as an enlightened response to recognizing
and optimizing the potential universal rational
character of humanity despite differences in
social background and as a means of peaceful
and productive coexistence among individuals.
Composed of essays by Robert Paul Wolff,
Barrington Moore, Jr., and Herbert Marcuse, A
Critique of Pure Tolerance, published in 1965,
sets the terms for subsequent debate over our
understanding of tolerance. Wolff addresses the
limits of Mill’s individualistic understanding for
analyzing complex societies and sees tolerance as
the particular virtue of industrial democratic
pluralism. Moore echoes Mill’s intellectual
concern for the role of toleration in a scientific
discourse which aims for truth in the face of the
recognition of the political subjectivity of its
practitioners. Marcuse sees tolerance in an
administered society as a force for repression
that has contradicted its original connection to
freedom and truth. In this essay, we take up the
debate over tolerance that these three
authors create as they build on their predecessor,
John Stuart Mill.
“The liberty of the individual must be thus far
limited; he must not make himself a nuisance to
other people. But if he refrains from molesting
others in what concerns them, and merely acts

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according to his own inclination and judgment in
things which concern himself, the same
reasons which show that opinion should be free,
prove also that he should be allowed, without
molestation, to carry his opinions into practice
at his own cost. That mankind are not infallible;
that their truths, for the most part, are only
half-truths; that unity of opinion, unless resulting
from the fullest and freest comparison of opposite
opinions, is not desirable, and diversity not an
evil, but a good, until mankind are much more
capable than at present of recognising all sides of
the truth, are principles applicable to men’s
modes of action, not less than to their opinions”
(John Stuart Mill, On Liberty).
According to Robert Paul Wolff, “for Mill and
the classical libertarian philosophy, tolerance is
the readiness to respect the inviolability of the
private sphere of the individual’s existence.
A man may choose to wear strange clothes,
grow a beard (or shave one off, if others wear
them), practice unfamiliar religions, deviate
from the sexual norms of his community, or in
any other way reject the tastes and habits of
society. The liberal philosophy demands that
society refrain from interfering with his practices,
either by legal or by informal social sanctions”
(Wolff, 1965, 25–26). Tolerance is conceived of
as a relation between individuals and between
society and the individual. What begins
as “grudging acceptance” hopefully turns into
“positive enjoyment of diversity” (p. 26). With
the individual as the basic unit of analysis, Mill’s
utilitarian philosophy sees society as the “intersection of all the public sphere of the individuals
who make it up,. . .a marketplace or battleground
in which each individual pursues his private goals
to the greatest extent compatible with the analogous pursuits by others.” Wolff continues his
analysis by contrasting Mill’s conception with
an understanding of tolerance in industrial
democracy as based on pluralism rather than
individualism.
According to Wolff, tolerance as a political
virtue should be considered the linchpin of
pluralistic democracy. He contrasts it with other
political virtues: equality as the virtue of liberal
democracy and fraternity as the virtue of socialist

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democracy (p. 4). For Wolff, our understanding
of the practice of tolerance should not be
centered on psychologies of prejudice but rather
on the political dimension of what allows
pluralistic democracy to work. Where liberal
democracy is centered on the individual citizen,
pluralistic democracy emerges out of the modern
industrialized
state
where
corporations
displace family firms and labor unions and trade
associations are organized, mediating the
relationship of individuals to the state. With universal adult franchise and the growth of industrial
economic institutional frameworks, the scale,
and organization of industrial society made
the classical democratic paradigm based on the
individual obsolete; “intermediating bureaucratic
organizations are necessary whether the
economy is private and capitalist or public and
socialist in structure” (pp. 7–8).
As the United States developed, both
federalism which reinforced the “natural ties of
tradition and emotion binding each citizen to
his [sic] native colony” and the American
“penchant,” first pointed out by Tocqueville, for
joining voluntary associations as a means of
addressing social problems contributed to the
development of a pluralistic democracy
organized around compromises balancing the
interests of particular group formations. Neither
turning to “God” or “the state” when confronted
with social problems, “Americans instinctively
form a committee, elect a president and
secretary-treasurer, and set about finding
a solution on their own” (p. 9). While warning
that this image is idealized, Wolff notes that the
US Constitution arose as “a series of
compromises among competing interests-large
states versus small, agriculture versus commerce,
slave-holding versus free labor” (p. 8). Politics
became understood as a conflict between “more
or less permanent groups” and an individual
participated in the nation’s political life, not
as an individual but as a member of one or more
of these groups (p. 9).
This was particularly true in the case of
religious groups. While many of the colonies
had been founded with particular religious

Tolerance

identities, the federal government did not allow
for an established religion, and thus diversity of
religious perspectives came to be recognized.
This legitimation of religious communities
eventually extended beyond the Protestant sects
to Roman Catholics and Jews. Nineteenth
century immigration reinforced this sense of
diversity of religious group life as cities became
“national enclaves,” composed of “Little Italies,
Chinatowns, Polish ghettos, German communities,” etc. (p. 12). Wolff comments that eventually those descending from the original settlers
received their own “identifying acronym,
WASP” (p. 13). The USA became “a nation of
minorities,” where each “‘hyphenated’ community (Italian-American, Polish-American, etc.)
had its own churches,” particular religious practices, newspapers in their language of origin,
clubs, societies, businessmen’s associations, and
trade union branches, “all based on the ethnic or
religious unity of the local community”
(pp. 12–13). And it was as a member of these
religious and ethnic groups that immigrants participated in political life, as these groups used
their voting populations as a way to gain power,
have a say in local politics, and elect members to
office (p. 13).
Wolff examines various justifications for
pluralism and hence intergroup tolerance. Either
it is a necessary evil, a way to balance power
such that groups get taken into account based
on their voting strength, or a way to transfer
loyalty from the group to the state as a whole.
The danger of “in-group loyalty” is its “natural
accompaniment,” “out-group hostility,” or
intolerance (p. 22). On the other hand, to weaken
these “primary ties” is to invite in the specter of
“‘mass man,’ the unaffiliated, faceless
member of the lonely crowd” (p. 22). Instead
society invites an appreciation of “primary
group diversity,” so that group members
maintain their distinctiveness rather than melt
into “a universal brotherhood.” The new ideology
claims that it is a positive good for society to be
constituted by multiplicity, many faiths, races
and ethnicities, and lifestyles. Pluralism is
necessary for the survival of modern industrial

Tolerance

society, and tolerance is the social psychological
orientation that allows it to function.
Much of Wolff’s discussion is centered on
a critique of John Stuart Mill’s notion of political
tolerance based on the freedom of the individual.
Wolff invokes Emile Durkheim’s study of
suicide to depict individuals as inherently social
and dependent on society to teach them to
constrain their impulses and egoistic tendencies
which result in higher suicide rates for groups
such as Protestants which are based more on
individualism than on group affiliation such
as Catholics and Jews (pp. 32–33). For Wolff,
“the individual is not capable of the
self-regulation which Mill’s doctrine of liberty
presupposes” (p. 34). Yet tolerance poses its
own threat to the integrity and survival of traditional allegiances and beliefs. For Wolff, despite
its dangers, we cannot retreat from modernity
with its promises of liberation to an era of superstition (p. 35). Democratic pluralism maintains
a tension between “the union of ‘liberal’ principles and ‘conservative’ sociology” (p. 36).
Where classical tolerance was directed to
individuals and noninterference in the private
spheres of life, the tolerance of democratic
pluralism focuses on groups – religious, ethnic,
and racial – as the “units of society between
which tolerance and mutual acceptance are to
be exercised” (p. 37). Mill’s arguments about
individuals are transformed into “arguments for
the right of a social group to differ from
other social groups” (p. 37). Wolff cites the
“catch-phrase of tolerance, without regard to
race, creed, color, or national origin” (p. 40).
The ideal of democratic pluralism is to achieve
a “healthy balance” between these groups and
others based on socioeconomic function,
owners, workers, consumers, and different
sectors of the economy (pp. 40–41).
Two problems emerge with this theory of
democratic pluralism. On the one hand, tolerance
of groups seems to coexist with a lack of
tolerance for the nonconforming individual;
tolerance of many religious groups does not entail
tolerance of the individual atheist (p. 37). On the
other hand, as it works in practice, democratic

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pluralism extends tolerance only to groups which
are recognized as legitimate; the conception of
acceptable social groups “becomes frozen”
and “favors groups in existence against those in
process of formation” (p. 41). As new groups
emerge – Wolff cites migrant workers, interfaith
couples seeking adoption, peace, and poverty
movements, but we might also think of
Muslim Americans, gays, lesbians, and the
transgendered – they may or may not achieve
inclusion in the sphere of democratic tolerance.
Then pluralistic democracy and tolerance may
function as an ideology, ensuring rights for
those already legitimated and making it
more difficult for members of groups who
are excluded (pp. 39, 45).
“The opinion which it is attempted to suppress
by authority may possibly be true. Those who
desire to suppress it, of course deny its truth; but
they are not infallible. They have no authority to
decide the question for all mankind, and
exclude every other person from the means of
judging. To refuse a hearing to an opinion,
because they are sure that it is false, is to
assume that their certainty is the same thing
as absolute certainty. All silencing of
discussion is an assumption of infallibility. Its
condemnation may be allowed to rest on this
common argument, not the worse for being common.” (John Stuart Mill, On Liberty)
For Barrington Moore, Jr. in “Tolerance and
the Scientific Outlook,” toleration, as he calls it
after Mill, is part of the scientific endeavor, by
which he includes literary and philosophical
inquiries, in addition to hard science: any
inquiry which is governed by sound reasoning
and evidence and submits itself to
verification. He is arguing against a form of
“pseudotoleration” that occurs in academic
debate that holds that objective knowledge is
impossible (Moore, 1965, 55). For Moore,
there are criteria – aesthetic and pragmatic/political – that allow us to understand the difference
between trivial and significant questions. “One
criterion for distinguishing significant from
trivial truth is. . .the amount of benefit or
harm that comes from its discovery” (p. 57).

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For Moore, different interpretations of history
may differ and supplement each other as long
as both are based on evidence; if they contradict
each other, the disagreements are to be solved
by appeal to evidence. Moore does not believe
in abstract tolerance, or as he calls it, “watery
toleration of every doctrine” because it might
yield some contribution, nor in being doctrinaire
(p. 54). He does not advocate tolerance on
the basis of different “Weltanschauungen,” or
different worldviews, because he believes that
contradictions between differing interpretations
can be resolved through scientific inquiry
(pp. 60–61). Moore acknowledges a subjective
and even partisan element in all interpretive
activity. “In the social sciences and history,
significant facts are bound to be partisan in the
sense that they upset somebody’s cherished
pre-conceptions” (p. 61). While there is
a greater probability that “truth will be subversive
of the established order, . . . there is no guarantee
whatever that a critical conception of society is
a correct one” (p. 61). Toleration of ideas is
necessary to maintain an open-mindedness that
is necessary to scientific inquiry which requires
that “every idea, including the most dangerous
and apparently absurd ones, deserves to have its
credentials examined.” This “does not mean
accepting the idea. Toleration implies the
existence of a distinctive procedure for testing
ideas, resembling due process in the realm
of law” (p. 63). Such procedures and their
development are the hallmark of the
scientific outlook (p. 63). Moore continues his
essay by illustrating some of these procedures;
he analyzes the features of what he calls
a “rational social criticism” of Nazism and
concludes with a discussion of “the conditions
under which the resort to violence is justified in
the name of freedom” (p. 75). In his discussion of
revolutionary violence, he uncovers three
considerations: that the regime is repressive and
society could exist with less suffering and
constraint, that a revolution is possible with
enough popular support to be successful, and
that the suffering caused by the revolutionary
activity is outweighed by the suffering entailed
by maintaining status quo (pp. 75–77).

Tolerance

“Protection, therefore, against the tyranny
of the magistrate is not enough: there needs
protection also against the tyranny of the
prevailing opinion and feeling; against the tendency of society to impose, by other means than
civil penalties, its own ideas and practices as
rules of conduct on those who dissent from
them; to fetter the development, and, if possible,
prevent the formation, of any individuality not in
harmony with its ways, and compel all characters to fashion themselves upon the model of its
own.” (John Stuart Mill, On Liberty).
“It is easy for any one to imagine an ideal
public, which leaves the freedom and choice
of individuals in all uncertain matters
undisturbed, and only requires them to abstain
from modes of conduct which universal
experience has condemned. But where has
there been seen a public which set any such
limit to its censorship? or when does the public
trouble itself about universal experience? In its
interferences with personal conduct it is seldom
thinking of anything but the enormity of acting
or feeling differently from itself; and this standard of judgment, thinly disguised, is held up to
mankind as the dictate of religion and philosophy, by nine-tenths of all moralists and speculative writers. These teach that things are right
because they are right; because we feel them to
be so. They tell us to search in our own minds
and hearts for laws of conduct binding on ourselves and on all others. What can the poor
public do but apply these instructions, and
make their own personal feelings of good and
evil, if they are tolerably unanimous in them,
obligatory on all the world?” (John Stuart Mill,
On Liberty).
In his essay on “Repressive Tolerance,”
Herbert Marcuse aims at restoring to
tolerance its original “partisan goal” of
a “subversive liberating notion and practice”
(Marcuse, 1965, 81). He concludes that what is
needed is to reverse strategies, to practice
“intolerance toward prevailing policies, attitudes, and opinions, and the extension of tolerance to policies, attitudes and opinions which are
outlawed or suppressed” (p. 81). For Marcuse,
“tolerance is an end in itself,” linked to the

Tolerance

creation of a humane society which is
predicated on eliminating violence and
reducing suppression (p. 82). As Marcuse sees
it, contemporary societies such as the USA are
saturated with violence and governed as
administered states which control the minds of
their citizenry. As practiced in these societies,
tolerance is part of the problem rather than the
solution. Tolerance reinforces “the tyranny of
the majority” while being “withdrawn from the
opposition,” where it would allow for energetic
debate and the search for truth. Tolerance
becomes passive rather than active, as citizens
adopt a “laissez-faire” attitude toward the status
quo (p. 82). Tolerance has become repressive
rather than liberatory. “Tolerance toward that
which is radically evil now appears as good
because it serves the cohesion of the whole on
the way to affluence or more affluence. The
toleration of the systematic moronization of
children and adults alike by publicity and propaganda, the release of destructiveness in aggressive driving, the recruitment for and training of
special forces, the impotent and benevolent tolerance toward outright deception in merchandising, waste, and planned obsolescence are not
distortions and aberrations: they are the essence
of a system which fosters tolerance as a means
for perpetuating the struggle for existence and
suppressing the alternatives” (p. 83).
For Marcuse, tolerance as practiced in
“an administered society” such as the USA is
a force for repression because such practices as
the tolerance of free speech in protest movements
ultimately serve to confer legitimacy on the
state, attesting to its democratic character, while
simultaneously limiting liberty to practice
through word rather than deed, with no threat to
the status quo. Marcuse’s perspective is complex
because his dialectical approach not only sees the
administered whole by which he means the
educative and ideological apparati of the state as
determining and limiting the character of
the part – in this case, free speech – but sees the
existence of these liberties also functioning as
reminders of “their original oppositional
function” (pp. 83–84). For Marcuse, tolerance
depends on its universality among all members

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of society and is therefore dependent on
equality. In a society such as the USA,
constitutional or formal equality coexists with
“institutionalized inequality” in the socioeconomic class structure. This inequality serves to
undermine the efficacy of opposing viewpoints,
as the power of education and the media, as
well as the police and armed forces, resides
with the dominant interests in society,
resulting in suppression in the name of national
security. Marcuse’s concern is focused on the
centrality of military violence in the national
consciousness (pp. 83–86).
Marcuse examines John Stuart Mill’s liberalist understanding of tolerance, liberty, and
truth, citing Mill’s connection of liberty to
truth; Mill sees liberty as applicable to rational
human beings who “have become capable of
being improved by free and equal discussion”
(Mill 1859, 86). For Marcuse, the ability to
think freely and express one’s thoughts is
linked essentially to one’s ability to think
one’s way to freedom; this “necessitates tolerance.” However, tolerance should not be indiscriminate; it should not protect false ideas or
legitimate deeds that “counteract the possibilities of liberation” (p. 88). “Tolerance of free
speech is the way of improvement, of progress
in liberation, not because there is no objective
truth, and improvement must necessarily be
a compromise between a variety of opinions,
but because there is an objective truth which
can be discovered. . .” (p. 89). Where freedom
and peace are concerned, “certain things cannot
be said, certain ideas cannot be expressed, certain policies cannot be proposed, certain behavior cannot be permitted without making
tolerance an instrument of servitude” (p. 88).
While he is against censorship in art, here Marcuse seems to espouse a political correctness in
speech such as we see in contemporary issues of
hate speech and the outlawing of Nazism in
Germany. For Marcuse, Mill’s liberalist ideal
of tolerance was predicated on the “(potential)
individuals who could learn to hear and see and
feel by themselves, to develop their own
thoughts, to grasp their true interests and rights
and capabilities, also against established

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authority and opinion. This was the rationale of
free speech and assembly” (p. 90). However,
this rationale does not seem to apply when we
confront “manipulated and indoctrinated individuals who parrot, as their own, the opinion of
their masters,” who claim freedom of thought
and moral independence in the very language
that forms what Marcuse seems to understand
as their administered false consciousness
(p. 90).
Given its link with truth and freedom,
tolerance depends on free and equal, rational
discussion and “independent thinking, free
from indoctrination, manipulation, extraneous
authority. The notion of pluralism and
countervailing powers is no substitute for this
requirement.” In an unequal society, balancing
of powers is impossible as dominant interests
far outweigh their potential opponents and
“coagulate. . .into an overwhelming whole,
integrating the particular countervailing powers
by virtue of an increasing standard of living and
an increasing concentration of power” (p. 93).
The real conflicts of interest between labor and
management, consumer and producer, and
intellectual and employer become inarticulable
and appear unreasonable as their would-be
proponents
“submit”
to
the
system;
alternatives to this whole are relegated to a
“utopian dimension in which. . .[they are] at
home, for a free society is indeed unrealistically
and undefinably different from the existing ones”
(p. 93).
The liberating dimension of democracy as
a system is its focus on the role of dissent.
When this is undermined by the existence of
“monopolistic media,” which function as
instruments of domination for the prevailing
economic and political powers, the possibility
of free thought is undercut by the particular
rigid use of language in which the “meaning of
words is rigidly stabilized. Rational persuasion,
persuasion to the opposite is all but precluded.
The avenues of entrance are closed to the meaning of words and ideas other than the established
one-established by the publicity of the
powers that be, and verified in their practices.

Tolerance

Other words can be spoken and heard, other
ideas can be expressed, but, at the massive
scale of the majority (outside such enclaves as
the intelligentsia) they are immediately ‘evaluated’ (i.e., automatically understood) in terms of
the public language-a language which determines a priori the direction in which the thought
process moves. Thus the process of reflection
ends where it started: in the given conditions
and relations. Self-validating, the argument of
the discussion repels the contradiction because
the antithesis is redefined in terms of the thesis”
(pp. 95–96).
Paradoxically, while effective dissent is
undermined, the tolerant society produces
a cacophony of voices and perspectives:
communist and fascist, left and right, and for
armament and for disarmament. Each opinion is
treated as equal to the other: “the stupid opinion is
treated with the same respect as the intelligent
one, the misinformed may talk as long as
the informed, and propaganda rides along with
education, truth with falsehood” (p. 94). The
justification is that no one is in sole possession
of the truth or able to determine right and wrong;
all opinions are to be judged in the court of public
opinion. This notion presupposes that the
public “must be capable of deliberating and
choosing on the basis of knowledge,” that they
are given access to appropriate information and
are capable of independent thought (pp. 94–95).
According to Marcuse, this is precisely what is
not the case. While an impartial reading of
competing ideas is central to the democratic
ideal, impartiality can result in a “neutralization
of opposites,” as when a “newscaster reports the
torture and murder of civil rights workers in
the same unemotional tone he uses to describe
the stockmarket or the weather, or with the
same great emotion with which he says his
commercials” (pp. 97–98). For Marcuse, this
kind of impartiality or “objectivity” is false and
manifests as an inhuman tolerance for acts of
cruelty and injustice. “The tolerance expressed
in such impartiality serves to minimize or even
absolve prevailing intolerance and suppression”
(p. 98). The audience has been “indoctrinated,”

Tolerance

is incapable of recognizing their indoctrination,
and cannot “transcend” the “conditions under
which they live and think” (pp. 98–99). The
“facts” are always mediated by those who
frame them, and any perception of the truth
which underlies the facts requires a “rupture
with their appearance. This rupture-prerequisite
and token of all freedom of thought and speechcannot be accomplished within the established
framework of abstract tolerance and spurious
objectivity because these are precisely the factors which precondition the mind against the
rupture” (p. 99).
Nevertheless, for Marcuse, societies with
democratic tolerance are more humane than
dictatorships which institutionalize intolerance.
Marcuse goes on to discuss when violence may
be necessary and what criteria would be used to
justify violence in the repressive affluentdemocratic society. It would be important to
recognize that violence is performed by
the state, but this recognition is “clouded by
ideologies which serve the perpetuation of
violence. . . . [V]iolence actually prevails; it is
practiced by police, in the prisons and mental
institutions, in the fight against racial minorities.”
In the name of expanding freedom and free
markets, it is carried into developing
countries as well (p. 102).
Marcuse presents a vivid depiction of false
consciousness as it functions in an administered
state. Because of this perspective, he differs
from Mills, who believes that better ideas will
eventually win out in the court of public opinion. His attempt to show how the philosophical
rupture that is necessary to apprehend truth is
prevented by the practices of tolerance does not
describe how that rupture is experienced or how
he and the enclave of intellectuals he mentions
achieve transcendent viewpoints capable of
seeing beyond given conditions. His arguments
for censorship and “precensorship” seem
dangerous, even as one can appreciate his
point that “hidden censorship. . .permeates the
free media” (p. 111). For Marcuse, a tolerance
that mainly serves to maintain a repressive society, silence opposition, and makes people

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“immune” to each other and a vision of
a better life is ultimately perverted from its
aims (p. 111). Ultimately, Marcuse sees intellectuals and others who have escaped false consciousness as dispersed among the population,
rather than located in one revolutionary class
determined by their material conditions. Their
task, as he sees it, is to try and make a space for
reflection. “The effort of emancipation becomes
‘abstract’; it is reduced to facilitating the recognition of what is going on, to freeing language
from the tyranny of the Orwellian syntax and
logic, to developing the concepts that comprehend reality. More than ever. . .progress in
freedom demands progress in the consciousness
of freedom.” What is needed is “political
education (or rather countereducation)”
(pp. 111–112).

Cross-References
▶ Democracy
▶ Freedom
▶ Human Rights
▶ Ideology
▶ Liberty
▶ Pluralism

References
Alexander, J. C. (2006). The civil sphere. Oxford, UK:
Oxford University Press.
Brown, W. (2006). Regulating aversion: Tolerance in the
age of identity and empire. Princeton, NJ: Princeton
University Press.
Marcuse, H. (1965). Repressive tolerance. In A critique of
pure tolerance. Boston: Beacon.
Mill, J. S. (1859). On liberty. Kindle Edition.
Moore, J. B. (1965). Tolerance and the scientific outlook.
In A critique of pure tolerance. Boston: Beacon.
Niebuhr, G. (2008). Beyond tolerance: Searching for
interfaith understanding in America. New York:
Viking.
Wolff, R. P. (1965). Beyond tolerance. In A critique of
pure tolerance. Boston: Beacon.
Wolff, R. P., Moore, J. B., & Marcuse, H. (1965). A
critique of pure tolerance. Boston: Beacon.

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Tolerance Toward Partner Violence
▶ Public Attitudes Toward Partner Violence
Against Women

Tool for Research Synthesis on
Happiness
▶ World Database of Happiness

Top Ten US Best Towns: Outside
Magazine
Ariel Rodrı́guez and Burcu Kaftanoglu
School of Community Resources and
Development, Arizona State University,
Phoenix, AZ, USA

Description
Outside is a magazine circulated throughout
the United States in paper and online formats.
Its readers are largely outdoor ▶ recreation
enthusiasts (Outside, 2013a). Each year, Outside
searches for the city in the United States with the
best overall ▶ quality of life with the help of its
readers (Outside, 2013b). Their selection is based
on the cultural vibrancy (including nightlife),
economic well-being (including home prices
and job prospects), stress-free living, and
proximity to the outdoors of various cities
(Outside, 2013c).
In 2011, the selection of the “Best Town”
within the USA was based on a two-stage
process. First, Outside provided a list of ten cities
they deemed had reasonable home prices, culture,
jobs, stress-free living, and proximity to the
outdoors. The specific criteria for what is
“reasonable” are not readily available. Then, Outside opened up the voting on their Facebook page.

Tolerance Toward Partner Violence

In 2011, a total of 21,975 individuals voted on the
Outside Facebook site (Outside, 2011).
Ten Best Towns of 2011
1. Chattanooga, Tennessee (33.8 %) (Outside,
2011)
2. Tucson, Arizona (27 %)
3. Charleston, South Carolina (10.2 %)
4. Boulder, Colorado (7.7 %)
5. Ashland, Oregon (5.3 %)
6. Burlington, Vermont (3.6 %)
7. Madison, Wisconsin (3.4 %)
8. Portland, Maine (3.2 %)
9. Portland, Oregon (3.1 %)
10. Santa Fe, New Mexico (2.7 %)
Selection Process Critique
In reviewing the selection process of past years,
a major component of the selection process is
done in-house by staff members of Outside.
Additionally, the recent introduction of voting
via Facebook reflects Outside’s efforts to use
social media in their voting process. An outcome
of this is the lack of a consistent selection process.
As such, it is not uncommon to have different
cities on the “Best Towns” list from 1 year to the
next. For instance, in 2008, the top five cities
included (1) Washington, DC; (2) Chattanooga,
Tennessee; (3) Ogden, Utah; (4) Portsmouth,
New Hampshire; and (5) Tacoma, Washington
(Outside, 2008). In 2009, the top five cities
included (1) Colorado Springs, Colorado;
(2) Seattle, Washington; (3) Atlanta, Georgia;
(4) Austin, Texas; and (5) Boston, Massachusetts
(Outside, 2009). In 2010, the top five cities
included (1) Boise, Idaho; (2) Carbondale, Colorado; (3) Portland, Maine; (4) Chattanooga, Tennessee; and (5) Grand Rapids, Michigan
(Outside, 2010). From the lists, one may conclude a great amount of change occurs in cities
throughout the United States from 1 year to the
next. However, these differences in lists are more
likely a product of the different methodologies
implemented from year to year.
Best Towns Online
In addition to the overall “Ten Best Towns” list
provided by Outside, they also provide

Top-Down QOL Models

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a customized “Best Town” for individual readers
based on an expansive list of top 19 best towns for
the current year selected by Outside staff. The
list includes the top ten best towns voted upon
by its readers but adds an additional nine which
were not voted upon by its readers. This option is
produced online through their interactive website
(http://www.outsideonline.com/adventure-travel/
best-towns). The categories readers may select
from include Nightlife and Culture, Affordability, Population, Weather, Running, and other
outdoor activities.

Michael Stones1 and Samuel Shye2
1
Department of Psychology, Lakehead
University, Thunder Bay, ON, Canada
2
The Van Leer Jerusalem Institute and
The Hebrew University of Jerusalem,
Jerusalem, Israel

References

Adaptation-level theory; Analysis of quality of
life (QOL) models; Decomposition; Set point
theory; Synthesis of quality of life models

http://www.louisvilleky.gov/NR/rdonlyres/7E20C33E55B4-41AC-9FF2-2A8FF1AD9C15/0/outside_mag
_aug2008_lg.pdf
http://www.outsideonline.com/
http://www.outsideonline.com/adventure-travel/America-sBest-Cities.html
http://www.outsideonline.com/adventure-travel/Best-Towns2010.html
http://www.outsideonline.com/adventure-travel/best-towns/
How-You-Picked-Them.html
http://www.outsideonline.com/adventure-travel/best-towns/
Life-is-Better-Here.html
Outside. (July 25, 2008). Best towns 2008: Progressive
candidates. Retrieved April 19, 2013, from http://
www.outsideonline.com/adventure-travel/ProgressiveCandidates.html.
Outside. (July 20, 2009). Best towns 2009: America’s best
cities. Retrieved April 19, 2013, from http://www.
outsideonline.com/adventure-travel/America-s-BestCities.html.
Outside. (July 29, 2010). Best towns 2010. Retrieved
April 19, 2013, from http://www.outsideonline.com/
adventure-travel/Best-Towns-2010.html.
Outside. (August 29, 2011). Best towns 2011: Life is
better here. Retrieved April 19, 2013, from http://
www.outsideonline.com/adventure-travel/best-towns/
Life-is-Better-Here.html.
Outside. (August 31, 2011). Best towns 2011: How you
picked them. Retrieved April 19, 2013, from http://
www.outsideonline.com/adventure-travel/best-towns/
How-You-Picked-Them.html.
Outside. (2013a). Adventure travel, gear, and fitness.
Retrieved April 19, 2013, from http://www.
outsideonline.com/.
Outside. (2013b). Best towns archive. Retrieved April 19,
2013, from http://www.outsideonline.com/adventuretravel/best-towns-archive.
Outside. (2013c). Best towns. Retrieved April 19, 2013,
from http://www.outsideonline.com/adventure-travel/
best-towns.

Top-Down QOL Models

Synonyms

Definition
The ▶ quality of life (QOL) literature refers to the
top-down versus bottom-up distinction in two ways.
With respect to model design, the point of departure
for the top-down modeling is the formulation and
specification of a general “umbrella” concept that
serves as a key construct for defining QOL. Then
the general concept is successively decomposed,
or differentiated, into lower levels of components
to attain the level of concrete QOL items. The
bottom-up approach builds models by specifying
concrete QOL items or lower-level components
in detail and then groups them into larger and
larger subsystems to form top-level components.
Diener (1984) introduced the terms top-down
and bottom-up to differentiate explanatory theories of ▶ subjective well-being (SWB). Topdown theories assume that phenotypic variation
accounts for differences in feelings, emotions,
and behavior when individuals interact with
their environments. Bottom-up model theories
assume that SWB represents an aggregate of feelings and emotions associated with such variables
as economic status, ▶ health condition, and
▶ social support. Whereas top-down theories
assume that “a person enjoys pleasures because
he or she is happy,” bottom-up theories suggest
that a happy life consists of “an accumulation of
happy moments” (Diener, 1984, p. 565).

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Description
Model Design
Taillefer, Dupuis, Roberge, and Le May (2003)
reviewed 68 models of QOL, finding that the
umbrella (i.e., top-level) concept could be any
one of the following: ▶ happiness, well-being,
satisfaction, performance, level of functioning,
goal attainment (including gaps between
a person’s goals and condition in different life
domains), needs satisfaction, and health. Many of
these concepts relate to an individual’s evaluation of global or specific facets of well-being;
others to appraised standing, or status, but without concomitant evaluation.
An example of a top-down model design is the
▶ Systemic Quality of Life (SQOL) model (Shye,
1989), which derives from the wider ▶ Faceted
Action System Theory. The point of departure is
the notion of QOL as an overall grand system,
defined as the effective functioning of the human
individual. Then, by a process of successive
partitioning, the model systematically divides the
whole QOL content space into classes of functioning, thereby identifying increasingly more specific
contents domains (in effect, subsystems, sub-subsystems, and so on), such that each progressively
lower order subsystem can be represented by one
or more concrete observational items.
This partitioning design (as opposed, e.g., to
the tree design) for going from the top downward
ensures the following properties at every level of
analysis. (1) The resulting systems are exhaustive
(cover the entire universe). (2) The resulting systems are exclusive (each representing a distinct
content not shared by another). (3) With the
partitioning carried out in a systematic and balanced fashion, the subsystems at any given level
are at a similar level of abstraction. For example,
the SQOL envisions four modes of functioning
(adaptive, conservative, expressive, integrative),
gauges their effectiveness within each of the four
domains of functioning (cultural, personality,
physical, and social), and measures that effectiveness by QOL items (questions) that sample each
of the resulting16 mode-domain interactions.
In contrast, a bottom-up QOL model begins by
searching for, and subsequently selecting, a set of

Top-Down QOL Models

items intended to sample the intended content
universe. The process of item selection is typically eclectic, with suitable items assembled
(e.g., by the researcher, a panel of referees) and
then grouped in stages into a manageable number
of classes. The grouping process may be formal
(e.g., using facet technique) or informal (e.g.,
clustered by apparent conceptual similarity).
Dalkey (1972) exemplified the bottom-up
approach. He obtained some 250 QOL items
from his students and combined them in stages,
first into 45 groups, then into 13 “actors.”
Explanatory Theories
Philosophical discussion of what became known
as bottom-up versus top-down dichotomy for
understanding variability in the happiness of people contrasted Lockean reductionism with Kantian idealism (Stones & Kozma, 1980). The
former understands concepts like SWB by reference to its elements (e.g., relative numbers of
pleasant and unpleasant experiences), whereas
Kant reasoned that SWB depends upon “satisfaction with one’s condition . . . with what nature
bestows” (Wike, 1994, p. 2).
Diener (1984) reasoned that challenges for
top-down modeling were to ascertain how
a person acquires a sanguine temperament, how
resistant it is to change, and how it interacts
with
changing
circumstance.
Evidence
supporting top-down interpretations of SWB
derives from studies of monozygotic and dizygotic twins, personality, and evaluative
cognitions:
1. Twin studies. Findings from at least nine studies of monozygotic and dizygotic twins during
the past 15 years showed that genetically
related effects explained 40–60 % of variance
in onetime assessment of QOL (i.e., mainly
SWB measures) and 80 % of variance in phenotypic cross-time correlations (Stones,
Kozma, McNeil, & Worobetz, 2011). Weiss,
Bates, and Luciano (2008) included both SWB
and the Big Five personality traits among their
measures (cf. ▶ Five Factor Model of Personality). They concluded that “subjective wellbeing was genetically indistinct from personality traits” (p. 209).

Top-Down QOL Models

A further conclusion by Weiss et al. (2008)
was that “the relationship between subjective
well-being and a range of health and socialrelationship factors may also be mediated by
common genetic effects” (p. 209). Schnittker
(2008) provided evidence of genetic mediation for marital status, marital support, and
wealth, but not for support from friends,
employment status, or income. Although
researchers routinely consider life domain
measures bottom-up influences on QOL,
Schnittker’s (2008) findings suggest that
some are subject to the same genetic endowment that applies to SWB. Consequently,
claims that the totality of bottom-up effects
accounts for 10–15 % of the variance in
SWB (Diener, Suh, Lucas, & Smith, 1999)
may be an overestimate.
2. Personality. Research on personality provides
abundant evidence that neuroticism and extraversion correlate with SWB. A meta-analysis
by Steel, Schmidt, and Schultz (2008)
reported correlations of .25– .44 between
▶ positive affect and extraversion and .46–
.54 between ▶ negative affect and neuroticism. Other findings indicate that Rushton
and Irwing’s (2011) General Factor of Personality shared 60 % of variance with the ▶ Positive and Negative Affect Schedule (PANAS)
and the ▶ Satisfaction with Life Scale
(SWLS) (Musek, 2007).
3. Evaluative cognitions. Findings on evaluative
cognitions indicate covariation between measures of well-being irrespective of their content. Stones and Kozma (1985) found that
a single higher-order factor subsumed relationships between composite scores on 27
measures of SWB. Findings on relationships
between different types of well-being (e.g.,
▶ eudaimonic well-being, psychological
well-being, SWB) similarly found substantial
covariation (Stones, Worobetz, & Brink,
2011). Such evidence is suggestive of
a general factor of well-being (gWB)
(cf. ▶ Personal Well-being).
Studies of relationships between global
measures of SWB and life domain satisfactions provide a paradigm to test between

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top-down and bottom-up explanations. Findings from designs including one or repeated
measurements more frequently showed that
global SWB subsumed variance in domain
satisfactions than vice versa (Stones, Kozma,
McNeil, & Worobetz, 2011; Stones, Worobetz,
& Brink, 2011). Stones and Kozma (1986), for
example, found support for top-down over
bottom-up explanation in 17/18 comparisons.
These findings indicate that Diener, Suh,
Lucas, and Smith (1999) were correct to
consider domain satisfactions a component of
(rather than an influence on) SWB.
4. Template for a top-down explanatory model.
Although ▶ adaptation-level and set point theories address the stability of SWB, they lack
the flexibility to account for lasting effects of
changing circumstance on some people. The
best available evidence suggests that temperament provides an encompassing umbrella
concept for the design of top-down explanatory model possessing such flexibility. Individual differences in temperament, acquired
through nature and nurture, include heritable
personality traits, cognitive evaluations, and
their behavioral manifestations. The latter
include happiness-inducing behaviors (HIB;
e.g., savoring the moment, acts of generosity)
(Warner & Vroman, 2011) and happy behaviors (HB) (i.e., behavioral manifestations of
positive affect). Bottom-up term influences
include substantive variables (e.g., life circumstance, life change) and unobserved variation (i.e., error).
Properties of the model in Fig. 1 include stability in SWB due to common effects from temperament and specific effects from personality traits (cf.
Weiss, Bates, & Luciano, 2008). Such stability is
consistent with Shye’s (1989) affirmation of conservative properties that safeguard the integrity of
systemic structures from assault from external
sources (e.g., as immune functions restore damage
due to disease). However, massive external assault
may impede recovery. Examples include individuals with multiple or chronic health problems that
lead to prolonged loss in SWB (cf. Diener et al.,
1999). Although usually interpreted as direct attribution (Eswb > SWB), such findings might

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Top-Down QOL Models

Top-Down QOL Models,
Fig. 1 Template for a topdown explanatory model
(Known effects indicated
by solid arrows; probable
effects by dashed arrows.
Substantive variables
represented by rectangles;
unmeasured variables by
ellipses)

plausibly represent mediation via HIB (e.g., Eswb
> Ehib > HIB > SWB), such that incapacitating
illness limits opportunities for positive health and/
or social behaviors.
Structural relationships of temperament variables indicate that personality traits contribute
variance to SWB both directly (Trait > SWB)
and instrumentally through mediation by HIB
(Trait > HIB > SWB) (Tkach & Lyubomirsky,
2006; Warner & Vroman, 2011). Warner and
Vroman (2011) found that neuroticism contributes directly to SWB, agreeableness and extraversion both directly and instrumentally,
and conscientiousness and openness only instrumentally (as represented by traits 1, 2, and 3 in
Fig. 1). Such functioning corresponds to the
integrative mode in Shye’s (1989) SQOL

model, the purpose of which is to engender
harmony among structural components.
Shye (1989) proposed that a purpose of
expressive functioning is to shape the environment in directions compatible with internal structures. Figure 1 represents expressive functioning
by contributions from HR and HIB to variance in
external correlates of SWB (HB > Eswb; HIB >
Eswb). Although previous research allows indirect inferences about environmental effects due
to HB and HIB, the evidence for such effects is
compelling. Examples include findings that prior
positive affect (HB) predicted subsequent success in socially valued life domains (e.g., health,
income, marriage), with behaviors subsumed by
HIB including those anticipated to elicit positive
environmental change (e.g., acts of kindness)

Toronto

(Lyubomirsky, King, & Diener, 2005; Warner &
Vroman, 2011). Adaptive functions in Shye’s
(1989) model represent compensatory exchanges
between the environment and behavior. Figure 1
represents adaptive functioning by the recursive
loop from Eswb > Ehib > HIB > Eswb.
Summary
Top-down refers to both model design and directional effects in explanatory modeling. Based on
the best available evidence, we illustrate a
template designed from temperament downward
that takes account of upward contributions to
QOL from external circumstance. Although necessarily framed at an abstract level, the template
may guide the design of more detailed models.

Cross-References
▶ Adaptation-Level Theory
▶ Affective Component of Happiness
▶ Genetic Disposition of Quality of Life

References
Dalkey, N. C. (1972). Studies in the Quality of Life. Lexington, MA: Lexington.
Diener, E. (1984). Subjective well-being. Psychological
Bulletin, 95, 542–575.
Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L.
(1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 276–302.
Lyubomirsky, S., King, L. A., & Diener, E. (2005). The
benefits of frequent positive affect: Does happiness
lead to success? Psychological Bulletin, 131,
803–855.
Musek, J. (2007). A general factor of personality: Evidence for the Big One in the five factor model. Journal
for Research in Personalit, 41, 1213–1233.
Rushton, J. P., & Irwing, P. (2011). The general factor of
personality: Normal and abnormal. In T. ChamorroPremuzic, S. von Stumm, & A. Furnham (Eds.), The
Wiley-Blackwell handbook of individual differences
(pp. 134–163). Chichester: Blackwell.
Schnittker, J. (2008). Happiness and success: Genes, families, and the psychological effects of socioeconomic
position and social support. The American Journal of
Sociology, 114((Suppl. 1)), S233–S259.
Shye, S. (1989). The systemic life quality model: A basis
for urban renewal evaluation. Social Indicators
Research, 21, 343–378.

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Steel, P., Schmidt, J., & Shultz, J. (2008). Refining the
relationship between personality and subjective wellbeing. Psychological Bulletin, 134, 138–161.
Stones, M. J., & Kozma, A. (1980). Issues relating to the
usage and conceptualization of mental health constructs employed by gerontologists. International
Journal of Aging & Human Development, 11,
269–281.
Stones, M. J., & Kozma, A. (1985). Structural relationships among happiness scales: A second-order factorial study. Social Indicators Research, 17, 19–28.
Stones, M. J., & Kozma, A. (1986). “Happy are they who
are happy. . .”: A test between two causal models of
relationships between happiness and its correlates.
Experimental Aging Research, 12, 23–29.
Stones, M.J., Kozma, A., McNeil, J.K. & Worobetz, S.
(2011). Subjective well-being in later life: Twenty
years after Butterworth’s monograph series on individual and population aging Canadian Journal on Aging.
DOI: 10.1017/S0714980811000365, Published online
by Cambridge University Press 16 August, 2011.
Stones, M. J., Worobetz, S., & Brink, P. (2011).
Overestimated
relationships
with
subjective
wellbeing. Canadian Psychology, 52(2), 93–100.
Taillefer, M. C., Dupuis, G., Roberge, M. A., & Le May, S.
(2003). Health-related quality of life models: Systematic review of the literature. Social Indicators
Research, 64, 293–323.
Tkach, C., & Lyubomirsky, S. (2006). How do people
pursue happiness?: Relating personality, happiness
increasing strategies, and well-being. Journal of Happiness Studies, 7, 183–225. doi:10.1007/s11205-0050213-y.
Warner, R. M., & Vroman, K. G. (2011). Happiness
inducing behaviors in everyday life: An empirical
assessment of the “How of Happiness”. Journal of
Happiness Studies. doi:10.1007/s10902-010-9245-3.
published online, January 4, 2011.
Weiss, A., Bates, T. C., & Luciano, M. (2008). Happiness
is a personal(ity) thing: The genetics of personality and
well-being in a representative sample. Psychological
Science, 19, 205–210.
Wike, V. S. (1994). Kant on happiness in ethics. Albany:
State University of New York Press.

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Toronto
John Lorinc
Toronto, Ontario, Canada

Definition
Toronto is the capital city of the province of
Ontario in Central Canada.

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Description
Located on the north shore of Lake Ontario, the
Greater Toronto Area (GTA) sits on a stretch of
highly arable land straddling several river
systems that originate from the Oak Ridges
Moraine, a geologic landform created in the
wake of the last ice age.
The GTA is Canada’s largest metropolitan
region, with a population of about 5.7 million
people. The City of Toronto sits at the core of
the GTA, with 2.7 million residents, or about
43 % of the region’s total, according to the 2011
census (City of Toronto, 2012). The city proper is
surrounded by suburban and exurban municipalities that developed rapidly in the 1970s. The
city’s population grew 4.5 % between 2006 and
2011, but it represents a shrinking proportion of
the GTA overall.
The region accounts for approximately a fifth
of Canada’s GDP and 18 % of the country’s total
population, which is highly diverse, both socially
and culturally. There are over 140 languages spoken in the city and its surrounding suburbs.
The GTA’s economy is also highly diversified
and includes a range of major industrial/commercial sectors/clusters, including financial services,
aerospace, automotive manufacturing, food
processing, biomedical research, fashion/apparel,
design, and media/entertainment (The economy
of the Toronto region is as large as it is diverse,
n.d.). Many of Canada’s leading media (print and
broadcast) and cultural institutions are located in
Toronto.
The City of Toronto has two major public
school boards, a 98-branch public library system,
four universities, and four community colleges
arrayed over several campuses (Universities and
colleges in Toronto, n.d.). It is also home to
Canada’s largest medical school, whose faculty
are linked to several teaching hospitals, including
the University Health Network, a regional cancer
care network, and the Hospital for Sick Children.
Finally, Toronto, by virtue of its geography,
has extensive opportunities for outdoor activity in
its ravine network, along the waterfront, and in
large urban parks, such as Rouge Park. The
region, moreover, is located within a few hours

Toronto

drive of a wide range of rural areas that offer
a wide range of recreational activities, including
cottages, hiking, skiing, riding, cycling, flying,
and boating. The city also has two commercial
airports, including a major international hub,
Lester B. Pearson International, and a smaller
shuttle airport, the Billy Bishop Toronto City
Airport, which is located in the harbor area and
provides turbo-prop flights to destinations within
a 90-min radius.
Consequently, the GTA consistently scores
well on various global city rankings. The Economist’s 2011 Liveability Ranking placed Toronto
fourth overall (Gulliver, 2011). While widely
cited, global cities’ rankings have attracted
critical scrutiny from some researchers
(Taylor, 2011).
History
In the precontact period, the Toronto region, and
specifically the Humber River valley, served as
a meeting place for local Huron tribes and communities. The French briefly maintained
a military foothold in the area, known Fort
Rouille, but withdrew in 1759. British colonialists arrived a few decades later and formally
established a settlement, known as York, in
1793. During the nineteenth century, the City of
Toronto, formally incorporated in 1834, became
a political and industrial hub where education
reformers made significant strides building
a public education system. By the dawn of the
twentieth century, however, Toronto was
experiencing significant growth pressures.
By the 1910s, many of the city’s residents
were struggling with infectious disease epidemics, slum conditions, and water shortages.
Many residents relied on privately operated
streetcar
services
that
suffered
from
overcrowding and unsafe conditions that resulted
in accidents, injuries, and deaths.
Between the early 1910s and World War
Two, the city experienced a period of rapid
modernization and growth. Civic reforms led to
progressive public health services, extensive
upgrades to municipal infrastructure, significant
improvements in water quality and an associated
decline in infant mortality, expansion of public

Toronto

transit into newly developing “streetcar suburbs,”
and the development of comfortable middle-class
neighborhoods on the urban periphery.
The postwar period saw accelerated development, the construction of a subway network, and
the evolution of new master planned suburbs,
such as Don Mills, which segregated land-use
categories and featured curvilinear residential
streets, shopping malls, and industrial parks.
Postwar housing shortages also spurred the
development of social housing projects, such as
Regent Park, intended to provide subsidized
apartments for low-income families.
In the early 1950s, the provincial government
established a two-tier federated structure on
Toronto and the rapidly growing suburban
municipalities on its fringes. The Municipality
of Metropolitan Toronto (“Metro”) had broader
powers than a traditional county government and
was overseen, initially, by councilors appointed
by the lower-tier municipalities. It had responsibility for regional planning, major roads and
other large-scale infrastructure, transit, and
▶ social housing. Its borders are coterminus
with the current City of Toronto (est. 1998).
Metro played an important role in the evolution of Toronto’s quality of life because it was
able to concentrate office, industrial, residential,
and apartment development through the use of
regional planning authority and infrastructure
investment. So while much postwar development
reflected a more automobile-focused approach to
urban planning, the population density of Metro
(amalgamated City of Toronto) – approximately
11,250 per square miles – is sufficient to sustain
one of North America’s busiest transit agencies
(Toronto Transit Commission; “List of North
American,” 2012).
In 1997, the provincial government decided to
dissolve Metro and amalgamate it with the six
lower-tier municipalities to create the current
City of Toronto. The move was opposed
by many residents and critics who argued that
amalgamation – and other related reforms to the
funding and delivery of municipal – would not
yield financial savings. While the amalgamated
City of Toronto has made significant policy
moves on a range of issues, from water quality

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to social services and infrastructure, it nonetheless struggles to identify sufficient sources of
revenue to maintain, enhance, and expand important municipal services, ranging from transit to
libraries and social housing.
Transportation/Travel
Much of Toronto’s core – developed between the
late nineteenth century and the beginning of
World War Two – features a compact urban
form featuring dense residential neighborhoods
focused on urban retail strips. In the 1970s,
municipal reformers and residents’ groups
successfully fought to protect the city’s historic
downtown form from urban redevelopment
projects or so-called “slum clearance”
campaigns, as well as the development of downtown highways.
During that period, the city also promoted
mixed-use development in the commercial
core, pedestrian-oriented neighborhoods and
cycling – a set of progressive policies that
triggered successive waves of ▶ gentrification
of older working class neighborhoods and
combined high-rise condo development in the
downtown area. The result is that in Toronto’s
prewar core, there is a firmly established pattern
of “downtown living.”
According to a 2008 walking survey
conducted for the City of Toronto, more than
three in ten Torontonians walk regularly to
work, school, or shopping. “Walking, all the
way, is the main mode of choice when going to
work, school, shopping or leisure/entertainment
activities for 31% of Torontonians. Even among
the 41% of Torontonians who take public transit,
almost all walk to their transit stop, which is an
average 5 minute walk.”
But due to land-use planning and infrastructure decisions made by the Ontario government in
the 1960s and the 1990s, the outer band of the
GTA suffers from extensive sprawl, with the
result that car usage and congestion have become
significant stressors. The GTA’s main east–west
thoroughfare, Highway 401, is in places the busiest restricted access highway in North America
(in terms of annual average daily volumes). The
region loses an estimated $6 billion a year, in

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terms of lost productivity, due to gridlock,
according to the Toronto Region Board of Trade
(BOT).
The congestion has increased commute times.
The BOT estimates that the average two-way
commute in the GTA is 66 min (2011), compared
to 56.2 min in Los Angeles. A Pembina Institute
survey conducted in 2012 puts the GTA one-way
average commute at 43 min. That survey also
shows that about two-thirds of drivers experience
commuting-related ▶ stress, and 84 % must use
a major highway to get to work. Over half of the
respondents reported that they did not
have access to rapid transit (either subway or
commuter rail).
Congestion impacts ▶ air quality. In the early
2000s, Toronto Public Health, using so-called
“burden of illness” population health techniques,
estimated 1,700 premature deaths and
3,300–6,000 hospitalizations annually within the
city due to poor air quality and the presence of
microparticles, sulfur dioxide, nitrogen oxide,
and ozone (Pengelly & Sommerfreund, 2004).
The causes include vehicle exhaust as well
as emissions from industrial facilities and
coal-burning electrical plants situated southwest
of the GTA.
Toronto has sought to improve air quality with
measures such as anti-idling policies, tree planting,
transit promotion, and energy conservation campaigns. The regional transportation authority –
which was established in 2006 by the provincial
government and is known as Metrolinx – is also
promoting a 25-year/$50 billion transit/demand
management strategy designed to reduce gridlock
(The big move, n.d.). The strategy, known as “the
Big Move,” involves the construction of light rail,
bus rapid transit, subways, and additional commuter rail service, as well as the use of measures
such as high-occupancy vehicle lanes, carpooling,
and congestion charges. As of spring, 2013,
Metrolinx had released a series of recommendations for funding the new transit projects, but was
awaiting final approval from the Government of
Ontario.
Such transportation planning moves are taking
place within a larger planning context. In 2005,
the provincial government established a

Toronto

one-million hectare greenbelt around the GTA
and then passed legislation, known as “the Places
to Grow Act,” that seeks to limit so-called greenfield development but requiring municipalities to
direct growth to areas within the existing urban
envelope. The goal of both policies is to contain
sprawl and direct infrastructure investment so as
to promote more compact urban form, intensification, pedestrian-oriented communities, and
other travel options besides the private automobile (Places to Grow Act, 2005).
Social Cohesion
Since the beginning of the twentieth century,
Toronto’s population has grown because of
immigration, initially from eastern and southern
▶ Europe and then ▶ Asia, south Asia, Latin
America, and Africa. During the postwar period,
the city also benefited from economic growth
related to the baby boom, manufacturing, and
key financial sectors, such as mining finance.
The growth created a large demand for suburban residential housing. In the years immediately
following the end of World War Two, acute
housing shortages prompted the federal government to underwrite the development of Canada’s
first subsidized housing complex (CMHC Official opening – Regent Park buildings, n.d.),
known as Regent Park and situated in an area
(“Cabbagetown”) known for its ▶ poverty and
deteriorating housing stock.
During the 1960s and 1970s, the city saw the
development of much more multiunit residential
housing, both in the form of high-rise “slabs” and
clustered town-house complexes. Some of it was
developed by public housing agencies and some
by private developers taking advantage of financially attractive tax measures. During the 1970s
and 1980s, some co-op and mixed-income
housing was also developed – mostly downtown
and mid-rise in scale – using various forms of
financial support from the federal and provincial
governments.
The result, in terms of built form, is that the
City of Toronto has a very large concentration of
high-rise apartment buildings. Toronto architect
Graeme Stewart has estimated approximately
1,000 high-rise slab apartments constructed

Toronto

between the 1950s and 1980s (About tower
renewal, n.d.). It also has a large proportion
of tenants – about 50 % of the city’s overall
population, by most estimates (Federation of
Metro Tenants’ Associations, 2011).
Since the 1980s, the combination of immigration and the nature of the city’s housing stock
have created a distinctive social dynamic related
to the more general trend in large urban centers
towards income polarization. In particular, older
apartment buildings, both private and subsidized,
account for a rapidly growing share of the city’s
low-income residents/families, including many
immigrants. In 1981, one-third of the city’s lowincome residents lived in high-rise apartments;
by 2006, that figure had risen to 43 %, a phenomena described as “vertical poverty” by the United
Way of Greater Toronto (United Way Toronto,
2011). Many of these buildings – about threequarters of which are privately owned and managed – have shown signs of significant deterioration (e.g., chronically broken elevators) and lack
of rehabilitative investment (e.g., replacement of
drafty windows) in recent years.
The growing concentration of poverty in highrise apartments is further reflected in the spatial
change in neighborhood-level poverty over time.
University of Toronto sociologist David
Hulchanski has documented these trends in
his “Three Cities” study, a landmark work
(Hulchanski, 2007). They show that over
the past three decades, large swaths of the city’s
postwar suburbs – and especially Scarborough –
have become conspicuously poorer, with
a growing concentration of low-income families
and a declining contingent of middle-income
households. Over the same period, the city’s
wealthiest families have become increasingly
concentrated in neighborhoods along the subway
corridors and in gentrifying downtown areas.
Overall, the proportion of low-income neighborhoods in Toronto jumped from 19 % to 53 %
between 1970 and 2005, while the ratio of
middle-class communities fell from 66 % to
29 %. Prof. Hulchanski posits that if this spatial
income polarization dynamic continues,
middle-income neighborhoods could all but
disappear within the next two decades.

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There is extensive academic literature on the
relationship between growing income polarization and declining ▶ quality of life in terms of
▶ health, ▶ social cohesion, and so on (Harrell,
2009). In Toronto and as Saskia Sassen (n.d.) has
documented in many other global cities, there has
also been an economic shift away from
manufacturing in favor of services – a trend
that creates both high-end professional services
positions as well as a more part-time, low-wage,
and nontraditional employment. So while these
trends are not unique to the City of Toronto, they
are nonetheless a cause for concern in terms of
the city’s quality of life.
Toronto, historically, has had a low crime rate
by comparison to other large North American cities (Safety, n.d.). What is more, there are broad
levels of acceptance towards newcomers (Reitz,
2003), which is demonstrated in various ways
(e.g., multilingual provision of services and government information and ethno-cultural education
programs in the public school system) in both the
central city and the surrounding suburban municipalities (e.g., Mississauga). Unlike some larger
American cities in the late 1960s and a handful of
European cities more recently, the GTA has not
experienced race riots or violent incidents involving disenfranchised immigrant youth.
In the mid-2000s, however, a handful of
highly publicized shootings drew broad public
and policy attention to the dearth of social, recreation, health, cultural, and other youth-related
services in some low-income communities
(CBC News, 2005; Ontario Ministry of Children
and Youth Services, 2011). In response, the city,
the provincial government, the school boards,
and various social service organizations in
2006 adopted a preventative approach – the
“Strong Neighbourhoods Taskforce” (Strong
Neighbourhoods Task Force, 2005) – by
targeting resources at thirteen “priority neighborhoods,” which have more crime, higher dropout
rates, less employment, and relatively few social
supports. Local law-enforcement agencies have
also adopted measures geared to these areas,
including more community policing, public
engagement, crime statistics analysis, and
targeted anti-guns and gangs campaigns.

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The city’s housing agency, Toronto Community Housing Corporation (TCHC), also sought to
improve living standards in some of the oldest
and most decrepit public housing projects.
Approved by Toronto council in 2007, the revitalization of Regent Park began with the demolition of old low-rise units and the temporary
relocation of tenants. The project employed
a cross-subsidization formula, whereby private
developers build market condo housing on
a portion of the area’s property, and the proceeds
are used to develop new subsidized units – a mix
of apartment buildings and town houses on the
same precinct (Regent Park revitalization, n.d.).
While the market and subsidized units are in
physically separate structures, the Regent Park
area overall now has a greater mix of incomes.
The project also includes other measures
to improve local quality of life, such as the
introduction of a new supermarket (Regent
Park was considered an urban “food desert”
due to the lack of local grocery stores), other
retail services, and a cultural facility. TCHC
required some of the retail tenants to provide
part-time jobs to local youth. The agency and
the city are looking at replicating this approach
on other sites (Building a plan in Alexandra
Park, 2012).
Questions about the Sustainability
of Toronto’s Urban Lifestyle
Two significant lifestyle trends characterize the
evolution of Toronto as a global city: the proliferation of high-rise condominiums and speculation-driven inflation in residential property
values, especially in older downtown neighborhoods experiencing gentrification. These factors,
driven by changes in regional planning and the
globalization of the GTA’s economy, speak to the
city’s livability and the perceived desirability of
Toronto’s urbanized core. But they also raise
questions about the sustainability of the city’s
quality of life.
As of 2012, Toronto exceeded all other North
American cities in terms of the number of active
high-rise condo projects (Alexander, 2012).
Demand for such apartments, many of which
are small bachelor or one-bedroom flats, has

Toronto

been fueled by various factors, including investment activity by offshore investors, planning
constraints on greenfield tract housing on the
GTA’s exurban fringe, rising fuel prices, commuting difficulties, and the influx of immigrants
from high-density Asian cities where high-rise
apartment living is the norm.
The result is that a record number of condos
were sold in the GTA in 2012 while the market
for new single-family home has remained
sluggish, according to media reports and
real-estate data (Johnson, 2012). Likewise, the
resale home-buying market has broken records
every year for over a decade, with the average
GTA sale price now exceeding $500,000, a figure
that rivals Vancouver, which has long had
Canada’s most costly residential real estate
(Pigg, 2012). Such trends have made the city
increasingly unaffordable for middle-income
families, the working poor, students, and artists.
Gentrification is not unique to Toronto, but the
city’s gentrification cycle has accelerated greatly
because the older parts of Toronto are generally
considered to be safe and readily accessible
by transit. Unlike many North American cities,
main street retail remains highly viable in much
of the older core, and residents in such neighborhoods also have easy access to public spaces,
parks, and other amenities.
Some condo developers are developing in
such areas, promising buyers ready access to an
urban lifestyle. Others locate near major transit
hubs and transportation corridors. And there’s
a third category that has focused on downtown
brownfield sites (the former rail lands, the
port lands, and other former industrial sites
that have been cleaned up and rezoned for
mixed-use housing).
Critics of current development trends
downtown argue that the city has rushed to
approve high-rise condo developments without
making sufficient investments in the public
realm, transit, and other services geared to growing downtown populations. Some, like Toronto
councilor Adam Vaughan, have warned that
many of the new condos going up in the core
are not suitable for families with children because
the vast majority of the units have two or fewer

Toronto

bedrooms (Ireland, 2012). Therefore, unlike
previous waves of downtown revitalization
driven by the renovation of older homes in
somewhat derelict working class neighborhoods,
the condo boom may not produce stable “vertical” communities but rather transitional high-rise
environments dominated by speculators, singles,
or first-time buyers.
In conclusion, the city’s greatest challenge
in coming decades – besides solving its
traffic congestion problems – may involve
confronting difficult questions about whether
the very attractiveness of certain aspects of
Toronto’s quality of life (mixed-income, green,
pedestrian-friendly neighborhoods) has triggered
a speculative real-estate boom that could actually
erode those very urban virtues.

Cross-References
▶ Canada: Social Cohesion
▶ Globalization and Well-Being
▶ Multicultural Quality of Life Research
▶ Multiculturalism
▶ Walkability

References
About tower renewal. (n.d.). Retrieved from City
of
Toronto
website:
http://www.toronto.ca/
tower_renewal/about.htm
Alexander, D. (2012, February 14). Toronto bubble
risk tops New York in condos: Mortgages.
Bloomberg. Retrieved from http://www.bloomberg.
com/news/2012-02-13/toronto-bubble-risk-topping-n
ew-york-in-market-for-condominiums-mortgages.html
Building a plan in Alexandra Park. (2012) Retrieved from
Toronto community housing corporation website: http://
www.torontohousing.ca/investing_buildings/alexandra_park
CBC News. (2005, December 27). “Toronto has lost its
innocence,” police say of boxing day shooting. CBC
News Canada. Retrieved from http://www.cbc.ca/news/
canada/story/2005/12/27/toronto-shooting-051227.html
City of Toronto. (2012). Toronto backgrounder 2011
census. Retrieved from http://www.toronto.ca/demographics/pdf/2011-census-backgrounder.pdf
CMHC Official opening – Regent Park buildings. (n.d.).
Retrieved from the Canada and Mortgage Housing
Corporation website: http://www.cmhc-schl.gc.ca/en/
corp/nero/sp/2010/2010-04-23-1100b.cfm

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Federation of Metro Tenants’ Associations. (2011). State of the
unit: Rental housing in Toronto 2011. Retrieved from
http://www.torontotenants.org/sites/torontotenants.org/files
/ITD-Tenant%20Report%202011-WEB.pdf
Gulliver. (2011, February 21). Liveability ranking: Where
the livin’ is easy [Web log post]. The Economist.
Retrieved from http://www.economist.com/blogs/gulliver/2011/02/liveability_ranking
Harrell, E. (2009, December). The importance of
economic equality. Timeworld. Retrieved from http://
www.time.com/time/world/article/
0,8599,1948806,00.html
Hulchanski, J. D. (2007). The three cities within Toronto:
Income
polarization
among
Toronto’s
neighbourhoods, 1970–2005. Retrieved from http://
www.urbancentre.utoronto.ca/pdfs/curp/tnrn/Three-Citi
es-Within-Toronto-2010-Final.pdf
Ireland, C. (2012, August 23). In Toronto, a battle for
the 3-bedroom condo. The Globe and Mail. Retrieved
from http://m.theglobeandmail.com/life/home-andgarden/real-estate/in-toronto-a-battle-for-the-3-bedroom
-condo/article4313259/?service¼mobile
Johnson, N. (2012, April 11). Toronto condo starts show
no sign of cooling. The Globe and Mail. Retrieved
from
http://www.theglobeandmail.com/report-onbusiness/economy/toronto-condo-starts-show-no-sign
-of-cooling/article2399137/
List of North American rapid transit systems by ridership. (2012, October 5). In Wikipedia, the free
encyclopedia. Retrieved from http://en.wikipedia.org/
wiki/List_of_North_American_rapid_transit_systems
_by_ridership
Ontario Ministry of Children and Youth Services. (2011).
Review of the roots of youth violence: Executive
summary, Ontario at a crossroads. Retrieved from
http://www.children.gov.on.ca/htdocs/English/topics/
youthandthelaw/roots/crossroads.aspx
Pengelly, L. D., & Sommerfreund, J. (2004).
Air pollution-related burden of illness in Toronto:
2004 update. Retrieved from City of Toronto website:
http://www.toronto.ca/health/hphe/pdf/air_and_health
_burden_technical.pdf
Pigg, S. (2012, April 4). Toronto real estate: Average
GTA
house
over
$500,000.
Moneyville.
Retrieved from http://www.moneyville.ca/article/
1156500–gta-housing-prices-nudge-over-500-000
Places to grow act. (2005). Retrieved from https://www.
placestogrow.ca/index.php?option¼com_content&task
¼view&id¼4&Itemid¼9
Regent Park revitalization. (n.d.). Retrieved from City of
Toronto website: http://www.toronto.ca/revitalization/
regent_park/
Reitz, J. G. (2003). Social risks for newcomers to Canada:
Issues respecting the role of government in Ontario.
Retrieved from Legislative Assembly of Ontario
website:
http://www.ontla.on.ca/library/repository/
mon/8000/244164.pdf
Safety. (n.d.). Retrieved from City of Toronto website:
http://www.toronto.ca/quality_of_life/safety.htm

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Sassen, S. (n.d.). The structural sources of inequality in
the global city. Retrieved from http://ctcp.edn.depaul.
edu/HGEwebsite/Abstracts/SaskiaSassen_Abstract.pdf
Strong Neighbourhoods Task Force. (2005). Strong
neighbourhoods – A call to action. Retrieved from City of
Toronto website: http://www.toronto.ca/demographics/
pdf/priority2006/priority_areas_sntf_report.pdf
Taylor, Z. (2011). “Lies, damned lies, and statistics”:
A
critical
examination
of
city
ranking
studies. Retrieved from Metapolis Urban Research
website:
http://www.metapolis.ca/index_files/
ICE_City_Ranking_Summary.pdf
The big move. (n.d.). Retrieved from http://www.
metrolinx.com/en/regionalplanning/bigmove/big
_move.aspx
The economy of the Toronto region is as large as it is
diverse. (n.d.). Retrieved from http://www.toronto.ca/
invest-in-toronto/clusteroverview.htm
United Way Toronto. (2011). Key findings from poverty
by postal code 2: Vertical poverty. Retrieved from
http://www.unitedwaytoronto.com/verticalpoverty/
report/key_findings/
Universities and colleges in Toronto. (n.d.). Retrieved
from City of Toronto website: http://www.toronto.ca/
quality_of_life/universities_colleges.htm#5

Torres Strait Islander
▶ Australian Indigenous Peoples

Tostan
Molly Melching
Tostan International, Dakar, Senegal

Torres Strait Islander

own language, and using their own cultural traditions (Gillespie & Melching, 2010). Tostan
believes that when program participants start
with what they already know, they can expand
and “breakthrough” to new understandings and
practices and easily share with others what they
have learned (Tostan, 2009).
Mission
Tostan’s mission is to empower African communities to bring about ▶ sustainable development
and positive social transformation based on
respect for ▶ human rights. Working in
sub-Saharan Africa, primarily in remote regions,
Tostan provides a participatory and nonformal
education program in local languages for adults
and adolescents who have had little to no access
to formal schools. Tostan has demonstrated that
providing nonformal education, which focuses on
the educational needs of learners and involves
them in curriculum creation, is transformative
both for individuals and their communities,
leading to meaningful and sustainable ▶ social
change (Gillespie & Melching, 2010). Tostan’s
curriculum, known as the Community Empowerment Program (CEP), is facilitated over the
course of 3 years. Participants attend sessions
based on their educational needs and, using their
acquired skills and knowledge, are encouraged to
use what they learn in their daily lives. Through
community-led outreach activities, they share the
information from these sessions with members of
their community, neighboring communities, and
extended ▶ social networks. As a result, Tostan
has transformed the lives of millions of Africans
(Tostan, 2009).

Brief History
Tostan is the name of a nongovernmental
organization dedicated to community-led
development in Africa. In Wolof, the most widely
spoken language in Senegal, Tostan means
“breakthrough,” as in the hatching of an egg.
The name was suggested to Tostan’s Founder
and Executive Director, Molly Melching, by the
renowned African scholar, Cheikh Anta Diop,
which describes the sharing and spreading of
knowledge by the people themselves, in their

Community Empowerment Program
As of 2012, Tostan has implemented the CEP to
nearly 900 villages in 8 African countries: Djibouti, Guinea, Guinea Bissau, Mali, Mauritania,
Senegal, Somalia, and The Gambia. Communities most frequently learn about the CEP by word
of mouth, and Tostan implements the program in
communities based on the availability of funding
while also considering factors such as location
and local language. Tostan provides all
educational material and a trained facilitator.

Tostan

The community must supply a meeting place for
the CEP sessions, as well as feed and house their
facilitator, who lives in the community and
facilitates one adult and one adolescent class of
25–30 participants each, three times a week
(Tostan, 2009).
The CEP has two phases, both containing
modules organized around a theme. The first
phase, lasting a year, is called the Kobi,
a Mandinka word that means “to prepare the
field for planting.” The sessions are shared orally,
since most participants beginning the program
cannot read or write. Facilitators draw on oral
traditions, such as proverbs and skits, which
spark debate and dialogue on issues related
to the community’s well-being. Participants sit
in a circle and express their ideas about the session topics.
The first part of the Kobi covers the core
themes of ▶ democracy, human rights, and problem solving. Rooted in theories of democratic
education, such as those of John Dewey (1944)
and Paulo Freire (2002), the CEP introduces new
information through a process of shared inquiry,
starting from the very first session when participants are asked to express their future hopes for
the community. As class members describe
a future that often includes peace, ▶ health,
▶ economic growth, ▶ security, ▶ education,
work, ▶ solidarity, and lack of discrimination,
they transition to examining what they have
already been doing that will help them to succeed.
These visioning sessions are highly relevant to
the introduction of democracy and human rights
and also serve as a reference for the rest of the
educational program, as the goals identified are
reviewed, discussed, revised, and implemented
throughout the CEP. Participants examine current practices that are blocking progress toward
their goals, and using the problem-solving strategies included in the Kobi, they develop strategies to overcome problems (Gillespie &
Melching, 2010).
The second part of the Kobi focuses on health
and hygiene. Participants learn about their own
mental and physical development, the systems of
the body, infectious diseases and the preventative
significance of vaccinations, the reproductive

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process and proper birth spacing, HIV/AIDS
and other sexually transmitted infections, and
the health consequences of traditional practices
such as female genital cutting (FGC) and child/
forced marriage. The module also promotes
positive, health-enhancing traditions, such as
breastfeeding and infant massage. By examining
these topics in the context of democracy, human
rights, and problem solving, participants speak
out and take action based on the information
studied (Gillespie & Melching, 2010). For example, after learning about germs and how to stop
their transmission, participants weigh the benefits
of prevention against the costs of treatment.
The second phase of the CEP is called the
Aawde, a word in the language of Fulani,
meaning “to plant the seed.” Devoted to
economic ▶ empowerment, this phase includes
sessions on ▶ literacy, numeracy, and
small-project management. Over the course of
18 months and 130 sessions, participants learn
to read and write in their own language, which
they practice by writing short letters, reports,
stories, poems, and songs. They also gain basic
math and project management skills. Participants
also learn how to assess the feasibility of incomegenerating activities and then select, implement,
and manage their own projects. Examples of
projects include developing products for sale
such as soap or dyed fabrics or offering
a needed service such as managing a cell phone
recharge station or orchestrating a village
cleanup. Participants practice their new skills
using interactive workbooks, which also serve
to review the information facilitated during the
Kobi phase.
In 2010, Tostan added Mobile Phones for
Literacy and Development to the CEP, which
enables participants to continue practicing and
reinforcing their skills in reading, writing, and
math. In addition, the SMS project enables
participants to communicate with people in
their extended family networks on a more regular basis and to save money through texting
rather than making phone calls (Beltramo &
Levine, 2010).
Throughout the CEP, Tostan emphasizes the
development of critical thinking and research

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skills, which help participants to investigate
the issues affecting their own communities. For
example, Tostan provides data on maternal and
infant mortality rates for analysis and uses illustrations that teach the steps involved in
preventing dehydration from diarrhea. In areas
where there is deforestation, Tostan shares
information about how to construct fuel-efficient
stoves and use solar-powered cookers (Tostan,
2009).
In 2011, Tostan began to pilot new modules
focused on reinforcing parental education (RPE).
The modules were developed by a team of
pedagogic specialists in early childhood
education to address concerns over traditional
parenting practices that negatively affect infant
and child development. Using the same participatory, nonformal, and human rights-centered
approach used throughout the CEP, the RPE
sessions aim to equip participants with information that enable them to uphold children’s
rights within their families and communities,
understand the different forms of intelligence
(emotional, social, psychomotor, verbal/linguistic, and logical/mathematical), understand how
babies and young children learn, adopt positive
practices that can contribute to the success of
their children in school and in life, and use
disciplinary alternatives that exclude ▶ violence
and abuse.
The Community Management Committee
Simultaneous to leading the CEP, the facilitator
helps establish and train a Community Management Committee (CMC), which ensures the
coordination, management, and ▶ sustainability
of community development activities. Composed of 17 democratically selected members,
at least nine of whom are women, these committees represent the first step in establishing democratic community leadership. The training
curriculum for CMCs provides the knowledge
and skills necessary to identify, prioritize, and
address human rights violations occurring in
their communities, using the same participatory
and reflective methods applied throughout the
CEP. CMCs also organize social mobilization
activities and propose and manage development

Tostan

projects in problem areas, often identified during
CEP sessions and CMC meetings, in the areas of
health and sanitation, the environment, and child
protection. As of 2012, Tostan has trained over
2,000 CMCs, hundreds of which have become
officially registered community-based organizations (Tostan, 2012).
In 2006, Tostan created the Empowered
Communities Network (ECN) to help CMCs
address needs in their communities by
facilitating partnerships with trusted NGOs,
service providers, donors, and decentralized
government services. ECN projects are related
to the environment (solar electrification, waste
management, solar cookers), health (family planning services, construction of community health
centers, further training for health agents), and
economic empowerment (community grants,
small businesses, agricultural projects).
Organized Diffusion
In the communities in which Tostan works,
decisions about important matters are never
limited to one individual village and are instead
made by a large and complex network of interrelated neighborhoods and communities, connected
through marriage and family ties, trade, local
resources, and a host of other influences. In
order to bring about sustainable development
and positive social transformations, all these
networks must be included in the educational
process. Based on this understanding, a central
aspect of the CEP is the dissemination of information and ideas discussed in sessions to the
community as a whole and to other communities
in its extended social network. This process,
termed organized diffusion, is achieved through
a variety of activities including:
The “adoption” of other community members and
villages: By adopting a friend or family
member, participants share and discuss
program topics with their community at
large. Similarly, the community itself goes
on to “adopt” surrounding communities and
family members in the diaspora, leading to the
development of consensus opinions within
extended social networks at regional, national,
and international levels.

Tostan

Community-wide social mobilization and
awareness-raising activities: Led by the
CMC, these activities serve to share important
information on issues affecting the community and develop strategies to resolve them.
These issues include infectious diseases,
harmful traditional practices, maternal health,
▶ school enrollment, and birth registration.
Intervillage meetings: Organized between
interconnected and adopted villages, these
meetings provide a platform for participants
to discuss important issues and, by promoting
open dialogue and consensus opinions, foster
collective and coordinated social transformations of ▶ norms and practices that undermine
or violate certain human rights.
Radio programs: Broadcast weekly in regions
where Tostan implements its program, these
provide yet another means of disseminating
information on topics such as democracy and
health and human rights, in local languages, to
affected populations. Broadcasts also provide
community members with a forum for sharing
positive participant and CMC accomplishments, generating further discussion and
support for local social mobilization
initiatives.
The Current Program: Origins and Evolution
Though officially founded in 1991 as a US
501(c) (3) nongovernmental organization,
Tostan’s origins date back to 1976 when founder Molly Melching established a children’s
center known as Démb Ak Tey (Yesterday and
Today), in a low-income area of Dakar. With
Senegalese cultural specialists, she published
educational materials in Wolof for hundreds of
street children who soon flocked to the center
(Harrell-Bond, 1981). In an effort to expand
their audience, Melching’s team produced the
first radio program for Senegalese children
using traditional songs, stories, and proverbs,
which they collected as they traveled through
Senegal.
As Melching continued to work in marginalized rural communities in the region, she noticed
that the general lack of basic education in national
languages was a major barrier to development.

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While the villagers were motivated, they lacked
the vital information and skills required to
improve their communities. Working with the
same team of specialists and villagers from the
rural community of Saam Njaay, a village located
100 km north of Dakar, Melching began to
develop adult educational materials based on the
African traditions and learning styles of dialogue
and active participation. The program proved
particularly beneficial to the women of the
community, providing a forum for them to discuss
their needs and hopes and take a more active role
in community development. Based on their
feedback about the problems their community
faced, Melching and her team refined the modules, culminating in the creation of a six-module
program in 1987 (Gillespie & Melching, 2010). In
1988, Melching began an ongoing collaboration
with UNICEF Senegal to train local facilitators to
implement the program in 55 rural villages in the
regions of Thiès and Kolda.
In 1995, Tostan conducted a year-long
research study with thousands of former participants to assess potential future educational
themes of interest. Women overwhelmingly
stated their desire to learn about their own bodies,
puberty, the reproductive cycle, menopause,
sexuality, and best practices for good health,
and sessions covering these themes were subsequently added to the program. However, during
this period, Tostan also discovered that the low
status of women in participating communities
and their lack of decision-making power impeded
their abilities to effectively advocate for change.
Indeed, despite having received information on
health, a lack of knowledge of their human rights,
such as the right to express their views freely,
meant that they were unable to voice their opinions and desires publicly or take concrete actions
to promote the health care of themselves and their
children. Based on these findings, Tostan subsequently added sessions on women’s rights and
children’s rights before the sessions on health
and early childhood development (Gillespie &
Melching, 2010).
While the addition of sessions specifically
addressing women’s and children’s rights proved
effective in contextualizing the information

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provided on health and childhood development,
they had an adverse effect on the engagement of
the men in participating communities, who felt
that their paternal authority was being
undermined and that they were being excluded
from the development process. Thus, in 2000,
modules that had initially discussed “women’s
rights” or “children’s rights” were rewritten as
“human rights” and placed at the beginning, as
the foundation for the entire program (Gillespie
& Melching, 2010). Similarly, men were invited
to attend classes and participate more actively in
the CEP process.

Activities/Major Accomplishments/
Contributions
Approach
Tostan’s local knowledge has facilitated the
development of innovative strategies and
curricula that are contextually and culturally
sensitive as well as relevant to villagers’ lives
and experiences (Diouf, Sheckley, & Kehrhahn,
2000). From the beginning, Tostan’s educational
practices have diametrically opposed more
authoritarian pedagogy prevalent in the French
model of school systems in Senegal. Teachers are
called facilitators and students are participants.
Tostan’s long-term facilitator training focuses on
helping facilitators unlearn stereotypes of the
teacher as the authority and the student as
a passive recipient (Gillespie & Melching,
2010). Drawing on the theories of Cheikh Anta
Diop, who believed that to foster democracy,
development must be educational for all involved
and always rooted in and growing out of existing
cultural practices and local knowledge, Tostan
hires and trains local field staff, often of the
same ethnic group as the community in which
they work (personal communication between
Molly Melching and Cheikh Anta Diop, date
unknown).
The CEP itself is facilitated in local languages
and taught in a participatory manner to encourage
dialogue and consensus building, both of which
are highly valued in African societies. Inspired by

Tostan

traditional culture, participants create songs,
dances, plays, and poetry to reinforce new knowledge. It is through these pedagogic methods that
active participation and reflection is encouraged
and participant feedback can be received so as to
quickly adapt to changing circumstances.
Results
According to both internal and external evaluations, Tostan has had results in the following
domains:
• Women’s empowerment: Women coordinate
over 80 % of Tostan-trained CMCs and often
go on to take up roles in local councils and
regional federations or associations. Female
participants also frequently report decreased
incidences of ▶ domestic violence following
CEP implementation (Diop, Faye, et al., 2004;
Diop, Zakari, et al., 2004; UNICEF, 2008).
• Children’s rights: The Tostan program
promotes community efforts to protect children’s rights, resulting in increased primary
school enrollment and birth registration rates
(Diop et al., 2008; Diop, Faye, et al., 2004).
• Maternal and child health: Community-led
efforts to improve maternal and child health
have led to increased vaccination rates,
increased prenatal consultations, family
planning, and a decline in the incidence of
malnutrition (Diop et al., 2008; UNICEF,
2008).
• Environmental health: CEP communities
organize regular community cleanups,
reforestation activities, and construct
fuel-efficient stoves (Diop, Faye, et al., 2004;
Diop, Zakari, et al., 2004).
• Community grants: CMCs set up community
grant operations based on rotating funds and
create small businesses for the production of
soap or mosquito repellent or the resale of
sugar and grains.
Movement to Abandon Female Genital
Cutting (FGC)
In addition to the results discussed above, some
of the most significant impacts of the Tostan
CEP are the public declarations made by

Tostan

participating communities to abandon FGC. By
examining the practice in the context of the
human rights to health, to a family, and to be
free from violence and abuse, participating communities are able to come to their own conclusions as to whether FGC constitutes an abuse of
human rights and decide if they wish to continue
the practice. Political scientist Gerry Mackie’s
theoretical work on the processes involved in the
community-led shift toward the abandonment of
FGC has helped inform Tostan’s approach.
Mackie argues that harmful practices such as
FGC persist because they are reinforced by
social conventions linked to marriageability. If
a family chooses not to conform to this social
expectation, their daughter’s marriage prospects
and reputation would face serious adverse
effects. Mackie’s work (1996, 2000) illustrates
that shared social conventions cannot be
overturned by one individual alone but require
group dialogue and a shared commitment to
abandon a practice. According to a 2008 evaluation conducted by UNICEF and Macro International, FGC rates had dropped by 77 % among
Tostan participants who had declared their abandonment of FGC 10 years earlier. Since the first
public declaration for the abandonment of FGC
made by 30 women from the village of
Malicounda Bambara, Senegal, in 1997, nearly
6,000 additional communities from eight countries in Africa have followed suit, publicly
declaring their abandonment of the practice.
Based on its success, the Tostan approach to
FGC abandonment has been integrated into various national and international strategies including those of the international Donor’s Working
Group on FGM/C and the Government of
Senegal’s Action Plan for the complete abandonment of FGC by 2015.

Social Norms
Tostan’s understanding of the social norms that
underlie FCG has been greatly aided by the work
of philosopher Cristina Bicchieri (2006). Social
norms are clusters of expected behaviors that
bind people within a community or culture.

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In communities where Tostan has implemented
the CEP, community members have operated for
thousands of years under the shared expectation
that all girls and daughters needed to be cut. As an
established social norm, this practice was
accepted by all members of the community and
continued without question. As these communities experienced the CEP, the dialogue and reflection integral to the Tostan approach allowed them
to reflect on the assumptions and beliefs upholding this practice. By creating a safe space for
dialogue, the communities are able to come to
a collective decision on whether FGC merits continuation and act accordingly. If the community
reaches the decision to abandon the practice, they
organize a public declaration, often in conjunction with others in their kinship network, to publicly announce their decision and understand that
the practice has been overturned. These public
declarations give rise to a new social norm or
behavioral expectation that FCG is no longer
practiced.

External Evaluations
Tostan has been evaluated extensively by various
external agencies including (but not limited to)
the Ministry of the Family, National Solidarity,
and Women’s Enterprise and Micro-credit of the
Government of Senegal in 2008 and Frontiers in
Reproductive Health with the Population Council
in 2003 and 2004.
In the 2008 study conducted by the Ministry of
the Family, National Solidarity, and Women’s
Enterprise and Microcredit of the Government
of Senegal, researchers found that:
The only activities that had been totally accomplished and with an unprecedented rate of success
within the framework of the Government National
Action Plan of 2000-2005 were those implemented
by the NGO Tostan in terms of nonformal education and social mobilization activities.

In the 2004 Frontiers study conducted between
2000 and 2003 to evaluate the success of the
Tostan CEP in 20 participating villages,
researchers found that, in terms of knowledge,
▶ attitudes, and behavior regarding reproductive

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health, human rights, and FGC, program results
were noteworthy. The study states:
The impact of the Tostan program on women’s and
men’s well-being has been substantial. The program has been able to bring about a social change
within the community and to mobilize the villagers
for better environmental hygiene, respect for
human rights, and improvement of health.

Prizes and Accolades
Tostan has been awarded the following prizes for
its work in community-led empowerment and
development:
• Skoll Award for Social Entrepreneurship, 2010
• Conrad N. Hilton Humanitarian Prize, 2007
• UNESCO King Sejong Literacy Prize, 2007
• Sweden’s Anna Lindh Prize, 2005
In addition, the Tostan program has been cited
as a best practice for achieving sustainable
development and changing social norms by the
following studies:
• Solutions to End Child Marriage, International
Center for Research on Women, 2011
• Innovation for Women’s Empowerment and
Gender Equality, International Center for
Research on Women, 2009
• Start with a Girl: A New Agenda for Public
Health, Center for Global Development, 2009
• Girls Count: A Global Investment & Action
Agenda, Center for Global Development,
2008
• Coordinated Strategy to Abandon Female
Genital
Mutilation/Cutting
in
One
Generation, UNICEF, 2008
• Eliminating Female Genital Mutilation: An
Interagency Statement, ONCHR, UNAIDS,
UNDP, UNECA, UNESCO, UNFPA,
UNHCR, UNICEF, UNIFEM, WHO, 2008
• Working with the Community for Improved
Health, Health Bulletin, no. 3. Washington,
DC: Population Reference Bureau, 2006
• Ending a Harmful Traditional Practice: Female
Genital Mutilation/Cutting, UNICEF, 2005

Cross-References
▶ Female Genital Cutting

Tostan

References
Bettramo, T., & Levine, D.I. (2010). Do SMS text messaging and SMS community forums improve outcomes of
adult and adolescent literacy programs? Evidence
from the Jokko Initiative in Senegal. Retrieved August
18, 2012, from http://tostan.org/data/images/project%
20jokko%20final%20 report%20 september%202010.
pdf
Bicchieri, C. (2006). The grammar of society: The nature
and dynamics of social norms. Cambridge, UK:
Cambridge University Press.
Dewey, J. (1944). Democracy and education: An
introduction to the philosophy of education.
New York: Free Press. Original work published 1916.
Diop, N., Faye, M. M., Morea, A., Cabral, J., Benga, H.,
Cissé, F., et al. (2004). The Tostan program: Evaluation of a community-based education program in
Senegal. Washington, DC: FRONTIERS Final Report,
Population Council.
Diop, N., Moreau, A., & Benga, H. (2008). Evaluation of
the long-term impact of the TOSTAN program on the
abandonment of FGM/C and early marriage: Results
from a qualitative study in Senegal. Washington, DC:
FRONTIERS Final Report, Population Council.
Diop, N., Zakari, D. O., Melching, M., Banza, B., Guiella,
G., & Baumgarten, I. (2004). Experience from
a community-based education program in Burkina
Faso: The Tostan program. Washington, DC:
FRONTIERS Final Report, Population Council.
Diouf, W., Sheckley, B. G., & Kehrhahn, M. (2000). Adult
learning in a non-Western context: The influence of
culture in a Senegalese farming village. Adult
Education Quarterly, 51, 32–44.
Freire, P. (2002). Pedagogy of the oppressed (30th
anniversary ed.) (M. B. Ramos, Trans.). New York:
Continuum.
Gillespie, D., & Melching, M. (2010). The transformative
power of democracy and human rights in nonformal
education: The case of Tostan. Adult Education
Quarterly, 60, 477–498. first published on March
26, 2010.
Harrell-Bond, B. (1981). The Demb Ak Tey resource
center. Hanover, NH: American Universities Field
Staff Reports.
Mackie, G. (1996). Ending footbinding and infibulation: A
convention account. American Sociological Review,
61(6).
Mackie, G. (2000). Female genital cutting: The beginning
of the end. In B. Shell-Duncan & Y. Herlund (Eds.),
Female circumcision in Africa: Culture, controversy
and change. Boulder, CO: Lynne, Rienner.
Tostan. (2009). Community-led development [Brochure].
Retrieved April 8, 2013, from http://www.tostan.org/
data/images/tostan%20 brochure.pdf
UNICEF. (2008). Long-term evaluation of the Tostan
program in Senegal: Kolda, thies and fatick regions.
New York: UNICEF Section of Statistics and
Monitoring, Division of Policy and Practice.

Total Survey Error

Total Quality Management (TQM)
▶ Service Quality in New Public Management

Total Survey Error
Willem Egbert Saris
Research and Expertise Centre for Survey
Methodology, Universitat Pompeu Fabra,
Barcelona, Spain

Synonyms
Survey errors

Definition
The combination of errors occurring in a survey.

Description
From the very beginning, the emphasis in
survey research was on the variation in survey
estimates due to the probability sampling of the
elements in the sample developed by Neyman
(1934). However, this uncertainty estimation is
based on the untenable assumption that all other
aspects of the survey do not introduce further
errors. Deming (1944) was the first to develop
the idea of multiple error sources in survey
research. Many classifications of error sources
have been made. Perhaps the most elegant
presentation of the total survey error components
linked to steps in the measurement and representational inference process has been given by
Groves, Fowler, Couper, Singer, and Tourangeau
(2004) which is presented in Fig. 1.
The elegancy of this picture is that it brings
together in a simple way the error sources
studied by statisticians with respect to sampling,
especially coverage errors, sampling errors, and
nonresponse errors, and the errors studied by

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survey researchers concerned with measurement
error such as validity errors, measurement error,
and processing errors. Before the book of Groves
(1989), these two fields were two different worlds
with very little contact. The book of Groves
brought these two approaches to survey error
sources together. After the publication of that
book, a conference was dedicated to this issue
as well (Biemer, Groves, Lyberg, Mathiowetz, &
Sudman, 1991). Since then, many efforts are
made to study the different types of errors and
not only sampling errors. However, so far there is
no simple procedure to determine the total
error of a survey estimate combining all the errors
mentioned in Fig. 1. There are many studies
concentrating on a specific type of error. It is
rather complex and expensive to design survey
research that also evaluates the total error of the
estimates of interest. Only in some large scale,
continuous research, one can see this development (ESS, PISA).
There is also criticism on the concept of
total survey error. For example, Morillon (2005)
suggested many more criteria for indicator quality including also credibility and relevance. The
reason is that a measure can have an excellent
quality (a small total error) but not be accepted by
researchers because of lack of relevance or lack
of credibility of the institute that developed the
measure.
The total survey approach has led to a lot of
studies that concentrate on specific error sources
and its causes. So there are many studies directed
to detect the reasons for measurement errors, to
mention some, Sudman and Bradburn (1982),
Schuman and Presser (1981), Saris and Gallhofer
(2007), and Alwin (2007). Similar studies have
been made to detect sources of the nonresponse
errors (Stoop, Billiet, Koch, & Fitzgerald, 2010 ).
If these sources of errors are better understood
and models are developed for prediction of the
errors, the size of the errors can be predicted.
With respect to measurement errors, this kind of
predictions is developed. The program SQP
for prediction of the quality of survey questions
on the basis of questions characteristics is an
example (Saris & Gallhofer, 2007, Saris et al.,
2012). It would be possible to develop similar

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Total Survey Error,
Fig. 1 Total survey error
components linked to steps
in the measurement and
representational inference
process

Town and Country Planning
Measurement

Representation

Construct

Inferential Population

Validity
Target Population
Measurement

Coverage
Error

Measurement
Error

Sampling Frame
Sampling
Error

Response
Sample

Processing
Error

Nonresponse
Error

Edited Data

Respondents
Survey Statistic

models and programs for other errors, for example,
nonresponse errors. However, this will require
more knowledge of the sources of nonresponse.
So far, our knowledge is still rather limited.

Stoop, I., Billiet, J., Koch, A., & Fitzgerald, R. (2010).
Improving survey response: Lessons learned from the
European Social Survey. Hoboken: Wiley.
Sudman, S., & Brandburn, N. (1982). Asking questions:
A practical guide to questionnaire design. San
Francisco: Jossey Bass.

References
Alwin, D. (2007). Margin or errors: A study if reliability
in survey measurement. New York: Wiley.
Biemer, P. R., Groves, R. M., Lyberg, L., Mathiowetz, N.,
& Sudman, S. (1991). Measurement errors in surveys.
New York: Wiley.
Deming, E. (1944). On errors in surveys. American
Sociological Review, 9, 359–69.
Groves, R. (1989). Survey errors and survey costs. New
York: Wiley.
Groves, R., Fowler, F., Couper, M., Singer, E., &
Tourangeau, R. (2004). Survey methodology.
New York: Wiley.
Morillon, A. (2005). Personal communication mentioned
by Groves and Lyberg 2010.
Neyman, J. (1934). On the two different aspects of the
representative method: The method of stratified
sampling and the method of purposive selection.
Journal of the Royal Statistical Society Series A, 161,
63–77.
Saris, W. E., & Gallhofer, I. N. (2007). Design, evaluation
and analysis of questionnaires for survey research.
Hoboken: Wiley.
Saris, W. E, Oberski, D., Revilla, M., Zavalla, D., Lilleoja,
L., Gallhofer, I., & Gr€
uner, T. (2012). Final report
about the project JRA3 as part of ESS infrastructure.
RECSM working paper 24.
Schuman, H., & Presser, S. (1981). Questions and answers
in attitude survey: Experiments on question form,
wording and context. New York: Academic.

Town and Country Planning
▶ Garden City Movement
▶ Land-Use Planning
▶ Planning, Spatial

Town Planning (UK)
▶ Community Planning

“Town-Gown” Relations
▶ Community-University Partnership(s)

Towns
▶ Cities, Characteristics of

Traffic Mobility

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Township

Traffic Mobility

▶ Local Government

Konrad Götz
ISOE Institute for Social-Ecological Research,
Frankfurt/Main, Germany

Tracking

Synonyms

▶ Monitoring

Movement; Transportation; Travel

Definition

Traditional Ecological Knowledge
▶ Education, Traditional

Traditional Ecological/
Environmental Knowledge (TEK)
▶ Indigenous Knowledge

Traditional Knowledge
▶ Indigenous Knowledge

Traditional Neighborhood Design
▶ New Urbanism

Traditional Way of Living
▶ Subsistence in the Arctic

While the heading of this essay is “traffic
mobility,” it is necessary to begin by
distinguishing between mobility and traffic.
There is an interactive, an economic and
a transportation dimension to the word “traffic.”
“Traffic” consolidates in one word the interpersonal and inter-market trade-offs that depend on
movement and transportation – traffic in the
name of commerce – along with the interaction
and communication involved in social intercourse between people, bodies, and genders. In
this very broad sense, the idea of traffic defines an
area in which being mobile is a question of social
integration, participation, and even reproduction.
The modern connotation of traffic comes
down to transport and denotes the rational, instrumental activities designed to move objects and
people around, with the help of means of transportation and the corresponding infrastructure.
This idea of “traffic” adopts a systemic, functional perspective focusing on the overall transport network and its level of efficiency and
rationality. Traffic in this sense is a core element
of any economic system, which reaches beyond
the subsistence economy. The development of
canals as waterways, the building of paved avenues, the expansion of the rail network, and
increase in transport capacity were key prerequisites and components of the social transformation
processes ultimately leading to the Industrial
Revolution. The mobilization of the masses
along with the creation of urban rail hubs in the

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cities was part of an urbanization process without
which the dissolution of the prevailing feudal,
rural structures would never have been possible
(cf. Wehler, 1995, pp. 68–75).
So, whereas the term “traffic” signifies transportation and the transport system, “mobility” –
from the Latin mobilitas or mobilis – denotes the
potential for movability or “the state of being
moveable” (Rammler, 2000, p. 41). Movability
and movement are at the heart of perception and
the way in which reasoning and individuation as
a whole develop. With the help of movement, the
toddler “transforms its perceptual field.”
It performs “perceptual activity” (Piaget, 1971,
pp. 33–38). For example, the three-dimensional
properties of objects can only be learned through
changing perspectives, in other words movement.
In later stages of personal development,
mobility with and without means of transportation becomes an instrument for fulfilling needs
and wishes. In our industrial society, domiciles,
workplaces, and social and leisure venues are
spatially separated, indeed often miles apart. It
is impossible for people to cope without traffic
mobility. They need the kind of mobility provided by transportation in order to get to their
workplace and back. They have to be mobile to
reach schools, vocational training, and universities. People wish and need to be mobile in order
to shop for provisions and meet up with friends
and relations. Last but not least, all out-of-home
leisure activities rely on mobility.
The heading “traffic mobility” as used here
refers to mobility and transport together and
looks at the kinds of movability and movement
in physical space realized outside the home
through the use of transportation.

Description
Mobility as a Basic Need
The possibility of being able to move, with or
without transportation, is a crucial factor when it
comes to fulfilling needs and hence achieving
quality of life. Those forbidden to move or
incapable of doing so are subject to restricted
freedom – and herein lies the deterrent potential

Traffic Mobility

of a prison sentence. Individuals without access
to transportation see their options curtailed,
whether this is a question of getting to work and
providing for themselves; finding fulfillment
through culture, sport, or travel; or cultivating
social contacts in other locations. The fact that,
far from being a luxury, this is actually one of
life’s necessities is shown by people whose
leisure mobility is so restricted by their underprivileged social status that they do not know
the meaning of holiday and holiday trips
(Götz, 2009).
Purposes and Means of Transport
This is not to say that every type of movement
serves social, socially meaningful, or even rational purposes. What people consider to be meaningful mobility is a highly subjective area
(Holz-Rau & Scheiner, 2009). For example, adolescents particularly enjoy cruising around just
for fun, as can be seen in countless movie
classics. Then, car driving is an outlet for aggression and a means of regaining equanimity or
traveling with friends as a vehicle for social integration. Certain leisure activities actually revolve
around movement: walking, hiking, horse riding,
cycling, land and water motorsports, swimming,
kayaking, sailing, and flying sports planes and
gliders. They are along with all forms of recreational exercise in water and on the beach, with
and without a parachute. In Germany, leisure
traffic makes up as much as one third of the
overall person distance traveled.
Besides the reasons for traffic mobility
as reflected in purposes for travel – work,
education/training, leisure, shopping, escorting/
accompanying – research is also interested in
the means of transportation used. Human beings
start out by moving around on all fours and then
go upright on two legs before eventually taking to
transportation such as a child’s scooter, roller
skates, bicycle, tram, underground, bus, train,
plane, and the car. Added to these possibilities
are ships, cable cars, skateboards, skis, sledges,
down to horse-drawn vehicles. With developments in electric mobility, we are seeing new
forms of two wheelers (e.g., segways, electric
bicycles, motorbikes, and motor scooters), three

Traffic Mobility

wheelers (e.g., hybrid scooters with two front
wheels), and also four-wheeled electric light
vehicles.
Travel Behavior Research
People’s choice of transportation is frequently
examined in transport research, appearing, for
instance, in the regular reports on mobility in
Germany (MID – Mobilit€at in DeutchLand,
2008) or in international comparative studies.
These studies, whose methods are the subject of
international congresses and scientific organizations such as the International Association of
Traffic Behavior Research (IATBR), look not
only at the spread of transportation choices, the
so-called modal split but also at the time spent
outside the home along with the purposes and
distances involved. Research into transport
behavior has ascertained that the number of journeys outside the home has in Germany hardly
changed almost in the past 35 years (from 3.1
trips per day 1977 to 3.3 in 2002) what is changing with increasing income is the motorization
and the time and distances involved, along with
the CO2 emissions per household – from 27 km/
day in 1977 to 37 km/day 2002. In the USA the
trips per day increased from 2.9 to 4.1 and the
distances from 42 km/day to 59 km/day (B€uhler
& Kunert, 2006).
Traffic mobility differs within the various
social groups and sociodemographic factors.
Taking Germany as an example, older people
(60+) have fewer journeys to make than the average. They make more frequent use of public
transport, walk more often, and use the car to
a disproportionately low degree. However,
today’s older citizens do use the car more often
than past older generations. The group exhibiting
the most person kilometers traveled per day is
the 40–49-year-old segment, most of whose
members are gainfully employed. People on
a high income manifest a greater person distance
traveled – they use the car more frequently and
are more likely to own their own car. There
are also gender differences, but these even out
more and more over time. Men make slightly
more journeys than women, covering more
person kilometers per day on average. However,

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this is not the case among the under-18 age
groups – here, the figures for women are either
the same or even higher than those for men. This
is doubtless linked to possession of car usage.
Men use the car more often than women. They
make their ways more often by foot and make less
use of the car. Women in the older cohorts are
less likely to have a driving license than the men,
whereas the gender ratio in the younger generation is more equal. The car is used more in rural
areas than in cities (MID, 2008). Urban areas
have a better and more consolidated public transport infrastructure. The big cities manifest the
most car-free households. That is not to say that
these belong solely to disadvantaged groups. In
the cities of Western Europe, one increasingly
finds social milieus choosing to live without
a car, even though they are more than able to
afford one.
Hence, there are socially and spatially
defined differences in traffic mobility. There are
differences in the provision of transportation, differences in access to traffic infrastructure, and
differences in the accessibility of locations.
Whether for social and socio-spatial reasons,
due to physical limitations, or because of
a traffic infrastructure that fails to cater to their
needs, those who are unable to move around
easily have their quality of life compromised,
or even find themselves socially excluded
(Cass, Shove, & Urry, 2005).
Negative Impacts
The reverse, however, is not necessarily true, that
is, that quality of life increases along with greater
mobility. And it is even less true to say that
quality of life is enhanced with increasing
traffic. Traffic volume or distances traveled
may well rise with increased income, but this
has repercussions that in turn can compromise
quality of life. These repercussions are unequally
distributed.
As early as the 1970s, the negative ecological
and social consequences of the growing number
of private cars and other motorized traffic like
freight transport in Western European countries
were becoming increasingly apparent. The traffic
jam was emblematic of the traffic problem.

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The growing amount of traffic was interpreted in
terms of a demand to which traffic planners had to
react by offering still more infrastructure. The
result was those multilane motorways
intersecting our cities and with which we struggle
today. Although such urban motorways are still
being built, it is actually clear to all that the idea
of supply and demand triggers a spiraling
dynamic in which traffic is responded to with
traffic infrastructure which then attracts still
more traffic that in turn has to be accommodated
by adding infrastructure.
In the 1980s it was becoming increasingly
obvious that rising automobility was not only
contaminating a common good, namely, the air
that we breathe, but also that car-based urban
planning would worsen mobility for those not
using in a car. Walkways and public transport
were transferred underground to allow car traffic
to drive though unhindered. Trams and train
systems were cut back.
And then there is the long-term impairment to
quality of life for the countless people seriously
injured in traffic accidents. In 1970, 19,000
people died in accidents on Germany’s roads –
at the present time 4,000. The car industry may
have invested heavily and with some success in
research to find technical means of improving
passenger safety, while legislators introduced
a seat belt law. But this gave rise to a plethora
of performance features and safety measures.
Each new generation of vehicles saw improved
acceleration and with this came the need to
improve safety. Since enhanced crash and
interior safety means greater weight, vehicle performance had to be boosted to an exorbitant
degree to ensure that top speeds and acceleration
could likewise increase.
People are using the car not just to get from
A to B as quickly and economically as possible
(as hoped by traffic economists), they are also
taking an active and fun-based approach to driving, traveling fast and taking risks, and coveting
and emotionalizing the car. A car is of particular
benefit to families, and it is highly symbolic of
the level of affluence achieved.
But the “side effects” cannot be ignored. After
a long period of concentrating solely on the

Traffic Mobility

prosperity-enhancing aspect of the car, in the
1980s people started to shift their perspective,
and this is still effective today. The first major
goal is to reduce emissions. The different stages
in catalytic converter technology have meant that
today’s cars produce far less in the way of
toxic substances. However, diesel vehicles are
still emitting considerable amounts of carcinogenic micro particles. In mega cities such as
Delhi, Teheran, Sao Paulo, or Peking, air pollution from emissions remains a highly visible,
disease-inducing problem of daily life. Two
different methods are being attempted to
combat ultrafine particles. There is the classic
end-of-the-pipe technology involving particle
filters combined with environmental zones barred
to vehicles without filter technology, as practiced
in many German cities for example in Frankfurt/
Main. The slightly more radical version of this
approach is to create car-free districts like
Freiburg Vauban or the Floridsdorf district in
Vienna. While residents here commit voluntarily
to living without a car, London, for example,
simply imposes a “congestion charge” to encourage a reduction in traffic. Along with reconsideration of the benefits to be had from a densely
populated, mixed-function city, attention also
turned to the irreversible destruction of historical
substance and evolved structures: the sealing of
landscapes with motorways and their sprawling
intersections; the consequences of suburbanization and urban sprawl and the way it eats away at
the boundaries between town and country side;
the countless victims of roadkill; traffic noise as
a cause of illness and a mechanism leading to
social segregation as high-grade historical residential areas are sacrificed to traffic, abandoned
as attractive housing space, and given over to
disadvantaged groups whose situation worsens
as a result. And last but not least the exhaustion
of energy reserves: before the first oil crisis
(1973), the Club of Rome in its “Limits to
Growth” study was quick to point out the
impending end of fossil fuels (Meadows,
Meadows, Randers, & Behrens III, 1972).
Today, 40 years later, these early warnings have
proved to be farsighted. The results of research on
peak oil show that oil extraction has already

Traffic Mobility

peaked and that further sources can only be
opened up at a very high cost to society.
Today, practical measures revolve around
slowing down the rate of climate change by
reducing carbon dioxide emissions, to which
road traffic contributes 15–17%. Research findings in this field were long a subject of debate –
today a social consensus has been reached and
even major car manufacturers are declaring zero
emissions as their goal for the future.
It is thus fair to say that an increasing volume
of motorized traffic can seriously lower one’s
quality of life; the car-friendly city is no longer
considered a modern model. The more details
that emerge about the risks and problems posed
by a mobility based on mass private car ownership, the clearer it becomes that they can only be
solved via inter- and transdisciplinary collaboration (cf. Bergmann & Schramm, 2008). This
means that the various approaches to problem
solving are no longer mutually exclusive; they
need to be intertwined. We are talking here
about urban and regional planning measures to
reduce distances and improve accessibility, technological advancements to increase efficiency
and reduce emissions, car sharing services
installed on smart phones, and legislation to promote public transport, cycling and walking, and
roll back motorized individual traffic (cf. Banister, 2008). Such advancements are today being
combined with measures derived from socioscientific findings: the lifestyle Approach in combination with results of travel behavior research
lead to mobility styles (Götz, 2003). On this base
it is possible to develop target group specific
alternatives to the private car and geared to different lifestyles and their differing definitions
when it comes to quality of life (cf. Götz &
Ohnmacht, 2011). New offerings must be fun
and appeal to people’s hedonistic side. Getting
around on foot and by bike is quick, considered
a healthy option, and can take far more individualistic forms than driving a car.
Modern urban design projects such as those in
Z€
urich or Malmö combine so-called hard and soft
measures with a new kind of mobility culture
(Deffner & Götz, 2008). They focus on the integration of planning and communication and the

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new paradigm of quality of open spaces, taking
individuals’ subjective mobility needs as their
starting point. Fulfillment of these needs is seen
in terms of quality of life and identification with
the city. It is no longer the primary purpose of
urban roads and squares to promote a quick and
smooth flow of mass traffic; they are also
designed to serve individual experiences: space
for strolling around, allowing people to chat to
each other as they walk, providing senior citizens
with opportunities to rest and to drink, and recreational fun for the younger generation. This way,
the different social milieus are able to take back
possession of their city. They can win back the
spaces taken up by cars and use them for individual modes of transport. Mobility is then defined,
as outlined above, as potential for movement with
a view to satisfying wishes and needs, a mobility
that does not necessarily have to be realized in
terms of traffic economy.
Discussion
Mobility or movability (good access to transport
infrastructure, accessibility of localized functions
such as work, social contacts, household provisioning, home living, and leisure activities) has
a crucial impact on quality of life in the sense of
fulfilling needs and desires. However, the realization of such mobility via more and more individual
motorized transport affects quality of life through
noise, environmental pollution, urban destruction,
and impairment of natural livelihoods. A conflict
arises between enjoying the freedom to achieve
each and every goal as quickly as possible and
yet avoiding the damage this causes.
A much debated proposal is the partial
decoupling of need fulfillment and passenger
transportation, mobility and harmful consequences, affluence, and increasing traffic. This
kind of sustainable mobility “allows the basic
access and development needs of individuals,
companies and societies to be met safely and in
a manner consistent with human and ecosystem
health and promotes equity within and between
successive generations” says the European Union
Council of Ministers of Transport (2001).
Moreover, it is “affordable, operates fairly and
efficiently, offers choice of transport mode,

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and supports a competitive economy, as well as
balanced regional development.” Such a mobility
“limits emissions and waste within the planet’s
ability to absorb them.” It “uses renewable
resources at or below their rates of generation,
and, uses non-renewable resources at or below
the rates of development of renewable substitutes
while minimising the impact on the use of land
and the generation of noise.”
In other words, sustainable mobility is needrelated mobility with less traffic (cf. Becker, 2003).

Cross-References
▶ Air Quality
▶ Built Environment
▶ Car Ownership
▶ Eco-Efficiency
▶ Ecological Footprint
▶ Environmental Sustainability
▶ Land Use
▶ Mobility
▶ New Urbanism
▶ Social Mobility
▶ Spatial Planning (Europe)
▶ Suburbanization
▶ Sustainable Development
▶ Sustainable Lifestyles
▶ Sustainable Transportation and Well-being
▶ Sustainable Urban Design
▶ Time Needed to Travel to Work
▶ Traffic Noise Abatement
▶ Transportation and the Quality of Life
▶ Urban Design
▶ Urban Ecology
▶ Urban Life, Quality of
▶ Walkability

References
Banister, D. (2008). The sustainable mobility paradigm.
In: Transport Policy 15, 73–80.
Becker, U. (2003). Was ist nachhaltige Mobilit€at? In:
Politische Ökologie. Nr. 83 Mai/Juni 2003. 14–17.
Bergmann, M., & Schramm, E. (Eds.). (2008). Transdisziplin€
are Forschung. Integrative Forschungsprozesse
verstehen und bewerten. Frankfurt am Main/
New York: Campus Verlag.

Traffic Noise
B€
uhler, R., Kunert, U. (2006). Trends und Determinanten
des Verkehrsverhaltens in den USA und in Deutschland; Trends and Determinants of Travel Behavior in
the USA and in Germany. Endbericht. Berlin. http://
www.diw.de/sixcms/detail.php?id¼diw_01.c.94284.de
Cass, N., Shove, E., & Urry, J. (2005). Social exclusion,
mobility and access. The Sociological Review, 53(3),
539–555.
Holz-Rau, Ch., & Scheiner, J. (Eds.). (2009). Subjectoriented Approaches to Transport. Dortmunder
Beitr€age zur Raumplanung V 6. Dortmund:
Informationskreis f€
ur Raumplanung.
Deffner, J., & Götz, K. (2008). Integration of communication into planning to create a sustainable mobility
culture. 4th international symposium on travel demand
management, July 18, 2008, Vienna/Semmering.
Austria http://www.rali.boku.ac.at/fileadmin/_/H85/
H856/TDM2008/Presentations/Deffner.pdf
European Union Council of Ministers of Transport.
(2001). Strategy for integrating environment and
sustainable development into the transport policy –
Council Resolution-2340th Council meeting. Presse
131. Nr. 7587/01.
Götz, K. (2003). A research concept of mobility styles.
Conference Paper. Moving through nets. The physical
and social dimension of travel. 10th international conference on travel behaviour research. Lucerne 10. – 15.
August 2003. http://www.isoe.de/ftp/kogzueric.pdf
Götz, K. (2009). The interdependence of ‘subjektive’ and
‘objektive’ factors: ‘socio-cultural distance patterns’
and ‘social accessibility’ as categories of empirical
mobility research. In: Ch. Holz-Rau., & J. Scheiner
(Eds.), Subject-oriented Approaches to Transport.
Dortmund: Dortmunder Beitr€age zur Raumplanung
V 6.
Götz, K., & Ohnmacht, T. (2011). Research on Mobility
and Lifestyle – What are the Results? In M. Grieco &
J. Urry (Eds.), Mobilities: new perspectives on transport and society. Farnham, England: Ashgate.
MID – Mobilit€at in Deutschland. (2008). Ergebnisbericht:
Struktur – Aufkommen – Emissionen – Trends.
http://www.mobilitaet-in-deutschland.de/02_ MiD2008/
publikationen.htm
Meadows, D. H., Meadows, D. L., Randers, J., Behrens
III, W. W. (1972). The limits to growth. New York:
Universe Books.
Piaget, J. (1971). Die Entwicklung des r€aumlichen
Denkens beim Kinde. Stuttgart: Kleh.
Rammler, St. (2000). Die Wahlverwandtschaft von
Moderne und Mobilit€at. Berlin: Dissertation.
Wehler, H.-U. (1995). Deutsche Gesellschaftsgeschichte.
1849–1914. M€
unchen.

Traffic Noise
▶ Traffic Noise Abatement

Traffic Noise Abatement

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Description

Traffic Noise Abatement
Michael A. Minor1 and Thomas W. Sanchez2
1
Michael Minor & Associates, Portland, OR,
USA
2
Urban Affairs and Planning, Virginia Tech,
Blacksburg, VA, USA

Synonyms
Highway noise; Noise abatement; Road noise;
Sound reduction; Traffic noise

Definition
Human response to noise is subjective and can
vary greatly from person to person. Factors that
can influence individual response include the
loudness, frequency, and time pattern, the
amount of background noise present before an
intruding noise, and the nature of the activity
(e.g., sleeping) that the noise affects.
The sensitivity of the human ear to sounds of
different frequencies is measured by the
A-weighted decibel scale (dBA). A 10-dBA
change in noise levels is judged by most people
as a doubling of sound level. The smallest change
in noise level that a human ear can perceive is
about 3 dBA. Increases of 5 dBA or more are
clearly noticeable. Normal conversation ranges
between 44 and 65 dBA when the people
speaking are 3–6 ft apart.
Table 1 shows sound levels for some common
noise sources and compares their relative loudness
to that of an 80-dBA source such as a garbage
disposal or food blender. Noise levels in a quiet
rural area at night are typically between 32 and
35 dBA. Quiet urban nighttime noise levels range
from 40 to 50 dBA. Noise levels during the day in
a noisy urban area are frequently as high as
70–80 dBA. Noise levels above 110 dBA become
intolerable and then painful; levels higher than
80 dBA over continuous periods can result in
hearing loss. Constant noises tend to be less noticeable than irregular or periodic noises.

Traffic Noise Sources and Propagation
Noise sources associated with transportation
projects can include passenger vehicles, medium
trucks, heavy trucks, and buses. Each of these
vehicles produces noise; however, the source
and magnitude of the noise can vary greatly
depending on vehicle type. For example, while
the noise from passenger vehicles occurs mainly
from the tire-roadway interface and is therefore
located at ground level, noise from heavy trucks
is produced by a combination of noise from tires,
engine, and exhaust, resulting in a noise source
that is approximately 8 ft above the ground. The
following list provides information on the types
of transportation noise sources that will be part of
a roadway project and describes the type of noise
each produces.
• Passenger Vehicles (cars): Noise emitted from
0 to 2 ft above roadway, primarily from
tire-roadway interface. This category includes
normal passenger vehicles, small and regular
pickup trucks, small- to midsize sport
utility vehicles, and mini- and full-size
passenger vans. Typical noise levels for passenger vehicles are 72–74 dBA at 55 mph at
a distance of 50 ft.
• Medium Trucks (MT): Noise emitted from 2
to 5 ft above roadway, combined noise from
tire-roadway interface and engine exhaust
noise. This category includes delivery vans,
such as UPS and Federal Express trucks,
large sport utility vehicles with knobby
tires, large diesel engine trucks, some tow
trucks, city transit and school buses
with under vehicle exhaust, moving vans
(U-haul-type trucks), small to medium recreational motor homes, and other larger trucks
with the exhaust located under the vehicle.
Typical noise levels for medium trucks are
80–82 dBA at 55 mph at 50 ft.
• Heavy Trucks (HT): Noise emitted from 6 to
8 ft above the roadway surface, combined
noise sources includes tire-roadway interface, engine noise, and exhaust stack noise.
This category includes all log-haul tractortrailers (semitrucks), large tow trucks, dump

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Traffic Noise Abatement

Traffic Noise Abatement, Table 1 Sound levels and relative loudness of typical noise sources
Noise source or activity
Jet aircraft takeoff from carrier (50 ft)
50-hp siren (100 ft)
Loud rock concert near stage, jet takeoff
(200 ft)
Float plane takeoff (100 ft)
Jet takeoff (2,000 ft)
Heavy truck or #motorcycle (25 ft)
Garbage disposal, food blender (2 ft),
pneumatic drill (50 ft)
Vacuum cleaner (10 ft), passenger car at
65 mph (25 ft)
Large store air conditioning unit (20 ft)
Light auto traffic (100 ft)
Bedroom or quiet living room, bird calls
Quiet library, soft whisper (15 ft)
High-quality recording studio
Acoustic test chamber

Sound level
(dBA)
140

Subjective
impression
Threshold of
pain

130
120

32 times as loud
Uncomfortably 16 times as loud
loud
8 times as loud
Very loud
4 times as loud
2 times as loud
Moderately
Reference loudness
loud
1/2 as loud

110
100
90
80
70
60
50
40
30
20
10
0

Quiet

Relative loudness (human judgment of
different sound levels)
64 times as loud

1/4 as loud
1/8 as loud
1/16 as loud

Very quiet
Just audible
Threshold of
hearing

Sources: Michael Minor &Associates, Inc.

trucks, cement mixers, large transit buses,
motor homes with exhaust located at top of
vehicle, and other vehicles with the exhaust
located above the vehicle (typical exhaust
height of 12–15 ft). Typical noise levels for
heavy trucks are 84–86 dBA at 55 mph at
50 ft2. Several factors determine how sound
levels decrease over distance. Under ideal
conditions, a line noise source (such as constant flowing traffic on a busy highway)
decreases at a rate of approximately 3 dB
each time the distance doubles. Under reallife conditions, however, interactions of the
sound waves with the ground often result in
attenuation that is slightly greater than the
ideal reduction factors given above. Other
factors that affect the attenuation of sound
with distance include existing structures,
topography, foliage, ground cover, and atmospheric conditions such as wind, temperature,
and relative humidity. The following list provides some general information on the potential affects each of these factors may have on
sound propagation.

• Existing Structures: Existing structures can
have a substantial effect on noise levels in any
given area. Structures can reduce noise by
physically blocking the sound transmission.
(Under special circumstances, structures may
cause an increase in noise levels if the sound is
reflected off the structure and transmitted to
a nearby receiver location.) Measurements
have shown that a single-story house has the
potential, through shielding, to reduce noise
levels by as much as 10 dB or greater. The
actual noise reduction will depend greatly on
the geometry of the noise source, receiver, and
location of the structure. Increases in noise
caused by reflection are normally 3 dB or less,
which is the minimum change in noise levels
that can be noticed by the human ear.
• Topography: Topography includes existing
hills, berms, and other surface features
between the noise source and receiver
location. As with structures, topography has
the potential to reduce or increase sound
depending on the geometry of the area. Hills
and berms, when placed between the noise

Tragedy of the Commons Avoidance

source and receiver, can have a significant
effect on noise levels. In many situations,
berms are used as noise mitigation by physically blocking the noise source from the
receiver location. In some locations, however,
the topography can result in an overall
increase in sound levels by either reflecting
or channeling the noise towards a sensitive
receiver location.
• Foliage: Foliage, if dense, can provide slight
reductions in noise levels. FHWA provides for
up to a 5-dBA reduction in traffic noise for
locations with at least a 30-ft depth of dense
evergreen foliage.
• Ground Cover: The ground cover between the
receiver and the noise source can have
a significant effect on noise transmission. For
example, sound will travel very well across
reflective surfaces such as water and pavement
but can be attenuated when the ground cover is
field grass, lawns, or even loose soil.
Traffic Noise Mitigation
In theory, there are a number of options that can
be used to reduce or mitigate traffic noise. These
include traffic management, highway design, and
noise barriers including earthen berms. In reality,
noise mitigation is often infeasible due to space
requirements, aesthetic issues, and financial costs
or because the costs outweigh the benefits. Any
specific mitigation measure recommended as part
of a project must be feasible and have
a reasonable cost in relation to the benefit. Potential mitigation measures are described below.
• Traffic Management: Traffic management
measures include modification of speed limits
and restricting or prohibiting truck traffic. Due
to the plan purpose of most projects, traffic
management measures are rarely used as
noise mitigation. Restricting truck use on
a given roadway would reduce noise levels at
nearby receivers since trucks are louder than
cars. However, displacing truck traffic from
one roadway to another would only shift
noise impacts from one area to another and
may conflict with the planned function of the
roadway (e.g., an arterial generally carries
truck traffic). While reducing speeds may

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reduce noise, a reduction of at least 10 mph
is needed for a noticeable difference in noise
to result. Also, because roadways are planned
and designed to support speeds consistent with
their functional classification (e.g., 35–45 mph
on an arterial), changing speeds for the purpose of noise mitigation is not common.
• Roadway Design: Roadway design measures
include altering the roadway alignment and
depressing roadway cut sections. Alteration
of roadway alignment could decrease noise
levels by moving the traffic farther away
from the affected receivers. Because there
are usually noise-sensitive receivers along
both sides of a street, changing the alignment
may benefit one side of the street but would
increase noise levels on the other.
• Noise Barriers: Construction of noise barriers
between the roadways and the affected
receivers would reduce noise levels by physically blocking the transmission of trafficgenerated noise. Barriers can be constructed
as walls or earthen berms. Earthen berms
require more right of way than walls and are
usually constructed with a 3-to-1 slope. Using
this requirement, a berm 8 ft tall would slope
24 ft in each direction, for a total width of
48 ft. Berms are not feasible in some areas
because of the right-of-way requirement.
Noise walls should be high enough to break
the line of sight between the noise source and
the receiver. They must also be long enough to
prevent significant flanking of noise around
the ends of the walls. Openings in the wall,
such as for driveways and walkways, can significantly reduce the barrier effectiveness.

T
Cross-References
▶ Environmental Impact Assessment
▶ Social Impact Assessment

Tragedy of the Commons Avoidance
▶ Fostering Pro-environmental Behavior

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6714

Training
Martina Dieckhoff
Research Unit Skill Formation and Labor
Markets, Social Science Research Center, Berlin,
Germany

Synonyms
Job-related continuing education and training;
Learning

Definition
The focus here is on job-related continuing education and training, which the OECD has defined
as follows: “job-related continuing education
and training refers to all organised, systematic
education and training activities in which people
take part in order to obtain knowledge and/or
learn new skills for a current or a future job,
to increase earnings, to improve job and/or
career opportunities in a current or another
field and generally to improve their opportunities for advancement and promotion” (OECD,
2002:369). In empirical practice, however, the
definition and measurement of continuing education and training varies substantially across
surveys, making the comparison of different
research on labor market outcomes of training
difficult if they did not draw on the same data
source (e.g., Kuckulenz, 2006).

Description
The centrality of training and learning opportunities for the quality of work is increasingly
acknowledged (Gallie, 2003: 65). Empirical
investigations of training outcomes to date, however, have predominantly been concerned with
wage effects. This work has arrived at very different results. Some studies suggest significant
wage returns (e.g., Booth & Bryan, 2005;
Muehler, Beckmann, & Schauenberg, 2007),

Training

but very often extant work has reported small
or no wage impacts (e.g., Conti, 2005; Görlitz,
2011; Leuven & Oosterbeek, 2008). Work on
nonpecuniary returns – hitherto much more
scarce than studies on monetary returns – by
contrast, appears to provide more consistent evidence showing that training participation
increases workers’ objective as well as subjective employment ▶ security (Bassanini, 2006;
Ok & Tergeist, 2003) and also improves their
promotion aspects (Melero, 2010). Since job
security and promotion opportunities are considered to be important extrinsic constituents of
global ▶ job satisfaction measures, it seems
likely that training participation indeed
increases individuals’ subjective well-being at
work. Training can also be expected to trigger
more intrinsic job rewards by promoting selfactualization (e.g., Burgard & Görlitz, 2011).
Only recently, however, has research started to
directly investigate the impact of training on
subjective well-being at work. D’Addio,
Eriksson, and Frijters (2007) analyze the determinants of ▶ job satisfaction. Employerprovided training in the past 12 months is one
of the predictors they analyze, and their satisfaction measure pertains to individuals’ overall satisfaction with their main job or activity
(D’Addio Eriksson & Frijters, 2007: 2419). The
authors use the European Community Household Panel for Denmark and find that training is
an important determinant of men’s job satisfaction – even after individual fixed effects are
controlled for – while this is not the case for
women. Jones, Jones, Latreille, and Sloane
(2009) estimate the impact of training on seven
dimensions of job satisfaction using the British
Workplace Employee Relations Survey (2004).
Their training measure comprises any training
during the past 12 months that was paid for or
organized by the employer (excluding any health
and safety courses). They find that having participated in training is associated with notable
increases in individuals’ satisfaction with both
extrinsic (e.g., job security, pay) and intrinsic
(e.g., influence over the job, scope for using
own initiative) job features. When estimating
separate models for men and women, the authors

Training

find important differences, however. While
training participation increases men’s satisfaction with all dimensions, women only experience this effect on four of the dimensions.
Notably, the three dimensions which appear
unaffected by female workers’ training participation pertain to intrinsic properties of jobs.
Burgard and Görlitz (2011) use the German
Socio-Economic Panel to analyze the impact of
training on job satisfaction (using a composite
measure of overall job satisfaction). In their
study training measures “participation in formal
training that is organized in courses, seminars or
lectures.” The authors show that participation in
job-related training has significant positive
effects for men, but not for women. While men
are more likely to take part in longer training or
in training that was funded by employers than
women, the authors show that these differences
in training composition do not explain the lack of
association between training incidence and job
satisfaction among women.

Discussion
Existing work on the relationship between training participation and job satisfaction suggests
that training positively affects job satisfaction.
However, this is mainly the case for men. An
important avenue for future research in this area
is to unveil the mechanisms behind the gender
gap in satisfaction returns on training. While
high levels of job satisfaction are a desirable
labor market outcome in and of itself, job satisfaction has also been shown by some to be associated with life satisfaction (e.g., Heller, Judge,
& Watson, 2002; note, though, that the direction
of causality remains heavily debated). Continuing training may thus not only be an important
instrument to increase workers’ happiness with
their work, but it may possibly also have the
potential to increase a society’s overall wellbeing levels. Unfortunately, however, continuing training participation remains low in many
EU countries. Moreover, opportunities for jobrelated training are heavily stratified with older
and low-skilled employees as well as those
employed part-time or on temporary contracts

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being at a significant disadvantage (e.g.,
Dieckhoff, Jungblut, & O’Connell, 2007).

Cross-References
▶ Exercise
▶ Job Satisfaction
▶ Job Security

References
Bassanini, A. (2006). Training, wages and employment
security: An empirical analysis on European data.
Applied Economics Letters, 13, 523–527.
Booth, A. L., & Bryan, M. L. (2005). Testing some predictions of human capital theory: New training evidence from Britain. The Review of Economics and
Statistics, 87, 391–394.
Burgard, C., & Görlitz, K. (2011). Continuous training,
job satisfaction and gender – An empirical analysis
using German panel data. Ruhr Economic Papers,
No. 265.
Conti, G. (2005). Training, productivity and wages in
Italy. Labour Economics, 12, 557–576.
D’Addio, A. C., Eriksson, T., & Frijters, P. (2007). An
analysis of the determinants of job satisfaction when
individuals’ baseline satisfaction levels may differ.
Applied Economics, 39, 2413–2423.
Dieckhoff, M., Jungblut, J.-M., & O’Connell, P. (2007).
Job-related training in Europe: Do institutions matter?
In D. Gallie (Ed.), Employment regimes and the quality
of work (pp. 77–103). New York: Oxford University
Press.
Gallie, D. (2003). The quality of working life: Is Scandinavia different? European Sociological Review, 19,
61–79.
Görlitz, K. (2011). Continuous training and wages: An
empirical analysis using a comparison-group
approach. Economics of Education Review, 30,
691–701.
Heller, D., Judge, T. A., & Watson, D. (2002). The
confounding role of personality and trait affectivity
in the relationship between job and life satisfaction.
Journal of Organizational Behaviour, 28, 815–835.
Jones, M. K., Jones, R. J., Latreille, P. L., & Sloane, P. J.
(2009). Training, job satisfaction, and workplace performance in Britain: Evidence from WERS 2004.
Labour, 23, 139–175.
Kuckulenz, A. (2006). Continuing vocational training in
Germany – A comparative study using 3 German data
sets. ZEW Discussion Paper, No. 06–024.
Leuven, E., & Oosterbeek, H. (2008). An alternative
approach to estimate the wage returns to private-sector
training. Journal of Applied Econometrics, 23,
423–434.

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Melero, E. (2010). Training and promotion: Allocation of
skills or incentives? Industrial Relations, 49, 640–667.
Muehler, G., Beckmann, M., & Schauenberg, B. (2007).
The returns to continuous training in Germany: New
evidence from propensity score matching estimators.
Review of Managerial Science, 1, 209–235.
OECD. (2002). Education at a glance. Paris: OECD.
Ok, W., & Tergeist, P. (2003). Improving workers’ skills:
Analytical evidence and the role of the social partners.
OECD social, employment and migration (working
papers), Paris, OECD.

Trait Affect

Transcendence
▶ Religion/Spiritual Fulfillment, Satisfaction
with
▶ Spiritual Needs of Those with Chronic
Diseases

Transcendental Experience
▶ Peak Experiences vs. Everyday Feelings

Trait Affect
▶ Core Affect

Transdisciplinary Studies
▶ Meta-studies

Trait Reporting
▶ Retrospective Reports

Transformational Planning
▶ Community-Based Planning

Traitlikeness of Happiness
▶ Happiness Levels Stability

Trait-State Associations in Women’s
Well-Being
▶ Personality and Quality of Life in MiddleAged Women

Transformative Leaders
Laura Lorente1 and Marisa Salanova2
1
Work & Organizational Psychology, Universitat
de València, Valencia, Spain
2
Work & Organizational Psychology, University
Jaume I, Castellón, Spain

Definition

Trajectory Analysis
▶ Longitudinal Data Analysis

Leader behaviors that transform and inspire
followers to perform beyond expectations while
transcending self-interest for the good of the organization (Avolio, Walumbwa, & Weber, 2009).

Description

Tranquility
▶ Peace of Mind

Traditionally, transformational or charismatic
leaders have been compared to transactional

Transformative Leaders

leaders because they often appear at the same
time and share certain characteristics. Transactional leaders, however, base their relationship
with followers on continuous exchange and interactions, while transformational leaders try to
bring about a change in them.
The concept of transformative leadership was
initially introduced by James MacGregor Burns
in 1978 and was subsequently taken up again in
1985 by Bernard Bass, who developed the Transformational Leadership Theory (Bass, 1985).
This theory assumes that transformational leadership influences followers positively at both the
individual and the group levels, and it has four
components:
1. Idealized influence: this reflects the extent to
which leaders choose to do what is right rather
than what is simple or expedient. It builds,
above all, mutual ▶ trust and respect between
managers and employees.
2. Inspirational ▶ motivation: leaders challenge
employees to do their very best and convince
both employees and work groups that they can
perform beyond expectations. This enhances
employees’ feelings of ▶ self-confidence and
▶ self-efficacy, thereby enabling them to
perform optimally in their jobs.
3. Intellectual stimulation: this consists in
encouraging employees to think for themselves, to challenge cherished assumptions
about the way in which work takes place, and
to think about old problems in new ways; thus,
leaders foster employee growth and control in
the workplace.
4. Individualized consideration: leaders care
about the work-related ▶ development of
their employees, promoting ▶ social support
at work.
Thus, in contrast to the transactional leader,
who practices contingent reinforcement of
followers, the transformational leader inspires
and intellectually stimulates and is individually
considerate of them. This leadership is therefore
characterized by higher quality leader-member
relationships. Hence, a transformational leader
will foster closer relationships with subordinates,
which are characterized by a short power distance
and by individualized consideration of members’

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needs and capabilities. This relationship is
sustained by mutual trust and openness (House
& Shamir, 1993) and by the richness of verbal
communication between leaders and members
(Klauss & Bass, 1982).
In recent decades, transformational leadership
has been widely studied. It has been found to be
positively associated with leadership effectiveness and relevant positive individual and collective outcomes across many different types of
contexts, organizations, and levels of analyses.
More especially, important efforts have been
made to analyze the processes involved in the
relationship between transformational leadership
and positive constructs. Such processes include
subordinates’ task performance, work engagement, and extra-role performance (Dumdum,
Lowe, & Avolio, 2002; Salanova, Lorente,
Chambel, & Martı́nez, 2011); self-efficacy,
▶ organizational commitment, and ▶ job satisfaction (Walumbwa, Lawler, Avolio, Wang, &
Shi, 2005); organizational citizenship behavior
(Wang, Law, Hackett, Wang, & Chen, 2005);
and ▶ well-being at work and motivation
(Turner, Barling, & Zacharatos, 2002).
A large number of studies have focused on the
positive influence of transformational leadership
and ▶ performance indicators, attitudes, and
behaviors at work. For example, in their recent
meta-analytic review, Wang, Oh, Courtright, and
Colbert (2011) concluded that transformational
leaders lead individuals, teams, and organizations
to achieve higher levels of performance. Moreover, they also concluded that transformational
leadership has an augmentation effect over contingent reward leadership in predicting followers’
individual-level contextual and team-level
performance.
Some authors, however, have focused on less
positive aspects of this leadership style. This
arises as a result of some criticism launched
against transformational leaders. Many of these
critics argue that transformational leadership is
unethical. They contend that it manipulates followers into ignoring their own best interests,
without distinguishing between transformational and pseudo-transformational leadership
(Bass & Steidlmeier, 1999). Therefore, the

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authors advocate the need for authentic leadership, which includes two main concepts: a
central core of moral values (Walumbwa,
Avolio, Gardner, Wernsing, & Peterson, 2008)
and servant leadership, which only focuses on
follower development (Walumbwa, Hartnell, &
Oke, 2010). Both of them have opened up new
horizons in research.
But despite the criticism, transformational
leadership currently inspires many studies and
research also needs to be conducted in this area.
For example, future research should try to determine what the main antecedents of this leadership are as well as the main consequences it has
for both employees and organizations that promote this type of leadership. It would be particularly interesting to analyze in greater depth the
underlying psychological processes through
which transformational leaders may encourage
followers to attain higher levels of motivation
and organizational citizenship behaviors. Moreover, as Avolio et al. (2009) suggested,
researchers need to incorporate alternative
research designs in which they dare to introduce
mixed methods rather than simply limiting
themselves to experimental designs. Wang and
Howell (2010) also suggested that more
multilevel analyses are needed in transformational leadership research. Finally, the main
challenge for researchers is to apply the results
of research studies to professional practices in
order to be able to promote this type of leadership and, consequently, encourage the development of healthy organizations.

Cross-References
▶ Development
▶ Experimental Design
▶ Job Satisfaction
▶ Mixed Method
▶ Motivation
▶ Multilevel Analysis
▶ Organizational Commitment
▶ Performance Indicators
▶ Self-confidence
▶ Self-efficacy

Transformative Leaders

▶ Social Support
▶ Transformative Leaders
▶ Trust
▶ Well-being at Work

References
Avolio, B. J., Walumbwa, F. O., & Weber, T. J. (2009).
Leadership: Current theories, research and future
directions. Annual Review of Psychology, 60,
421–449.
Bass, B. (1985). Leadership and performance. New York:
Free Press.
Bass, B., & Steidlmeier, P. (1999). Ethics, character and
authentic transformational leadership behavior.
Leadership Quarterly, 10, 181–217.
Burns, J. M. (1978). Leadership. New York: Harper and
Raw.
Dumdum, U. R., Lowe, K. B., & Avolio, B. J. (2002).
A meta-analysis of transformational and transactional
leadership correlates of effectiveness and satisfaction:
An update and extension. In B. J. Avolio &
F. J. Yammarino (Eds.), Transformational and charismatic leadership: The road ahead (pp. 35–66).
Oxford, UK: Elsevier.
House, R. J., & Shamir, B. (1993). Toward the integration
of transformational, charismatic, and visionary
theories. In M. M. Chemers & R. Ayman (Eds.),
Leadership theory and research: Perspectives and
directions (pp. 81–103). San Diego, CA: Academic
Press.
Klauss, R., & Bass, B. M. (1982). Interpersonal communication in organizations. New York: Academic Press.
Salanova, M., Lorente, L., Chambel, M. J., & Martı́nez, I.
(2011). Linking transformational leadership to nurses’
extra-role behavior: The mediating role of selfefficacy and work engagement. Journal of Advanced
Nursing, 67(10), 2256–2266.
Turner, N., Barling, J., & Zacharatos, A. (2002). Positive
Psychology at work. In C. Snyder & J. Shane (Eds.),
Handbook of positive psychology (pp. 715–728).
New York: Oxford University Press.
Walumbwa, F. O., Avolio, B. J., Gardner, W.,
Wernsing, T., & Peterson, S. J. (2008). Authentic
leadership: Development and validation of a theorybased measure. Journal of Management, 34, 89–126.
Walumbwa, F. O., Hartnell, C., & Oke, A. (2010). Servant
leadership, procedural justice climate, service climate,
employee attitudes and organizational citizenship
behavior: A cross level investigation. Journal of
Applied Psychology, 95, 517–529.
Walumbwa, F., Lawler, J., Avolio, B., Wang, P., & Shi, K.
(2005). Transformational leadership and work-related
attitudes: The moderating effect of collective and selfefficacy across cultures. Journal of Leadership and
Organizational Studies, 11, 2–16.

Transit Systems and the Quality of Life
Wang, H., & Howell, J. M. (2010). Exploring the dual-level
effects of transformational leadership on followers.
Journal of Applied Psychology, 95, 1134–1144.
Wang, H., Law, K. S., Hackett, R. D., Wang, D. X., &
Chen, Z. X. (2005). Leadermember exchange as
a mediator of the relationship between transformational leadership and followers’ performance and
organizational citizenship behavior. Academy of
Management Journal, 48, 420–432.
Wang, G., Oh, I., Courtright, S. H., & Colbert, A. E.
(2011). Transformational leadership and performance
across criteria and levels: A meta-analytic review of
25 years of research. Group & Organization
Management, 36, 223–270.

Transit Systems and the Quality
of Life
Muhammad (Ahsan) Habib
School of Planning, Department of Civil and
Resource Engineering (cross), Dalhousie
University, Halifax, NS, Canada

Synonyms
Mass transportation; Public transport and quality
of life

Definition
Transit systems refer to the common carrier type
of passenger transport systems used for conveying
people from one place to another, especially
within an urban or regional boundary. Generally,
these are public transport systems with fixed
routes and schedules, available for use by all persons who pay the fare (e.g., bus, light rail transit,
and rapid transit/metro). Physical components of
a transit system include vehicles, rights-of-ways,
stops/stations, control systems, and routes.

Description
Public transit has a substantial impact on quality
of life and social well-being. When transit is not
available as a better transportation choice, cities

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remain highly automobile dependent, which, as
Shay and Khattak (2010) explain, is untenable in
the long term due to high level of congestion and
energy consumption, reduced safety, and reduced
environmental and human health. Steg and
Gifford (2005) offer an extensive literature
review on the definition of quality of life and
approaches to measuring quality of life in relation
to sustainable transport alternatives.
Equity in access to opportunities (e.g.,
employment, services, ▶ education, and ▶ health
care) that contribute to meeting basic human
needs and aspiration for a better life is central to
understanding the impacts of transit on quality of
life (Boschmann & Kwan, 2008). Inadequate
access to employment for disadvantaged and
minority workers in US cities created spatial
mismatch, higher level of unemployment, more
costly commute, or compromised wages (Preston
& McLafferty, 1999). Similar evidence is found
in the UK and in Canadian cities (e.g., Morency,
Paez, Roorda, Mercado, & Farber, 2011).
Public transit affects many aspects of daily
activities, including commuting to work or school.
Wener, Evans, Phillips, and Nadler (2003) suggest
that improved mass transit reduces commuting
▶ stress. The long-term impacts of such stress on
psychological and physical health, including
depression and cardiovascular disease, have been
well documented. Recently several researchers
investigated how public transit is directly related
to human health (see Litman, 2010). According to
the 2001 National Household Travel Survey, only
3.1 % of adults in the US walk to or from transit
during a typical weekday, and only 30 % of public
transit users meet the required 30 min of physical
activity daily (Besser & Dannenberg, 2005).
Wener and Evans (2007) found that the average
New York City train commuter walked about
9,500 steps per day, 30 % more steps compared
to the average car commuter. Edwards (2008)
concluded that the potential benefits of modal
shifts towards transit will generate savings of
around $5,500 per person in avoided medical
expenses through increased ▶ physical activity
and decreased obesity in the United States.
Many other benefits of transit influence
▶ social well-being. For instance, public transit

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increases social capital: transit tends to promote
a lifestyle that focuses on collective and societal
goals. High-quality transit promotes transitoriented development (TOD): mixed-use communities with pedestrian-friendly environments
served by public transportation nodes, which
encourage active lifestyles. A growing body of
empirical research examines transit impacts on
urban form (see Badoe & Miller, 2000). Several
studies also investigate the impact of transit on
land and property values: values tend to be higher
near commuter rail and subway stations (e.g.,
Habib & Miller, 2008). Chatman and Noland
(2011) review theoretical and empirical studies
that examine how public transport improvements
increase economic productivity and agglomeration economies.
Despite literature suggesting multifaceted
impacts and benefits of public transit, empirical
relationships between public transit and the quality of life remain implicit and to some extent
unknown. Recent studies examine alternative
methodologies exploring the effects of temporary
mode switching to public transit on happiness and
satisfaction (e.g., Abou-Zeid, Witter, Bierlaire,
Kaufmann, & Ben-Akiva, 2012). Further empirical research in this area will offer better in-depth
understanding of how public transit systems are
directly influencing the quality of life and social
well-being.

Cross-References

Transition Questions or Items
Boschmann, E. E., & Kwan, M. (2008). Toward socially
sustainable urban transportation: Progress and
potentials. International Journal of Sustainable
Transportation, 2, 138–157.
Chatman, D. G., & Noland, R. B. (2011). Do public
transport improvements increase agglomeration
economies? A review of literature and an agenda for
research. Transport Reviews, 31(6), 725–742.
Edwards, R. D. (2008). Public transit, obesity, and
medical costs: Assessing the magnitudes. Preventive
Medicine, 46, 14–21.
Habib, M. A., & Miller, E. J. (2008). Influence of transportation access and market dynamics on property
values: Multilevel spatiotemporal models of housing
price. Transportation Research Record: Journal of the
Transportation Research Board, 2076, 183–191.
Litman, T. (2010). Evaluating public transportation
health benefits. Victoria: Victoria Transport Policy
Institute.
Morency, C., Paez, A., Roorda, M. J., Mercado, R., &
Farber, S. (2011). Distance traveled in three Canadian
cities: Spatial analysis from the perspective of vulnerable population segments. Journal of Transport Geography, 19, 39–50.
Preston, V., & McLafferty, S. (1999). Spatial mismatch
research in the 1990s: Progress and potential. Papers
in Regional Science, 78(4), 387–402.
Shay, E., & Khattak, A. J. (2010). Towards sustainable
transport: Conventional and disruptive approaches in
the U.S. context. International Journal of Sustainable
Transportation, 4(1), 14–40.
Steg, L., & Gifford, R. (2005). Sustainable transportation
and quality of life. Journal of Transport Geography,
13, 59–69.
Wener, R. E., & Evans, G. W. (2007). A morning stroll:
Levels of physical activity in car and mass transit commuting. Environment and Behaviour, 39(1), 62–74.
Wener, R. E., Evans, G. W., Phillips, D., & Nadler, N.
(2003). Running for the 7:45: The effects of
public transit improvements on commuter stress.
Transportation, 30, 203–220.

▶ Transportation and the quality of life

References
Abou-Zeid, M., Witter, R., Bierlaire, M., Kaufmann, V.,
& Ben-Akiva, M. (2012). Happiness and travel mode
switching: Findings from a Swiss public transportation
experiment. Transport Policy, 19(1), 93–104.
Badoe, D. A., & Miller, E. J. (2000). Transportation-land-use
interaction: Empirical findings in North America, and
their implications for modeling. Transportation Research
Part D: Transport and Environment, 5(4), 235–263.
Besser, L., & Dannenberg, A. (2005). Walking to public
transit: Steps to help meet physical activity recommendations. American Journal of Preventive Medicine,
29(4), 273–280.

Transition Questions or Items
David Morley, Crispin Jenkinson and
Helen Lloyd
Department of Public Health, University of
Oxford, Oxford, UK

Definition
Transition questions ask respondents to assess
whether they consider their health or functioning

Transition Questions or Items

to have stayed the same, improved, or worsened
compared with a previous time point, often a
pre-intervention time point.

Description
Central to the importance of measuring patientreported outcomes are methods that evaluate
changes in health-related status over time. Transition questions do this by directly asking respondents to assess whether they consider their health
or functioning to have stayed the same, improved,
or worsened compared with a previous time
point, as illustrated below:
Thinking of the overall effects that your arthritis
may have had on you, how would you describe
yourself compared to the last time I interviewed
you (month)? Do you feel that you are ‘much
better,’ ‘slightly better,’ ‘the same,’ ‘slightly
worse’ or ‘much worse’? (Fitzpatrick, Ziebland,
Jenkinson, Mowat, & Mowat, 1992)

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Regehr, 1997). A further concern is the issue of
“present state bias” whereby respondents tend to
rate their change in health status in line with their
current health and consequently underestimate
the severity of the previous health state (Cella,
Hahn, & Dineen, 2002; Norman et al., 1997).
Furthermore, while transition items may indicate
perceived change, they are not a good indicator of
present health status: i.e., it is possible to report
relatively substantial improvements in health yet
remain in poor health.

Cross-References
▶ Minimal Important Difference
▶ PROs, Patient-Reported Outcomes
▶ Quality of Life
▶ Reliability

References
These questions elicit evaluative judgments
from the patient’s perspective of their health
changes over time. The benefits of using transition questions to involve patients in the direct
assessment of health services have been acknowledged by several authors, mainly as a result of
their validity and practicality (Feinstein & Wells,
1977; Tugwell et al., 1987). Many generic and
disease-specific health and health-related ▶ quality of life measures include a global transition
question to measure the impact or outcome of
surgery, medical intervention, or health services
(Guyatt, Norman, Juniper, & Griffith, 2002).
Transition items are often used to determine minimally important differences on standard format
patient-reported outcome measures. As an assessment of outcome, this approach has become
increasingly important as a test of the success of
medical or surgical care considered important to
patients.
There is, however, debate as to the
▶ reliability and meaningfulness of global transition questions as outcome measures (Knox &
King, 2009). Firstly, single questions cannot be
subject to standard tests of reliability such as
inter-item consistency (Norman, Stratford, &

Cella, D., Hahn, E. A., & Dineen, K. (2002). Meaningful
change in cancer-specific quality-of-life scores:
Differences between improvement and worsening.
Quality of Life Research, 11, 207–221.
Feinstein, A., & Wells, C. (1977). A new clinical taxonomy for rating change in functional activities of
patients with angina. American Heart Journal, 93,
172–182.
Fitzpatrick, R., Ziebland, S., Jenkinson, C., Mowat, A., &
Mowat, A. (1992). Importance of sensitivity to change
as a criterion for selecting health status measures.
Quality in Health Care, 1, 89–93.
Guyatt, G. H., Norman, G. R., Juniper, E. F., &
Griffith, L. E. (2002). A critical look at transition ratings. Journal of Clinical Epidemiology, 55, 900–908.
Knox, S. A., & King, M. T. (2009). Validation and calibration of the SF-36 health transition question against
an external criterion of clinical change in health status.
Quality of Life Research, 18, 637–645.
Norman, G. R., Stratford, P., & Regehr, G. (1997).
Methodological problems in the retrospective computation of responsiveness to change: The lesson of
Cronbach. Journal of Clinical Epidemiology, 50,
869–879.
Tugwell, P., Bombadier, C., Bucchanan, W. W.,
Goldsmith, C. H., Grace, E., & Hanna, B. (1987).
The MACTAR Patient Preference Disability
Questionnaire – An individualized functional priority
approach for assessing improvement in physical
disability in clinical trials in rheumatoid arthritis.
Journal of Rheumatology, 14, 446–451.

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Transition to Retirement
▶ Retirement Effects, Quality of Life

Transition Towns
▶ Sustainable Communities Movement

Translating Health Status
Questionnaires/Outcome Measures
Abigail Griffin1, Diane Wild2 and Alyson Grove3
1
Oxford Outcomes, Oxford, UK
2
eCOA, Oxford Outcomes Seacourt Tower,
Oxford, UK
3
Oxford Centre for Innovation, Oxford, UK

Synonyms
ClinRO – clinician-reported outcome; COA – clinical outcomes assessment; HSQ – health status
questionnaire; PRO – patient-reported outcome

Definition
A health status questionnaire (HSQ) is a tool that is
used to measure patients’ health status. It is usually
completed by the patient but it may also be completed by a clinician or caregiver. HSQs may be
disease specific, such as the Asthma Quality of
Life Questionnaire (AQLQ), which was developed
specifically for use among asthma patients, or
generic and therefore appropriate for use across
diseases or conditions (e.g., SF-36 or EQ-5D).

Description
Rationale
The development of both disease-specific and
generic health status questionnaires (HSQs) has

Transition to Retirement

meant that there is now a broad range of health
outcomes that can be measured in a consistent,
rigorous, and scientific way. The inclusion of
HSQs in clinical trials allows subtle changes in
health status over time and between treatment
groups to be assessed more effectively (Price
et al., 2009). In recent years, not only has there
been an increase in patient awareness of their
healthcare options but also there have been huge
advances in information technology and
a proliferation of ways in which patients can
record and send information. This has resulted
in an increased interest in and availability of
patients’ opinions about the outcome of their
treatment.
HSQs are increasingly used in multinational
studies, not just in Europe and the USA but more
recently in Asia, South America, and Africa.
The majority of HSQs are developed in UK or
US English and therefore need to be translated
and culturally adapted to make them appropriate
for use in other countries. In order for data generated from different countries within multinational studies to be pooled, the validity of the
original measure must be preserved across all
languages.
It is therefore essential that careful attention is
paid to the way in which HSQs are translated.
This is particularly challenging because of the
inherent potential ambiguity of language generally and the possible cultural sensitivity of some
questions and concepts in particular. Correct
interpretation of every part of a HSQ is vital for
the validity of the questionnaire to be maintained
across different languages.
In the USA, the Food and Drug Administration (FDA) has taken an increasing interest
in how HSQs are translated. They now require
evidence to support claims of linguistic
equivalence and content validity between the
source and translated text when a HSQ has been
used to collect data for making a product label
claim (Eremenco, Cella, & Arnold, 2005).
There has therefore been discussion over
recent years regarding the optimal methodology
for the translation and linguistic validation
of HSQs (Beaton, Bombardier, Guillemin, &
Bosi Ferraz, 2000). In 2005 Wild et al. worked

Translating Health Status Questionnaires/Outcome Measures

collaboratively with other practitioners in the
field to develop a “best practice” methodology,
based on the requirements for accuracy and
cultural relevance within the context of
real-world experience. It has subsequently
been adopted as standard by those sponsoring
and regulating multinational clinical studies
(Wild et al., 2005).
Example Methodology
The following is an example of a translation
methodology which is consistent with Wild
et al.’s paper (2005) (Fig. 1):
Preparation

Once an appropriate HSQ has been identified and
before any translation work commences, it is
essential that permission to translate and use the
instrument should be sought from the instrument
developer or copyright owner. It is also advisable
for an explanation of all the concepts included in
the measure to be developed, which can be made
available for reference throughout the translation
process.
Forward Translation

The source English measure is translated into
the target language independently by two
native speakers of that language. One of these
acts as the “in-country investigator” and should
be resident in the target country. The second
forward translator does not necessarily need
to reside in their native country but it is
preferable.
Reconciled Translation

The two forward translations are then reconciled
into a “best of both” translation. This could be
carried out by the in-country investigator, but this
is not the only method of achieving a reconciled
forward translation.
Backward Translation

Two independent back translations should be
carried out by native speakers of the original
language, who are fluent in the target language.
Ideally, they should reside in the source language country but this is not essential.

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The back translators should have no previous
knowledge of the instrument.
Back Translation Review

The two back translations should be compared
with the source text to determine points of
difference. Any discrepancies are highlighted
and revised until the translation is deemed to
match the source on every question or item.
Developer/Clinician Review

For some measures, the developer may require an
opportunity to review the translation. Any
changes suggested by the developer should be
discussed with the in-country investigator
before finalizing the translation. In addition,
some questionnaires, particularly those to be
used with a specific patient population, may
benefit from a clinician review. The clinician’s
role is to ensure that the language used is
appropriate for the target patient population and
understandable to all.
Harmonization

Harmonization is the process by which conceptual
equivalence across different translations is
checked, which helps to ensure inter-translation
validity and allow reliable pooling of data from
randomized controlled trials and other clinical
studies. However, how harmonization might best
be achieved is a matter as yet unresolved, and thus,
it is not normally included as a formal step in
linguistic validation guidelines.
Where it is considered necessary, the preferred
solution is to hold a harmonization meeting to
which in-country investigators or back translators
are invited to represent each language.
Cognitive Debriefing

The translated questionnaire is tested on
a number of respondents, who ideally should
be part of the target patient population. However,
it is recognized that setting strict criteria,
which would be difficult to meet in real-world
situations, should be avoided, though it is still
important to ensure that interviewee-recruitment
recommendations are rigorous enough to give
meaningful results. Advice on the number of

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Translating Health Status Questionnaires/Outcome Measures

Translating Health
Status Questionnaires/
Outcome Measures,
Fig. 1 An example
translation methodology

Preparation

ORIGINAL INSTRUMENT

Second forward translation

First forward translation

Reconciled translation

First backward translation

Second backward translation

Back translation review

Developer/clinician review

Harmonization

Cognitive debriefing

Cognitive debriefing review

Proof reading

FINAL TRANSLATION

respondents to be interviewed varies, but the
minimum number recommended is five.
Cognitive Debriefing Review

The cognitive debriefing results are reviewed
and any revisions to the original translation
should be agreed with the in-country investigator.
Sometimes it might be useful for clarification to
be sought from the developer.

Proofreading

As a final quality control step, it is recommended that two proof readings are carried out in
order to catch and correct any remaining minor
errors.
Discussion
Although this type of approach is widely used and
has been accepted as standard methodology by

Translating Health Status Questionnaires/Outcome Measures

the FDA, very little research has been carried
out to examine the value of these methods as
compared to other methods available.
However, some applied research has been
carried out (Gordon-Stables, 2008) to evaluate
the contribution that each of the individual steps
outlined here makes to the final translation.
The results of research demonstrated that refinements are made to the translation during each
step, which together result in a final translation
that is conceptually equivalent to the source.
The most contentious aspect of the
process, however, is the backward translation
(Mckenna & Doward, 2005), with some
contributors suggesting that it might encourage
unnecessary changes to be made to the reconciled
translation. In an attempt to evaluate whether this
might indeed be occurring, Gordon Stables and
Wild carried out some research to consider
the extent to which translations are amended
during the back translation stage and whether
these amendments are, in fact, unnecessary and
only made as a result of the process. They
concluded that translators are not pressured
into changing their translation because of
queries raised at the back translation review
stage (Gordon-Stables, 2008) and therefore
that back translation is actually a useful tool to
catch important misunderstandings and errors
in the translation.
Some researchers believe that, rather
than developing a HSQ in one language and
translating it into the target languages, it would
be better to develop measures concurrently in
each culture (Mckenna & Doward, 2005).
While this approach has been employed on
a few occasions (e.g., WHOQOL), it is very
time- and resource-consuming, making it
impractical for most studies and relatively
uncommon. The methodology described here,
then, is the most accessible and widely used in
current translation practice. Despite ongoing
discussion about relative demerits of including
back translation, there are dangers in omitting
it from this type of translation, including
a risk that the translation includes questions
or items that are conceptually inaccurate
(Wild et al., 2009).

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In the absence of an alternative methodology
offering the delivery of the same quality of
translation within the same cost and time
constraints, it remains the accepted standard in
the field. It is recommended that further research
is carried out to explore the specific value of each
stage in the translation process.

Cross-References
▶ Disease-Specific Questionnaire
▶ HSQ – Health Status Questionnaire

References
Beaton, D. E., Bombardier, C., Guillemin, F., &
Bosi Ferraz, M. (2000). Guidelines for the process of
cross-cultural adaptation of self-report measures.
Spine, 24, 3186–3191.
Eremenco, A., Cella, D., & Arnold, B. J. (2005).
A comprehensive method for the translation
and cross-cultural validation of health status
questionnaires. Evaluation & the Health Professions,
28, 212–232.
Gordon-Stables, W. D. (2008). Use of back translation
review in the translation of PRO instruments.
Value in Health, 11, A181.
Mckenna, S. P., & Doward, L. C. (2005). The translation
and cultural adaptation of patient-reported outcome
measures. Value in Health, 2, 89–91.
Price, V. E., Klaasen, R. J., Bolton-Maggs,
P. H. B., Grainger, J. D., Curtis, C., Wakefirled, C.,
et al. (2009). Measuring disease-specific quality of life
in rare populations: A practical approach to
cross-cultural translation. Health and Quality of Life
Outcomes, 7, 92–99.
Wild, D., Eremenco, S., Mear, I., Martin, M., Houchin,
C., Gawlicki, M., et al. (2009). Multinational
trials-recommendations on the translations required,
approaches to using the same languages in different
countries, and the approaches to support pooling
the data: The ISPOR Patient-Reported Outcomes
Translation and Linguistic Validation Good
Research Practices Task Force report. Value in Health,
12, 430–440.
Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy,
S., Verjee-Lorenz, A., et al. (2005). Principles of
good practice for the translation and cultural
adaptation process for patient-reported outcomes
(PRO) measures: Report for the ISPOR Task Force
for translation and cultural adaptation. Value in
Health, 8, 94–104.

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Translation Research
Acquadro Catherine and Katrin Conway
Mapi Research Trust, Lyon, France

Definition
What does translating mean? While theories are
discussed elsewhere (Acquadro, Jambon, Ellis, &
Marquis, 1996), the definition given by Umberto
Eco (2008) seems refreshing and sensible: translating means “saying almost the same thing.”
What, however, is the extent of almost and how
do you evaluate it? According to Eco, being
faithful to a source document is not performing
a word for word translation but a world for world
translation, and negotiating with the requirements of the source world becomes the key
issue. In other words, the elasticity of almost
depends on criteria which should be discussed
and defined before embarking on the translation
as such and in collaboration with the author of the
original text.

Description
When preparing Patient-Reported Outcome
(PRO) instruments for use internationally, it is
helpful to remember Umberto Eco’s observation.
There are currently three strategies for the international development of PRO instruments: the
sequential, parallel, and simultaneous approaches
(Bullinger et al., 1996). The (1) sequential
approach involves the translation into one or
multiple target languages of a PRO measure
which was initially developed for and within
one cultural setting. This approach may be
regarded as the least time consuming and most
frequently used, although it is criticized for its
potential risk of insufficient cultural and conceptual relevance in the target country (Guyatt, 1993;
Hunt, 1993). The (2) parallel approach defines
a process which includes an international consensus among several teams about the conceptual
framework and concepts to be used in a PRO

Translation Research

measure which is then developed in one language
and subsequently translated into others. This is
the strategy chosen by the European Organization
for Research and Treatment of Cancer (EORTC)
Group (Aaronson, Cull, Kaasa, & Sprangers,
1994). The (3) simultaneous approach was used
by the World Health Organization (WHO) to
develop a measure applicable to a large variety of
cultures, with equivalent versions developed
simultaneously in many languages (Sartorius,
1993). Although this approach may be regarded
as the ideal one as it strives to maximize
cross-cultural equivalence of concepts while integrating country-specific considerations, it can be
time consuming and costly. In addition, a range of
criticisms has been raised regarding the conceptualization and the metric quality of some dimensions of the WHOQOL, in particular the social one
(Hagerty et al., 2001; Schmidt & Bullinger, 2007).
These three approaches to international development lean on a key concept: equivalence.
While the best method to maximize this is still
being discussed, multiple taxonomies have been
developed (Herdman, Fox-Rushby, & Badia,
1997; Herdman, Fox-Rushby, & Badia, 1998;
Hui & Triandis, 1985; Sartorius & Kuyken,
1994; Stewart & Napoles-Springer, 2000).
Stewart and Napoles-Springer provide the latest
classification for assessing equivalence that
integrates and modifies the approaches of
numerous researchers. They describe six levels
of equivalence and the basic methods for
addressing each type of equivalence. Conceptual
equivalence of constructs and items is achieved
when the constructs exist, are relevant and are
acceptable in all cultures. Semantic equivalence
is obtained when the words used to express
the items mean the same thing to people from
different groups in both the source and target
languages. Operational equivalence is achieved
when standardized methods of survey administration are appropriate in both the source and
target culture. Psychometric or measurement
equivalence is achieved when comparable
psychometric properties are observed in the
source and target measures. Item equivalence is
observed when (a) items are not differentially
more difficult (e.g., biased) in the target culture

Translation Research

than in the original, (b) item weights reflect
comparative importance of items in all groups,
and (c) the meaning of and distance between
response choices is similar across cultures.
Finally, criterion equivalence is obtained when
the interpretation of scores is the same across
groups and when compared with norms for each
group. Translated versions should also demonstrate similar associations with any previously
set independent criteria established during the
validation of the original version.
As most PRO questionnaires for global use are
developed according to the sequential approach,
regulators have focused their interest on the
validity of the translations and their ability to
express and investigate equivalent concepts
across all language versions: the European Medicines Agency (EMA) published a reflection
paper on the “regulatory guidance for the use of
health-related quality of life (HRQL) measures in
the evaluation of medicinal products” (European
Medicines Agency [EMA], 2005), and the United
States Food and Drug Administration (FDA) (US
Department of Health. Food and Drug Administration, 2009) released a report on the use of
PROs in the evaluation of medical products.
With the question, “Are health-related quality of
life (HRQL) instruments internationally validated?” (Chassany et al., 2001), the EMA clearly
made the aspect of equivalence one of the key
issues of HRQL evaluation. The FDA shares this
view in its guidance, section III.G.3. and provides
some recommendations (US Department of
Health. Food and Drug Administration, 2009).
The guidance states: “Regardless of whether the
instrument was developed concurrently in multiple cultures or languages or whether a fully
developed instrument was adapted or translated
to new cultures or languages, we recommend that
sponsors provide evidence that the content validity and other measurement properties are adequately similar between all versions used in the
clinical trial. We will review the process used to
translate and culturally adapt the instrument for
populations that will use them in the trial.”
Recent reviews suggest that translations using
a rigorous and multistep process with centralized
review procedures may lead to better translations

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and can meet the regulators’ requirements stated
above (Acquadro, Conway, Hareendran, &
Aaronson, 2008; Wild et al., 2005). There is,
however, no agreement on the best method to be
used. The multistep process usually reveals difficulties when adapting the format, instructions,
concepts, idiomatic expressions, response scales,
or demographic items to different languages. To
overcome these difficulties, a Translatability
Assessment can be performed before starting
the translation. Translatability Assessment can
be defined as the evaluation of the extent to
which a PRO measure can be meaningfully translated into another language. A meaningful translation in the context of international clinical trials
is one that is conceptually equivalent to the source
text and culturally and linguistically appropriate in
the target country to facilitate comparison and
pooling of data. The goal of Translatability Assessment is to identify translation difficulties before
embarking on the translation process as such. The
process involves the critical review of an original
instrument developed in one cultural setting in
order to assess the appropriateness and relevance
of its key aspects to the target culture: items,
response choices, format, and instructions. It
defines the concept of the original item, proposes
acceptable alternatives for translations, and suggests alternative formulations for the original if it
is still modifiable. Ideally, the process is conducted
by linguists in collaboration with the developer of
the measure prior to finalizing the wording of the
original. It takes into account the context and constraints of other languages and cultures with the
goal of optimizing the original measure for subsequent translation efforts and for its use in international settings. To speak with Eco, Translatability
Assessment defines the specific requirements of
the source text in the context of international clinical trials in order to facilitate and guide subsequent negotiations and to ultimately produce
meaningful translations.

Discussion
Several methods are available to translate standardized measures. Although there is no

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agreement on the best method to be used,
multistep approaches seem the most appropriate
to ensure that the content validity between the
original and the translations is comparable. The
Translation and Cultural Adaptation Special
Interest Group (TCA-SIG) within the ▶ International Society for Quality of Life Research
(ISOQOL) is currently promoting research in
the translation of standardized measures. Its
objectives are the following: (1) to identify and
advance research into practices and outcomes of
translation and cultural adaptation of patientreported outcome instruments, (2) to provide an
evidence database on translation and cultural
adaptation of PROs, and (3) to promote visibility
of cross-cultural issues in development and use of
PROs in ISOQOL. One of the subgroups of the
TCA-SIG has set up the following research
agenda: (1) When should an original questionnaire and its translations be revised and updated?
(2) Which aspect of the currently employed linguistic
validation
methodologies
makes
a difference? (3) What should be reported on
a given linguistic validation and how should this
be organized/presented? (4) What are the components of the «reconciliation» process? More
information on the TCA-SIG activities can be
found on the ISOQOL website (www.isoqol.org).

Cross-References
▶ International Society for Quality of Life
Research ISOQOL
▶ Translating Health Status Questionnaires/
Outcome Measures

References
Aaronson, N. K., Cull, A., Kaasa, S., & Sprangers,
M. A. G. (1994). The EORTC modular approach to
quality of life assessment in oncology. International
Journal of Mental Health, 23(2), 75–96.
Acquadro, C., Conway, K., Hareendran, A., & Aaronson, N.
(2008). Literature review of methods to translate healthrelated quality of life (HRQL) questionnaires for use in
multinational clinical trials. Value in Health, 11,
509–521.

Translation Research
Acquadro, C., Jambon, B., Ellis, D., & Marquis, P. (1996).
Language and translation issues. In B. Spilker (Ed.),
Quality of life and pharmacoeconomics in clinical trials (2nd ed., pp. 575–585). Philadelphia: LippincottRaven Publishers.
Bullinger, M., Power, M. J., Aaronson, N. K., Cella, D. F.,
& Anderson R.T. (1996). Creating and evaluating
cross-cultural instruments. In B. Spilker (Ed.), Quality
of life and pharmacoeconomics in clinical trials
(2nd ed., pp. 659–668). Philadelphia: LippincottRaven Publishers.
Chassany, O., Sagnier, P., Marquis, P., Fullerton S., &
Aaronson N. K. for the European Regulatory Issues
on Quality of Life Assessment (ERIQA) group (2001).
Patient-reported outcomes: The example of healthrelated quality of life – a European guidance document
for the improved integration of health-related quality
of life assessment in the drug approval process. DIA
Journal, 36, 209–238.
Eco, U. (2008). Experiences in translations. Toronto:
University of Toronto Press.
European Medicines Agency [EMA] (2005). Reflection
paper on the regulatory guidance for the use of
health-related quality of life (HRQL) measures in the
evaluation of medicinal products. EMEA/CHMP/
EWP/139391/2004. London: Author, 2006.
Guyatt, G. H. (1993). The philosophy of health-related
quality of life translation. Quality of Life Research, 2,
461–465.
Hagerty, M. R., Cummins, R. A., Ferris, A. L., and, K.,
Michalos, A. C., Peterson, M., Sharpe, A., Sirgy, J., &
Vogel, J. (2001). Quality of life indexes for national
policy: Review and agenda for research. Social Indicators Research, 55, 1–91.
Herdman, M., Fox-Rushby, J., & Badia, X. (1997). Equivalence and the translation and adaptation of
health-related quality of life questionnaires. Quality
of Life Research, 6, 237–247.
Herdman, M., Fox-Rushby, J., & Badia, X. (1998).
A model of equivalence in the cultural adaptation of
HRQL instruments: The universalist approach. Quality of Life Research, 7, 323–335.
Hui, C. H., & Triandis, H. C. (1985). Measurement in
cross-cultural psychology. A review and comparison
of strategies. Journal of Cross-Cultural Psychology,
16(2), 131–152.
Hunt, S. M. (1993). Cross-cultural comparability of quality of life measures. Drug Information Journal, 27,
395–400.
Sartorius, N. (1993). A WHO method for the assessment
of health-related quality (WHOQOL). In S. R. Walker
& R. M. Rosser (Eds.), Quality of life assessment: key
issues in the 1990’s (pp. 201–207). Boston: Kluwer.
Sartorius, N., & Kuyken, W. (1994). Translation of health
status instruments. In J. Orley & W. Kuyken (Eds.),
Quality of life assessment: International perspectives
(pp. 3–18). Berlin Heidelberg: Springer Verlag.
Schmidt, S., & Bullinger, M. (2007). Cross-cultural quality of life assessment approaches and experiences from

Transportation and the Quality of Life
the health care field. In I. Gough & J. A. McGregor
(Eds.), Wellbeing in developing countries: From theory to research (pp. 219–241). Cambridge: Cambridge
University Press.
Stewart, A. L., & Napoles-Springer, A. (2000). Healthrelated quality of life assessments in diverse population groups in the United States. Medical Care, 38(9),
102–124.
US Department of Health. Food and Drug Administration.
(2009). Patient-reported outcome measures: Use in
medical product development to support labeling
claims. Federal Register, 74(35), 65132–65133.
Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy,
S., Verjee-Lorenz, A., & Erikson, P. for the ISPOR
Task Force for Translation and Cultural Adaptation
(2005). Principles of good practice for the translation
and cultural adaptation process for patient-reported
outcomes (PRO) measures: Report of the ISPOR task
force for translation and cultural adaptation. Value in
Health, 8(2), 94–104.

Translational Process, Quality of Life

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Transportability
▶ Mobility Issues for People with Disabilities

Transportation
▶ Traffic Mobility

Transportation and the
Quality of Life
Litman Todd
Victoria Transportation Policy Institute, Victoria,
BC, Canada

▶ Cross-Cultural Adaptation

Synonyms

Transmigrants

Mass transit and qol; Transport; Transport
mobility

▶ Immigrants, an Overview

Definition

Trans-national Comparison

Transportation (or just transport) refers to
people’s ability to travel and the amount and
type of travel activity that occurs in an area.

▶ Cross-National Comparison(s)

Description

Transport
▶ Transportation and the Quality of Life

Transport Mobility
▶ Transportation and the Quality of Life

Transportation affects the quality of people’s
lives in many ways:
• Transportation is an essential activity that
provides access services and activities, such
as education, employment, shopping, and
social events. The quality of transport options
available affects people’s ability to participate
in social and economic activities.
• Active modes (walking and cycling and their
variants such as travel by wheelchair and

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scooter) provide enjoyment and exercise, so
the quality of walking and cycling conditions
in a community can affect residents’ happiness and health.
• Transportation costs can be a significant financial burden, particularly to lower-income
households.
• Transportation activities impose significant
indirect and external costs, including traffic
congestion, road and parking facility costs,
accident risk, plus air and noise pollution.
• Transportation facilities and activities
affect community development patterns.
A transportation system designed for walking
and public transit will result in very different
land-use development patterns than an automobile-oriented transport system.
These impacts affect people in many ways.
People who are physically, economically, or
socially disadvantaged tend to be particularly
vulnerable to certain impacts and constraints.
For example, people with disabilities, low
incomes, children, and young adults tend to be
particularly sensitive to the quality of walking,
cycling, and public transit services in their
communities.
Conventional planning tends to overlook
and undervalue many of these factors, particularly indirect and nonmarket impacts that tend
to be difficult to quantify. Such impacts are
often called intangibles with the implication
that they cannot be measured and so can be
ignored. However, new evaluation methods
allow many of these impacts to be quantified
and monetized (measured in monetary units), so
they can be incorporated into planning and
economic evaluation (Litman, 2009; Maibach
et al., 2008).
Transportation can be defined and measured in
different ways that lead to very different conclusions concerning which transport improvement
options are optimal. Conventional planning
often assumes that transportation means traffic
(vehicle travel) or mobility (physical movement)
and measures transport system performance
based on automobile travel speed and distance.
This tends to favor automobile-oriented

Transportation and the Quality of Life

improvements over improvements to walking,
cycling, and public transit. However, mobility is
not usually an end in itself; it is generally a way to
access services and activities. When evaluated
based on overall access, travel speed is only one
factor in transport system quality; equally important are land-use accessibility (the location of
activities within a community), transportation
affordability, and the quality of mobility substitutes such as telecommunications and delivery
services (Litman, 2010). Table 1 compares three
different ways of defining and measuring
transportation.
In addition, active transport (walking and
cycling) is an important form of recreation and
exercise, benefits that are often overlooked in
conventional transport planning. As a result,
transportation planning tends to undervalue
walking and cycling improvements, based on
the assumption that transportation systems are
intended to provide utilitarian travel rather than
supporting recreational or exercise activities.
A paradigm shift (a fundamental change in the
way problems are defined and potential solutions
evaluated) is occurring in the way people
think about and evaluate transportation and its
quality of life impacts. This shift expands the
range of transport options, objectives, and
impacts considered in transport planning. This is
sometimes called sustainable transport planning.
This approach allows much greater consideration
of quality of life impacts such as affordability,
social equity, and physical fitness (Table 2).
In general, transportation planning that
incorporates sustainability and quality of life
objectives tends to recognize the following
objectives:
• Diversity. A sustainable transportation system
tends to provide a diverse range of mobility
and accessibility options, including walking,
cycling, automobile, public transit, telecommunications, and delivery services. This
allows users, including those who cannot
drive due to physical, economic, or social constraints, to choose the best option for each trip.
• Service quality. Improving service quality,
such as the quality of walking and cycling

Transportation and the Quality of Life

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Transportation and the Quality of Life, Table 1 Comparings transportation measurements
Traffic
Definition of
Vehicle travel
transportation
Unit of measure Vehicle miles and vehicle trips
Modes
considered
Common
performance
indicators
Assumptions
concerning
what benefits
consumers
Consideration
of land use
Favored
transportation
improvement
strategies

Access
Ability to obtain goods, services,
and activities
Person miles, person trips, and Trips
ton miles
Automobile and truck
Automobile, truck, and public All modes, including mobility
transit
substitutes such as
telecommuting
Vehicle traffic volumes and
Person trip volumes and
The quality of different transport
speeds, roadway level of service, speeds, road and transit level modes, land-use accessibility,
costs per vehicle mile, parking
of service, cost per person trip, quality of telecommunications
convenience
travel convenience
and delivery services
Maximum vehicle mileage and
Maximum personal travel and Maximum transport options,
speed, convenient parking, low
goods movement
convenience, land-use
vehicle costs
accessibility, cost efficiency
Favors low-density, urban fringe
development patterns
Increased road and parking
capacity, speed, and safety

Mobility
Person and goods movement

Favors some land-use
clustering, to accommodate
transit
Increased transport system
capacity, speeds, and safety

Favors land-use clustering, mix,
and connectivity
Various strategies to increase
transport and land-use system
capacity, efficiency, and safety

Source: Author’s analysis
This table compares the three major approaches to measuring transportation

Transportation and the Quality of Life, Table 2 Comparing transportation planning paradigms
Old paradigm
New paradigm
Transportation primarily means automobile travel. Transportation includes various modes: walking,
Other modes are unimportant
cycling, public transit, telecommunications, delivery
services, etc.
Objectives Maximize travel speeds, minimize user costs,
Maximize overall accessibility and support various
particularly vehicle operating costs and traffic crash strategic economic, social, and environmental
injury rates
objectives
Impacts
Congestion delay
Congestion delay
Roadway costs
Roadway and parking facility costs
Vehicle operating costs
Vehicle ownership and operating costs
Traffic accident rates per vehicle mile
Accessibility for nondrivers
Physical fitness and activity
Energy consumption
Per capita traffic accident rates
Energy consumption
Pollution emissions
Strategic land-use objectives (smart growth)
Options

Source: Author’s analysis
Transportation planning is becoming more comprehensive, considering more options, objectives, and impacts than
previously

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conditions, and the convenience and comfort
of public transit service, are important but
often overlooked ways to improve transport
system users’ quality of life.
• Affordability. Affordability refers to the cost
burdens imposed on lower-income users.
Increasing transport system affordability
by reducing costs and improving the quality
of affordable modes (walking, cycling,
ridesharing, public transit, and delivery
services) helps improve accessibility and
reduce financial burdens on lower-income
people.
• Efficient system management. Transport
system performance can often be improved
by favoring higher value trips and more efficient modes over lower-value trips and less
efficient modes. This can be done, for example, through more efficient pricing of roads,
parking, and fuel and through roadway
management that favors high-occupancy
vehicles.
• Transportation land-use integration. More
integrated planning can increase land-use
accessibility, so less travel is needed to access
desired goods and services, and reduce negative impacts causes by transportation facilities, for example, by encouraging more
compact, infill development that reduces
travel distances and impervious surface area.
• Supports active modes. Walking and cycling
play an important and unique role in an efficient transport system by providing affordable
basic access, providing recreation and
exercise, and reducing external costs such as
traffic congestion and pollution emissions.
Walkability also tends contribute to community cohesion, that is, the quality of interactions among people in a community and
therefore public safety. As a result, improving
walking and cycling conditions and encouraging nonmotorized modes tend to improve residents’ quality of life.
Transportation demand management (TDM,
also called mobility management) refers to
various policies and programs that encourage
more efficient use of the transportation system.
It typically includes improvements to alternative

Transportation and the Quality of Life

modes (walking, cycling, public transit, etc.),
incentives to use the most efficient mode for
each trip (more efficient road, parking, and fuel
pricing; roadway management that favors more
space-efficient modes such as public transit; and
commute trip reduction programs), and smart
growth development policies that create more
accessible land-use patterns. TDM tends to
support efforts to incorporate quality of life
objectives into transport planning.
Transportation professionals increasingly
apply multimodal planning tools that consider
walking, cycling, and public transit travel conditions, as well as automobile travel conditions
(Dowling et al., 2008). This allows decision
makers to better understand the impacts and
trade-offs involved in particular planning decisions. For example, with conventional planning,
expanding a roadway is generally assumed to be
desirable because it improves automobile travel
speeds, and impacts on other modes or land-use
development patterns are not quantified.
Multimodal level-of-service indicators recognize
that roadway widening often has negative
impacts on walking and cycling conditions and
tends to stimulate sprawl which reduces land-use
accessibility. This type of analysis can help evaluate more quality of life impacts of transport
planning decisions.

Cross-References
▶ Accessibility
▶ Environmental Sustainability
▶ Land-Use Planning
▶ Public Health
▶ Quality of Place

References
Dowling, R., Reinke, D., Flannery, A., Ryus, P.,
Vandehey, M., Petritsch, T., et al. (2008), Multimodal
level of service analysis for urban streets, NCHRP
Report 616. Transportation Research Board. Retrieved
6 April 2013 from http://trb.org/news/blurb_detail.
asp?id¼9470

Traumatic Brain Injury
Litman, T. (2009). Transportation cost and benefit analysis. Victoria Transport Policy Institute. Retrieved 6
April 2013 from www.vtpi.org/tca
Litman, T. (2010). Evaluating accessibility for transport
planning. Victoria Transport Policy Institute
(www.vtpi.orga). Retrieved 6 April 2013 from www.
vtpi.org/access.pdf
Maibach, M., Schreyer, C., Sutter, D., van Essen, H. P.,
Boon, B. H., Smokers, R., et al. (2008). Handbook on
estimation of external cost in the transport sector.
Internalisation Measures and Policies for All
External Cost of Transport (IMPACT). CE Delft, for
the European Commission DG TREN. Retrieved 6
April 2013 from http://www.cer.be/uploads/media//
2312_External_Costs_update_study_FINAL.pdf

Transprejudice
▶ Homophobia and Transphobia

Trauma/Compassion Fatigue Scale
▶ Emergency Workers’ Quality of Life

Traumatic Brain Injury
Leonard Jason1 and Sharon Song2,3
1
Center for Community Research, DePaul
University, Chicago, IL, USA
2
Clinical Practice Guidelines Unit, Department
of Research and Scientific Affairs, American
Academy of Orthopaedic Surgeons, Rosemont,
IL, USA
3
Internal Medicine/Psychology Section,
Presence Resurrection Medical Center,
Chicago, IL, USA

Synonyms
Concussion; Contusion; Craniocerebral trauma;
Head injury

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Definition
Traumatic brain injury (TBI) refers to acquired
damage to parts of the brain, including the skull,
dura mater, blood vessels, myelinated fibers,
and axons.

Description
Traumatic injury to the brain can be open or nonpenetrating and arises when sudden force is
inflicted to the head usually secondary to motor
vehicle accidents, firearm assaults, ▶ child abuse,
or sports injuries (Langlois et al., 2006).
Although diagnostically simple to identify, the
condition is associated with medical and
neurocognitive complications that make its
course heterogeneously complex (American
Academy of Neurology, 2013).
Since the brain and skull are discrete organs
that have cerebral spinal fluid separating them,
a strong blow can set the head in motion with
delayed movement of the cerebrum, or motion of
the head can be arrested despite the occurrence of
internal forceful movements. Additionally, the
brain is attached to the head at the brain stem,
which creates torque to the cerebral hemispheres
during traumatic brain injury. When the cerebral
hemispheres pathologically rotate and shift,
the following aftereffects can occur: bruising,
hemorrhages, tearing of myelinated fibers, shearing or rupturing of axons to the nerve fibers, and
skull fractures (Ropper & Samuels, 2009).
The National Institute of Neurological Disorders and Stroke has described Phineas Gage as
the most legendary TBI patient in the history of
medicine (NINDS, 2011). He worked as
a railway construction foreman for more than
25 years on the Rutland and Burlington Railroad
in Vermont. Brain function was not well understood, and there were not any protocols for
treating injury to it in 1848 when an explosion
propelled a three-foot pointed rod through his
head. This type of injury would usually cause
death due to bleeding or infection. The object
entered at the top of Gage’s head, passed through
his brain, and exited the skull near his temple.

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A physician named John Harlow treated him for
73 days and miraculously helped him to survive
the event. Of note was that before the accident,
Gage was quiet and mild-mannered, but he
became obscene, obstinate, and self-absorbed
after his injuries. He suffered personality and
behavioral problems for the remainder of his
life (See Rosenthal & Ricker, 2000; White
et al., 2009).
Skull fractures can have severe sequelae.
Depending on their location, certain fractures
can precipitate major medical emergencies if
they cause lacerations to arteries that result in
life-threatening bleeding. Skull fractures may
end up allowing foreign particles to enter the
brain, or vital fluids can be lost. They can also
create blood flow problems and cause autoimmune dysfunction (Dutton & McCunn, 2003).
Life-threatening bleeding results when core
arteries and veins have been torn that are
typically located in the lobes nearest to the top
and sides of the head. Although the bleeding
eventually clots, the time frame involved is
several hours. During this time, bleeding can
spread to multiple regions, and paralysis or
coma can result. Early recognition, removal of
the clot, and surgical repair of torn vessels are
essential for increasing the likelihood of survival
(Shukla et al., 2011).
Contusion and concussion occur when the
head accelerates or decelerates at critically high
velocities. Sudden loss of consciousness is experienced for altering periods of time due to the
flinging of the coils along the cerebral hemispheres against the bony and dense surfaces of
the inner skull. Duration of unconsciousness is
directly related to the seriousness of the head
injury (Dutton & McCunn, 2003). Severe damage
can lead to brain death (i.e., a medical term
meaning irreversible cessation of all lifesustaining bodily functions), partial paralysis,
vision loss, and speech and language deficits.
When an injury is primarily concussive, its
course is characterized by drowsiness and confusion with a relatively rapid return to consciousness. When there is contusion, altered mentation
can be prolonged, and recovery varies based on if
hemorrhages or subdural hematomas develop and

Traumatic Brain Injury

if the injury type is penetrating (e.g., open)
(Ropper & Samuels, 2009).
If there is bleeding underneath the arachnoid
or dura (layers of the skull) that becomes
arrested by intracranial pressure, asymptomatic
clots form that are usually small and do not
necessitate medical intervention. In contrast,
subdural hematomas require immediate attention. They form when encasements of blood
have collected in the subdural space and have
become encapsulated by adjacent membranes
that abnormally attach to the dura (Ropper &
Samuels, 2009). These types of fluid sacs
frequently enlarge, and when they do, the risk
of compression or displacement of the underlying brain increases. If neurological dysfunction
such as headache, confusion, paralysis, or inability to swallow progressively worsens, then
surgical drainage becomes necessary (Shukla
et al., 2011).
Traumatic brain injury is a widespread
▶ public health problem that affects more than
one million people in the United States each year
(Rutland-Brown et al., 2006). With one third of
soldiers wounded in the Iraqi and Afghanistan
Wars sustaining head injuries, it has received
increased attention by the Veterans Administration (Department of Veterans Administration,
2010). In the nonmilitary sector, falls, automobile
accidents, and assaults are the first, second, and
third most common causes of traumatic brain
injuries. There is a higher incidence of TBI
among males, infants, adolescents, the elderly,
and individuals who abuse substances
(Rutland-Brown et al., 2006).
In addition to a gap in memory from the point
where consciousness is lost to the time when
consecutive memories can be reconstructed,
postconcussion syndrome often results from
traumatic brain injury when persistent headache,
fatigue, irritability, light-headedness, concentration
difficulties,
sleep
disturbances,
depression, and ▶ anxiety complicate healing
(White et al., 2009). Prevalence rates are higher
when litigation is involved (Rosenthal & Ricker,
2000). The most common cognitive sequelae of
TBI are diffuse reductions in attention and information processing, impaired learning and

Treiman’s Standard Index of Occupational Prestige Scale (SIOPS)

retrieval of new information, sensory processing
deficits, and executive dysfunction (i.e., poor
planning and organizing, impaired motor execution, perseveration, impulsivity) (Lucas &
Addeo, 2006).

Cross-References
▶ Anxiety
▶ Child Abuse
▶ Cognitive Abilities
▶ Public Health
▶ Substance Abuse

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Shukla, D., Devi, B. I., & Agrawal, A. (2011). Outcome
measures for traumatic brain injury. Clinical Neurology and Neurosurgery, 113, 435–441. doi:10.1016/j.
clineuro.2011.02.013.
White, R. F., Krengel, M. H., & Thompson, T. (2009).
Common neurological disorders associated with psychological-behavioral problems. In P. M. Kleespies
(Ed.), Behavioral emergencies: An evidence-based
resource for evaluating and managing risk of suicide,
violence, and victimization (pp. 289–309). Washington,
DC: American Psychological Association.

Traumatic Life Events
▶ Stressful Life Events

References
American Academy of Neurology. Traumatic brain
injury. Retrieved June 21, 2013, from http://
patients.aan.com/disorders/index.cfm?event¼view
&disorder_id¼1092
Department of Veteran Affairs. (2010). A conceptual
framework for TBI assessment and management. In
Department of Veteran Affairs TBI Independent Study
Course (pp. 1–4). Washington DC: Department of
Veteran Affairs.
Dutton, R. P., & McCunn, M. (2003). Traumatic brain
injury. Current Opinion in Critical Care, 9,
503–509.
Langlois, J. A., Rutland-Brown, W., & Wald, M. M.
(2006). The epidemiology and impact of traumatic
brain injury: A brief overview. The Journal of Head
Trauma Rehabilitation, 21(5), 375–378.
Lucas, J. A., & Addeo, R. (2006). Traumatic brain injury
and postconcussion syndrome. In P. J. Snyder,
P. D. Nussbaum, & D. L. Robins (Eds.), Clinical
neuropsychology: A pocket handbook for assessment
(2nd ed., pp. 351–380). Washington, DC: American
Psychological Association.
National Institute of Neurological Disorders and Stroke.
(2011). Traumatic brain injury: Hope through
research. Retrieved from http:www.ninds.nih.gov/disorders/tbi/detail_tbi.htm
Ropper, A. H., & Samuels, M. A. (2009). Craniocerebral
trauma. In Principles of neurology (9th ed.,
pp. 747–770). New York: McGraw-Hill.
Rosenthal, M., & Ricker, J. (2000). Traumatic brain
injury. In R. G. Frank & T. R. Elliott (Eds.), Handbook
of rehabilitation psychology (pp. 49–74). Washington,
DC: American Psychological Association.
Rutland-Brown, W., Langlois, J. A., Thomas, K. E., &
Yongli, L. X. (2006). Incidence of traumatic brain
injury in the United States, 2003. The Journal of
Head Trauma Rehabilitation, 21(6), 544–548.

Travel
▶ Traffic Mobility

Travel Child Care
▶ Parental Time and Child Well-Being

Treatability of Illness
▶ Duke Severity of Illness Checklist

T
Treatment Choice
▶ Decision Making

Treiman’s Standard Index of
Occupational Prestige Scale (SIOPS)
▶ Social Inequalities

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Trend Analysis
Alasdair Rae
Town and Regional Planning,
University of Sheffield, Sheffield, UK

Synonyms
Trend evaluation; Trend studies

Definition
Trend analysis is, fundamentally, a method for
understanding how and why things have changed –
or will change – over time. One issue to be aware
of when attempting to understand trend analysis is
the wide variety of disciplinary contexts within
which it is discussed. This makes it more difficult
to define in a universal sense, but for the purposes
of clarity, it can be defined here as an approach to
analysis which collates data and then attempts to
discover patterns, or trends, within that data for the
purposes of understanding or predicting behaviors.
This typically involves the elimination of “noise”
or error in a time-series dataset. Thus, this encyclopedia entry is about statistical trend analysis.

Description
Given the definition for trend analysis provided
here, and alternative definitions in existence, it is
useful to first give a contextualized example. For
this purpose, imagine a time-series dataset for
a particular area, with population values available
for ten different time points within a 100-year
period. Many readers will recognize this situation
from national censuses, as in the United States or
the United Kingdom. Through a statistical
analysis of trends within the time-series dataset,
it would be possible to make direct inferences on
trends or patterns existing within the dataset
(e.g., “baby booms”) and it would also be
possible to make predictions for the future
(e.g., population growth or decline).

Trend Analysis

These basic principles have been applied in
statistical trend analyses in a number of ways in
the past and continue to be important in scenariobuilding exercises and futures research. For
example, Lutz, Sanderson, and Scherbov (2001)
applied this approach in their study of world
population growth, and Hirsch, Slack, and
Smith (1982) adopted trend analysis in their analysis of water quality. The range of statistical
methods used in such studies varies and there
are no “automatic” trend analysis techniques
which can provide all the answers so in a sense
trend analysis is imprecise, but it does allow
analysts to understand patterns and trends which
would not otherwise be possible.
In recent years, one of the most ambitious and
complex trend analyses carried out was the
United Nations’ “World Population to 2300”
report (United Nations [UN], 2004). In this ambitious project, statistical trend analyses were
carried out for low- and high-growth regions
from 1950 to 2300, and assumptions based on
previous trends were used as the basis for statistical extrapolation forward to the year 2300. This
document in itself is a good indicator of the level
of complexity and uncertainty that trend analysis
often deals with since it includes many figures
and charts which visualize trends over time.
Trend analysis is an important technique in the
quality of life research “toolbox,” but because
of its complexity, it is not often fully utilized.
Nonetheless, it remains a valuable and powerful
method which should not be ignored.

References
Hirsch, R., Slack, J., & Smith, R. (1982). Techniques of
trend analysis for monthly water quality data. Water
Resource Research, 18, 107–121.
Lutz, W., Sanderson, W., & Scherbov, S. (2001). The end
of world population growth. Nature, 412, 543–545.
United Nations. (2004). World population to 2300.
New York: Author.

Trend Evaluation
▶ Trend Analysis

Trends in International Mathematics and Science Study (TIMSS)

Trend Studies
▶ Trend Analysis

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curricula. In addition to math and science achievement data, TIMSS collects contextual information
on students, teachers, schools, curricula, and
official education policies that may be related to
student achievement.

Trends in International Mathematics History and Purpose of TIMSS
Originally, the acronym TIMSS stood for Third
and Science Study (TIMSS)
Martin Guhn1, Anne Gadermann2 and
Amery D. Wu3
1
Human Early Learning Partnership, School of
Population and Public Health, University of
British Columbia, Vancouver, BC, Canada
2
Health Care Policy, Harvard Medical School,
Boston, MA, USA
3
The Department of Educational and Counselling
Psychology, and Special Education,
The University of British Columbia, Vancouver,
BC, Canada

Definition
The Trends in International Mathematics and
Science Study (TIMSS) is a large-scale international comparative study that has collected data
on students’ knowledge and skills in mathematics
and science since 1995. Data are collected every
4 years from students in grade 4 and grade 8, that
is, at about 9–10 and 13–14 years of age.

Description
The Trends in International Mathematics and Science Study (TIMSS) is an ongoing international
study that intends to compare mathematics and
science achievement across international education
systems as well as over time. Every 4 years, crosssectional data on math and science achievement are
collected via standardized assessments from representative samples of students in grade 4 and grade
8 in participating education systems. The TIMSS
assessment is designed to align with the curricula in
mathematics and science in the participating countries and education systems. Score results are used
to suggest the degree to which students have
learned the concepts and skills with respect to the

International Mathematics and Science Study. The
Third International Mathematics and Science Study
was conducted in 1995, following the First International Mathematics Study (FIMS; 1964; www.
iea.nl/fims.html) and the Second International
Mathematics Study (SIMS; 1980–1982; www.iea.
nl/sims.html), as well as the First International
Science Study (FISS; 1970–71; www.iea.nl/fiss.
html) and the Second International Science
Study (SISS; 1983–1984; www.iea.nl/siss.html).
The program was designed and remains coordinated by the ▶ International Association for the
Evaluation of Educational Achievement (IEA).
The IEA is an “independent, international
cooperative of national research institutions and
governmental research agencies [which] conducts large-scale comparative studies of educational achievement and other aspects of
education” (www.iea.nl).
Since 1995, TIMSS has collected five cycles
of data. In the most recent TIMSS data collection
in 2011, over 500,000 students from over 60
educational systems around the world participated. An overview of countries participated in
which cycles/years of TIMSS can be found at
http://nces.ed.gov/TIMSS/countries.asp.
TIMSS data are published in publicly accessible reports, with the goal to inform the general
public, educators, and policy makers about the
variability in math and science achievement
(1) between different education systems,
(2) between different student subpopulations,
and (3) between different points in time.
Assessment Design and Data Collection
The questions in the TIMSS assessment have
been designed by international panels of educators to broadly reflect the aligned grade 4 and
grade 8 math and science curricula in the participating education systems.

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Trends in International Mathematics and Science Study (TIMSS)

TIMSS assessments are administered by
trained staff – not by classroom teachers – in
two blocks of 36 min for grade 4 students or
two blocks of 45 min for grade 8 students,
followed by a 30-min administration of the
school and home environment survey.
TIMSS uses a matrix-sampling design where
each student responds to one of the set of booklets. The entire set of booklets represents the pool
of mathematics and science items at each grade
level. Booklets are distributed among students in
participating classrooms in a predetermined order
so that approximately equal numbers of students
complete each booklet and that the groups of
students completing each booklet are approximately equivalent in terms of ability.
In order to establish representative results, participating education systems need to meet certain
sampling criteria. The goal is that each education
system collects data for a minimum of 4,500 students, with a “combined participation rate” of 75 %
(see Provasnik et al., 2012, for further details).
Score Reporting and Results
TIMSS assessment scores are reported on a scale
from 0 to 1000 with a mean score of 500 and
a standard deviation of 100, separately for each
domain and each grade. Data of subsequent
cycles have been rescaled and linked so that
scores are comparable across cycles despite the
data being cross-sectional (see, Provasnik et al.,
2012, for discussion).
Reports of TIMSS in general explore educational issues, such as monitoring relative standing
of an education system in a global context,
change in achievement over time within an education system, and establishing achievement
standards and goals for system improvement or
curriculum reform. Detailed reports and summaries of results can be found at the international
IEA website (www.iea.nl) as well as on national
websites of participating countries. Two comprehensive websites featuring the TIMSS results for
the USA can be found at the government’s
National Center for Education Statistics website
(nces.ed.gov/TIMSS/index.asp) and the TIMSS
and PIRLS website at Boston College (http://
timssandpirls.bc.edu).

Related Studies and Projects
TIMSS is related to several other international
programs on assessment of academic achievement. A study that is also conducted by the IEA
is the ▶ Progress in International Reading Literacy Study (PIRLS). PIRLS complements TIMSS,
as it covers an additional foundational aspect of
academic achievement – reading literacy. In
combination, TIMSS and PIRLS cover the three
areas of reading, mathematics, and science.
PIRLS is conducted only on grade 4 students
(at 9–10 years of age) on a 5-year cycle.
A project that covers the same domains as
TIMSS and PIRLS, but is conducted with older
students, is the ▶ Programme for International
Student Assessment (PISA). The PISA is coordinated by the Organisation for Economic
Co-operation and Development (OECD; www.
oecd.org/pisa/). Like TIMSS, the PISA examines
student academic achievement via standardized
assessments in the areas of numeracy, literacy,
and science. However, the PISA data are collected from students at the age of 15. PISA data
have been collected on 3-year cycles since 1997,
in over 70 countries worldwide.
In the USA, the ▶ National Assessment of
Educational Progress (NAEP) is a representative
study on student achievement in multiple subjects, including mathematics, science, literacy,
and the arts. NAEP data has been linked to the
TIMSS data allowing comparisons in the assessment of achievement of similar subjects within
and across the states of America (see further
details at http://nces.ed.gov/timss/naeplink.asp).
Use and Criticism
TIMSS data have evoked debates about
education among the general public, educators,
education researchers, and policy makers.
Advocates of TIMSS have highlighted its major
accomplishment, that is, the establishment of the
first international database on academic achievement that uses standardized assessment tools
across countries. This arguably greatest asset of
the TIMSS has, however, been subject to criticism, as far as the interpretability and validity of
cross-national comparisons is concerned. In particular, it has been questioned whether TIMSS

Trends of Youth Violence in Five European Countries

data can be used to evaluate the “quality” of
education systems, because (1) it has been
found that one of the strongest correlates of
TIMSS scores has been socioeconomic status
(e.g., parental level of education; see Bos &
Kuiper, 1999), (2) education systems may not
be equivalent in regard to curricula and learning
goals (Wang, 2001), and (3) sampling procedures
may differ from country to country, making it
impossible to conclude whether average scores
are representative for given populations and subpopulations of students (Rotberg, 1998).
Resources
Detailed documentation of the TIMSS study
design, implementation, and results is available on
the websites IEA (see above; www.iea.nl), as well
as on websites of several of the organizations that
coordinate TIMSS in participating countries. Two
comprehensive resources on TIMSS are provided
on the website of the National Center for Education
Statistics (NCES) of the US Department of Education’s Institute of Education Sciences (http://nces.
ed.gov/timss/), and on the website of the TIMSS
and PIRLS International Study Center at Boston
College (http://timssandpirls.bc.edu).

Cross-References
▶ International Association for the Evaluation of
Educational Achievement (IEA): Civic
Education Study of 1999
▶ National Assessment of Educational Progress
(NAEP)
▶ Programme for International Student
Assessment (PISA)
▶ Progress in International Reading Literacy
Study (PIRLS)

References
Bos, K., & Kuiper, W. (1999). Modelling TIMSS data in
a European comparative perspective: Exploring
influencing factors on achievement in mathematics in
grade 8. Educational Research and Evaluation: An
International Journal on Theory and Practice, 5,
157–179. doi:10.1076/edre.5.2.157.6946.
Provasnik, S., Kastberg, D., Ferraro, D., Lemanski, N.,
Roey, S., & Jenkins, F. (2012). Highlights from TIMSS

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2011: Mathematics and science achievement of U.S.
fourth- and eighth-grade students in an international
context (NCES 2013009). National Center for Education Statistics. Retrieved from http://nces.ed.gov/
pubsearch/pubsinfo.asp?pubid¼2013009.
Rotberg, I. C. (1998). Interpretation of international test
score comparisons. Science, 280, 1030–1031.
doi:10.1126/science.280.5366.1030.
Wang, J. (2001). TIMSS primary and middle school data:
Some technical concerns. Educational Researcher, 30,
17–21. doi:10.3102/0013189X030006017.

Trends of Youth Violence in Five
European Countries
Zuzana Podaná1 and Dirk Enzmann2
1
Department of Sociology, Charles University in
Prague Faculty of Arts, Prague, Czech Republic
2
Institute of Criminal Sciences, University of
Hamburg, Faculty of Law, Hamburg, Germany

Definition
Youth violence generally refers to any socially
disapproved violent behavior of young people
(children and juveniles) under 18 years old. A
narrow definition equates it to violent crime in
a legal sense (e.g., aggravated assault or robbery),
whereas a broader criminological approach
includes misdemeanors or misbehaviors
(e.g., ▶ bullying, minor assaults, carrying of
weapons). Trends of youth violence are routinely
studied on the basis of official police statistics
which have, however, many problematic aspects,
and additional information from victim surveys
or from self-report studies is needed for a deeper
understanding of (the extent of) the problem. This
entry discusses trends of youth violence in five
European countries, namely, the Czech Republic,
Germany, Poland, Russia, and Slovenia.

Description
The general term ▶ violence comprises many
phenomena which can be distinguished into

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several types of different nature (Krug, Dahlberg,
Mercy, Zwi, & Lozano, 2002). A long-term
growing sensitivity to violence seems to be
a feature typical of late modern societies in
which various forms of violence, which used to
be tolerated in the past, have gradually become
disapproved. As an example, we can name
physical punishment of children by parents
which was legally banned in Sweden in 1979.
Since then similar laws have been passed in
many European countries, as well (Gershoff &
Bitensky, 2007; Commissioner for Human
Rights, 2009). This sensitization to violence
resulting in diminishing violence from many
spheres of everyday life contributes positively
to well-being and ▶ quality of life. Trends in
officially registered and self-reported physical
youth violence, which is the topic of this entry,
might also be affected by this general tendency.
This hypothesis will be further discussed based
on results from ▶ victimization and self-report
delinquency surveys.
In the recent years, there have been serious
concerns about supposedly growing rates of
▶ youth violence, expressed often by the general
public, the media, and politicians but also by
scientists who reflected the upward trends in
officially registered violent offending during
the 1990s found in police statistics across
Europe. Youth violence is naturally a disturbing
phenomenon which has not only serious negative
consequences for the victims but affects also the
▶ quality of life in the community by contributing to social disorder and increasing ▶ fear of
crime. To investigate whether the trend of youth
violence actually continued to grow after the year
2000, we used data from five Central and Eastern
European countries: the Czech Republic,
Germany, Poland, Russia, and Slovenia.
Until recently, the only possibility to compare
the level of juvenile crime across countries was to
make use of official police statistics. These comparisons are, however, seriously limited by many
factors. The most important problems are differences in legal definitions of criminal offenses,
different police practices in recording crime,
and different willingness of victims to report
crimes to the police (Enzmann, 2012). Reporting

Trends of Youth Violence in Five European Countries

behavior is directly affected by the extent of
sensitivity to violence but also by the level of
general trust to the police which is lower in
post-socialist countries compared to Nordic and
Western European countries (K€a€ari€ainen, 2007).
A unique source of data summarizing police statistics from European countries is the European
Sourcebook of Crime and Criminal Justice Statistics (Killias et al., 2010). Its data indicate that
during the 1990s in Europe, the trend of violent
crime for adult population grew substantively
(Aebi, 2004). In Central and Eastern European
countries, this tendency is partly supported by
data from victimization surveys (Gruszczynska,
2004). Studies by Estrada (1999) and Pfeiffer
(2003) found an increase in violent crime committed by juveniles in the same period, as well.
However, as to the five countries under consideration, extending the time frame until 2006,
a continuation of the increase of assault and robbery victimizations of adults is apparent only in
Germany (and partly in Russia), whereas in the
Czech Republic, Poland, and Slovenia, the trends
have stabilized or even seem to decline (Killias
et al., 2006, 2010).
The limitations of police statistics render them
highly problematic especially for the comparison
of crime level and crime development across
countries. For this purpose, a better source of
data is self-report surveys which are capable of
capturing latent crime and allow to obtain
detailed information on offenders, as well.
Self-report surveys are, nevertheless, also not
flawless. Known limitations are, for instance,
their focus on less serious crime and
a likely underrepresentation of high-risk youth
(see, Junger-Tas & Marshall, 1999; Thornberry
& Krohn, 2000). Although internationally comparable self-report surveys are still rare, an
important milestone of these efforts represents
the International Self-Report Delinquency Study
(ISRD). Its first sweep took place in 1992, and the
second in 2006 (Junger-Tas, Terlouw, & Klein,
1994; Junger-Tas et al., 2010, 2012). The five
countries under consideration were involved not
only in ISRD-2 study but also in similar selfreport surveys (SRD) which took place in 2000
in selected cities. Although the design of both

Trends of Youth Violence in Five European Countries

surveys was not identical and the comparison is,
therefore, limited (for details, see Enzmann &
Podana, 2010), the studies allow to investigate
trends of attitudes toward violence, victimization
experiences, and self-reported violent behaviors.
The main results of the comparison of SRD
and ISRD-2 can be summarized as follows
(Enzmann & Podana, 2010):
• Between 2000 and 2006, a substantial
decrease in juveniles’ attitudes toward
violence occurred in all five countries.
The decrease in acceptance of violence
was considerable both as to wanton violence
(“violence as being fun”) and concerning
culturally accepted violence (“to hit back”).
• The prevalence rate of wanton violence was
higher in the Czech Republic and Germany
than in the other three countries in 1999 and
dropped significantly in both countries in
2006. The level of wanton violence remained
similar in Poland, Russia, and Slovenia
between 1999 and 2006. Since the definition
of wanton violence included also less serious
offenses (group fights) in 2006, it is most
likely that the trend actually decreased in all
countries in this period.
• Instrumental (acquisitive) violence was
highest in Russia and Slovenia in 1999 and
lowest in the Czech Republic. By 2006 it
decreased substantially in all countries except
for Germany where it remained on the same
level.
• A considerable significant drop between 1999
and 2006 can also be observed in the victimization rates of juveniles by both assault and
robbery. The only exception is Poland where
the decrease is lower and statistically
insignificant.
In summary, survey data of youth in the five
countries clearly indicate that the increase in
▶ youth violence apparent from police statistics
during the 1990s did not continue after the year
2000. To the contrary, there is evidence that it
has rather decreased. The drop in experiences of
violent victimizations and in self-reported violent behavior is very likely related to a growing
sensitivity toward violence in the society, which
is well reflected in the observed dramatic change

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in juveniles’ attitudes toward violence.
Although the higher sensitivity to violence
among juveniles could have resulted in
underreporting of their own violent behavior,
the concurrent decrease in victimization experiences by violent offenses rather supports the
assumption that the decrease in youth violence
is real. Finally, these results lend support to the
hypothesis that the process of increasing sensitization to violence applies to youth violence, as
well. One should expect that growing sensitivity
toward physical acts of violence is accompanied
by a lower threshold to report incidences of
violence to the police. Of course, this optimistic
outlook of a general trend in the decrease in
violent behavior needs confirmation by further
research.
The findings clearly underscore the importance of internationally comparative self-report
delinquency research. Its potential is not only in
comparison of offending rates and trends across
different countries but also in the possibility to
capture changes in ▶ attitudes, lifestyle, living
conditions, etc., which are highly relevant for
the interpretation and explanation of changes in
crime rates. Therefore, it is most welcome that
the ISRD studies will be continued, and hopefully, even more countries will take part in the
next sweep.

Cross-References
▶ Crime Estimates

T
References
Aebi, M. F. (2004). Crime trends in Western Europe from
1990 to 2000. European Journal on Criminal Policy
and Research, 10, 163–186.
Commissioner for Human Rights. (2009). Children and
corporal punishment: “The right not to be hit, also
a children’s right” (Issue Paper 2009). Strasbourg,
France: Council of Europe. Retrieved March 6, 2013,
from https://wcd.coe.int/com.instranet.InstraServlet?
Index¼no&command¼com.instranet.CmdBlobGet&
InstranetImage¼1370686&SecMode¼1&DocId¼120
6996&Usage¼2

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Enzmann, D., & Podana, Z. (2010). Official crime statistics and survey data: Comparing trends of youth
violence between 2000 and 2006 in cities of the
Czech Republic, Germany, Poland, Russia, and Slovenia. European Journal on Criminal Policy and
Research, 16, 191–205.
Enzmann, D. (2012). Social responses to offending.
In J. Junger-Tas, I. H. Marshall, D. Enzmann,
M. Killias, M. Steketee, & B. Gruszczynska (Eds.),
The many faces of youth crime (pp. 143–182). New
York: Springer.
Estrada, F. (1999). Juvenile crime trends in post-war
Europe. European Journal on Criminal Policy and
Research, 7, 23–42.
Gershoff, E. T., & Bitensky, S. H. (2007). The case
against corporal punishment of children: Converging
evidence from social science research and international human rights law and implications for U.S.
public policy. Psychology, Public Policy, and Law,
13, 231–272.
Gruszczynska, B. (2004). Crime in Central and Eastern
European countries in the enlarged Europe. European
Journal on Criminal Policy and Research, 10,
123–136.
Junger-Tas, J., Terlouw, G.-J., & Klein, M. W. (Eds.).
(1994). Delinquent behaviour among young people
in the Western World: First results of the International Self-Report Delinquency Study. Amsterdam:
Kugler.
Junger-Tas, J., & Marshall, I. H. (1999). The self-report
methodology in crime research. Crime and Justice, 25,
291–367.
Junger-Tas, J., Marshall, I. H., Enzmann, D., Killias, M.,
Steketee, M., & Gruszczynska, B. (Eds.). (2010). Juvenile delinquency in Europe and beyond: Results of the
second international self-report delinquency study
(ISRD2). New York: Springer.
Junger-Tas, J., Marshall, I. H., Enzmann, D., Killias, M.,
Steketee, M., & Gruszczynska, B. (Eds.). (2012). The
many faces of youth crime: Contrasting theoretical
perspectives on juvenile delinquency across countries
and cultures. New York: Springer.
K€a€ari€ainen, J. T. (2007). Trust in the police in 16 European
countries: A multilevel analysis. European Journal of
Criminology, 4, 409–435.
Killias, M., Aebi, M. F., Aromaa, K., de Cavarlay, B. A.,
Barclay, G., Gruszczyńska, et al. (2006). European
sourcebook of crime and criminal justice statistics –
2006 (3rd ed.). The Hague: WODC. Retrieved March
6, 2013, from http://www.europeansourcebook.org
Killias, M., Aebi, M. F., de Cavarlay, B. A., Barclay, G.,
Gruszczyńska, B., Harrendorf, S., et al. (2010).
European sourcebook of crime and criminal justice
statistics – 2010 (4th ed.). The Hague: WODC.
Retrieved March 6, 2013, from http://www.europeansourcebook.org
Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B.,
& Lozano, R. (2002). World report on violence
and health. Geneva, Switzerland: World Health

Trias Politica (Separation of Powers)
Organization. Retrieved March 6, 2013, from www.
who.int/violence_injury_prevention/violence/world_
report/en
Pfeiffer, C. (2003). Juvenile crime and violence in Europe.
In M. Tonry (Ed.), Crime and justice. A review of
research (Vol. 23, pp. 255–328). Chicago: Chicago
University Press.
Thornberry, T. P., & Krohn, M. D. (2000). The self-report
method for measuring delinquency and crime. Criminal Justice, 4, 33–83.

Trias Politica (Separation of Powers)
Jan Ott
Erasmus University Rotterdam, Rotterdam,
The Netherlands

Synonyms
Control of corruption; Rule of law

Definition
The trias politica is the philosophy that there has
to be a strict separation between three independent powers in every nation: for legislation,
administration, and jurisdiction.

Description
This philosophy is developed by the
French enlightenment philosopher Charles de
Montesquieu and published in his book
“De L’esprit des Lois” in 1748. This philosophy
had a substantial impact on the American
Constitution (1789), on the French Revolution
(1791), and on political philosophy in many
European nations. The separation of powers is
one of the two pillars of the modern state; the
other pillar is the separation of the state and
religion. There is no specific indicator for the
separation of powers, but this separation is
reflected in the assessment of the rule of law
and control of corruption by the World Bank’s
Government Indicators.

Trust

Ratings “Rule of Law”
http://info.worldbank.org/governance/wgi/index.asp

Cross-References

6743

T

Trust
Jan Delhey
School of Humanities and Social Sciences,
Jacobs University, Bremen, Germany

▶ Good Governance and Happiness in Nations
▶ World Bank World Development Indicators

Synonyms
Reference
Data-Sources, See site

Confidence; Culture of trust; Faith in people;
General trust; Interpersonal trust scale; Particular
trust; Political trust; Radius-adjusted trust; Social
trust; Trust and the theory of role complexity;
Trust in most people

Tribute Fees
▶ Taxes

Trigger Events
▶ Tipping Points

Trioxygen (O3)
▶ Ozone

Tropospheric Ozone
▶ Ozone

Trouble Shooting Alternatives in
Program Planning

Definition
Trust can be defined as the belief that others will
not, at worst, knowingly or willingly do you harm
and will, at best, act in your interests. When we
trust, we give others the benefit of a doubt,
because we cannot know for sure how they will
behave. Trust includes commitment, since by
trusting, we commit ourselves “to action with at
least partly uncertain and unpredictable consequences” (Sztompka, 2001, p. 15913). There is
a general consensus among social scientists that
social trust is important at all levels of human
organization. Unusually in the increasingly specialized academic world, the interest in trust
covers several disciplines. Social trust is a core
component of social capital (Putnam, 1995) and
is normally used as a key indicator of it. Trust is
also at the center of other concepts that are no less
important for social science theory than for
▶ quality of life (QOL), including ▶ subjective
well-being, ▶ health, economic prosperity, education, societal well-being, ▶ community, civil
society, and ▶ democracy.

▶ Program Planning

Description

Truancy
▶ School Attendance

Types of Trust
The most important distinction is between social
trust and political trust. The former is trust in

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(categories of) people, whereas the latter is confidence in key sociopolitical institutions and its
representatives. Some argue for a close link
between social and political trust, but the empirical evidence is mixed (Newton, 2007). In the
remainder, this entry deals exclusively with
social trust.
Scholars commonly separate particular from
general trust (e.g., Sztompka, 1999, chap. 3).
Particular trust is the “thick” trust prevailing in
people whom we know personally and with
whom we have a lot in common, such as family
members, friends, and neighbors. General trust,
in contrast, is the “thin” trust in unfamiliar people
who are often unlike us – large categories of
people and strangers. It is widely accepted that
general trust is particularly important in largescale societies which are complex, heterogeneous, and individualistic. An often-heard
assumption is that particular trust and general
trust are antithetical, yet recent research suggests
a positive relationship between them (Delhey &
Welzel, 2012; Glanville & Paxton, 2007).
Functions of Trust
The assumed positive functions of trust are so
many (Sztompka, 1999, chap. 5) that Eric
Uslaner (2002) refers to trust as the chicken
soup of social life. Trust, it is said, contributes
to ▶ economic growth and efficiency in market
economics, to the provision of public goods, to
▶ social integration, to cooperation and harmony,
to personal ▶ life satisfaction, to democratic stability and development, and even to good health
and longevity. Two general functions of trust
stand out (cf. Phillips, 2006): As a lubricant,
trust metaphorically oils the wheels of society
by lowering transactions costs (Fukuyama,
1995); as a social glue, trust works as an integrative force in society (Simmel, 1950).
Theories of Social Trust
Several theories about what trust is and where it
comes from exist side by side.
Rational choice theory views trust as a rational
calculation (Coleman, 1990). The potential
truster calculates his potential gain (G) from
cooperating, his potential loss (L), and the

Trust

likelihood that the cooperation partner will
behave trustworthy (p). Only if the calculation
turns out positive (i.e., p/(1-p) > L/G), trust is
placed.
According to a well-developed socialpsychological school of thought developed in
the 1950s and 1960s, social trust is a core personality trait (e.g., Erikson, 1950), closely related to
optimism and belief in cooperation. Since its
foundations are laid in childhood, especially
through warm-hearted parents-child interactions,
trust tends to persist in later life, changing only
slowly as a result of major events thereafter.
According to a third school of thought, trust
crucially depends on people’s life experiences
(Hardin, 1998). When we generally experience
our fellow citizens as behaving fair, honest, and
polite, we tend to trust them; when our experiences are overwhelmingly negative, we tend to
distrust them. As a consequence, the capacity to
trust is not fixed but constantly updated.
The culture of trust approach (Sztompka,
1999, chap. 6) is a macrolevel theory. Trust is
conceptualized as a social norm which is historically rooted and dependent on collectively
shared positive experiences with trust. The social
conditions which produce, in the long run,
a robust trust culture can be many, among them
normative coherence, stability of social order, the
accountability of institutions, and socioeconomic
security.
A final set of theories is about the general role
of trust in (modern) society. The theory of role
complexity (Seligman, 2001) sees trust as an
essentially modern phenomenon. Only when
social roles become complex and the expectations tied to them flexible, the need to trust arises
in order to deal with uncertainty. Similarly,
Niklas Luhmann has described trust as
a mechanism to reduce the complexities of modern life so that we are able to act in a confident
manner (Luhmann, 1979).
Measuring Social Trust
The standard measure of general trust is trust in
most people: “Generally speaking, would you say
that most people can be trusted or that you need to
be very careful in dealing with people?” This

Trust

question, devised by Noelle-Neumann in 1948,
has the merits of simplicity and is associated with
trustworthy behavior (Fehr, Fischbacher, von
Rosenbladt, Schupp, & Wagner, 2002) and with
plausible correlates at the level of individuals and
countries (see below).
However, recent research has shown that the
standard question is not unproblematic in worldwide comparisons, because the wording leaves
“most people” unspecified. Obviously, “most
people” is rather narrowly understood in countries with a Confucian heritage and more broadly
in Western prosperous nations (Delhey, Newton,
& Welzel, 2011). To make up for this difference
in trust radiuses, a radius-adjusted measure of
trust in most people has been suggested, which
is better comparable across countries. Currently,
adjusted scores are available for 50 countries.
Another measure for general trust is the threeitem scale for faith in people (Rosenberg, 1957).
Next to trust in most people, this question asks
respondents about the perceived fairness of other
people and their general helpfulness. At least in
the European context, this instrument produces
results which are fully comparable across nations
(Reeskens & Hooghe, 2008).
In psychology, the interpersonal trust scale
(Rotter, 1967) is widely used, which collects
respondents’ trust in various persons and social
categories such as parents, classmates, and politicians; additional items tap into respondent’s
general optimism regarding society. Due to its
length, it is rarely used in international surveys.
Few research studies combine attitudinal and
behavioral-experimental measures of trust (Fehr
et al., 2002). Another recent innovation is a new
trust battery issued in the World Values Survey
2005, which allows measuring both particular
trust in in-groups and general trust in out-groups
(see Delhey et al., 2011).
Determinants of Social Trust
Why are some individuals more trustful than
others? Whereas some determinants seem to be
country-specific, others are more universal
(cf. Delhey & Newton, 2003). Characteristics of
personal success and well-being are generally
positively associated with individual trust: higher

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education, occupation, income, status, high life
satisfaction, and income satisfaction. Likewise,
strong ▶ social support networks are conducive
to individual trust in many societies, as is
a positive assessment of society by the respondents, e.g., when social conflicts are perceived to
be low. In contrast, personality characteristics
such as optimism and membership in clubs and
civic associations are less consistently related to
individual trust.
In international comparisons, the Nordic
countries and Switzerland usually come on top
of the trust ranking, while Latin American and
Muslim countries are on the bottom. Why are
some nations more trusting than others? Crucially, income inequality lowers trust (e.g.,
Bjornskov, 2008b). Others stress the modernization syndrome, since in rich and well-governed
countries, people tend to trust each other more
(Delhey & Newton, 2005). Yet others emphasize
effective and fair street-level bureaucracies
(Rothstein & Stolle, 2008). Finally, countries
with a Protestant legacy score consistently high
on general trust, whereas the positive role of
▶ Confucianism is debated. Notably, population
diversity with respect to ethnicity, religion, or
language has been rarely found to lower general
trust, at least not in international comparisons.
Yet there is evidence that diversity plays out
negatively in local and regional settings (Putnam,
2007).
Trust in Quality of Life Research
Trust is a key component in many accounts of
QOL. Welfare concepts such as social capital,
▶ social cohesion, and social quality, which aim
at ▶ social well-being of communities, regions,
and societies, incorporate social trust as a key
dimension or indicator. Trust flows into the
OECD’s Better Life Index as a proxy for “community” and into the Legatum Prosperity Index as
a proxy for social capital.
Since trust is crucial for forming social relations, and social relations are crucial for ▶ happiness and life satisfaction, it comes as no
surprise that many studies discovered a link to
SWB. This is particularly true for individuals –
trusting persons tend to be happy and satisfied

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6746

with life (e.g., Helliwell & Wang, 2011). Yet
since most studies are cross-sectional, it is difficult to disentangle causality: Are more trustful
individuals happier, or are happier individuals
more trustful?
Largely mirroring the results from the
microlevel, SWB tends to be higher in countries
with a strong trust climate, over and above the
effect of other favorable conditions such as
national income and good governance. Deviating
from the mainstream, Rati Ram (2010) reports
a fragile relationship between trust and average
life satisfaction. Yet he also found trust to be
more important for average life satisfaction in
a subsample of rich nations than of poor nations,
in line with other studies (Bjornskov, 2003).
Obviously, for poor nations, the benefits of
a trust climate are more instrumental, flowing
mainly through higher GDP. Further evidence –
both cross-sectional and longitudinal – for a close
link between trust and SWB in rich nations comes
from the USA (Bjornskov, 2008a). In this context, it has also been suggested that for the USA,
the ▶ Easterlin paradox can be resolved by
accounting for the declining stock of trust and
social capital.
Conclusion
Trust is a flourishing, multidisciplinary topic
which has a lot to offer for QOL researchers
(cf. Michalos, 1990); it is common sense that
trust is an important ingredient of the well-being
of individuals and nations. One issue for future
research is to accumulate more knowledge about
determinants and consequences of particular
trust, which has been somewhat neglected in
past research. A second challenge is a yet more
systematic methodological review of trust in
most people as the key indicator of general trust,
in order to make worldwide country rankings
shakeproof.

Cross-References
▶ General Fair Treatment Index
▶ Life Satisfaction
▶ Personal Fair Treatment Index

Trust

▶ Quality of Life
▶ Social Cohesion
▶ Social Integration
▶ Social Interaction
▶ Social Well-being
▶ Subjective Well-being
▶ Values

References
Bjornskov, C. (2003). The happy few: Cross-country evidence on social capital and life satisfaction. Kyklos, 56,
3–16.
Bjornskov, C. (2008a). Social capital and happiness in the
United States. Applied Research in Quality of Life, 3,
43–62.
Bjornskov, C. (2008b). Social trust and fractionalization:
A possible reinterpretation. European Sociological
Review, 24, 271–283.
Coleman, J. S. (1990). Foundations of social theory.
Cambridge, MA: Harvard University Press.
Delhey, J., & Newton, K. (2003). Who trusts? The origins
of social trust in seven societies. European Societies,
5, 93–137.
Delhey, J., & Newton, K. (2005). Predicting crossnational levels of social trust: Global pattern or nordic
exceptionalism? European Sociological Review, 21,
311–327.
Delhey, J., Newton, K., & Welzel, C. (2011). How general is trust in ‘Most People’? Solving the radius of
trust problem. American Sociological Review, 76,
786–807.
Delhey, J., & Welzel, C. (2012). Generalizing Trust: How
Outgroup-Trust Grows Beyond Ingroup-Trust. World
Values Research, 5, 46–69.
Erikson, E. H. (1950). Childhood and society. Ney York:
Norton.
Fehr, E., Fischbacher, U., von Rosenbladt, B., Schupp, J.,
& Wagner, G. G. (2002). A nation-wide laboratory.
Examining trust and trustworthiness by integration
behavioral experiments into representative surveys
(DIW Discussion Papers). Berlin: German Institute
for Economic Research (DIW).
Fukuyama, F. (1995). Trust. The social virtues and the
creation of prosperity. New York: Free Press.
Glanville, J. L., & Paxton, P. (2007). How do we learn to
trust? A confirmatory tetrad analysis of the sources of
generalized trust. Social Psychology Quarterly, 70,
230–242.
Hardin, R. (1998). Trust in government. In
V. A. Braithwaite & M. Levi (Eds.), Trust & governance (pp. 9–27). New York: Russel Sage Foundation.
Helliwell, J. F., & Wang, S. (2011). Trust and wellbeing.
International Journal of Wellbeing, 1, 42–78.
Luhmann, N. (1979). Trust and power. Chichester, UK:
John Wiley & Sons.

Trust, Satisfaction, and Donor Retention
Michalos, A. C. (1990). The impact of trust on business,
international security and the quality of life. Journal of
Business Ethics, 9, p. 4, 619–638.
Newton, K. (2007). Social and political trust. In
R. J. Dalton & H.-D. Klingemann (Eds.), The oxford
handbook of political behavior (pp. 342–361). Oxford,
UK: Oxford University Press.
Phillips, D. (2006). Quality of life. Concept, policy and
practice. London/New York: Routledge.
Putnam, R. D. (1995). Bowling alone: America’s declining social capital. Journal of Democracy, 6, 65–78.
Putnam, R. D. (2007). E Pluribus Unum: Diversity and
community in the twenty-first century. The 2006 Johan
Skytte prize lecture. Scandinavian Political Studies,
30, 137–174.
Ram, R. (2010). Social capital and happiness: Additional
cross-country evidence. Journal of Happiness Studies,
11, 409–418.
Reeskens, T., & Hooghe, M. (2008). Cross-cultural measurement equivalence of generalized trust. Evidence
from the European social survey (2002 and 2004).
Social Indicators Research, 85, 515–532.
Rothstein, B., & Stolle, D. (2008). The state and social
capital: An institutional theory of generalized trust.
Comparative Politics, 40, 441–459.
Rotter, J. B. (1967). A new scale for the measurement of
interpersonal trust. Journal of Personality, 35,
651–665.
Rosenberg, M. (1957). Misanthropy and Attitudes
towards International Affairs. The Journal of Conflict
Resolution, 1, 340–345.
Seligman, A. B. (2001). Role complexity, risk, and the
emergence of trust. Boston University Law Review, 81,
619–634.
Simmel, G. (1950). The sociology of Georg Simmel
(K. Wolff, Trans., Eds.). Glencoe: The Free Press.
Sztompka, P. (1999). Trust. A sociological theory.
Cambridge, UK: Cambridge University Press.
Sztompka, P. (2001). Trust: Cultural concerns. In
N. J. Smelser & P. B. Baltes (Eds.), International
encyclopedia of the social & behavioral sciences
(pp. 15913–15917). Amsterdam: Elsevier.
Uslaner, E. M. (2002). The moral foundation of trust.
Cambridge, UK: Cambridge University Press.

Trust and the Theory of Role
Complexity
▶ Trust

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Trust in Institutions
▶ Confidence in Government
▶ Confidence in Institutions

Trust in Most People
▶ Trust

Trust in People
▶ Faith in People

Trust, Satisfaction, and Donor
Retention
Julia Naskrent
University of Applied Sciences for Economics
and Management, Essen, Germany

Synonyms
Determinants of donor loyalty; Factors for maintenance of financial support

Definition
Donor retention, in the sense of establishing long
lasting relationships with donors, is an important
goal in fund-raising. Here, it is understood as
a target latent variable which should be explained
with the help of a structural equation model.
▶ Trust and satisfaction as well as two other
factors (commitment and involvement) are latent
variables which determine donor retention.

Description

Trust in Government
▶ Confidence in Government

Raising funds has become extremely difficult in
the past decades. A more or less constant amount

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of ▶ charitable donations opposes a growing
number of nonprofit organizations (in the following: NPOs), and the competitive pressure has
grown tremendously (Sargeant, 2001). Therefore,
the reasons why donors continue donating and
supporting organizations play an important role
for those NPOs. The knowledge of the significance of determinants of donor retention is an
essential requirement for the formulation of
effective and efficient fund-raising strategies.
Donor retention represents the target variable,
which has to be explained through determinants.
In the commercial field of marketing, the related
phrase customer retention is often referred to as
a noncoincidental sequence of market transactions between a buyer and a supplier (Royce,
1971). In general, donor retention can be understood as a long-term and consistent relationship
between the donor and the NPO.
For NPOs, long-term relationships with donors
are advantageous, since many projects and activities are of lasting or permanent duration and
require well-founded, long-term financial planning with continuous and dependable financial
support. Due to the decline of government subsidies, such planning is not possible without donations. Promoting retention among donors with
appropriate actions is a central task in fund-raising.
When considering the effects of donor retention, one can differentiate between stabilityrelated, revenue-increasing, and cost-reducing
potentials (Hennig-Thurau, Gwinner, & Gremler,
2002). Over time, the relationship gains stability,
which translates into security for the organization. This is based on the insights of the needs and
intentions of their donors gained through the
long-term relationship. Donor retention also represents a central determining factor in expanding
an NPO’s share of the donation market. Along
with an increase in the average donation size,
with which the donor provides increased support
for a project, a loyal donor can also show
a readiness to increase her/his donation frequency. This contributes to an increase in the
NPO’s donation volume (Sargeant, 2009). Promoting retention among donors is a means of
reducing costs, something that is appealing particularly with regards to the widespread request

Trust, Satisfaction, and Donor Retention

for NPOs to allocate their resources efficiently
(Lee, 2002). These cost-reducing potentials are
created by the fact that focusing on existing
donors allows for a reduced emphasis on donor
recruitment. The acquisition of new donors can
be neglected, since the NPO is able to maintain its
existing donor base by developing and strengthening their relationship on the one hand and
because the NPO will automatically acquire
new donors through recommendations and references on the other hand. Tight relationships
between the NPO and its donors also create savings in information and coordination costs. This
means, costs for donor care are thus reduced.
In summary, it can be said that donor retention
can increase the capabilities and profitability of
the NPO and enables the organization to concentrate its efforts on fulfilling its mission. In order to
actualize these effects of particular importance to
NPO, it is necessary to foster the retention of
donors. The following paragraph will introduce
the influencing factors.
Research in the area of commercial marketing
centered a lot around behavioristic, organizationspecific determinants of customer retention in
the past. Two latent variables dominate the
research: ▶ trust and satisfaction (Mittal &
Kamakura, 2001).
Trust is usually defined with two dimensions:
ability describes the confidence of one party
regarding the performance capability of another
party, i.e., in this case the trusted NPO (Shelley &
Polonsky, 2002), while willingness describes the
expectation of the donor regarding the NPO’s
reliability (Sirdeshmukh, Singh, & Sabol, 2002).
Satisfaction, understood as a process of comparing expectations of donors with the actual
perceived performance of the NPO, is a very
important determinant of retention (Garbarino &
Johnson, 1999).
Besides trust and satisfaction, two other determinants have been discussed to have an impact on
donor retention: commitment and involvement.
Commitment is usually defined through three
different dimensions: normative, calculative, and
affective. Normative commitment is an emotion
of duty and responsibility (Allen & Meyer, 1990)
and is an important aspect for donor retention.

Trust, Satisfaction, and Donor Retention

Moral concerns or the fulfillment of perceived
obligations frequently dominate the motivation
of the ongoing donations to an NPO (Bennett &
Ali-Choudhury, 2009). Calculative commitment
represents a rationale and the “emotionless” position of the donor to the supported organization.
A net “gain” that is based on a rational cost-benefit
analysis fosters the retention of the donor
(Johnson, Herrmann, & Huber, 2006). The last
dimension, affective commitment, is an emotion
of inner, psychological affection, which is based
on a true sympathy of the donor for the NPO
(Allen & Meyer, 1990).
The fourth determinant, involvement of
a donor, can be understood as a permanent interest in the NPO and the donor’s perceived personal
relevancy of the NPO (Mittal, 1995). While
involvement in this context “merely” represents
the personal meaning of the NPO for the donor,
commitment describes a more holistic approach
and signifies the appreciation of the entire relationship with the NPO.
The previous paragraphs already indicated
that the four determinants trust, satisfaction, commitment, and involvement have a direct effect on
donor retention. According to the literature, commitment represents the central influencing variable of donor retention as it forms the basis for the
willingness to continue with the exchange relation (Sargeant & Woodliffe, 2007). But also the
other determinants are mentioned as important
prerequisites to establish a stable donor-NPO
relationship
(Shabbir,
Palihawadana,
&
Thwaites, 2007).
In addition to these direct effects, the determinants trust, satisfaction, and involvement also
have indirect effects on donor retention (Causal
Inference). First of all, all three variables increase
the level of commitment, which then has
a positive impact on donor retention (Sargeant
& Woodliffe, 2007).
A further interdependency exists between satisfaction and the establishment of trust. Trust is
based on experiences with the NPO. The experiences gained in a certain period of time facilitate
the foundation of trust; they support the creation
of the donor’s expectation with regard to the
reliability and the integrity of the NPO (Crosby,

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Evans, & Cowles, 1990). A further
interdependency is the influence of involvement
on satisfaction. Through the intensive dealing
with the charitable donation, the donor becomes
aware of the valuable support she or he gives.
This realization fosters her or his satisfaction and
helps to keep up the financial support for a longer
period of time (Bennett & Ali-Choudhury, 2009).
Naskrent and Siebelt (2011) suggest
a structural equation model aligning these interdependencies and relationships. This model is
depicted in Fig. 1. All arrows represent the
influencing relations between the factors as
described. In addition to the arrows, Fig. 1 also
discloses the strength and significance (symbolized by the stars) of the path coefficients which
give evidence on how much an exogenous construct influences an endogenous construct. The
data, conducted from a study interrogating 364
donors, allows the following interpretation: Negative values show a relation that is contrary to the
postulated hypotheses. Values close to zero represent a weak explanatory contribution of a latent
variable, while values close to one imply a strong
relationship. In the model of Naskrent and
Siebelt, three of the postulated hypotheses show
insufficient path strengths and significances,
while the other hypotheses could be verified.
A further angle to evaluate the inner model is
the coefficient of determination (abbreviation:
R2). The R2 represents the share of the explained
variance of the latent variable. This means that it
analyzes the effect strength of all exogenous constructs explaining an endogenous construct.
Values of R2 range between 0 and 1. The higher
the value of R2, the higher is the explained variance. Results above 0.3 are average and values
below 0.19 are weak. For donor retention, the
study of Naskrent and Siebelt (2011) yields an
R2 of 0.33, for commitment 0.63, for trust 0.69,
and for satisfaction 0.25. Therefore, all endogenous variables deliver satisfactory results.
The empirical tests conducted by Naskrent
and Siebelt (2011) confirmed six of the nine
hypotheses, which represent a nomological validity of the model. Even if involvement and satisfaction do not directly influence donor retention,
they do have an indirect effect.

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6750

Trust, Satisfaction, and
Donor Retention,
Fig. 1 Trust and
satisfaction as part of
a structural equation model
of influencing factors of
donor retention (Source:
Naskrent and Siebelt
(2011))

Trust, Satisfaction, and Donor Retention

Involvement of
the donor
0.66***

0.03 n.s.

Commitment of
the donor
0.50***
0.02 n.s.

0.38***
Donor retention

0.16**

0.21***
Trust of the donor
0.83***

0.10 n.s.

Satisfaction of
the donor

Discussion
In the study of Naskrent and Siebelt (2011),
involvement does not seem to have a direct effect
of donor retention. A theoretical explanation for
this could be that NPOs and charitable donations
cause more extreme forms of involvement
than commercial consumption situations where
values in the middle range are quite common
(Rothschild, 1979). Donor involvement might
have more bipolar characteristics: Either people
possess an extremely high involvement with
regards to an organization and are consequently
willing to engage emotionally and to support the
NPO financially or they do not show any involvement, meaning they would never consider giving
money to it (Rothschild). Therefore, involvement
might rather represent a precondition for the acquisition of new donors and as a result does not have a
direct but an indirect effect on donor retention.
The fact that the satisfaction of the donor does
not have a large-scale impact on donor retention
shows that the latent variable does not have the
general importance that the marketing and nonprofit research ascribes to it. Some studies already
yielded the result that donor satisfaction does not
have such a big impact on retention as it is frequently assumed (Arnett, German, & Hunt, 2003;
Michalski & Helmig, 2010). Anyhow, the authors
(Arnett et al., 2003) concluded that the result of

Legend:
* = p ≤ 0.10
** = p ≤ 0.05
*** = p ≤ 0.01

their study does not neglect the common importance of satisfaction for the donor-NPO relation.
These speculations are starting points for further research. A replication study could for example yield valuable findings. A further research
gap exists in a long-term study (▶ Longitudinal
Data Analysis) of donor retention.

Cross-References
▶ Altruism
▶ Charitable Donations

References
Allen, J. N., & Meyer, J. P. (1990). The measurement and
antecedents of affective, continuance and normative
commitment to the organization. Journal of Occupational Psychology, 63, 1–18.
Arnett, D. B., German, S. D., & Hunt, S. D. (2003).
The identity salience model of relationship
marketing success: The case of nonprofit marketing.
Journal of Marketing, 67, 89–105. doi:10.1509/
jmkg.67.2.89.18614.
Bennett, R., & Ali-Choudhury, R. (2009). Second-gift
behavior of first-time donors to charity: An empirical
study. International Journal of Nonprofit and Voluntary Sector Marketing, 14, 161–180. doi:10.1002/
nvsm.347.

Twinship
Crosby, L. A., Evans, K. R., & Cowles, D. (1990). Relationship quality in service selling: An interpersonal
influence perspective. Journal of Marketing, 54,
68–81.
Garbarino, E., & Johnson, M. S. (1999). The different
roles of satisfaction, trust, and commitment in customer relationships. Journal of Marketing, 63, 70–87.
Hennig-Thurau, T., Gwinner, K. P., & Gremler, D. D.
(2002). Understanding relationship marketing outcomes: An integration of relational benefits and relationship quality. Journal of Service Research, 4(3),
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Johnson, M. D., Herrmann, A., & Huber, F. (2006). The
evolution of loyalty intentions. Journal of Marketing,
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Lee, S. (2002). From marketing products to fundraising
for causes. In C. Walker & C. Pharoah (Eds.), A lot of
give: Trends in charitable giving for the 21st century
(pp. 109–115). London: Hodder Arnold.
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(pp. 229–249). Wiesbaden, Germany: Gabler.
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Tune
▶ Music

Turning Points
▶ Tipping Points

Twin Relationship
▶ Twinship

Twin-Parents Relationship
▶ Twinship

Twinship
T
Luca Rollè, Piera Brustia and Eva Gerino
Department of Psychology, University of Torino,
Torino, Italy

Synonyms
Dizygotic twin; Identical twin; Monozygotic
twin, Multiples; Twin relationship; Twin-parents
relationship

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Twinship

Definition

In fact, beyond the medical risks, the twin pregnancy may be emotionally engaging and unsettling. In all pregnancies, women have to create
physical and mental space for the unborn child;
representations contained in the mental space
concern both herself and the partner as future
parents. Fantasies, hopes, fears, and desires
coexist in this mental place. In the case of
twins, an individual sense of inability to meet
children’s concurrent needs and a discrepancy
perceived between parental aspirations and reality could complicate the transition to parenthood
and postnatal adjustment (Brustia, 2012).
The father’s role is very important because it
is a source of support for the mother to cope
with material and emotional situations. In addition to having to create a double space in his
mind, the father also has to support his wife in
family commitment. This great paternal involvement means that he often becomes a main
▶ attachment figure, acting as a surrogate for
the mother and playing an important role in
the twinship (Brustia, Rollè, & Pogliano, 2009).
Twinship is a peculiar condition because of
the high genetic resemblance and familiarity
of the involved parts, which have a deep effect
on the dyadic relationship, shaped by genetic
and environmental influences (Neyer, 2002).
The literature identifies twinship as
a unique relationship, not comparable to any
other type of interpersonal relationship in terms
of the level of intimacy and intensity (Ebeling
et al., 2003; Fraley & Tancredy, 2012; Neyer,
2002; Tancredy & Fraley, 2006). Indeed, twin
relationship is different from that established
between singletons (Ebeling et al., 2003). From
the earliest stages of pregnancy, twins’ bond
takes shape with specific interactional patterns,
and it continues, although in different ways, even
after birth. Thanks to the development of more
and more advanced ultrasound instruments,
recent studies concern the prenatal life of twins.
New ultrasound techniques allow researchers to
observe the fetal spontaneous activity as well as
the early complex sensory and perceptual skills
of children. In utero, the interaction between
twins is continuous (first reciprocal stimulations
can be observed in the 11th week or 12th week

Multiple pregnancy involves the simultaneous
development in the uterus of two or more
fetuses. Twins could be identical or ▶ monozygotic (MZ – one zygote means a single egg is
fertilized), or they could be nonidentical or dizygotic (DZ – two or more different eggs are
fertilized). This clarification is important
because it highlights the wrong, but common,
belief that twinship is synonymous with equality;
in fact, the term twins refers not only to monozygotic individuals but also to siblings who
are born on the same day and are the result of
the same pregnancy (dizygotic twins). Twinship
is the condition of two or more subjects at the
same birth with a focus on the relationship
between a twin and his/her co-twin as well as
between them and their parents, family, and
social environment. The very close relationship
of twins begins from the day of conception: the
start of nine months together in a very close
relationship (Zazzo, 1984).

Description
Risk pregnancies are those in which actual
or potential pathological conditions (risk factors)
may endanger the health or life of the mother, the
fetus, or both. Because of the high risk of complications in the fetus and in the pregnant
woman, twin pregnancy falls into this category.
Also, twin delivery may present peculiar problems relating to the period and to the types
of delivery. These aspects can be risk factors
for the physical and psychological well-being
of mothers and, consequently, of the fathers
and the twins themselves. Starting from the diagnosis of a multiple pregnancy, it is possible to
also consider the twins’ situation as particular
because of the psychological aspects derived
from it. Often, pregnant women have reactions
characterized by strong conflicts and ambivalence: next to the happiness and pride stemming
from the uniqueness of twin pregnancy, fear,
worry, confusion, sense of loss, difficulty of
acceptance, and, sometimes, despair emerge.

Twinship

of gestation), and they are mutually influencing
in terms of both physical and psychological
development. For example, one of the complications that can occur during twin pregnancy is
the loss of a fetus. Since the mutual stimulation
becomes a constant feature of intrauterine life,
the survivor will suffer although he/she does not
know he/she was a twin – in some way he/she
will feel the loss of the stimulation that was
coming from the co-twin; especially same-sex
twins may feel a pervasive feeling of loss and
deep loneliness and, consequently, the need to
find a special bond with someone (Woodward,
1998).
It is important to consider that each twin
perceives the intrauterine environment differently from the other. Many sensations of fetuses
are different and, since the early stages of
pregnancy, they show clear differences in temperament (Piontelli, 2002). Twins have a close
relationship, an interdependence linked to genetic
similarity and the sharing of similar experiences
(Neyer, 2002). Besides genetic makeup and
environmental influence, a third factor exists:
the so-called couple effect (Zazzo, 1984);
namely, to differentiate oneself from his/her
co-twin, who is perceived as deeply similar to
him/her, a twin needs to structure his/her own
personality in a way that is opposite of his/her
co-twin’s personality but often still complementary to the co-twin’s personality.
At birth, twins can be considered psychologically part of each other, and only gradually, with
the help of parents, each will learn to see
himself/herself as distinct and independent from
the co-twin. This initial unity in twin couples
generates a very intense attachment, where sharing is a normal state of existence, while the experience of separation is atypical (Tancredy &
Fraley, 2006). In twins, the concept is referred
to as the individuation-separation process
(Mahler, Pine, & Bergman, 1975). This process
may be more complex for twins than for singletons due to the difficulty in overcoming the symbiosis with both the mother and the co-twin
(Brustia, Marino, Garbarini, & Gerino, 2011).
The separation and identification process in
twins is different from that in singletons because

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it can occur more slowly (due to the strong twinship), but, equally, it may lead to the establishment of a healthy personality possessing a greater
degree of empathy for and harmony with
another person (Barbieri & Fischetti, 1997). Parents have to interact with two or more children at
the same time and develop a close relationship
with each twin individually, which is not easy.
By taking care of each single child, the mother
can learn to recognize each child’s specific physical and temperamental characteristics. In this
way, the individuality of each child is recognized
not only by correlating him/her with the co-twin
but also by focusing on his/her peculiarities so
that each child can develop his/her sense of full
identity (Brustia, 2012).
Due to the exclusive twinship relation, it is
important that each child can enjoy separate
moments and experiences in order to encourage
the internalization of the other so that each of
them learns to be separated from the other.
Separating twins from an early age not only
helps them to have their own experiences but
also allows their parents to think of their children
as two separate individuals and not as a whole
(Brustia, Rollè, & Ambrosoli, 2011).
The more exclusive and prolonged a twin’s
identification with the co-twin is, the more it
interferes with the mother-child relationship and
reduces the twin’s likelihood of being in relationship with anyone other than the co-twin; this
often happens because the relationship between
twins is very pleasing both for the children and
for the parents. If adults recognize each twin
as a separate and unique individual, the children
will more easily be able to have two independent
lives; if twinship becomes the center around
which their lives are structured, their identities
will merge together. However, if a balance
exists among each element, the twins will have
no difficulty in establishing a personal identity
(Bernier, 2006). Studies on the dynamics of twins
in childhood and early adolescence showed
negative effects such as delay in social communication, isolation, social dysfunction, strong
conflicting dominant-dominated, and status
asymmetry dynamics in the twins. Adolescence
and early adulthood, because of the importance

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of differentiation and independence needs, are
often considered critical stages for multiples
because they force the twins to begin
a psychological process of separation from both
parental figures and from one another; these
developmental stages expose twins to frequent
feelings of loss, loneliness, and fear of losing
the special bond with one another (Ebeling
et al., 2003). Twins can use nonverbal forms of
mutual understanding and perception, and sometimes, this causes a language development retardation. Some twins have serious language
difficulties, such as cryptophasia, that complicate
the development of communicational skills,
causing isolation in severe cases. The shift from
initial psychological comfort to subsequent
dependence is quick. However, it is important to
consider the positive aspects of twinning; for
instance, young twins can give and receive
reassurance and emotional support.
Each twin pair has an internal equilibrium that
is not solely based on an unlimited amount of love
and resemblance: for example, psychophysical
imbalance frequently induces a twin to dominate
and the other to submit. It is normal that twins
would structure the complementary roles. Indeed,
an unexpected transferring of roles from one to
another also can happen because children develop
at different times. Rotation of roles is normal:
difficulties actually arise when a role is fixed
and rigid, thus forcing children into a conflicting
and unchangeable polarity (Ebeling et al., 2003).
The bond of twins can be considered
a particular form of close relationship that usually
satisfies attachment needs. Research results seem
to indicate a greater liking of twins to establish
mutual sibling attachment relationships, while
non-twin siblings mainly use parents as attachment figures (Bernier, 2006; Fraley & Tancredy,
2012; Tancredy & Fraley, 2006). Even in adulthood, the twin relationship meets the typical
criteria of attachment relationships such as proximity seeking, separation distress, secure base,
and safe haven. Tancredy and Fraley (2006) highlight some aspects that distinguish the twin bond
from all others, such as empathy, sharing activities, and the inclusion of the other (the co-twin) in
the Self. In addition, the tendency of twins to

Twinship

contact each other more frequently, to seek common experiences, and to live geographically
closer could indicate behaviors of proximity
seeking. From childhood, separation anxiety
(separation distress) would not be linked only to
the separation from the mother but also to the
separation from the co-twin; furthermore, the
twin would continue to be considered among
the main supportive resources in case of need
(safe haven). Finally, the mutual function of
secure base is demonstrated by the comfort
given by the co-twin’s presence in social exploration experiences. In twins, relational rather
than structural factors seem to favor the maintenance of this type of sibling attachment bond.
With regard to these aspects, a study on adult
twins by Neyer (2002) showed that, as pointed
out in sibling bonds, contact and emotional
closeness between twins seems to decrease
until they reached thirties or forties and increase
in late adulthood. Monozygotic adults would be
likely to keep higher levels of contact and proximity (spatial and emotional) than dizygotic
twins did, especially the female-female pairs.
Moreover, among twins, social support seems
to grow into adolescence, remain constant in
adulthood, and increase significantly in old age.
By comparing twinship (twin-and-co-twin) and
twin-sibling relationships, we can infer that
the twin bond is closer (for frequency of contact,
intimacy, and social support – both instrumental
and emotional) but also more conflicting than
the brotherly one (Neyer, 2002).
The twinships, given their temporal continuity
and importance in the life cycle, can be included
among the relationships that potentially contribute to the social and emotional well-being for the
twins (Neyer, 2002; Scharf, Shulman, & AvigadSpitz, 2005). From this point of view, the twin
bond seems to be important for mental health: the
co-twin may represent a referent object of security, a primary attachment figure, a constant presence, a main internalized object, and even
a source of ambivalence toward constraining
unity and incompleteness (Bernier, 2006). Psychic and emotional elaboration of the detachment
from the co-twin is necessary for the development of a harmonious personality. In addition,

Two-Stage Sampling

the degree of dominance-submission in the couple seems to be a good predictor of psychological
well-being in twins: being subdued can generate
a strong discomfort in the subject, with negative
consequences (depression, anhedonia, low selfconfidence, and psychosomatic symptoms)
(Ebeling et al., 2003). Regarding the positive
characteristics of the relationship between
twins, a bond characterized by closeness and
intimacy can prevent or reduce unpleasant feelings, such as loneliness. In particular, Woodward
(1998) found a higher sense of loneliness and
isolation in a twin who faces grief related to the
co-twin’s or the partner’s death compared with
the case of a singleton’s reaction to the loss of
a sibling or a partner. In analyzing the research
results on the topic of twinship, it is interesting to
note that the focus of investigations is on the
distinctive features of twins’ personality development, which source is ascribing to genetic or
environmental influences or to the interaction of
both factors in terms of active, passive, or reactive effects. However, few investigations analyze
the shape, structure, and consequences of the twin
relationship. Trait d’union between the studies on
this subject is the observation that the process of
construction of Self in twins has a peculiarity:
the influence of couple dynamics on individuals
(Zazzo, 1984). From this point of view, the issue
regarding the connection between identity development, dyadic effects, and well-being in twins
remains still broadly unexplored and could be
considered one of the more interesting and fascinating future research themes.

Cross-References
▶ Attachment
▶ Mother-Father Relationship
▶ Siblings, Overview

6755

Bernier, J. (2006). Influence du facteur gémellaire sur
l’acquisition d’une identité distincte. Nouvelles perspectives en sciences sociales: Revue internationale
de systémique complexe et d’études relationnelles,
1(2), 9–66.
Brustia, P. (2012). Prendersi cura della complessità
genitoriale quando nascono i gemelli. In L. Cena, F.
Baldoni, & A. Imbasciati (Eds.), Prendersi cura dei
bambini e dei loro genitori (pp. 113–124). Milano:
Springer.
Brustia, P., Marino, E., Garbarini, C., & Gerino, E. (2011).
La relazione gemellare. In P. Brustia (Ed.), Vivere con
i gemelli. Piccola guida alla sopravvivenza
(pp. 93–137). Torino: Espress Edizioni.
Brustia, P., Pogliano, S., & Rollè, L. (2009). Sostegno
sociale percepito: Un confronto tra madri di gemelli
e madri di nati singoli. International Journal of Developmental and Educational Psychology, INFAD, 1(4),
345–353.
Brustia, P., Rollè, L., & Ambrosoli, A. (2011). Diventare
genitori. In P. Brustia (Ed.), Vivere con i gemelli.
Piccola guida alla sopravvivenza (pp. 35–66). Torino:
Espress Edizioni.
Ebeling, H., Porkka, T., Penninkilampi-Kerola, V., Berg,
E., Jarvi, S., & Moilanen, I. (2003). Inter-twin.
Relationships and mental health. Twin Research,
6(4), 334–343.
Fraley, R. C., & Tancredy, C. M. (2012). Twin and sibling
attachment in a nationally representative sample. Personality and Social Psychology Bulletin, 38(1),
308–316.
Mahler, M., Pine, M., & Bergman, A. (1975). The psychological birth of the human infant. New York: Basic
Books.
Neyer, F. J. (2002). Twin relationships in old age:
A developmental perspective. Journal of Personality
and Social Psychology, 19, 483–503.
Piontelli, A. (2002). Twins: From fetus to child. London:
Routledge.
Scharf, M., Shulman, S., & Avigad-Spitz, L. (2005). Sibling relationships in emerging adulthood and in adolescence. Journal of Adolescent Research, 20(1),
64–90.
Tancredy, C. M., & Fraley, R. C. (2006). The nature of
adult twin relationships: An attachment-theoretical
perspective. Journal of Personality and Social
Psychology, 90(1), 78–93.
Woodward, J. (1998). The lone twin: Understanding twin
bereavement and loss. London: Free Association
Books.
Zazzo, R. (1984). Le paradoxe des jumeaux. Paris:
Stock/Laurence Pernoud.

References
Barbieri, F., & Fischietti, C. (1997). Crescere gemelli.
Individuazione psichica e relazione con l’ambiente
nelle coppie gemellari. Roma: Phoenix.

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Two-Stage Sampling
▶ Subsampling

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Type I Diabetes Mellitus and
Quality of Life
Berit Rokne1 and Marit Graue2,3
1
Department of Global Public Health and
Primary Care, University of Bergen, Bergen,
Norway
2
Centre for Evidence–Based Practice, Bergen
University College, Bergen, Norway
3
Department of Pediatrics, Haukeland University
Hospital, Bergen, Norway

Synonyms
Diabetes mellitus type 1; T1D

Definition
Type 1 diabetes is a hormonal and metabolic
disorder caused by deficiency of insulin secretion
with the consequences of chronic hyperglycemia
and disturbances of fat and protein metabolism.
In genetically susceptible individuals, exposed to
environmental risk factors, the body attacks and
destroys its own pancreatic beta cells (Atkinson
& Maclaren, 1994). Still the knowledge about
these possible environmental risk factors for
type 1 diabetes is very limited. The geographic
variation in incidence of type 1 diabetes varies
around the world with the highest prevalence in
the Nordic countries, in particular Finland, and in
Sardinia (Stoltesz, Patterson, Dahlquist, &
EURODIAB Study Group, 2007). The debut of
the disease occurs at all ages; however, the incidence is higher around puberty. Globally, the
most common cause of death among people
with type 1 diabetes is the lack of access to insulin
(Gale, 2006).

Description
The main goals for the treatment are to achieve
acceptable metabolic control and to prevent or

Type I Diabetes Mellitus and Quality of Life

delay possible late complications associated
with the disease. Further goals are to prevent
acute complications, such as burdensome
episodes of hypoglycemia, ketoacidosis, and
hospitalization. The management of the disease
involves a complex regimen of insulin injections, home monitoring of blood glucose, and
attention to dietary intake and amount of exercise (Hanas, Donaghue, Klingensmith, & Swift,
2009). Studies have documented that maintenance of tight blood glucose control is related
to lower degree of late diabetes complications
such as retinopathy, nephropathy, and neuropathy (Diabetes Control and Complication Trial
(DCCT), 1993). The disease and its treatment
has a major impact on the daily life of people
with diabetes, and in industrialized countries,
the relationship between metabolic control and
overall well-being and health-related quality of
life (HRQOL) has been assessed in many studies. The impact of insulin pump therapy on
HRQOL, as well as capturing the consequences
of diabetes-related complications for the
afflicted, provides a way to better understand
how diabetes and its treatment affect the individual. During the last decades, numerous
instruments have been developed to obtain
information on HRQOL, and standardized measures are used to assess the relationship with
diabetes self-management behavior and motivational aspects of care (de Wit, Delemarre-van de
Waal, Pouwer, Gemke, & Snoek, 2007, Speight,
Reaney, & Barnard, 2009). Over the years, considerable efforts have been made to optimize the
insulin regimen by multiple daily injections or
insulin pump therapy. Intensified regimens
might induce better metabolic control and are
shown to be associated with slightly improved
quality of life in larger studies (Hoey et al.,
2001). However, glycemic control has not been
convincingly improved by the introduction of
new insulins, intensive treatment regimens, and
new technology (Skinner & Cameron 2010).
Achievement of tight blood glucose control is
difficult to maintain, and a greater focus on psychosocial issues related to living with the disease
seems to be fundamental to improve the health

Type I Diabetes Mellitus and Quality of Life

and quality of life of people with diabetes
(Funnell et al., 2011). Self-management support
is the keystone to successful diabetes care and
management. However, evidence shows that
better outcomes, medical as well as psychosocial, are difficult to achieve. It seems to be the
burden of symptoms or complaints, rather than
their existence or frequency that determines
quality of life (Schipper, Clinch, & Olwency,
1996). Furthermore, intervention studies suggest that patients’ perceived ability to control
their disease is associated with improved quality
of life (Rubin & Peyrot, 1999). In addition to
traditional biomedical indicators, instruments
that measure HRQOL are increasingly used to
measure the effects of interventions. The
patient’s role and responsibility has been frequently discussed in the empowerment approach
to diabetes health care (Anderson & Funnell,
2000). Educational and behavioral interventions
seem to have beneficial effects on self-management; however, the literature has not convincingly identified the most effective types of
interventions for different aspects of diabetes
self-care. The magnitude of effects and mechanism of changes of behavioral interventions
needs to be further examined (Zhang, Norris,
Chowdhury, Gregg, & Zhang, 2007). Promoting
and assessing patients’ HRQOL and burden of
disease in clinical trials is still a challenge.
Within a family approach, HRQOL should be
further explored in relation to diabetes-specific
family communication and the influence of family environments on diabetes outcomes. Interventions that target diabetes-specific family
interactions focusing on family relationships
and HRQOL should be further explored
(Weissberg-Benchell et al., 2009). Also, limited
evidence exists on the need for additional support for socioeconomically disadvantaged individuals living with diabetes (Imayama,
Plotnikoff, Courneya, & Johnsom, 2011). Thus,
transcultural aspects of care and different treatment strategies are areas to be addressed in
future research, and in addition studies examining the integration of HRQOL measures into
routine treatment and care.

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References
Anderson, R. M., & Funnell, M. M. (2000). Compliance
and adherence are dysfunctional concepts in diabetes
care. The Diabetes Educator, 26, 597–604.
Atkinson, M. A., & Maclaren, N. K. (1994). The pathogenesis of insulin-dependent diabetes mellitus.
The New England Journal of Medicine, 331,
1428–1436.
de Wit, M., Delemarre-van de Waal, H. A., Pouwer, F.,
Gemke, R. J. B. J., & Snoek, F. J. (2007). Monitoring
health related quality of life in adolescents with diabetes: A review of measures. Archives of Disease in
Childhood, 92, 434–439.
Diabetes Control and Complications Trial Research
Group (DCCT). (1993). The effect of intensive treatment of diabetes on the development and progression
of long-term complications in insulin-dependent
diabetes mellitus. The New England Journal of
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Funnell, M. M., Brown, T. L., Childs, B. P., Haas, L. B.,
Hosey, G. M., Jensen, B., et al. (2011). National
standards for diabetes self-management education.
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Gale, E. A. (2006). Dying of diabetes. The Lancet, 368,
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Hanas, R. K., Donaghue, K. C., Klingensmith, G., &
Swift, P. G. (2009). ISPAD clinical practice consensus
guidelines 2009 compendium. Pediatric Diabetes, 10
(Suppl. 12), 1–2.
Hoey, H., Aanstott, H. J., Chiarelli, F., Daneman, D.,
Danne, T., Dorchy, H., et al. (2001). Good metabolic
control is associated with better quality of life in 2101
adolescents with Type I diabetes. Diabetes Care, 24,
1923–1928.
Imayama, I., Plotnikoff, R.C., Courneya, K.A., Johnsom,
J.A. (2011). Determinants of quality of life in adults
with type 1 and type 2 diabetes. Health and Quality of
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Rubin, R. R., & Peyrot, M. (1999). Quality of life and
diabetes. Diabetes Metabolic Research and Reviews,
15, 205–218.
Schipper, H., Clinch, J. J., & Olwency, C. L. M. (1996).
Quality of life studies: Definitions and conceptual
frameworks. In B. Spilker (Ed.), Quality of life and
pharmacoeconomics in clinical trials (2nd ed.,
pp. 11–21). Philadephia: Lippincott-Raven. Chapter 2.
Skinner, T. C., & Cameron, F. J. (2010). Improving glycemic control in children and adolescents: Which
aspects of therapy really matter? Diabetic Medicine,
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Speight, J., Reaney, M. D., & Barnard, K. D. (2009). Not
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EURODIAB Study Group. (2007). Worldwide

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childhood type 1-diabetes incidence – what can we
learn from epidemiology? Pediatrics Diabetes, 8
(Suppl 6), 6–14.
Weissberg-Benchell, J., Nansel, T., Holbeck, G., Chen, R.,
Anderson, B., Wysocki, T., Laffel, L. for the Steering
Committee of the Family Management Diabetes Study
(2009). Generic and diabetes-specific parent-child
behaviours and quality of life among youths with
Type 1 diabetes. Journal of Pediatric Psychology 9,
077–88.
Zhang, X., Norris, S., Chowdhury, F. H., Gregg, E. W., &
Zhang, P. (2007). The effects of interventions on
health-related quality of life among persons with
diabetes – a systematic review. Medical Care, 45,
820–834.

Type I Error
▶ Type II Errors

Type I Error

occurring randomly. While these assumptions
acknowledge that some events are more likely
to occur than others, all the events are possible.
At times, unlikely events do occur just by chance
and NHST is unable to determine whether the
unlikely event was due to a nonrandom process
or did just randomly emerge (Hurlburt, 2003).
The logic of NHST dictates that when an
unlikely event is observed, it is concluded that it
did not occur by chance. Most times this is the
correct conclusion, occasionally, it will result in
a Type I error. The rate at which Type I errors will
be made is indicated by the alpha or probability
level that is being employed. Type I errors are
generally considered to be the more serious error
to make in research because it suggests that
something has an effect that really does not.
This will lead to a change in behavior in the
hope that something will improve, when it will
not. Thus, whenever a statistically significant
effect is found, one needs to be aware of the risk
of a Type I error (Sheskin, 2004).

Type I Errors
Ralph L. Piedmont
Pastoral Counseling Department, Loyola
University Maryland, Columbia, MD, USA

Cross-References

Synonyms

▶ Hypothesis Testing
▶ Null Hypothesis
▶ Type II Errors

Errors of the first kind; Hypothesis testing error;
Type II error

References

Definition
A Type I error is an incorrect conclusion drawn
from a Null Hypothesis Significance Test
(NHST). Also known as a “false positive,” a
Type I error is concluding that a nonrandom
effect was observed when in fact it was not
(Aron & Aron, 2003). Technically, a Type
I error is falsely rejecting a true null hypothesis,
or saying there was an effect when there was not.
All NHSTs are based on a certain set of assumptions about the likelihood of certain events

Aron, A., & Aron, E. N. (2003). Statistics for psychology
(3rd ed.). Upper Saddle River, NJ: Prentice Hall.
Hurlburt, R. T. (2003). Comprehending behavioral statistics (3rd ed.). Belmont, CA: Wadsworth/Thomson
Learning.
Sheskin, D. (2004). Handbook of parametric and
nonparametric statistical procedures. Boca Raton:
CRC Press.

Type II Error
▶ Type I Errors

Typomorphology

Type II Errors
Ralph L. Piedmont
Pastoral Counseling Department, Loyola
University Maryland, Columbia, MD, USA

Synonyms
Errors of the second kind; Hypothesis testing
error; Type I error

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other factors affect Type II error rates aside from
alpha level (e.g., effect size, sample size, and
power). While generally viewed as the less severe
error to commit, in certain circumstances (such as
when using a test as a screener), it can be the more
serious error. A consideration of Type II error
rates is particularly relevant when a study
fails to reject the null hypothesis. It would need
to be determined whether the effect is really not
there or if the study simply missed detecting the
effect (Sheskin, 2004).

Definition

Cross-References

A Type II error is an incorrect conclusion drawn
from a Null Hypothesis Significance Test
(NHST) (Aron & Aron, 2003). Also known as
a “false negative,” a Type II error is concluding
that a random effect did occur, when in fact it did
not. Technically, a Type II error is incorrectly
accepting a false null hypothesis, or saying there
was no effect when, in fact, there was. Type II
error, also known as beta error, is most closely
associated with the power of a study (i.e., its
ability to detect a significant effect if
a significant effect is present). The more power
a study has, the lower its Type II error rate.
Ideally, the Type II error rate should be 0.20 or
below (Hurlburt, 2003).
While Type I and Type II errors are inversely
related (as one reduces the risk of making a Type
I error, the probability of making a Type II error
increases), their relationship is not direct because

▶ Hypothesis Testing
▶ Null Hypothesis

References
Aron, A., & Aron, E. N. (2003). Statistics for psychology
(3rd ed.). Upper Saddle River, NJ: Prentice Hall.
Hurlburt, R. T. (2003). Comprehending behavioral statistics (3rd ed.). Belmont, CA: Wadsworth/Thomson
Learning.
Sheskin, D. (2004). Handbook of parametric and
nonparametric statistical procedures. Baco Raton:
CRC Press.

Typomorphology
▶ Urban Morphology and Citizens’ Life

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