Running out of adjectives

One of the problems that we have when trying to measure things like trauma or depression is that we run out of adjectives very fast.

For example, we might ask:
How upset were you that your computer crashed?
- Very upset.
How upset were you that your dog died?
- Very, very upset.
How upset were you that your spouse and children were killed in the volcano?
- Very, very, very upset.
How upset are you that a large asteroid is going to wipe out all of life on earth next week?

Banyard and Shevlin wrote a short paper a few years ago which reported high levels of psychological distress in supporters of football (soccer) teams that were demoted. I've always suspected that this effect is simply one of people using extremes - they were very, very upset that that goal was disallowed.

My favorite blog written by an anonymous ER doctor is WhiteCoatRants, and in this post he describes a similar problem when trying to get a patient to describe how much pain they are in:

The one [description] I use is that 10 out of 10 pain is pain that is bad enough that you are “on the ground wailing and pounding your fists on the floor because the pain is so bad.” This gives me an objective way to follow up the subjective ratings of “10.”

“So using my description, how bad is your pain from 1-10?”
The patient, sitting on the bed munching Doritos and watching TV, says “Oh, it’s definitely a 10.”
I reply, “That’s funny, because you’re still sitting on the bed, you’re not pounding your fists on the floor, and you’re not wailing. In fact, you appear to be rather comfortable.”
The usual response?

“Oh, then it’s a nine and a half.”

Some interesting discussion about this problem followed.