case study psychology strengths

Case Study Research Method in Psychology

Saul McLeod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

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Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews).

The case study research method originated in clinical medicine (the case history, i.e., the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.

The information is mainly biographical and relates to events in the individual’s past (i.e., retrospective), as well as to significant events that are currently occurring in his or her everyday life.

The case study is not a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.

Freud (1909a, 1909b) conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

This makes it clear that the case study is a method that should only be used by a psychologist, therapist, or psychiatrist, i.e., someone with a professional qualification.

There is an ethical issue of competence. Only someone qualified to diagnose and treat a person can conduct a formal case study relating to atypical (i.e., abnormal) behavior or atypical development.

 Famous Case Studies

• Anna O – One of the most famous case studies, documenting psychoanalyst Josef Breuer’s treatment of “Anna O” (real name Bertha Pappenheim) for hysteria in the late 1800s using early psychoanalytic theory.
• Little Hans – A child psychoanalysis case study published by Sigmund Freud in 1909 analyzing his five-year-old patient Herbert Graf’s house phobia as related to the Oedipus complex.
• Bruce/Brenda – Gender identity case of the boy (Bruce) whose botched circumcision led psychologist John Money to advise gender reassignment and raise him as a girl (Brenda) in the 1960s.
• Genie Wiley – Linguistics/psychological development case of the victim of extreme isolation abuse who was studied in 1970s California for effects of early language deprivation on acquiring speech later in life.
• Phineas Gage – One of the most famous neuropsychology case studies analyzes personality changes in railroad worker Phineas Gage after an 1848 brain injury involving a tamping iron piercing his skull.

Clinical Case Studies

• Studying the effectiveness of psychotherapy approaches with an individual patient
• Assessing and treating mental illnesses like depression, anxiety disorders, PTSD
• Neuropsychological cases investigating brain injuries or disorders

Child Psychology Case Studies

• Studying psychological development from birth through adolescence
• Cases of learning disabilities, autism spectrum disorders, ADHD
• Effects of trauma, abuse, deprivation on development

Types of Case Studies

• Explanatory case studies : Used to explore causation in order to find underlying principles. Helpful for doing qualitative analysis to explain presumed causal links.
• Exploratory case studies : Used to explore situations where an intervention being evaluated has no clear set of outcomes. It helps define questions and hypotheses for future research.
• Descriptive case studies : Describe an intervention or phenomenon and the real-life context in which it occurred. It is helpful for illustrating certain topics within an evaluation.
• Multiple-case studies : Used to explore differences between cases and replicate findings across cases. Helpful for comparing and contrasting specific cases.
• Intrinsic : Used to gain a better understanding of a particular case. Helpful for capturing the complexity of a single case.
• Collective : Used to explore a general phenomenon using multiple case studies. Helpful for jointly studying a group of cases in order to inquire into the phenomenon.

Where Do You Find Data for a Case Study?

There are several places to find data for a case study. The key is to gather data from multiple sources to get a complete picture of the case and corroborate facts or findings through triangulation of evidence. Most of this information is likely qualitative (i.e., verbal description rather than measurement), but the psychologist might also collect numerical data.

1. Primary sources

• Interviews – Interviewing key people related to the case to get their perspectives and insights. The interview is an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates, and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.
• Observations – Observing behaviors, interactions, processes, etc., related to the case as they unfold in real-time.
• Documents & Records – Reviewing private documents, diaries, public records, correspondence, meeting minutes, etc., relevant to the case.

2. Secondary sources

• News/Media – News coverage of events related to the case study.
• Academic articles – Journal articles, dissertations etc. that discuss the case.
• Government reports – Official data and records related to the case context.
• Books/films – Books, documentaries or films discussing the case.

3. Archival records

Searching historical archives, museum collections and databases to find relevant documents, visual/audio records related to the case history and context.

Public archives like newspapers, organizational records, photographic collections could all include potentially relevant pieces of information to shed light on attitudes, cultural perspectives, common practices and historical contexts related to psychology.

4. Organizational records

Organizational records offer the advantage of often having large datasets collected over time that can reveal or confirm psychological insights.

Of course, privacy and ethical concerns regarding confidential data must be navigated carefully.

However, with proper protocols, organizational records can provide invaluable context and empirical depth to qualitative case studies exploring the intersection of psychology and organizations.

• Organizational/industrial psychology research : Organizational records like employee surveys, turnover/retention data, policies, incident reports etc. may provide insight into topics like job satisfaction, workplace culture and dynamics, leadership issues, employee behaviors etc.
• Clinical psychology : Therapists/hospitals may grant access to anonymized medical records to study aspects like assessments, diagnoses, treatment plans etc. This could shed light on clinical practices.
• School psychology : Studies could utilize anonymized student records like test scores, grades, disciplinary issues, and counseling referrals to study child development, learning barriers, effectiveness of support programs, and more.

How do I Write a Case Study in Psychology?

Follow specified case study guidelines provided by a journal or your psychology tutor. General components of clinical case studies include: background, symptoms, assessments, diagnosis, treatment, and outcomes. Interpreting the information means the researcher decides what to include or leave out. A good case study should always clarify which information is the factual description and which is an inference or the researcher’s opinion.

1. Introduction

• Provide background on the case context and why it is of interest, presenting background information like demographics, relevant history, and presenting problem.
• Compare briefly to similar published cases if applicable. Clearly state the focus/importance of the case.

2. Case Presentation

• Describe the presenting problem in detail, including symptoms, duration,and impact on daily life.
• Include client demographics like age and gender, information about social relationships, and mental health history.
• Describe all physical, emotional, and/or sensory symptoms reported by the client.
• Use patient quotes to describe the initial complaint verbatim. Follow with full-sentence summaries of relevant history details gathered, including key components that led to a working diagnosis.
• Summarize clinical exam results, namely orthopedic/neurological tests, imaging, lab tests, etc. Note actual results rather than subjective conclusions. Provide images if clearly reproducible/anonymized.
• Clearly state the working diagnosis or clinical impression before transitioning to management.

3. Management and Outcome

• Indicate the total duration of care and number of treatments given over what timeframe. Use specific names/descriptions for any therapies/interventions applied.
• Present the results of the intervention,including any quantitative or qualitative data collected.
• For outcomes, utilize visual analog scales for pain, medication usage logs, etc., if possible. Include patient self-reports of improvement/worsening of symptoms. Note the reason for discharge/end of care.

4. Discussion

• Analyze the case, exploring contributing factors, limitations of the study, and connections to existing research.
• Analyze the effectiveness of the intervention,considering factors like participant adherence, limitations of the study, and potential alternative explanations for the results.
• Identify any questions raised in the case analysis and relate insights to established theories and current research if applicable. Avoid definitive claims about physiological explanations.
• Offer clinical implications, and suggest future research directions.

5. Additional Items

• Thank specific assistants for writing support only. No patient acknowledgments.
• References should directly support any key claims or quotes included.
• Use tables/figures/images only if substantially informative. Include permissions and legends/explanatory notes.
• Provides detailed (rich qualitative) information.
• Provides insight for further research.
• Permitting investigation of otherwise impractical (or unethical) situations.

Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.

Because of their in-depth, multi-sided approach, case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.

Research that only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension of experience, which is important to psychoanalytic and humanistic psychologists.

Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.

The method is, therefore, important for psychologists who adopt a holistic point of view (i.e., humanistic psychologists ).

Limitations

• Lacking scientific rigor and providing little basis for generalization of results to the wider population.
• Researchers’ own subjective feelings may influence the case study (researcher bias).
• Difficult to replicate.
• Time-consuming and expensive.
• The volume of data, together with the time restrictions in place, impacted the depth of analysis that was possible within the available resources.

Because a case study deals with only one person/event/group, we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the conclusions drawn from a particular case may not be transferable to other settings.

Because case studies are based on the analysis of qualitative (i.e., descriptive) data , a lot depends on the psychologist’s interpretation of the information she has acquired.

This means that there is a lot of scope for Anna O , and it could be that the subjective opinions of the psychologist intrude in the assessment of what the data means.

For example, Freud has been criticized for producing case studies in which the information was sometimes distorted to fit particular behavioral theories (e.g., Little Hans ).

This is also true of Money’s interpretation of the Bruce/Brenda case study (Diamond, 1997) when he ignored evidence that went against his theory.

Breuer, J., & Freud, S. (1895).  Studies on hysteria . Standard Edition 2: London.

Curtiss, S. (1981). Genie: The case of a modern wild child .

Diamond, M., & Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine , 151(3), 298-304

Freud, S. (1909a). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306

Freud, S. (1909b). Bemerkungen über einen Fall von Zwangsneurose (Der “Rattenmann”). Jb. psychoanal. psychopathol. Forsch ., I, p. 357-421; GW, VII, p. 379-463; Notes upon a case of obsessional neurosis, SE , 10: 151-318.

Harlow J. M. (1848). Passage of an iron rod through the head.  Boston Medical and Surgical Journal, 39 , 389–393.

Harlow, J. M. (1868).  Recovery from the Passage of an Iron Bar through the Head .  Publications of the Massachusetts Medical Society. 2  (3), 327-347.

Money, J., & Ehrhardt, A. A. (1972).  Man & Woman, Boy & Girl : The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.

Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.

Further Information

• Case Study Approach
• Case Study Method
• Enhancing the Quality of Case Studies in Health Services Research
• “We do things together” A case study of “couplehood” in dementia
• Using mixed methods for evaluating an integrative approach to cancer care: a case study

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

10 Case Study Advantages and Disadvantages

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

Learn about our Editorial Process

A case study in academic research is a detailed and in-depth examination of a specific instance or event, generally conducted through a qualitative approach to data.

The most common case study definition that I come across is is Robert K. Yin’s (2003, p. 13) quote provided below:

“An empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident.”

Researchers conduct case studies for a number of reasons, such as to explore complex phenomena within their real-life context, to look at a particularly interesting instance of a situation, or to dig deeper into something of interest identified in a wider-scale project.

While case studies render extremely interesting data, they have many limitations and are not suitable for all studies. One key limitation is that a case study’s findings are not usually generalizable to broader populations because one instance cannot be used to infer trends across populations.

Case Study Advantages and Disadvantages

1. in-depth analysis of complex phenomena.

Case study design allows researchers to delve deeply into intricate issues and situations.

By focusing on a specific instance or event, researchers can uncover nuanced details and layers of understanding that might be missed with other research methods, especially large-scale survey studies.

As Lee and Saunders (2017) argue,

“It allows that particular event to be studies in detail so that its unique qualities may be identified.”

This depth of analysis can provide rich insights into the underlying factors and dynamics of the studied phenomenon.

2. Holistic Understanding

Building on the above point, case studies can help us to understand a topic holistically and from multiple angles.

This means the researcher isn’t restricted to just examining a topic by using a pre-determined set of questions, as with questionnaires. Instead, researchers can use qualitative methods to delve into the many different angles, perspectives, and contextual factors related to the case study.

We can turn to Lee and Saunders (2017) again, who notes that case study researchers “develop a deep, holistic understanding of a particular phenomenon” with the intent of deeply understanding the phenomenon.

3. Examination of rare and Unusual Phenomena

We need to use case study methods when we stumble upon “rare and unusual” (Lee & Saunders, 2017) phenomena that would tend to be seen as mere outliers in population studies.

Take, for example, a child genius. A population study of all children of that child’s age would merely see this child as an outlier in the dataset, and this child may even be removed in order to predict overall trends.

So, to truly come to an understanding of this child and get insights into the environmental conditions that led to this child’s remarkable cognitive development, we need to do an in-depth study of this child specifically – so, we’d use a case study.

4. Helps Reveal the Experiences of Marginalzied Groups

Just as rare and unsual cases can be overlooked in population studies, so too can the experiences, beliefs, and perspectives of marginalized groups.

As Lee and Saunders (2017) argue, “case studies are also extremely useful in helping the expression of the voices of people whose interests are often ignored.”

Take, for example, the experiences of minority populations as they navigate healthcare systems. This was for many years a “hidden” phenomenon, not examined by researchers. It took case study designs to truly reveal this phenomenon, which helped to raise practitioners’ awareness of the importance of cultural sensitivity in medicine.

5. Ideal in Situations where Researchers cannot Control the Variables

Experimental designs – where a study takes place in a lab or controlled environment – are excellent for determining cause and effect . But not all studies can take place in controlled environments (Tetnowski, 2015).

When we’re out in the field doing observational studies or similar fieldwork, we don’t have the freedom to isolate dependent and independent variables. We need to use alternate methods.

Case studies are ideal in such situations.

A case study design will allow researchers to deeply immerse themselves in a setting (potentially combining it with methods such as ethnography or researcher observation) in order to see how phenomena take place in real-life settings.

6. Supports the generation of new theories or hypotheses

While large-scale quantitative studies such as cross-sectional designs and population surveys are excellent at testing theories and hypotheses on a large scale, they need a hypothesis to start off with!

This is where case studies – in the form of grounded research – come in. Often, a case study doesn’t start with a hypothesis. Instead, it ends with a hypothesis based upon the findings within a singular setting.

The deep analysis allows for hypotheses to emerge, which can then be taken to larger-scale studies in order to conduct further, more generalizable, testing of the hypothesis or theory.

7. Reveals the Unexpected

When a largescale quantitative research project has a clear hypothesis that it will test, it often becomes very rigid and has tunnel-vision on just exploring the hypothesis.

Of course, a structured scientific examination of the effects of specific interventions targeted at specific variables is extermely valuable.

But narrowly-focused studies often fail to shine a spotlight on unexpected and emergent data. Here, case studies come in very useful. Oftentimes, researchers set their eyes on a phenomenon and, when examining it closely with case studies, identify data and come to conclusions that are unprecedented, unforeseen, and outright surprising.

As Lars Meier (2009, p. 975) marvels, “where else can we become a part of foreign social worlds and have the chance to become aware of the unexpected?”

Disadvantages

1. not usually generalizable.

Case studies are not generalizable because they tend not to look at a broad enough corpus of data to be able to infer that there is a trend across a population.

As Yang (2022) argues, “by definition, case studies can make no claims to be typical.”

Case studies focus on one specific instance of a phenomenon. They explore the context, nuances, and situational factors that have come to bear on the case study. This is really useful for bringing to light important, new, and surprising information, as I’ve already covered.

But , it’s not often useful for generating data that has validity beyond the specific case study being examined.

2. Subjectivity in interpretation

Case studies usually (but not always) use qualitative data which helps to get deep into a topic and explain it in human terms, finding insights unattainable by quantitative data.

But qualitative data in case studies relies heavily on researcher interpretation. While researchers can be trained and work hard to focus on minimizing subjectivity (through methods like triangulation), it often emerges – some might argue it’s innevitable in qualitative studies.

So, a criticism of case studies could be that they’re more prone to subjectivity – and researchers need to take strides to address this in their studies.

3. Difficulty in replicating results

Case study research is often non-replicable because the study takes place in complex real-world settings where variables are not controlled.

So, when returning to a setting to re-do or attempt to replicate a study, we often find that the variables have changed to such an extent that replication is difficult. Furthermore, new researchers (with new subjective eyes) may catch things that the other readers overlooked.

Replication is even harder when researchers attempt to replicate a case study design in a new setting or with different participants.

Comprehension Quiz for Students

Question 1: What benefit do case studies offer when exploring the experiences of marginalized groups?

a) They provide generalizable data. b) They help express the voices of often-ignored individuals. c) They control all variables for the study. d) They always start with a clear hypothesis.

Question 2: Why might case studies be considered ideal for situations where researchers cannot control all variables?

a) They provide a structured scientific examination. b) They allow for generalizability across populations. c) They focus on one specific instance of a phenomenon. d) They allow for deep immersion in real-life settings.

Question 3: What is a primary disadvantage of case studies in terms of data applicability?

a) They always focus on the unexpected. b) They are not usually generalizable. c) They support the generation of new theories. d) They provide a holistic understanding.

Question 4: Why might case studies be considered more prone to subjectivity?

a) They always use quantitative data. b) They heavily rely on researcher interpretation, especially with qualitative data. c) They are always replicable. d) They look at a broad corpus of data.

Question 5: In what situations are experimental designs, such as those conducted in labs, most valuable?

a) When there’s a need to study rare and unusual phenomena. b) When a holistic understanding is required. c) When determining cause-and-effect relationships. d) When the study focuses on marginalized groups.

Question 6: Why is replication challenging in case study research?

a) Because they always use qualitative data. b) Because they tend to focus on a broad corpus of data. c) Due to the changing variables in complex real-world settings. d) Because they always start with a hypothesis.

Lee, B., & Saunders, M. N. K. (2017). Conducting Case Study Research for Business and Management Students. SAGE Publications.

Meir, L. (2009). Feasting on the Benefits of Case Study Research. In Mills, A. J., Wiebe, E., & Durepos, G. (Eds.). Encyclopedia of Case Study Research (Vol. 2). London: SAGE Publications.

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• Perspective
• Published: 22 November 2022

Single case studies are a powerful tool for developing, testing and extending theories

• Lyndsey Nickels   ORCID: orcid.org/0000-0002-0311-3524 1 , 2 ,
• Simon Fischer-Baum   ORCID: orcid.org/0000-0002-6067-0538 3 &
• Wendy Best   ORCID: orcid.org/0000-0001-8375-5916 4  

Nature Reviews Psychology volume  1 ,  pages 733–747 ( 2022 ) Cite this article

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Psychology embraces a diverse range of methodologies. However, most rely on averaging group data to draw conclusions. In this Perspective, we argue that single case methodology is a valuable tool for developing and extending psychological theories. We stress the importance of single case and case series research, drawing on classic and contemporary cases in which cognitive and perceptual deficits provide insights into typical cognitive processes in domains such as memory, delusions, reading and face perception. We unpack the key features of single case methodology, describe its strengths, its value in adjudicating between theories, and outline its benefits for a better understanding of deficits and hence more appropriate interventions. The unique insights that single case studies have provided illustrate the value of in-depth investigation within an individual. Single case methodology has an important place in the psychologist’s toolkit and it should be valued as a primary research tool.

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The authors thank all of those pioneers of and advocates for single case study research who have mentored, inspired and encouraged us over the years, and the many other colleagues with whom we have discussed these issues.

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Nickels, L., Fischer-Baum, S. & Best, W. Single case studies are a powerful tool for developing, testing and extending theories. Nat Rev Psychol 1 , 733–747 (2022). https://doi.org/10.1038/s44159-022-00127-y

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Case Studies

Last updated 22 Mar 2021

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

Evaluation of case studies:

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

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

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

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

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

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

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

• Case Studies

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Designing and Conducting Case Studies

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

Definition and Overview

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

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

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

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

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

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

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

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

Educational Applications

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

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

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

Types and Design Concerns

Researchers use multiple methods and approaches to conduct case studies.

Types of Case Studies

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

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

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

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

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

Identifying a Theoretical Perspective

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

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

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

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

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

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

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

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

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

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

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

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

Designing a Case Study

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

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

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

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

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

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

Conducting Case Studies

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

Method: Single or Multi-modal?

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

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

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

Participant Selection

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

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

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

Data Collection

There are six types of data collected in case studies:

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

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

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

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

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

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

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

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

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

Data Analysis

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

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

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

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

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

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

Composing the Case Study Report

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

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

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

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

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

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

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

Issues of Validity and Reliability

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

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

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

Commentary on Case Studies

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

Strengths and Weaknesses of Case Studies

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

Flexibility

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

Emphasis on Context

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

Inherent Subjectivity

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

High Investment

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

Ethical Considerations

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

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

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

Concerns about Reliability, Validity, and Generalizability

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

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

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

Annotated Bibliography

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No abstract available.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This article provides tips for writing more effective case studies.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Related Links

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

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

Becker, Bronwyn, Patrick Dawson, Karen Devine, Carla Hannum, Steve Hill, Jon Leydens, Debbie Matuskevich, Carol Traver, & Mike Palmquist. (2005). Case Studies. Writing@CSU . Colorado State University. https://writing.colostate.edu/guides/guide.cfm?guideid=60

• First Online: 27 October 2022

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• R. M. Channaveer 4 &
• Rajendra Baikady 5  

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This chapter reviews the strengths and limitations of case study as a research method in social sciences. It provides an account of an evidence base to justify why a case study is best suitable for some research questions and why not for some other research questions. Case study designing around the research context, defining the structure and modality, conducting the study, collecting the data through triangulation mode, analysing the data, and interpreting the data and theory building at the end give a holistic view of it. In addition, the chapter also focuses on the types of case study and when and where to use case study as a research method in social science research.

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Case Study Research

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IB DP Psychology Study Notes

4.2.1 case studies.

Case studies play an instrumental role in psychological research, diving deeply into specific instances or individuals to gain a profound understanding that broader studies might miss. They are particularly complementary to experimental research methods , providing insights that quantitative data alone cannot offer.

Characteristics and Uses of Case Studies

A case study is a detailed examination of a single individual, group, or event. Unlike other research methods that seek generalisable results, case studies focus on one specific instance to achieve a deeper understanding. This depth is often achieved through interviews and direct observations.

Characteristics:

• Depth over Breadth: Rather than trying to find general patterns across a large sample, a case study zooms in on a specific case to get a rich and detailed understanding.
• Multiple Data Sources: They often incorporate multiple sources of data, including interviews, observations, and historical records. The selection of these sources can significantly benefit from understanding sampling techniques .
• Flexibility: Researchers can adapt their approach based on new discoveries during the study. This flexibility is a crucial aspect when examining the reliability and validity of the research findings.
• Understanding Complexity: They are particularly useful in capturing the complexity of real-life situations where behaviours, feelings, and interpretations intersect.
• New Insights: As they delve deeply into specific instances, they can offer new insights or challenge established theories.
• Preliminary Research: They can be a starting point for further studies. Researchers might start with a case study to explore an area before undertaking broader research.
• Rare Phenomena: They're invaluable when studying rare conditions or behaviours, where large samples are hard to come by. These unique situations often require a deep ethical consideration, similar to those discussed in ethical considerations in animal studies .

IB Psychology Tutor Tip: Explore how individual experiences, revealed through case studies, can challenge and expand our understanding of psychological theories, demonstrating the complexity and diversity of human behaviour and cognition.

Strengths and Limitations

Case studies provide depth and detail, but they also come with challenges.

• Rich Data: The depth of a case study can provide a rich understanding that other research methods might not achieve.
• Real-world Application: Their real-world focus means they often have high ecological validity.
• Flexibility: Researchers can adapt their methods as they gather more information, allowing them to follow leads and explore different angles.

Limitations:

• Generalisability: Because they focus on a single case, their findings might not apply more broadly.
• Subjectivity: The depth and flexibility that are strengths of the case study can also be a limitation. Researchers might become too involved or lose objectivity.
• Time-Consuming: They can take a lot of time and resources to complete.
• Reliability: Different researchers might interpret the same data differently, leading to potential challenges in reliability.

Notable Examples in Psychology

Over the years, case studies have been foundational in psychology, leading to breakthrough understandings.

Phineas Gage:

Perhaps one of the most famous case studies, Phineas Gage was a railway worker who survived an accident where a large iron rod was driven through his head. The accident and its aftermath provided invaluable insights into the brain and personality. After the accident, Gage's personality changed drastically, which suggested that the frontal lobes (damaged in his accident) play a role in personality and behaviour.

Little Hans:

Sigmund Freud's study of a five-year-old boy, dubbed "Little Hans", is a notable example in the development of psychoanalytic theory. Freud used the boy's fear of horses to explore and support his ideas about childhood development and the Oedipus complex.

IB Tutor Advice: When revising case studies, focus on understanding the unique findings and their implications for broader psychological theories, rather than memorising every detail of the case.

A more recent and tragic case, Genie was a girl who was found in the 1970s having been locked away and isolated for most of her life. Psychologists studied her case to understand the effects of extreme social isolation and the importance of socialisation in language development and cognitive growth.

In essence, while case studies may have their limitations, they remain a cornerstone in psychology, offering deep dives into human behaviour and cognition that larger studies can't match. They challenge and enrich our understanding, proving that sometimes, the study of one can illuminate the experiences of many.

The replicability of case studies can be a matter of contention. Due to the intrinsic nature of case studies, which focus on specific events or individuals in great detail, it can be challenging to replicate them precisely. The specific conditions, contexts, and time frames make it almost impossible to have an exact replication. However, the methodology or approach used in a case study can certainly be applied to other similar contexts or events. It's essential to differentiate between replicating the exact conditions and outcomes of a case study and using its methodological framework in different scenarios.

Ensuring objectivity in case studies is challenging but achievable. First, researchers can employ triangulation, which involves using multiple sources of data or methods to validate findings. By comparing and contrasting different data sources or methods, researchers can enhance the validity of their conclusions. Second, maintaining a clear, detailed record of all data collection and analysis processes (often called an audit trail) can help. This allows others to scrutinise the research process and the conclusions drawn. Finally, involving peer reviewers or external checks can provide an additional layer of objectivity, as they can identify potential biases or alternative interpretations.

A researcher might choose a case study method over an experimental method for various reasons. Case studies are particularly beneficial when the researcher aims to gain a deep understanding of a complex issue, phenomenon, or context, which might not be achievable through experimental methods. If the goal is to explore the 'how' or 'why' of a specific real-life event, then a case study might be more appropriate. Additionally, case studies are valuable when manipulating the independent variable, as in experiments, is either unethical or not feasible. They allow for real-world, naturalistic observations, capturing the richness and intricacies of human experiences.

While case studies can hint at potential causations, they cannot definitively establish causation. This is because case studies examine a single instance or a few instances in great depth, making it challenging to control for confounding variables. Also, the lack of randomisation and the fact that they don't employ experimental methods means that direct causal relationships cannot be reliably established. Instead, case studies are better suited for exploring the complexity of specific cases, generating hypotheses, or offering deep insights into certain phenomena.

Case studies are considered a qualitative research method because they primarily focus on gathering in-depth, descriptive data rather than numerical or quantitative data. The essence of a case study lies in its exploration of individual or group experiences, beliefs, and processes, delving deep into the contextual realities of the subject. This often involves open-ended interviews, direct observations, and document analysis, all of which aim to gain a holistic understanding of the phenomenon under study. The richness and depth of the data collected are key features of qualitative research, and this is what case studies exemplify.

Practice Questions

Case studies offer a unique depth of analysis that is hard to achieve with other research methods. Their main strength lies in their ability to provide rich data, capturing the complexity of real-life situations. This means they often have high ecological validity and allow for real-world applications. Additionally, their flexibility is noteworthy, letting researchers adapt methods based on new discoveries. However, this depth comes with limitations. The findings of a case study may lack generalisability since they focus on a specific instance. Subjectivity can be a concern, with researchers potentially losing objectivity due to the study's depth. They can also be time-consuming and face challenges in reliability as interpretations may vary among different researchers.

The case study of Phineas Gage significantly contributed to our understanding of the brain's role in personality and behaviour. Gage, after surviving an accident where a rod pierced through his frontal lobes, underwent drastic personality changes. This transformation suggested the frontal lobes' critical function in shaping personality. Prior to this incident, the specifics of the brain's regions in determining behaviour weren't as clear. Gage's case provided empirical evidence of the frontal lobes' role in governing personality traits and social behaviours, highlighting the intricate relationship between specific brain structures and exhibited behaviours. This has been foundational in neuropsychology, aiding in the comprehension of brain-behaviour relationships.

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Pros and Cons of Case Studies Psychology

Case studies in psychology offer a detailed look at individual behaviors and experiences, revealing unique insights but posing challenges. They allow deep exploration of complex cases, providing rich understanding of rare phenomena . However, focusing on specific cases may limit generalizability and introduce potential for bias. Despite these limitations, case studies complement broader research methods and can generate hypotheses for further studies. Understanding the pros and cons of case studies in psychology can enhance research and therapeutic interventions.

Table of Contents

• Provide in-depth insights into individual behavior and experiences.
• Contribute to advancing psychological knowledge.
• Challenges in generalizing findings beyond specific cases.
• Potential for researcher and participant bias.
• Complement other research methods for holistic understanding.

Advantages of Case Studies

One of the primary advantages of case studies in psychology is their ability to provide in-depth, detailed insights into individual behavior and experiences. By focusing on a single individual or a small group, case studies allow researchers to deeply explore the unique circumstances and complexities of a particular case.

This level of detail is often not possible in larger-scale research methods, such as surveys or experiments, where individual variations may be overlooked.

Case studies also offer the opportunity to investigate rare or unusual phenomena that may not be easily studied through other research approaches. This can lead to the discovery of new theories or the validation of existing ones, contributing to the advancement of psychological knowledge.

Additionally, case studies can provide a more holistic understanding of complex behaviors or psychological disorders by considering multiple factors in a single case.

In-Depth Exploration of Individuals

The examination of individuals in psychology allows for a thorough analysis of their behaviors, thoughts, and emotions.

By conducting a detailed individual analysis, psychologists can gain rich personal insights that contribute to a comprehensive understanding of an individual's behavioral patterns.

This in-depth exploration provides a holistic view of the complexities that shape an individual's psychological makeup.

Detailed Individual Analysis

A thorough examination of the intricate layers of an individual's psyche reveals profound insights into their behaviors and thought processes. Through detailed individual analysis in psychology, researchers dive deep into the complexities of a person's mind to understand the underlying factors that drive their actions. This method involves thorough observation, interviews, and sometimes even psychological testing to gather extensive data about an individual's cognitive processes, emotions, and behaviors.

• Holistic Perspective: Provides a complete view of the individual's psychological makeup.
• Identification of Patterns: Helps in recognizing recurring themes or behaviors that may offer valuable insights.
• Understanding Triggers: Uncovers the specific stimuli or events that lead to certain reactions.
• Personalized Interventions: Enables the development of tailored psychological interventions based on the individual's unique characteristics.

Detailed individual analysis offers a rich source of information that contributes significantly to the field of psychology by offering a nuanced understanding of human behavior and cognition.

Rich Personal Insights

Through in-depth exploration of individuals, psychology uncovers rich personal insights that illuminate the intricacies of human behavior and cognition. By delving deeply into the lives, experiences, and thought processes of individuals, psychologists gain a profound understanding of the factors shaping behavior and mental processes.

Case studies offer a unique opportunity to observe and analyze the complexities of human nature in a real-world context, providing valuable insights that may not be captured through other research methods.

One of the key advantages of this approach is the ability to uncover unique patterns , motivations, and influences that contribute to an individual's behavior. These rich personal insights allow psychologists to develop a more nuanced understanding of how external and internal factors interact to shape an individual's thoughts, emotions, and actions.

Comprehensive Behavioral Understanding

By conducting in-depth exploration of individuals, psychologists aim to achieve a profound understanding of human behavior and cognition. This extensive behavioral understanding involves delving into the intricacies of an individual's thoughts, emotions, motivations, and actions to gain insight into the underlying factors that drive behavior.

Through in-depth case studies, psychologists can uncover patterns, triggers, and influences that contribute to a person's psychological makeup and decision-making processes.

• Identification of Root Causes : Case studies allow psychologists to identify the root causes of behaviors by examining the individual's past experiences, traumas, and environmental factors.
• Personalized Interventions : By understanding the unique aspects of an individual's behavior, psychologists can tailor interventions and treatments that are specifically suited to address their needs.
• Enhanced Empathy and Connection : Extensive behavioral understanding fosters empathy and connection between psychologists and their clients, promoting a more effective therapeutic relationship.
• Contribution to Psychological Knowledge : Through detailed case studies, psychologists contribute valuable insights to the broader field of psychology, advancing understanding of human behavior and cognition.

Limited Generalizability

Generalizability in case studies in psychology is often constrained by the unique and specific nature of individual cases . Unlike large-scale studies that aim for broad generalizability across populations, case studies explore deeply into the intricate details of a single individual or a small group .

This focused approach, while valuable for understanding the nuances of a particular case, limits the extent to which findings can be applied to a wider population. The idiosyncrasies of each case study subject, including their personal history, circumstances, and characteristics, make it challenging to extrapolate the results to the broader population.

This limitation is particularly evident in clinical psychology , where patients seeking treatment may have complex and individualized experiences that do not represent the typical response or behavior of the general population. While case studies offer rich insights into the complexities of human behavior and individual experiences, researchers and practitioners must exercise caution when attempting to generalize findings beyond the specific case under investigation.

Balancing the depth of understanding gained from case studies with the limited generalizability is a critical consideration in psychological research and practice.

Unique Insights Into Rare Phenomena

Exploring rare phenomena in psychology offers valuable opportunities to gain in-depth understanding that may not be possible through broader studies. By focusing on unique cases, researchers can uncover insights that provide a deeper understanding of complex psychological conditions or behaviors.

However, it is essential to acknowledge the limited generalizability of findings from these rare cases to the larger population.

Rare Phenomena Exploration

An examination of rare phenomena in psychology offers valuable and distinctive insights into the complexities of human behavior. These unique occurrences provide psychologists with a rare opportunity to explore further into understanding the intricacies of the human mind and its behavior.

When investigating rare phenomena, researchers can uncover hidden aspects of psychological processes that may not be observable in more common situations. This exploration can lead to groundbreaking discoveries and advancements in psychological knowledge.

• Uncover underlying mechanisms : Rare phenomena allow researchers to unveil the underlying mechanisms that govern human behavior, shedding light on the intricacies of cognitive processes.
• Challenge existing theories : Studying rare phenomena can challenge established psychological theories and offer new perspectives on human behavior.
• Inform therapeutic interventions : Insights gained from exploration of rare phenomena can inform the development of more effective therapeutic interventions for individuals facing similar challenges.
• Expand the boundaries of knowledge : Exploring rare phenomena pushes the limits of psychological knowledge, leading to a deeper understanding of human behavior and cognition.

In-depth Understanding Opportunities

Uncommon occurrences in psychology offer unparalleled opportunities for gaining in-depth understanding and unique insights into the complexities of human behavior. By focusing on rare cases or unusual events, researchers can delve deeply into the intricacies of individual experiences , behaviors, and mental processes that may not be easily observable in more common situations.

These unique cases offer a chance to explore the underlying factors contributing to specific behaviors or psychological conditions, providing a rich source of information that can inform theory development and therapeutic interventions.

Studying rare phenomena allows researchers to uncover hidden patterns , causal relationships , and potential mechanisms that may not be apparent in larger, more generalized studies. The detailed examination of these exceptional cases can lead to the discovery of novel perspectives and alternative explanations that challenge existing theories or shed light on previously unexplored aspects of human psychology.

Additionally, the insights gained from studying rare phenomena can have practical implications for clinical practice, offering new approaches to assessment, diagnosis, and treatment strategies for individuals with similar presentations.

Limited Generalizability Consideration

The examination of unique phenomena in psychology presents a challenge in considering the limited generalizability of findings to broader populations. When delving into rare occurrences, researchers must navigate the complexities of applying these insights to larger groups.

In the context of case studies, the following points highlight the considerations regarding limited generalizability:

• Small Sample Size: Case studies often involve a small number of participants, making it challenging to extend findings to the broader population.
• Unique Individual Factors: Each case study participant may possess unique characteristics or experiences that limit the applicability of findings to others.
• Context-Specific Dynamics: The specific circumstances surrounding a rare phenomenon may not be easily replicable or generalized to different settings.
• Potential Bias: Researchers and participants in case studies may introduce biases that affect the transferability of results to a wider population.

Navigating the tension between the richness of insights gained from unique cases and the limited generalizability to broader populations remains a critical consideration in psychological research.

Potential for Bias

In psychological case studies, the potential for bias must be carefully considered and managed to guarantee the integrity of the research findings. Bias can arise from various sources, such as researcher bias , participant bias , and even the inherent biases of the case study method itself.

Researcher bias occurs when the investigator's preconceived notions or beliefs influence the interpretation of data or the selection of information to include in the study. This can lead to skewed results that do not accurately reflect the reality of the case.

Participant bias is another significant concern, where participants may alter their behavior or responses based on what they believe the researcher wants to hear, impacting the validity of the findings.

Additionally, the qualitative nature of case studies can introduce inherent biases, as the interpretation of data is subjective and open to individual researcher perspectives.

To mitigate bias in case studies, researchers should employ rigorous methodologies, maintain transparency in data collection and analysis, consider alternative explanations for findings, and utilize triangulation by incorporating multiple data sources or researchers.

Complement to Other Research Methods

Given the potential for bias in psychological case studies, it is imperative to recognize how this research method can serve as a valuable complement to other research methods in the field. While case studies have their limitations, they offer unique advantages that can enhance the overall understanding of complex psychological phenomena when used in conjunction with other research methods.

Here are some ways in which case studies can complement other research approaches:

• In-depth exploration : Case studies allow for a detailed examination of individual cases, providing rich insights that may not be captured through quantitative methods alone.
• Hypothesis generation : They can help generate hypotheses for further research by highlighting patterns or relationships that warrant investigation on a larger scale.
• Real-world application : Case studies offer a bridge between theory and practical application, showcasing how psychological principles manifest in real-life settings.
• Thorough understanding : By incorporating varied sources of data, including interviews, observations, and archival records, case studies can offer a thorough understanding of complex phenomena.

Frequently Asked Questions

Can case studies be used to study large populations?.

Case studies are not typically used to study large populations due to their focus on in-depth examination of individual cases. They are more suited for exploring complex phenomena in detail rather than generalizing findings to broader populations.

Are There Ethical Concerns With Case Study Research?

Ethical concerns in case study research revolve around issues like informed consent, confidentiality, and potential harm to participants. Researchers must prioritize ethical guidelines to protect the rights and well-being of those involved in the study.

How Do Researchers Ensure the Objectivity of Case Studies?

Researchers guarantee objectivity in case studies by using rigorous data collection methods, maintaining transparency, employing multiple investigators for data analysis, and conducting member checks to verify findings. These practices help minimize bias and enhance the credibility of results.

What Are the Limitations of Using Case Studies in Psychology?

The limitations of utilizing case studies in psychology include issues related to generalizability, sample size, and potential researcher bias. While offering in-depth insights, they may not always be representative of broader populations or provide causal conclusions.

Can Findings From Case Studies Be Applied to Real-World Situations?

Findings from case studies can offer valuable insights into real-world situations. While individual cases provide in-depth understanding, generalizability may be limited. Applying findings cautiously, considering context and potential biases, can enhance their relevance in practical settings.

To sum up, case studies in psychology offer a valuable opportunity to explore individuals in depth and provide unique insights into rare phenomena. However, their limited generalizability and potential for bias must be carefully considered.

When used in conjunction with other research methods, case studies can complement and enhance our understanding of complex psychological phenomena.

Related Posts:

• Pros and Cons of Observational Studies
• Pros and Cons of Narrative Research
• Pros and Cons of Descriptive Research

Related posts:

• Pros and Cons of Punishment Psychology
• Pros and Cons of Positive Psychology
• Pros and Cons of Evolutionary Psychology

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Key Study: HM’s case study (Milner and Scoville, 1957)

Travis Dixon January 29, 2019 Biological Psychology , Cognitive Psychology , Key Studies

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HM’s case study is one of the most famous and important case studies in psychology, especially in cognitive psychology. It was the source of groundbreaking new knowledge on the role of the hippocampus in memory. 

Background Info

“Localization of function in the brain” means that different parts of the brain have different functions. Researchers have discovered this from over 100 years of research into the ways the brain works. One such study was Milner’s case study on Henry Molaison.

The memory problems that HM experienced after the removal of his hippocampus provided new knowledge on the role of the hippocampus in memory formation (image: wikicommons)

At the time of the first study by Milner, HM was 29 years old. He was a mechanic who had suffered from minor epileptic seizures from when he was ten years old and began suffering severe seizures as a teenager. These may have been a result of a bike accident when he was nine. His seizures were getting worse in severity, which resulted in HM being unable to work. Treatment for his epilepsy had been unsuccessful, so at the age of 27 HM (and his family) agreed to undergo a radical surgery that would remove a part of his brain called the hippocampus . Previous research suggested that this could help reduce his seizures, but the impact it had on his memory was unexpected. The Doctor performing the radical surgery believed it was justified because of the seriousness of his seizures and the failures of other methods to treat them.

Methods and Results

In one regard, the surgery was successful as it resulted in HM experiencing less seizures. However, immediately after the surgery, the hospital staff and HM’s family noticed that he was suffering from anterograde amnesia (an inability to form new memories after the time of damage to the brain):

Here are some examples of his memory loss described in the case study:

• He could remember something if he concentrated on it, but if he broke his concentration it was lost.
• After the surgery the family moved houses. They stayed on the same street, but a few blocks away. The family noticed that HM as incapable of remembering the new address, but could remember the old one perfectly well. He could also not find his way home alone.
• He could not find objects around the house, even if they never changed locations and he had used them recently. His mother had to always show him where the lawnmower was in the garage.
• He would do the same jigsaw puzzles or read the same magazines every day, without ever apparently getting bored and realising he had read them before. (HM loved to do crossword puzzles and thought they helped him to remember words).
• He once ate lunch in front of Milner but 30 minutes later was unable to say what he had eaten, or remember even eating any lunch at all.
• When interviewed almost two years after the surgery in 1955, HM gave the date as 1953 and said his age was 27. He talked constantly about events from his childhood and could not remember details of his surgery.

Later testing also showed that he had suffered some partial retrograde amnesia (an inability to recall memories from before the time of damage to the brain). For instance, he could not remember that one of his favourite uncles passed away three years prior to his surgery or any of his time spent in hospital for his surgery. He could, however, remember some unimportant events that occurred just before his admission to the hospital.

Brenda Milner studied HM for almost 50 years – but he never remembered her.

Results continued…

His memories from events prior to 1950 (three years before his surgery), however, were fine. There was also no observable difference to his personality or to his intelligence. In fact, he scored 112 points on his IQ after the surgery, compared with 104 previously. The IQ test suggested that his ability in arithmetic had apparently improved. It seemed that the only behaviour that was affected by the removal of the hippocampus was his memory. HM was described as a kind and gentle person and this did not change after his surgery.

The Star Tracing Task

In a follow up study, Milner designed a task that would test whether or not HMs procedural memory had been affected by the surgery. He was to trace an outline of a star, but he could only see the mirrored reflection. He did this once a day over a period of a few days and Milner observed that he became faster and faster. Each time he performed the task he had no memory of ever having done it before, but his performance kept improving. This is further evidence for localization of function – the hippocampus must play a role in declarative (explicit) memory but not procedural (implicit) memory.

Cognitive psychologists have categorized memories into different types. HM’s study suggests that the hippocampus is essential for explicit (conscious) and declarative memory, but not implicit (unconscious) procedural memory.

Was his memory 100% gone? Another follow-up study

Interestingly, HM showed signs of being able to remember famous people who had only become famous after his surgery, like Lee Harvey Oswald (who assassinated JFK in 1963). (Image: wikicommons)

Another fascinating follow-up study was conducted by two researchers who wanted to see if HM had learned anything about celebrities that became famous after his surgery. At first they tested his knowledge of celebrities from before his surgery, and he knew these just as well as controls. They then showed him two names at a time, one a famous name (e.g. Liza Minelli, Lee Harvey Oswald) and the other was a name randomly taken from the phonebook. He was asked to choose the famous name and he was correct on a significant number of trials (i.e. the statistics tests suggest he wasn’t just guessing). Even more incredible was that he remembered some details about these people when asked why they were famous. For example, he could remember that Lee Harvey Oswald assassinated the president. One explanation given for the memory of these facts is that there was an emotional component. E.g. He liked these people, or the assassination was so violent, that he could remember a few details. 

HM became a hugely important case study for neuro and cognitive Psychologists. He was interviewed and tested by over 100 psychologists during the 53 years after his operation. Directly after his surgery, he lived at home with his parents as he was unable to live independently. He moved to a nursing home in 1980 and stayed there until his death in 2008. HM donated his brain to science and it was sliced into 2,401 thin slices that will be scanned and published electronically.

Critical Thinking Considerations

• How does this case study demonstrate localization of function in the brain? (e.g.c reating new long-term memories; procedural memories; storing and retrieving long term memories; intelligence; personality) ( Application )
• What are the ethical considerations involved in this study? ( Analysis )
• What are the strengths and limitations of this case study? ( Evaluation )
• Why would ongoing studies of HM be important? (Think about memory, neuroplasticity and neurogenesis) ( Analysis/Synthesis/Evaluation )
• How can findings from this case study be used to support and/or challenge the Multi-store Model of Memory? ( Application / Synthesis/Evaluation )

Exam Tips This study can be used for the following topics: Localization – the role of the hippocampus in memory Techniques to study the brain – MRI has been used to find out the exact location and size of damage to HM’s brain Bio and cognitive approach research method s – case study Bio and cognitive approach ethical considerations – anonymity Emotion and cognition – the follow-up study on HM and memories of famous people could be used in an essay to support the idea that emotion affects memory Models of memory – the multi-store model : HM’s study provides evidence for the fact that our memories all aren’t formed and stored in one place but travel from store to store (because his transfer from STS to LTS was damaged – if it was all in one store this specific problem would not occur)

Milner, Brenda. Scoville, William Beecher. “Loss of Recent Memory after Bilateral Hippocampal Lesions”. The Journal of Neurology, Neurosurgery and Psychiatry. 1957; 20: 11 21. (Accessed from web.mit.edu )

The man who couldn’t remember”. nova science now. an interview with brenda corkin . 06.01.2009.       .

  Here’s a good video recreation documentary of HM’s case study…

Travis Dixon is an IB Psychology teacher, author, workshop leader, examiner and IA moderator.

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Self-affirmation activates brain systems associated with self-related processing and reward and is reinforced by future orientation

Christopher n cascio, matthew brook o’donnell, francis j tinney, matthew d lieberman, shelley e taylor, victor j strecher, emily b falk.

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Correspondence should be addressed to: Christopher N. Cascio, Annenberg School for Communication, University of Pennsylvania, 3620 Walnut St., Philadelphia, PA 19104, USA. Email: [email protected]

Corresponding author.

Received 2015 May 6; Revised 2015 Oct 4; Accepted 2015 Nov 3; Issue date 2016 Apr.

Self-affirmation theory posits that people are motivated to maintain a positive self-view and that threats to perceived self-competence are met with resistance. When threatened, self-affirmations can restore self-competence by allowing individuals to reflect on sources of self-worth, such as core values. Many questions exist, however, about the underlying mechanisms associated with self-affirmation. We examined the neural mechanisms of self-affirmation with a task developed for use in a functional magnetic resonance imaging environment. Results of a region of interest analysis demonstrated that participants who were affirmed (compared with unaffirmed participants) showed increased activity in key regions of the brain’s self-processing (medial prefrontal cortex + posterior cingulate cortex) and valuation (ventral striatum + ventral medial prefrontal cortex) systems when reflecting on future-oriented core values (compared with everyday activities). Furthermore, this neural activity went on to predict changes in sedentary behavior consistent with successful affirmation in response to a separate physical activity intervention. These results highlight neural processes associated with successful self-affirmation, and further suggest that key pathways may be amplified in conjunction with prospection.

Keywords: self-affirmation, fMRI, reward, positive valuation, emotion regulation

Introduction

It is well documented that people seek to maintain a positive self-view and that threats to perceived self-competence across many domains are met with resistance ( Sherman and Cohen, 2006 ). A large body of literature; however, demonstrates that a class of interventions called self-affirmations have benefits across threatening situations; affirmations can decrease stress, increase well being, improve academic performance and make people more open to behavior change [for a review, see Cohen and Sherman (2014) ]. Self-affirmations are acts that affirm one’s self-worth, often by having individuals reflect on core values, which may give individuals a broader view of the self. This in turn can allow individuals to move beyond specific threats to self-integrity or self-competence ( Steele, 1988 ; Cohen and Sherman, 2014 ).

Effects associated with self-affirmation interventions often occur without explicit awareness ( Sherman et al ., 2009 ). This lack of awareness makes it difficult for individuals to introspect on their experience and makes it difficult for researchers to examine specific underlying mechanisms that lead from the affirmation experience to behavioral change. Neuroimaging methods offer one way to examine a set of processes underlying self-affirmation interventions at the point of actual affirmation exposure, without the need for individuals to reflect on their experience ( Falk et al ., 2015 ); however, the neural mechanisms that underpin acts of self-affirmation have not been studied ( Cohen and Sherman, 2014 ). Understanding the underlying neural mechanisms associated with self-affirmation will help to further expand our theoretical understanding of the processes at play during self-affirmation and may contribute to the development of more effective interventions. Thus, our first research question centers on the neurocognitive processes associated with the act of self-affirmation. Furthermore, the core brain systems involved in self-related processing and reward, that we hypothesize to be involved in affirmation, overlap with past studies of temporal orientation[(i.e. considering events in the past and future; ( D’Argembeau et al ., 2008 , 2010 )]. Thus, our second research question focuses on whether the neural pathways to self-affirmation might be amplified in conjunction with specific temporal orientations.

Potential pathways to self-affirmation

One account of why self-affirmations are successful is attributed to their ability to broaden a person’s overall perspective and reduce the effect of negative emotions ( Sherman, 2013 ; Cohen and Sherman, 2014 ). For example, researchers have suggested that self-affirmations remind individuals of psychosocial resources that extend beyond a specific threat, which allows them to focus on sources of positive self-worth that transcends the threat. This in turn is thought to reduce reactivity to the threat and protect overall psychological wellbeing ( Koole et al ., 1999 ; Cohen et al. , 2009 ; Cook et al. , 2012 ; Sherman et al ., 2013 ).

Such effects might arise through several different pathways. First, affirmations may increase focus on sources of positive value to individuals. Self-affirmation interventions often rely on having participants reflect on personal core values and rewarding experiences. This pathway would engage neural mechanisms associated with reward and positive valuation. A recent meta-analysis demonstrates that brain regions most prominently involved in reward and positive valuation includes the ventral striatum (VS) and ventral medial prefrontal cortex (VMPFC; Bartra et al. , 2013 ).

Related to the pathway described earlier, affirmations could also work by focusing people on sources of positive self-worth, such as personal successes. This may also involve specific reflection on personal attributes outside of the threat (Sherman and Hartson, 2011; Sherman, 2013 ). Meta-analyses across a variety of tasks find that self-related processing is most often associated with increased activity in the medial prefrontal cortex (MPFC) and posterior cingulate cortex (PCC; Northoff et al ., 2006 ; Denny et al. , 2012 ). Thus, if self-affirmations succeed due to a boost in self-related processing prior to threat exposure, activity in the MPFC and PCC should increase during affirmation.

Furthermore, self-affirmations may allow for more efficient use of psychological resources needed to deal with the incoming threat ( Sherman, 2013 ). This has been demonstrated in studies that examine the success of self-affirmation interventions in counteracting manipulations that reduce available cognitive and psychological resources [e.g. cognitive load and ego-depletion manipulations; (Vohs and Faber, 2007; Schmeichel and Vohs, 2009; Burson et al ., 2012 ; Logel and Cohen, 2012)]. Although these studies find evidence that affirmation interventions can reduce threat, it is unclear which psychological resources are actually involved in this process. One possible source of regulatory resources include the ventrolateral prefrontal cortex (VLPFC) and anterior cingulate cortex (ACC), which have been implicated in regulation of emotion and facilitating difficult choices (Oschner et al ., 2004; Marsh, 2007; Wager et al ., 2008). Self-affirmations may work by priming these regions to regulate emotions.

Affirmation and temporal orientation

Activity within several of our key self-related processing and reward regions of interest (ROIs) changes with manipulations of temporal focus. Although self-affirmation interventions have been successfully carried out using manipulations that focus both on past experiences as well as future goals [for a review, see McQueen and Klein (2006) ], temporal orientation has not been a core focus of affirmation research. Given the overlap between brain systems hypothesized to support affirmation effects and to support temporal orientation effects; however, we examined whether neural responses in brain systems associated with successful self-affirmation might change with or be reinforced by temporal focus.

For example, it has been found that imagining future personally relevant, emotionally positive and rewarding events is associated with changes in VMPFC, striatum, MPFC and PCC ( D’Argembeau et al ., 2008 , 2010 ; Benoit et al. , 2011 , 2014 ). Increased activity in the MPFC has also been shown to positively correlate with imagining positive ( vs negative) future episodes ( D’Argembeau et al ., 2008 ) and such activation is further associated with projected reward value of the imagined future ( Benoit et al ., 2011 , 2014 ). In addition, a recent meta-analysis found that increased activity in the MPFC and PCC, among other regions, was associated with thinking about hypothetical (e.g. future) compared with past episodes ( Benoit and Schacter, 2015 ). Furthermore, another recent meta-analysis examining neural correlates associated with personal goals, future thinking and mind wandering found that the MPFC is consistently activated in all three domains ( Stawarczyk and D’Argembeau, 2015 ). These studies support the idea that mentally simulating future events, especially those relevant to personal goals, involves key regions hypothesized to be involved in self-affirmation interventions, including the VMPFC, MPFC and PCC. Thus, if both future-oriented thought and self-affirmation rely on similar neural mechanisms, they may mutually reinforce one another.

Importantly, these differences are not limited to neural activity. For example participants have better memory recall when encoding new information coupled with imagined scenarios that plan for the future, in comparison to remembering past events or events that are considered without a time relationship ( Klein et al. , 2010 ). In addition, mental simulations focusing on future events have been shown to benefit goal planning and one’s psychological wellbeing (for a review, see Schacter, 2012 ). Taken together, all of these studies reinforce the hypothesis that engagement of our key ROIs may differ by temporal focus, and that future orientation may reinforce the effects of reflecting on personally relevant core values. Thus, we examined temporal focus as a potential moderator of neural responses in our key ROIs during affirmation.

The current study

In sum, this study aims to elucidate the underlying mechanisms associated with self-affirmation by examining participants’ neural activity during a self-affirmation task specifically designed for functional magnetic resonance imaging (fMRI). We tested the extent to which exposure to self-affirmation produced increases in brain systems associated with positive valuation (VS+VMPFC), self-related processing (MPFC+ PCC), and emotion regulation (rACC+rVLPFC). In addition, we examined whether the neural effects of affirmation are moderated by temporal orientation (past vs future). We validated our fMRI-compatible self-affirmation intervention in relation to its ability to increase receptivity to a subsequent set of health messages designed to reduce sedentary behavior in sedentary adults ( Falk et al ., 2015 ).

Participants

Participants ( n  = 67; self-affirmed = 33; unaffirmed = 28) were adults between the ages of 18–64 (41 females; mean age = 33.42 years, SD = 13.04; 44 White, 12 Black, 3 Asian, 1 Hispanic, 7 Other), recruited as part of a study examining neural correlates of exposure to health messages that encouraged physical activity behavior in sedentary adults. All participants were sedentary (participants self-reported an estimated <195 min of combined walking, moderate or vigorous activity per week at the time of recruitment). This was defined by mean activity on short-form International Physical Activity Questionnaire at the time of recruitment. On average, recruited participants reported 23.5 min/week of activity, SD = 49.5; mean body mass index (BMI) = 27.99, SD = 6.84, indicating that on average participants were in the overweight category. Participants were right-handed, did not suffer from claustrophobia, were not currently taking any psychoactive medications, had normal (or corrected to normal) vision, and did not have metal in their body that was contraindicated for MRI (see Supplementary Materials for additional sample details).

Study design

Participants completed a three-part study (see Figure 1 ). At baseline, participants ranked a list of eight personal values, completed self-report questionnaires and were fitted with an accelerometer to measure physical activity behavior. One week later participants completed an fMRI appointment in which they underwent the fMRI-compatible self-affirmation (or control) intervention. All participants then saw potentially threatening messages encouraging physical activity and the success of the affirmation manipulation was validated based on objectively measured physical activity/sedentary behavior change attributable to self-affirmation in the subsequent month. Additional details on the sample and task session can be found in Falk et al . (2015) ; however, the neural processes associated with the actual affirmation task have not been previously examined.

Study design.

Self-affirmation task

During the initial baseline appointment participants were asked to rank a list of eight values from least to most valued, ‘Please order the following values according to how important they are to you’. The list of eight values included, creativity, relations with family and friends, sense of humor, independence, business or earning money, politics, religious values and spontaneity or living life in the moment. These values were then used in the MRI portion of the self-affirmation task, such that participants in the affirmed condition reflected on their top ranked value and participants in the control condition reflected on their lowest ranked value.

Although there are many approaches to self-affirmation, two of the most prominent approaches ask individuals to write about a highly ranked personal value or to respond to questionnaires containing questions relevant to a highly ranked personal value ( McQueen and Klein, 2006 ; Sherman, 2013 ; Cohen and Sherman, 2014 ). Typically self-affirmation writing tasks instruct affirmed participants to write for a period of time on one of their core values; control groups typically write on a topic that is not valued ( McQueen and Klein, 2006 ; Napper et al. , 2009 ). Similarly, value scales involve the completion of questionnaires that allow participants to express their identification with the core value and why their core value is important to them; control participants complete questionnaires about topics of lower personal value and importance ( Sherman, 2013 ). As in other widely used affirmation manipulations (see McQueen and Klein, 2006 ; Cohen and Sherman, 2015 for reviews), there were some differences in the values most consistently ranked as top and bottom values in this study; however, there is also substantial overlap in values used in the affirmation and control conditions (for distribution, see Table 1 ).

Value rankings

To save time and standardize instructions, participants received task instructions for the affirmation task during the structural scan, directly prior to the task. To start the task preparation, participants were initially instructed during the structural scan to ‘Please think about an experience you had involving [VALUE]’, where [VALUE] was replaced with their assigned value. This was followed by instructions to ‘Try and visualize yourself in the experience and remember as many specific details as possible’. Participants were then prompted with phrases to help keep them prepare for the main affirmation task. Example statements included ‘Think about when the experience occurred’ and ‘Think about how you currently feel about this experience’. Once participants had come up with scenarios relevant to their top (or bottom) ranked value during the structural scan, they completed the main self-affirmation task during functional scanning.

To test the interaction between affirmation and temporal orientation, the main fMRI affirmation task instructed participants on different trials to think about a time when value-relevant scenarios had occurred (past) and when parallel scenarios could occur (future). Participants in both affirmation and control conditions were presented with prompts for scenarios focused on value statements as well as everyday activities (as a within subjects control condition). All participants were presented with the same control (everyday) activity scenarios. Example statements relating to experience of a specific value in the past or future condition are as follows [value = friends and family]: ‘Think about a time in the past when you had fun with family and friends’, ‘Think about a time in the future when you might be having fun with family and friends’. Example everyday statements included: ‘Think about a time in the past when you charged your cell phone’, ‘Think about a time in the future when you might charge your cell phone’. Importantly it should be noted that all statements (value and control) were focused on oneself and not subject to factual knowledge. This was done in order to have the distinction between high and low values pertain more to the importance placed on the topic rather than on topic knowledge. For example, for those who were assigned to think about what we referred to as ‘politics’, the statements were not about politicians but rather how political values might be manifest in one’s life (e.g. ‘Think about a time in the future when you might read about current events; Think about a time in the future when you might be inspired by people taking political action’). The self-affirmation task used a 2×2 block design, (past vs future)×(everyday vs value). Each block consisted of exposure to the scenario prompt for 12 s in which participants thought about the given statement and responded by pressing a button with their index figure each time they thought of a personally relevant example associated with the given statement. Participants were instructed to think about as many examples as they could for each scenario. Ten different scenarios were given for each condition (past value, past everyday, future value and future everyday) for a total of 40 blocks in the task. Value-specific scenarios were created based on reflections one may have when engaging in a self-affirmation writing exercise, whereas everyday scenarios were created to represent common events that occur on a daily basis. Participants saw a fixation cross for 2 and 12 (every fifth trial) s between each block.

Validation of the fMRI self-affirmation intervention

Following their randomly assigned affirmation or control intervention, all participants were exposed to the same health messages encouraging increased physical activity and decreased sedentary behavior. The success of the affirmation intervention was validated using behavior change effects attributable to the experimental manipulation of self-affirmation. More specifically, aggregate measures of sedentary behavior were created measuring pre and post intervention activity captured for 1 week prior and one month following the intervention using triaxial accelerometers, and compared by condition. For further details on the health messaging task and accelerometer data collection and analysis, (see Falk et al ., 2015 ).

fMRI data acquisition and data analysis

Imaging data were acquired using a 3 Tesla GE Signa MRI scanner. One functional run was acquired for each participant (323 volumes total 1 ). Functional images were recorded using a reverse spiral sequence (TR = 2000 ms, TE = 30 ms, flip angle = 90°, 43 axial slices, FOV = 220 mm, slice thickness = 3 mm; voxel size = 3.44×3.44×3.0 mm). We also acquired in-plane T1-weighted images (43 slices; slice thickness = 3 mm; voxel size = 0.86×0.86×3.0 mm) and high-resolution T1-weighted images (SPGR; 124 slices; slice thickness = 1.02×1.02×1.2 mm) for use in coregistration and normalization.

Functional data were pre-processed and analyzed using Statistical Parametric Mapping (SPM8, Wellcome Department of Cognitive Neurology, Institute of Neurology, London, UK; please see supplementary Materials for details of pre-processing stream). Data were modeled using the general linear model as implemented in SPM8. Four trial types were modeled: past value scenarios, future value scenarios, past everyday scenarios, future everyday scenarios; fixation trials were not modeled and constituted an implicit baseline. The six rigid-body translation and rotation parameters derived from spatial realignment were also included as nuisance regressors. Data were high-pass filtered with a cutoff of 128 s.

ROI analysis

To test the balance of activity within brain networks involved in positive valuation and reward (VS+VMPFC), self-related processing (MPFC+PCC) and regulating emotions (rACC+rVLPFC), we first conducted a priori defined ROI analyses on each network of interest independently. Percent signal change scores were extracted from each combined network ROI contrasting the value > everyday scenarios; past value > past everyday scenarios; and future value > future everyday scenarios for each participant (see Supplementary Materials for ROI definitions and analysis details).

To investigate neural processes associated with self-affirmation that extended beyond our main ROI analyses, we subsequently conducted whole brain analyses examining differences between the affirmed and control participants for each of our main target contrasts: value > everyday scenarios; past value > past everyday scenarios; and future value > future everyday scenarios. All analyses are reported with a threshold of P  = 0.005, K  = 35, corrected for multiple comparisons based on a Monte Carlo simulation using AlphaSim ( Ward, 2000 ). Furthermore, based on a priori hypotheses linking valuation activity (VS+VMPFC) to self-affirmation processes, the relatively small size of VS, and positive results from a priori planned ROI analyses, additional analyses were run using a threshold of ( P  = 0.005, K  = 19), corrected for multiple comparisons based on a Monte Carlo simulation for the VS+VMPFC mask (949 total voxels) in order to maintain an appropriate balance of type I and II error risk, given the exploratory nature of the whole-brain analysis ( Lieberman and Cunningham, 2009 ).

Effects of affirmation: ROI analysis

Main effects of affirmation.

First, we examined whether activity in our a priori hypothesized ROIs associated with valuation (VS+VMPFC), self-related processing (MPFC+PCC), and emotion regulation (rACC+rVLPFC) were differentially activated for those in the affirmed vs control group as they reflected on value > everyday scenarios. Overall, affirmed participants displayed significantly greater activity in the valuation/reward network ( M  = 0.102) vs control participants ( M  = 0.012) when exposed to value vs everyday scenarios [ t (57)=2.43, P  = 0.018]. Activity in the self-processing network while viewing value vs everyday scenarios was not significantly different for those in the affirmed vs control group, when averaging across temporal orientations [ t (57) = 0.88, P  = 0.382]. Activity in the emotion regulation network also did not differ between affirmed and control groups when averaging across temporal orientations [ t (57) = 0.62, P  = 0.540]. All ROI results are summarized in Table 2 .

ROI analysis summary for the contrasts value > control, value future > control future, and past value > past control

Second, we tested whether affirmation effects differed by temporal orientation within our key ROIs (see Table 2 ). On average, affirmed participants displayed significantly greater activity in the valuation network ( M  = 0.133) than control participants ( M  = −0.029) when viewing future-oriented value scenarios vs future-oriented everyday scenarios [ t (57) = 3.26, P  = 0.002]; the difference between responses to future- and past-oriented value scenarios was also significantly different between affirmed and control participants [ t (57) = 3.09, P  = 0.003]. Additionally, affirmed participants displayed significantly greater activity in the self-processing network ( M  = 0.100) than control participants ( M  = 0.032) when viewing future-oriented value scenarios vs future-oriented everyday scenarios [ t (57) = 2.50, P  = 0.015]; the difference between responses to future- and past-oriented value scenarios was also significantly different between affirmed and control participants [ t (57) = 3.48, P  = 0.001]. Participants in the affirmation and control conditions did not differ in their activity in the emotion regulation network when reflecting on future-oriented value and everyday scenarios [ t (57) = 1.30, P  = 0.200]; however, the difference between responses to future- and past-oriented value scenarios was significantly different between affirmed and control participants [ t (57) = 2.39, P  = 0.02].

Next, we examined whether affirmation effects differed by past orientation within our key ROIs. No significant differences were observed between those in the affirmation vs control condition for activity in regions associated with valuation [ t (57) = 0.34, P  = 0.738], self-related processing [ t (57) = −0.97, P  = 0.337] or emotion regulation [ t (57) = 1.77, P  = 0.540] when reflecting on past-oriented value v s everyday scenarios.

Finally, within the affirmation group paired samples t -tests were run to examine whether neural activity within our hypothesized ROIs were differently activated depending on temporal orientation (past vs future). Neural activity within the valuation network (VS+VMPFC) was significantly greater when viewing future-oriented value scenarios ( M  = 0.108) compared with viewing past-oriented value scenarios ( M  = 0.003), t (29) = 3.83, P  < 0.001. Similarly, neural activity with our self-processing network (MPFC+PCC) was also significantly greater when viewing future-oriented value scenarios ( M  = 0.114) compared with viewing past-oriented value scenarios ( M  = 0.044), t (29) = 2.79, P  = 0.009. Finally, neural activity within our emotion regulation network (rACC+rVLPFC) was not significantly different when viewing future-oriented value scenarios ( M = 0.056) compared with viewing past-oriented value scenarios ( M  = 0.025), t (29) = 1.65, P  = 0.111.

Whole brain analysis

Following our hypothesis-driven ROI analyses, we ran a series of exploratory whole brain analyses that examined differences in neural activity between the affirmed and control groups for key contrasts of interest to explore regions outside of those covered by our ROI analyses. Results of the whole brain contrast of value > everyday scenarios did not yield significant results; future value > future everyday scenarios are reported in Table 3 , Figure 2 ; past value > past everyday scenarios did not yield significant results; and future > past value scenarios are reported in Table 4 . Significant results from the whole brain analysis reinforce effects observed in the ROI analyses. We observed increased activity within VMPFC and VS when affirmed (relative to control) participants reflected on future-oriented (but not past-oriented) value scenarios highlighting the role of activity within the valuation system, particularly during prospection.

Whole brain analysis comparing the contrast (future value > future control scenarios) for the affirmed group subtracted from the control group ( P  = 0.005, K  = 35)

a Results based on cluster correction for multiple comparisons using the VS+VMPFC mask ( P  = 0.005, K  = 19).

Whole brain analysis comparing the contrast (future value > future control scenarios) for the affirmed group > control group.

Whole brain analysis comparing the contrast (future value > past value scenarios) for the affirmed > control group ( P  = 0.005, K  = 35)

Neural activity during affirmation and subsequent behavior change

Validating the downstream effect of our affirmation manipulation on behavior change following exposure to health messages, participants in the self-affirmation condition showed steeper declines in their levels of sedentary behavior over time compared with control participants, P  = 0.008 ( Falk et al ., 2015 ). Given that the effects of affirmation within the brain during the affirmation task were strongest in our hypothesized valuation and self-processing regions, we next examined whether this activity was related to target behavior change. Increased activity in the VS + VMPFC ( Figure 3 ) and MPFC+PCC ROIs during value > everyday scenarios were associated with decreased average post-intervention sedentary behavior, controlling for age, gender, education, BMI and pre-intervention sedentary behavior [β = −0.26, t (33) = −2.27, P  = 0.030; β = −0.27, t (33) = −2.15, P  = 0.039, respectively]. Next, a follow up analysis was run examining temporal orientation differences. Results indicate that increased neural activity in the valuation network during future value vs future everyday scenarios was marginally associated [β = − 0.22, t (33) = −1.97, P  = 0.057] and the self-processing network was significantly associated [β = −0.25, t (33) = −2.39, P  = 0.023] with decreased sedentary behavior following the affirmation intervention, controlling for age, gender, BMI and pre-intervention sedentary behavior. No significant results were found for past-oriented scenarios, P  > 0.05.

Scatter plot of the residualized percent signal change activity in the valuation network (VS+VMPFC) ROI from the contrast (value > control scenarios) predicting post intervention sedentary behavior, controlling for age, gender, education, BMI and pre intervention sedentary behavior.

Finally, we tested the indirect relationship between group assignment (affirmation vs control) and changes in one’s sedentary behavior (post–pre-intervention) through neural activity in valuation and self-processing systems. Significant indirect effects were found for both the valuation and self-processing ROIs [average causal mediation effect (ACME); B  = −0.07, CI = (−0.13, −0.02), P  = 0.01; B  = −0.03, CI = (−0.07, −0.00), P  = 0.04; respectively], such that those in the affirmed condition displayed greater activity in valuation and self-processing networks relative to those in the control condition; in turn participants who displayed greater activation in the valuation and self-processing networks also displayed significantly greater decreases in sedentary behavior following the affirmation intervention, controlling for age, gender, years educated and BMI. 2

Results from this study provide initial evidence of neural processes associated with the act of self-affirmation. First, our hypotheses regarding the relationship between affirmation and neural reward pathways were supported. ROI analyses revealed that affirmed relative to control participants showed significantly greater activity in the hypothesized positive valuation regions (VS+VMPFC), and that this effect was driven by affirmations focusing on future rather than past experiences. In addition, increased activity in reward/valuation regions during self-affirmation was associated with decreases in sedentary behavior following the affirmation intervention. Furthermore, we observed a significant indirect effect, such that those in the affirmed condition displayed greater activity in the valuation network, which was associated with greater change in sedentary behavior following the affirmation intervention.

Thus, our results are consistent with the hypothesis that systems associated with positive valuation play an important role in successful affirmation and are consistent with the broadened value account of why self-affirmation interventions succeed ( Koole et al ., 1999 ; Cohen et al ., 2009 ; Cook et al ., 2012 ; Sherman et al ., 2013 ). The VS and VMPFC are brain regions that are most commonly associated with the expectation and receipt of positively valued or rewarding outcomes ( Bartra et al ., 2013 ). Importantly, this system encodes not only primary rewards (such as food) but also more abstract rewards ( Bartra et al ., 2013 ), of the type that are called to mind by personally meaningful values in self-affirmation.

In addition, our findings suggest that positive affirmations may have especially strong effects within the reward system in conjunction with future orientation. This finding converges with prior studies demonstrating that increased activity in the VMPFC is associated with imagining positive rather than negative future events ( D’Argembeau et al ., 2008 ) and increases when anticipating future rewards ( Benoit et al ., 2011 , 2014 ). This account is also consistent with a role of the reward system in guiding reinforcement learning and future behavioral decisions through computation of the ‘incentive value of a contemplated behavioral act’ ( McClure et al. , 2003 ; Knutson and Cooper, 2005 ).

Furthermore, although not directly addressed by our data, past research suggests that self-transcending values and goals may be particularly powerful. For example, affirmation of self-transcending values is more powerful in reducing behaviors associated with ego depletion than affirmation of self-enhancing values ( Burson et al. , 2012 ). Our neural data provide a possible link between such behavioral results and research examining neural reward activity in response to prosocial (eudaimonic) vs selfish (hedonic) decisions, which finds that VS activity differentially predicts later mental health outcomes. More specifically, increased activity in the VS in response to potential prosocial rewards, relative to self-focused rewards is associated with later positive outcomes ( Telzer et al. , 2014 ). These findings along with the findings from this study support potential synergy between prospection and value affirmation in eliciting the types of reward response that can prime positive behavior.

Second, we found support for the hypothesis that future-oriented affirmations activated brain regions implicated in self-related processing. In particular, the MPFC is often implicated in reflecting on one’s own preferences, motivations and in the process of self-insight (for a review, see Lieberman, 2010 ). During future-oriented affirmation, affirmed, relative to control, participants displayed significantly greater activity in our MPFC and PCC ROIs. Importantly, MPFC and PCC are consistently implicated in both self-related processing ( Northoff et al ., 2006 ; Denny et al ., 2012 ) and imagining personally relevant future events ( D’Argembeau et al ., 2010 ), as well as remembering past events (for a review, see Schacter, 2012 ). Furthermore, increased activity in the MPFC is associated with imagining positive rather than negative future events ( D’Argembeau et al ., 2008 ) and increases while anticipating future rewards ( Benoit et al ., 2011 , 2014 ). Thus, this data and recent meta-analytic evidence suggests that in addition to a strong role in self-related processing ( Northoff et al ., 2006 ; Denny et al ., 2012 ), the MPFC is more active when thinking about future compared with past episodes ( Benoit and Schacter, 2015 ) and when thinking about personal goals, future thinking, and mind wondering ( Stawarczyk and D’Argembeau, 2015 ). Successful self-affirmation interventions bring together several of these components and our neural data suggest a new way in which these paths may mutually reinforce one another. In other words, we find novel evidence that a future frame may act synergistically with value-based self-affirmations to bolster a sense of self prior to threat exposure. This may occur by calling to mind desired future states or motivations, also consistent with the broadened value account of why self-affirmation interventions succeed.

Finally, this study reports on the successful development of an fMRI-compatible self-affirmation task, which can be used to examine neural mechanisms associated with self-affirmation in other behavioral or theoretical contexts, and combined with other subsequent tasks of interest to affirmation researchers. One strength of this task is that all aspects of the task (including the within subjects control condition and instructions) are identical for affirmed and control participants, differing only in the importance of the focal value to participants. This rule out many confounds related to differing tasks. An additional strength is that our objective behavioral results indicate that the self-affirmation manipulation was successful in decreasing sedentary behavior in at-risk (sedentary) adults, which was mediated by activity in the valuation network during affirmation and by activity in both valuation and self-related processing systems during future-oriented affirmations.

This adds to our understanding of affirmation from both basic science and applied perspectives. The current results (i) highlight novel pathways to affirmation through neural reward and self-processing pathways; and (ii) suggest that these mechanisms may be reinforced or augmented by prospection. It is possible that future-oriented affirmations may be more successful than past-oriented affirmation, though between subjects follow up studies are needed to test this hypothesis. Finally, the creation of a scanner compatible affirmation task opens future research possibilities to explore the neural effects of affirmation in other contexts.

In addition to the primary strengths of the study addressed earlier, it should be noted that each of our primary ROIs serves functions that go beyond those hypothesized in this investigation and thus should be taken as one of several possibilities ( Poldrack, 2006 ). However, in this study the use of a priori hypothesized and theoretically driven ROIs helps reduce problems with reverse inference. Furthermore, there are confines associated with the scanning environment, such that we cannot know the specific scenarios envisioned by each participant in response to our prompts at the time of affirmation exposure, we can only examine neural processing that takes place during that time. Therefore, it is likely that variability in how important the ‘lowest’ ranked value was to participants existed, which may have allowed for affirming benefit to some of those in the control condition, resulting in a conservative test of our hypotheses. In addition, self-affirmation interventions are often confounded with value and content making it difficult to distinguish which aspects of the intervention are driving results. Future neuroimaging studies should attempt to untangle these differences in order to better understand the underlying mechanisms associated with self-affirmation interventions.

This results demonstrate that activity in hypothesized reward/valuation regions (VS+VMPFC ( Bartra et al ., 2013 ) are primary pathways associated with self-affirmation. Furthermore, regions associated with self-related processing (MPFC+PCC) ( Northoff et al ., 2006 ; Denny et al ., 2012 ) and prospection ( D’Argembeau et al ., 2008 , 2010 ) are associated with self-affirmations that are future oriented. These neural correlates of self-affirmation were further associated with objectively measured behavior change, suggesting the external validity of the affirmation task. Taken together, our results highlight ways in which brain systems implicated in positive valuation and self-related processing may be reinforced by prospection and suggest novel insight into the balance of processes supporting affirmation. These results also introduce a task for understanding the underlying mechanisms associated with self-affirmation and hence provide a tool for future studies to examine effects of self-affirmation interventions across a wide range of potential applications and outcomes.

Supplementary Material

Acknowledgements.

We thank Holly Derry, Ian Moore and Michele Demers for assistance in developing intervention materials, and the staff of the University of Michigan fMRI Center for support and assistance with fMRI data acquisition. We thank Angela Fagerlin, Thad Polk, Lawrence An, Kennith Resnicow and the Michigan CECCR for support in realizing this project and Sonya Dal Cin and Sara Konrath for helpful discussions. This research was supported by The Michigan Center of Excellence in Cancer Communication Research/NIH-P50 CA101451 (PI Strecher), a NIH New Innovator Award/1DP2DA03515601 (PI Falk) and NIH/NCI 1R01CA180015-01 (PI Falk). The authors thank Kristin Shumaker, Nicolette Gregor, Alison Sagon for assistance with data collection and Jonathan Mitchell for advice regarding processing of the accelerometer data.

1 Note: For the first six participants (1 control, 5 affirmed due to the randomizer), a slightly longer (2 run) version of the task was used, in which the blocks were 16 s long instead of 12, and the affirmation task was split into two runs of 209 volumes each. These participants were the first to do the study and we initially had longer scan time that included an extra 4 s for each block.

2 Note: In addition to examining changes in sedentary behavior using difference scores, a test of indirect effects was also run that examined post intervention sedentary behavior controlling for pre intervention sedentary behavior [ACME; B  = −0.08, CI = (−0.15, −0.03), P  < 0.01]. Results were consistent for future oriented statements [ACME; B  = −0.04, CI = (−0.09, −0.01), P  = 0.01]; past-oriented statements were not significant [ACME; B  = −0.02, CI = (−0.06, 0.01), P  = 0.23].

Supplementary data

Supplementary data are available at SCAN online.

Conflict of interest . None declared.

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Strengths and Weaknesses of Case Studies

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

Advantages of Case Studies

Intensive Study

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

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

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

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

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

Developing New Research

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

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

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

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

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

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

Contradicting Established Ideas or Theories

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

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

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

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

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

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

Giving New Insight

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

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

Another famous study was the sociological study of Milgram.

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

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

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

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

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

Disadvantages of Case Studies

Inability to Replicate

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

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

Key Term! Hawthorne Effect

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

Researcher Bias

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

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

No Classification

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

Time Intensive

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

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

Possibility of Errors

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

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

Ethical Issues

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

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

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

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

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

Advantages and Disadvantages in Real-Life Studies

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

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

Genie – Advantages

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

Genie – Disadvantages

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

Tylenol – Advantages

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

Tylenol – Disadvantages

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