METHODOLOGY · LAST UPDATED NOVEMBER 9, 2026

Methodology
how this reflection was built and what it does not claim

This page documents the item bank, the scoring rules, the safety boundaries, and the limitations of MirrorCare. It is written so that a reader — or a clinician — can judge the tool without having to trust the marketing.

1. Purpose and scope

MirrorCare is an educational self-reflection tool for adults aged 18 and over. Its purpose is to help a person organize self-reported family interaction patterns, current impact, and boundary difficulties into a structured description they can act on or bring to a professional.

It is not a diagnostic instrument, a treatment, a risk assessment, or a substitute for clinical judgment. It does not assess whether a parent has narcissistic personality disorder, and it does not measure the presence, severity, or cause of any mental-health condition.

2. How the item bank was developed

The item bank is original. It was written to cover four constructs that recur in the research and clinical literature on narcissistic parenting and family-of-origin adversity:

• Control and entitlement — who decides, who is corrected, whose preferences are treated as facts.
• Emotional invalidation — whether feelings are acknowledged, minimized, rewritten, or punished.
• Role reversal and parentification — whether the child is recruited to manage a parent's emotions, image, or responsibilities.
• Conditional warmth — whether affection is stable or contingent on compliance and performance.

Items were written in plain language, as single statements rather than double-barrelled claims, and answered on a five-point frequency scale (1 = never, 5 = almost always). The deep assessment uses a fixed set of 24 items so that results are comparable across respondents; the free reflection rotates nine items from the same bank.

The items are not copied, adapted, or translated from a copyrighted clinical instrument, and no license is claimed for one.

3. What has not been done

This is the part most commercial quizzes omit. As of the date above, the item bank has not completed:

• expert content validation (a formal panel of clinicians rating item relevance);
• bilingual back-translation or cross-cultural adaptation;
• cognitive interviews with target respondents;
• pilot testing or item-response analysis;
• test-retest reliability;
• structural validity (factor analysis);
• clinical criterion validation against a diagnostic interview or an established instrument.

Public research informs the concepts. It does not validate this instrument, and no institution has endorsed it. We do not describe the tool as validated, clinically proven, or evidence-based in the regulatory sense.

4. Scoring

Items are grouped into three domains: family interaction patterns, current impact, and boundaries and self-regulation. Each domain mean is calculated first (range 1–5), then one overall descriptive mean. The report additionally ranks the specific items a respondent endorsed most often, because two people with the same mean can have materially different profiles.

We have not established measurement error or a minimal clinically important difference. We therefore cannot say whether a difference of 0.4 has clinical meaning; we can only say it is uninterpretable without that data.

All three domains are scored in the same direction: a higher mean means more of the measured difficulty. The boundaries domain is not reverse-scored; a higher boundary score means more difficulty pausing, expressing needs, or protecting yourself.

There are no validated cutoffs. A mean is not a severity grade. We cannot yet determine whether the difference between 3.4 and 3.8 has clinical meaning. Low scores do not prove the absence of harm; high scores do not prove a disorder.

5. Interpretation rules

• Scores describe this answer set, at this time.
• We use the relative ranking of the three domains to organise the reflection. That is a product-design choice, not an empirical claim that relative scores are more valid.
• We have not run a test-retest study, so we cannot say how large a change is meaningful. Treat small differences as uninterpretable until such data exist.
• A result should never be used for medical, legal, custody, or safety decisions.
• The report is rule-generated. It is not a clinician's individual review or a treatment plan.

6. Safety design

A safety screen appears before the assessment, and crisis resources are available on every assessment page and in every report. The screen is not a risk assessment and does not predict danger. Its only job is to put help in front of someone who needs it before they answer questions.

If a respondent reports immediate danger, the product directs them to local emergency services or a crisis line and does not require payment, an account, or a completed assessment to access those resources.

7. GAD-7 on the anxiety page

The anxiety self-check includes the seven items of the Generalized Anxiety Disorder 7-item scale (GAD-7), reproduced without changes to the item wording, alongside 13 contextual prompts that are not part of the scale and do not contribute to the score.

Source: Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine. 2006;166(10):1092–1097. doi:10.1001/archinte.166.10.1092

Where the page displays screening bands (for example, 5, 10, and 15), they follow the source publication's suggested bands and are labeled as screening thresholds, not diagnoses. MirrorCare's interpretation of a GAD-7 score has not been independently validated, and the page does not diagnose an anxiety disorder.

8. Privacy-preserving design

The quick reflection runs in page memory. Deep-assessment answers are transmitted over HTTPS to generate the report. The raw answer array and the report text are not written to the application database; to enforce one report per payment, the service stores a payment identifier and a SHA-256 digest of the answer array.

If email delivery is enabled, the service stores the purchaser's email address and the generated report so the private link can be reopened, and either can be deleted on request. Optional trend history stays in the browser and contains dates and four averages, never item answers. The full account is in the privacy policy.

9. Change log

10. References

• Centers for Disease Control and Prevention. Adverse Childhood Experiences (ACEs). https://www.cdc.gov/aces/
• Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine. 1998;14(4):245–258.
• Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine. 2006;166(10):1092–1097.
• American Psychiatric Association. What is narcissistic personality disorder? psychiatry.org
• World Health Organization. LIVES: First-line support for women experiencing intimate partner violence. who.int

These sources explain constructs and safety principles. They do not validate MirrorCare, and they do not imply endorsement by the authors or institutions.

11. Evidence status

• Content validity: not established.
• Test-retest reliability: not measured.
• Internal end-to-end test: completed (payment → report render → download).
• Independent user study: none yet; a small pilot is planned.
• Clinical validation: none; the tool does not diagnose.
• What does exist: a full sample report built from invented answers, and this methods page.

11. How to cite this page

MirrorCare. Methodology: how this reflection was built, and what it does not claim. Updated November 9, 2026. https://mirrorcare.cc/methodology