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Assessing Social Connectedness Among Persons with Schizophrenia: Psychometric Evaluation of the Perceived Social Connectedness Scale

  • Scott E. WilksEmail author
  • Mary E. Heintz
  • Catherine M. Lemieux
  • Xi Du
Article

Abstract

The purpose of this study was a psychometric evaluation of the 4-item perceived social connectedness (PSC) scale. The study analyzed secondary data from a project that assessed physical, behavioral, and social health characteristics of adults with serious mental illness receiving integrated services at community mental health centers (CMHs). The current sample comprised those diagnosed with schizophrenia attending these CMHs (N = 146). Most participants were African-American males who receive disability benefits with Medicaid as health insurance. The sample self-reported low-to-moderate levels of social connectedness, daily functioning, and symptom severity. Factor analysis of the PSC scale revealed one dimension, accounting for 66% of total variance, with strong item loadings. Reliability coefficients indicated sufficient scale internal consistency. Construct validity was suggested via the PSC scale’s directional, significant convergence with daily functioning and symptom severity. Implications include the application of the PSC scale for this socioeconomically disadvantaged population that customarily lacks meaningful social networks.

Notes

Acknowledgments

Some content on this manuscript was taken, with permission, from a graduate thesis by Mary E. Heintz.

Compliance with Ethical Standards

Ethical guidelines of researchers’ evaluative independence and requisite objectivity throughout the study were followed, as required by the LSU Institutional Review Board.

Conflict of Interest

The authors declare that they have no conflict of interest.

Disclaimer

Data from this study were obtained from a previous research project supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), Grant No. SM-59688, Primary and Behavioral Health Care Integration. The views reported in this manuscript do not represent those of SAMHSA CMHS.

References

  1. 1.
    House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241:540–545.CrossRefGoogle Scholar
  2. 2.
    Wilkinson R, Marmot M. Social Determinants of Health: The Solid Facts, Second Edition. Copenhagen, Denmark: WHO Regional Office for Europe, 2003.Google Scholar
  3. 3.
    Wills TA. Social support and interpersonal relationships. In: MS Clark (Ed). Psychosocial Behavior. Newbury Park, CA: Sage, 1991, pp. 265–289.Google Scholar
  4. 4.
    Berkman LF, Syme SL. Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology. 1979;102(2):186–204.CrossRefGoogle Scholar
  5. 5.
    Brown JL, Sheffield D, Leary MR, et al. Social support and experimental pain. Psychosomatic Medicine. 2003;65(2):276–283.CrossRefGoogle Scholar
  6. 6.
    Kulik JA, Mahler HIM. Emotional support as a moderator of adjustment and compliance after coronary artery bypass surgery: A longitudinal study. Journal of Behavioral Medicine. 1993;16(1):45–64.CrossRefGoogle Scholar
  7. 7.
    Marteau TM, Bloch S, Baum JD. Family life and diabetic control. Journal of Child Psychology & Psychiatry & Allied Disciplines. 1987;28(6):823–833.CrossRefGoogle Scholar
  8. 8.
    Clara IP, Cox BJ, Enns MW, et al. Confirmatory factor analysis of the multidimensional scale of perceived social support in clinically distressed and student samples. Journal of Personality Assessment. 2003;81(3):265–270.CrossRefGoogle Scholar
  9. 9.
    George LK, Blazer DG, Hughes DC, et al. Social support and the outcome of major depression. British Journal of Psychiatry. 1989:154(4):478–485.CrossRefGoogle Scholar
  10. 10.
    Keitner GI, Ryan CE, Miller IW, et al. Role of the family in recovery and major depression. American Journal of Psychiatry. 1995;152(7):1002–1008.CrossRefGoogle Scholar
  11. 11.
    Koelmel E, Hughes AJ, Alschuler KN, et al. Resilience mediates the longitudinal relationships between social support and mental health outcomes in multiple sclerosis. Archives of Physical Medicine and Rehabilitation. 2017;98:1139–1148.CrossRefGoogle Scholar
  12. 12.
    Hammer M. Social supports, social networks, and schizophrenia. Schizophrenia Bulletin. 1981;7(1):45–57.CrossRefGoogle Scholar
  13. 13.
    Cresswell C, Kuipers L, Power M. Social networks and support in long-term psychiatric patients. Psychological Medicine. 1992;22(4):1019–1026.CrossRefGoogle Scholar
  14. 14.
    Crits-Cristoph K. Dimensions of Social Support, Stress and Symptomology Among Chronic Schizophrenics: An Examination of the Buffering Hypothesis [doctoral dissertation]. New York, NY: Fordham University, 1985.Google Scholar
  15. 15.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: Author, 2013.CrossRefGoogle Scholar
  16. 16.
    Wasylenki D, James S, Clark C, et al. Clinical issues in social network therapy for clients with schizophrenia. Community Mental Health Journal. 1992;28(5):427–440.CrossRefGoogle Scholar
  17. 17.
    Beels CC. Social support and schizophrenia. Schizophrenia Bulletin. 1981;7(1):58–72.CrossRefGoogle Scholar
  18. 18.
    O’Connor F. A vulnerability-stress framework for evaluating clinical interventions in schizophrenia. Journal of Nursing Scholarship. 1994;26(3):231–237.CrossRefGoogle Scholar
  19. 19.
    Faccincani C, Mignolli G, Platt S. Service utilization, social support and psychiatric status in a cohort of patients with schizophrenic psychoses: A 7-year follow-up study. Schizophrenia Research. 1990;3(2):139–146.CrossRefGoogle Scholar
  20. 20.
    Rosenick SG, Rosenheck RA. Integrating peer-provided services: A quasi-experimental study of recovery orientation, confidence and empowerment. Psychiatric Services. 2008;59: 1307–1314.CrossRefGoogle Scholar
  21. 21.
    Roessler W. Social support modifies perceived stigmatization in the first years of mental illness: A longitudinal approach. Social Science Medicine. 2006;62:39–49.CrossRefGoogle Scholar
  22. 22.
    Lemieux CM, Richards KN, Hunter DR, et al. Interrelationships among physical health, health-related, and psychosocial characteristics of persons receiving integrated care in community mental health settings. Journal of Social Service Research. 2015;41(5):561–583.CrossRefGoogle Scholar
  23. 23.
    Parks J, Radke AQ, Mazade NA. Measurement of Health Status for People with Serious Mental Illness. Alexandria, VA: National Association of State Mental Health Program Directors, Medical Directors Council, 2008.Google Scholar
  24. 24.
    Nover CH. Mental health in primary care: Perceptions of augmented care for individuals with serious mental illness. Social Work in Health Care. 2013;52:656–668.CrossRefGoogle Scholar
  25. 25.
    Kobau R, Zack MM. Attitudes toward mental illness in adults by mental illness-related factors and chronic disease status: 2007 and 2009 Behavioral Risk Factor Surveillance System. American Journal of Public Health. 2013;103:2078–2089.CrossRefGoogle Scholar
  26. 26.
    Taylor SE. Social support: A review. In: HS Friedman (Ed). Oxford Handbook of Health Psychology. New York, NY: Oxford University Press, 2011, pp. 192–217.Google Scholar
  27. 27.
    Ashida S, Heaney CA. Differential associations of social support and social connectedness with structural features of social networks and the health status of older adults. Journal of Aging and Health. 2008;20(7):872–893.CrossRefGoogle Scholar
  28. 28.
    Cornwell EY, Waite LJ. Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior. 2009;50(1):31–48.CrossRefGoogle Scholar
  29. 29.
    Uchino BN. Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science. 2009;4(3):236–255.CrossRefGoogle Scholar
  30. 30.
    Utz RL, Swenson KL, Caserta M, et al. Feeling lonely versus being alone: Loneliness and social support among recently bereaved persons. The Journals of Gerontology: Series B. 2014;69(1):85–94.CrossRefGoogle Scholar
  31. 31.
    Lemieux CM, Thomas KA, Newransky CM, et al. Correlates of treatment retention among persons with serious mental illness receiving integrated care in a community mental health setting. Journal of Social Service Research. 2018. Available online at https://www.tandfonline.com/doi/full/10.1080/01488376.2018.1457594. Accessed on May 22, 2018.
  32. 32.
    Jerrell JM. Psychometrics of the MHSIP adult consumer survey. Journal of Behavioral Health Services & Research. 2006;33(4):483–488.CrossRefGoogle Scholar
  33. 33.
    Schacht LM. NRI/MHSIP Inpatient Consumer Survey: Results of Pilot Implementation. Alexandria, VA: National Association of State Mental Health Program Directors, 2001.Google Scholar
  34. 34.
    Carpiano R. Toward a neighbourhood resource-based theory of social capital for health: Can Bourdieu and sociology help? Social Science & Medicine. 2006;62(1):165–175.CrossRefGoogle Scholar
  35. 35.
    Carpiano R. Neighbourhood social capital and adult health: An empirical test of a Bourdieu-based model. Health & Place. 2007;13(3):639–655.CrossRefGoogle Scholar
  36. 36.
    Substance Abuse and Mental Health Services Administration [SAMHSA]. NOMs Client-Level Measures for Discretionary Programs Providing Direct Services: Services Tool for Adult Programs. OMB No. 0930–0285, Rockville, MD: Center for Behavioral Health Services, 2011.Google Scholar
  37. 37.
    Heintz ME. Characteristics Associated with Improvements in Health Among Community Mental Health Clients with Thought Disorders Receiving Co-Located Primary Care Services [master’s thesis]. Baton Rouge, LA: Louisiana State University, 2018.Google Scholar
  38. 38.
    Hatcher L. A Step-by-Step Approach to Using the SAS System for Factor Analysis and Structural Equation Modeling. Cary, NC: SAS Institute, 1994.Google Scholar
  39. 39.
    Nunnally JC. Psychometric Theory, Second Edition. New York: McGraw Hill, 1978.Google Scholar
  40. 40.
    Shafer A, Ang R. The Mental Health Statistics Improvement Program (MHSIP) Adult Consumer Satisfaction Survey factor structure and relation to external criteria. Journal of Behavioral Health Services and Research. 2018;19:1–14.Google Scholar
  41. 41.
    Kessler RC, Green JG, Gruber MJ, et al. Screening for serious mental illness in the general population with the K6 screening scale: Results from the WHO world mental health survey initiative. International Journal of Methods in Psychiatric Research. 2010;19:4–22.CrossRefGoogle Scholar
  42. 42.
    Gitlin LN, Winter L, Dennis MP, et al. Assessing perceived change in the well-being of family caregivers: Psychometric properties of the perceived change index and response patterns. American Journal of Alzheimer’s Disease and Other Dementias. 2007;21:304–311.CrossRefGoogle Scholar
  43. 43.
    Wilks SE. Support for Alzheimer’s caregivers: Psychometric evaluation of familial and friend support measures. Research on Social Work Practice. 2009;19:722–729.CrossRefGoogle Scholar
  44. 44.
    Kaiser H. An index of factorial simplicity. Psychometrika. 1974;39:31–36.CrossRefGoogle Scholar
  45. 45.
    Tabachnick BG, Fidell LS. Using Multivariate Statistics, Fifth Edition. New York: Pearson Education, 2007.Google Scholar
  46. 46.
    Stevens JP. Applied Multivariate Statistics for the Social Sciences, Second Edition. Hillsdale, NJ: Lawrence Erlbaum, 1992.Google Scholar
  47. 47.
    Pagano RR. Understanding Statistics in the Behavioral Sciences, Ninth Edition. Belmont, CA: Wadsworth Publishing, 2009.Google Scholar
  48. 48.
    Benton T. An empirical assessment of Guttman’s Lambda 4 reliability coefficient. In: R Millsap, D Bolt, L van der Ark, et al. (Eds). Quantitative Psychology Research: The 78th Annual Meeting of the Psychometric Society. New York: Springer, 2015, pp. 301–310.Google Scholar
  49. 49.
    Garson GD. Reliability Analysis: Split-Half Reliability. 2009. Available online at http://tx.liberal.ntu.edu.tw/~purplewoo/Literature/!DataAnalysis/ReliabilityAnalysis.htm. Accessed on May 13, 2018.
  50. 50.
    IBM. (n.d.). SPSS Statistics Version 25. Available online at https://www.ibm.com/products/spss-statistics. Accessed on May 13, 2018.
  51. 51.
    Shin P, Alvarez C, Sharac J, et al. A Profile of Community Health Center Patients: Implications for Policy. Washington, DC: Kaiser Family Foundation, 2013.Google Scholar
  52. 52.
    Mlinaca ME, Feng MC. Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology. 2016;31:506–516.CrossRefGoogle Scholar
  53. 53.
    Haro JM, Novick D, Suarez D, et al. Remission and relapse in the outpatient care of schizophrenia: Three-year results from the Schizophrenia Outpatient Health Outcomes Study. Journal of Clinical Psychopharmacology. 2006;26(6):571–578.CrossRefGoogle Scholar
  54. 54.
    Harvey PD, Strassing M. Predicting the severity of everyday functional disability in people with schizophrenia. World Psychiatry. 2012;11(2):73–79.CrossRefGoogle Scholar
  55. 55.
    Ellis JL. A standard for test reliability in group research. Behavior Research Methods. 2013;45(1):16–24.CrossRefGoogle Scholar
  56. 56.
    Carlson KD, Herdman AO. Understanding the impact of convergent validity on research results. Organizational Research Methods. 2012;15(1):17–32.CrossRefGoogle Scholar
  57. 57.
    Niemi RG, Carmines EG, McIver JP. The impact of scale length on reliability and validity. Quality and Quantity. 1986;20:371–376.CrossRefGoogle Scholar
  58. 58.
    Glidewell L, Thomas R, MacLennan G, et al. Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires? Two randomised controlled trials. BMC Health Services Research. 2012;12(1):250–258.CrossRefGoogle Scholar
  59. 59.
    Sahlqvist S, Yena S, Bull F, et al. Effect of questionnaire length, personalisation and reminder type on response rate to a complex postal survey: Randomised controlled trial. BMC Medical Research Methodology. 2011;11(1):62–69.CrossRefGoogle Scholar
  60. 60.
    Jeste DV, Maglione JE. Treating older adults with schizophrenia: Challenges and opportunities. Schizophrenia Bulletin. 2013;39(5):966–968.CrossRefGoogle Scholar
  61. 61.
    Molinari V, Merritt S, Mills W, et al. Serious mental illness in Florida nursing homes: Need for training. Gerontology & Geriatrics Education. 2008;29(1):66–83.CrossRefGoogle Scholar
  62. 62.
    Stanghellini G, Ballerini M. Values in persons with schizophrenia. Schizophrenia Bulletin. 2007;33:131–141.CrossRefGoogle Scholar

Copyright information

© National Council for Behavioral Health 2019

Authors and Affiliations

  1. 1.Louisiana State University (LSU) School of Social WorkBaton RougeUSA

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