Psychometric properties of the Personal and Social Performance scale (PSP) among individuals with schizophrenia living in the community
- 995 Downloads
Symptoms and cognitive impairments of schizophrenia affect social integration and functioning. Accurate measurement is essential in evaluating treatment needs and outcomes. The Personal and Social Performance scale (PSP; Morosini et al. Acta Psychiatrica Scandinavica 101(4):323–329, 2000) is a clinical tool assessing social functioning in rehabilitation settings.
One hundred and twenty-nine patient/informant dyads at eight US sites participated in this study. Patients were at least 18 years old, have had schizophrenia/schizoaffective disorder for one year or more, and were currently residing in the community. Informants were at least 21 years old, cared for the patient for at least one month, and had contact at least twice weekly. The PSP, Personal Evaluation of Transitions in Treatment (PETiT), Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions—Severity (CGI-S), and Quality of Life Scale (QLS) tools were completed. Analyses focused on descriptive statistics, item characteristics, reliability, and validity.
Patients were community-dwelling outpatients without severe difficulties. The PSP scores were well correlated with each other and related measures. Socially useful activities and personal and social relationships were the strongest indicators, suggesting separate aspects of functioning. Internal consistency reliability was adequate (α = 0.76). The PSP was sensitive to differences in social functioning by clinical severity.
The PSP suggested scale reliability and validity among outpatients. Future examination should expand validity analyses and evaluate responsiveness.
KeywordsSchizophrenia Validation Social functioning PSP Personal and Social Performance scale
Analysis of variance
Clinical Global Impressions—Severity
Diagnostic and statistical manual of mental disorders, fourth edition
Global Assessment of Functioning scale
Health-related quality of life
Intraclass correlation coefficient
Institutional Review Board
Minimum clinically important difference
Positive and Negative Syndrome Scale
Personal Evaluation of Transitions in Treatment
Personal and Social Performance scale
Quality of Life Scale
Statistical Analysis System
Social and Occupational Functioning Assessment Scale
Skills assessment and definition of goals (translated into English)
This research was sponsored by Wyeth Research, Collegeville, PA. We thank David Strutton, PhD and Arthur S. Zbrozek, MS at Wyeth Research for their support in implementing the study and their helpful comments toward improving this paper. Alan S. Bellack, PhD, ABPP at the University of Maryland and Kim T. Mueser, PhD at New Hampshire-Dartmouth Psychiatric Research Center provided thoughtful review and assistance in the development of a conceptual framework and revision of item content. Jennifer Hanlon, MPH, Sally Mannix, BA, and Meghan Werner, MPP provided project management support throughout the study and Sandra Macker, BS provided statistical programming support. Also, we thank the many staff members who worked on this project at each study site, in particular, José M. Canive, MD, F.R.C.P. and Robin R. Douglas, MA, CCRC at New Mexico VA Healthcare System; Deepak D’Souza, MD and Corie Palazzolo, BA at Connecticut Mental Health Center, Yale University; Robert L. Weisman, DO and Lisa McCartan, MA, CCRC at Strong Ties Community Support Program, University of Rochester Medical Center; Scott Stroup, MD, MPH and Marianne Livingston, LCSW at the University of North Carolina at Chapel Hill; Henry A. Nasrallah, MD and Tracie Northern, MA at Psychiatric Professional Services, Inc., University of Cincinnati Medical Center; Corinne Cather, PhD and Thomas W. Quinlin, BA at North Suffolk Mental Health Association, Freedom Trail Clinic; Irving Belz, MD and Susan Lyngaas, LSW at Tri-County Mental Health Mental Retardation (MHMR) Services; and Saroj Brar, MD and Mira Sugar, RN of Cleveland, OH.
- 1.National Institute of Mental Health (NIMH). (2007). When someone has schizophrenia. Available online at: http://www.nimh.nih.gov/publicat/schizoph.cfm.
- 2.American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders, 4th edition, text revision. Washington, DC: American Psychiatric Press.Google Scholar
- 4.Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51(1), 8–19.PubMedGoogle Scholar
- 5.Regier, D. A., Narrow, W. E., Rae, D. S., Manderscheid, R. W., Locke, B. Z., & Goodwin, F. K. (1993). The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry, 50(2), 85–94.PubMedGoogle Scholar
- 6.World Health Organization (WHO). (2006). Schizophrenia. Home page at: http://www.who.int/mental_health/management/schizophrenia/en/.
- 11.Gaite, L., Vázquez-Barquero, J. L., Borra, C., Ballesteros, J., Schene, A., Welcher, B., et al. (2002). Quality of life in patients with schizophrenia in five European countries: the EPSILON study. Acta Psychiatrica Scandinavica, 105(4), 283–292. doi: 10.1034/j.1600-0447.2002.1169.x.PubMedCrossRefGoogle Scholar
- 13.Kasckow, J. W., Twamley, E., Mulchahey, J. J., Carroll, B., Sabai, M., Strakowski, S. M., et al. (2001). Health-related quality of well-being in chronically hospitalized patients with schizophrenia: comparison with matched outpatients. Psychiatry Research, 103(1), 69–78. doi: 10.1016/S0165-1781(01)00260-8.PubMedCrossRefGoogle Scholar
- 15.Palmer, B. W., Heaton, R. K., Gladsjo, J. A., Evans, J. D., Patterson, T. L., Golshan, S., et al. (2002). Heterogeneity in functional status among older outpatients with schizophrenia: employment history, living situation, and driving. Schizophrenia Research, 55(3), 205–215. doi: 10.1016/S0920-9964(01)00218-3.PubMedCrossRefGoogle Scholar
- 19.Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 101(4), 323–329.PubMedGoogle Scholar
- 20.Davidson, M., Emsley, R., Kramer, M., Ford, L., Pan, G., Lim, P., et al. (2007). Efficacy, safety and early response of paliperidone extended-release tablets (paliperidone ER): results of a 6-week, randomized, placebo-controlled study. Schizophrenia Research, 93(1–3), 117–130. doi: 10.1016/j.schres.2007.03.003.PubMedCrossRefGoogle Scholar
- 22.Marder, S. R., Kramer, M., Ford, L., Eerdekens, E., Lim, P., Eerdekens, M., et al. (2007). Efficacy and safety of paliperidone extended-release tablets: results of a 6-week, randomized, placebo-controlled study. Biological Psychiatry, 62(12), 1363–1370. doi: 10.1016/j.biopsych.2007.01.017.PubMedCrossRefGoogle Scholar
- 26.Rhee, C. G., & Kim, Y. H. (2006). The newer assessment tools for functionings and the Personal and Social Performance Scale in patients with schizophrenia. Korean Journal of Psychopharmacology, 17(2), 128–142.Google Scholar
- 30.Guy, W. (1976). The Clinical Global Impression Scale. In ECDEU assessment manual for psychopharmacology (revised). Rockville, MD: National Institute for Mental Health.Google Scholar
- 31.SAS Institute, Inc. (2002–2003). SAS software, Version 9.1. Cary, NC: SAS Institute, Inc.Google Scholar
- 33.Hays, R. D., & Revicki, D. A. (2005). Reliability and validity, including responsiveness. In P. Fayers & R. D. Hays (Eds.), Assessing quality of life in clinical trials (2nd ed.). New York: Oxford University Press.Google Scholar
- 34.Gagnon, D. D., Adriaenssen, I., Nasrallah, H., & Morosini, P. (2006). Reliability, validity, and sensitivity to change of the Personal and Social Performance Scale in patients with stable schizophrenia. Presented at the Annual Meeting of the American Psychiatric Association, Toronto, Canada, May 2006.Google Scholar