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Does the Social Functioning Scale reflect real-life social functioning? An experience sampling study in patients with a non-affective psychotic disorder and healthy control individuals
Published online by Cambridge University Press: 23 May 2017
Abstract
The ecological validity of retrospective measures of social functioning is currently unknown in patients with schizophrenia. In the present study, patients with a diagnosis of non-affective psychosis were compared with controls on two measures of social functioning: the Social Functioning Scale (SFS) and daily-life measures collected with the Experience Sampling Methodology (ESM). The associations between both measures were examined in each group of participants to test for the ecological validity of the SFS.
A total of 126 participants with a non-affective psychotic disorder and 109 controls completed the SFS and a 6-day momentary ESM protocol assessing various aspects of social functioning. Multiple linear and multilevel regression analyses were performed to test for group differences in social functioning level and examine associations between the two assessment techniques.
Lower social functioning was observed in patients compared with controls on retrospective and momentary measures. The SFS interpersonal domain (social engagement/withdrawal and interpersonal behaviour dimensions) was associated with the percentage of time spent alone and negative appraisal of social interactions. The SFS activity domain (pro-social and recreational activities dimensions) was negatively associated with time spent in leisure activities.
The SFS showed some degree of ecological validity at assessing broad aspects of social functioning. Low scores on the SFS social engagement/withdrawal and interpersonal behaviour dimensions captured social isolation and social avoidance in daily life, but not lack of interest in socializing. Ecological validity of the SFS activity domain was low. ESM offers a rich alternative to classical assessment techniques of social functioning.
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Footnotes
GROUP Investigators are: Berhooz Alizadeh, Agna A. Bartels-Velthuis, Richard Bruggeman: University of Groningen, Faculty of Medical Sciences, Groningen, The Netherlands; Wiepke Cahn: University Medical Centre Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands; Lieuwe de Haan: Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands; Philippe Delespaul: Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands, Rene S. Kahn: University Medical Centre Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands; Carin J. Meijer: Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands; Inez Myin-Germeys: KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium; Claudia Simons: Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands; Neeltje van Haren: University Medical Centre Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands; Jim van Os: Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands, and King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom; Ruud van Winkel: KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium, and Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands.
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