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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

M. Schneider*
Affiliation:
KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
U. Reininghaus
Affiliation:
Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
M. van Nierop
Affiliation:
KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
M. Janssens
Affiliation:
Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
I. Myin-Germeys
Affiliation:
KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
*
*Address for correspondence: M. Schneider, KU Leuven, Department of Neurosciences, Research group Psychiatry, Center for Contextual Psychiatry, Kapucijnenvoer 7 bus 7001, 3000 Leuven, Belgium. (Email: [email protected])

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

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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.

References

Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615623.Google Scholar
Balaji, M, Chatterjee, S, Brennan, B, Rangaswamy, T, Thornicroft, G, Patel, V (2012). Outcomes that matter: a qualitative study with persons with schizophrenia and their primary caregivers in India. Asian Journal of Psychiatry 5, 258265.Google Scholar
Barrantes-Vidal, N, Chun, CA, Myin-Germeys, I, Kwapil, T (2013). Psychometric schizotypy predicts psychotic-like, paranoid, and negative symptoms in daily life. Journal of Abnormal Psychology 122, 10771087.CrossRefGoogle ScholarPubMed
Birchwood, M, Smith, J, Cochrane, R, Wetton, S, Copestake, S (1990). The Social Functioning Scale – the development and validation of a new scale of social-adjustment for use in family intervention programs with schizophrenic patients. British Journal of Psychiatry 157, 853859.Google Scholar
Blanchard, JJ, Kring, AM, Horan, WP, Gur, R (2011). Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophrenia. Schizophrenia Bulletin 37, 291299.CrossRefGoogle Scholar
Blum, LH, Vakhrusheva, J, Saperstein, A, Khan, S, Chang, RW, Hansen, MC, Zemon, V, Kimhy, D (2015). Depressed mood in individuals with schizophrenia: a comparison of retrospective and real-time measures. Psychiatry Research 227, 318323.Google Scholar
Brissos, S, Molodynski, A, Dias, VV, Figueira, ML (2011). The importance of measuring psychosocial functioning in schizophrenia. Annals of General Psychiatry 10, 1–7.CrossRefGoogle ScholarPubMed
Brown, LH, Silvia, PJ, Myin-Germeys, I, Kwapil, TR (2007). When the need to belong goes wrong: the expression of social anhedonia and social anxiety in daily life. Psychological Science 18, 778782.Google Scholar
Burns, T, Patrick, D (2007). Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatrica Scandinavica 116, 403418.Google Scholar
Cieslak, K, Walsh-Messinger, J, Stanford, A, Vaez-Azizi, L, Antonius, D, Harkavy-Friedman, J, Goetz, D, Goetz, RR, Malaspina, D (2015). Olfactory performance segregates effects of anhedonia and anxiety on social function in patients with schizophrenia. Journal of Psychiatry and Neuroscience 40, 387393.Google Scholar
Csikszentmihalyi, M, Larson, R (1992). Validity and reliability of the experience-sampling method. Journal of Nervous and Mental Disease 175, 526536.Google Scholar
Endicott, J, Spitzer, RL, Fleiss, JL, Cohen, J (1976). The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766771.Google Scholar
Gard, DE, Kring, AM, Gard, MG, Horan, WP, Green, MF (2007). Anhedonia in schizophrenia: distinctions between anticipatory and consummatory pleasure. Schizophrenia Research 93, 253260.Google Scholar
G.R.O.U.P. (2011). Evidence that familial liability for psychosis is expressed as differential sensitivity to cannabis: an analysis of patient-sibling and sibling-control pairs. Archives of General Psychiatry 68, 138147.Google Scholar
Hellvin, T, Sundet, K, Vaskinn, A, Simonsen, C, Ueland, T, Andreassen, OA, Melle, I (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology 51, 525533.CrossRefGoogle ScholarPubMed
Jääskeläinen, E, Juola, P, Hirvonen, N, McGrath, JJ, Saha, S, Isohanni, M, Veijola, J, Miettunen, J (2013). A systematic review and meta-analysis of recovery in schizophrenia. Schizophrenia Bulletin 39, 12961306.CrossRefGoogle ScholarPubMed
Janssens, M, Lataster, T, Simons, CJP, Oorschot, M, Lardinois, M, van Os, J, Myin-Germeys, I, GROUP (2012). Emotion recognition in psychosis: no evidence for an association with real world social functioning. Schizophrenia Bulletin 142, 116121.Google Scholar
Käkelä, J, Panula, J, Oinas, E, Hirvonen, N, Jääskeläinen, E, Miettunen, J (2014). Family history of psychosis and social, occupational and global outcome in schizophrenia: a meta-analysis. Acta Psychiatrica Scandinavica 130, 269278.CrossRefGoogle ScholarPubMed
Korver, N, Quee, PJ, Boos, HBM, Simons, CJP, de Haan, L, investigators G (2012). Genetic Risk and Outcome of Psychosis (GROUP), a multi-site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. International Journal of Methods in Psychiatric Research 21, 205221.Google Scholar
Kwapil, TR, Brown, LH, Silvia, PJ, Myin-Germeys, I, Barrantes-Vidal, N (2012). The expression of positive and negative schizotypy in daily life: an experience sampling study. Psychological Medicine 42, 25552566.Google Scholar
Morgan, C, Lappin, J, Heslin, M, Donoghue, K, Lomas, B, Reininghaus, U, Onyejiaka, A, Croudace, T, Jones, PB, Murray, RM, Fearon, P, Doody, GA, Dazzan, P (2014). Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study. Psychological Medicine 44, 27132726.Google Scholar
Myin-Germeys, I, Birchwood, M, Kwapil, T (2011). From environment to therapy in psychosis: a real-world momentary assessment approach. Schizophrenia Bulletin 37, 244247.Google Scholar
Myin-Germeys, I, Oorschot, M, Collip, D, Lataster, J, Delespaul, P, van Os, J (2009). Experience sampling research in psychopathology: opening the black box of daily life. Psychological Medicine 39, 15331547.Google Scholar
Myin-Germeys, I, van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409424.CrossRefGoogle ScholarPubMed
Oorschot, M, Lataster, T, Thewissen, V, Lardinois, M, van Os, J, Delespaul, PAEG, Myin-Germeys, I (2012). Symptomatic remission in psychosis and real-life functioning. British Journal of Psychiatry 201, 215220.CrossRefGoogle ScholarPubMed
Piskulic, D, Addington, J, Auther, A, Cornblatt, BA (2011). Using the global functioning social and role scales in a first-episode sample. Early Intervention in Psychiatry 5, 219223.Google Scholar
Priebe, S (2007). Social outcomes in schizophrenia. British Journal of Psychiatry 191, s15s20.Google Scholar
Reininghaus, U, Depp, CA, Myin-Germeys, I (2015). Ecological interventionist causal models in psychosis: targeting psychological mechanisms in daily life. Schizophrenia Bulletin 42, 264269.Google Scholar
Robinson, DG, Woerner, MG, McMeniman, M, Mendelowitz, A, Bilder, RM (2004). Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. American Journal of Psychiatry 161, 473479.Google Scholar
Silvia, PJ, Kwapil, TR (2011). Aberrant asociality: how individual differences in social anhedonia illuminate the need to belong. Journal of Personality 79, 13151332.Google Scholar
Simes, R (1986). An improved Bonferroni procedure for multiple tests of significance. Biometrika 73, 751754.Google Scholar
StataCorp (2014). Stata Statistical Software: Release 12. StataCorp: College Station, TX.Google Scholar
Vazquez Morejon, AJ, Jimenez Ga-Boveda, R (2000). Social functioning scale: new contributions concerning its psychometric characteristics in a Spanish adaptation. Psychiatry Research 93, 247256.CrossRefGoogle Scholar
Wechsler, D (1997). Wechsler Adult Intelligence Scale – III: Administration and Scoring Manual. Psychological Corporation: San Antonio, TX.Google Scholar
Wykes, T, Steel, C, Everitt, B, Tarrier, N (2008). Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin 34, 523537.Google Scholar
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