UCSD Performance-Based Skills Assessment: Development of a New Measure of Everyday Functioning for Severely Mentally Ill Adults

Patterson, Thomas L.; Goldman, Steve; McKibbin, Christine L.; Hughs, Troy; Jeste, Dilip V.

doi:10.1093/oxfordjournals.schbul.a006870

Cited by 677 publications

(542 citation statements)

References 56 publications

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“…Measures included a comprehensive neuropsychological battery, the SLOF, functional capacity assessments the University of California, San Diego performance-based skills assessment (UPSA Patterson et al, 2001a) and the social skills performance assessment (SSPA Patterson et al, 2001b), assessments of psychiatric symptom severity positive and negative syndrome scale (PANSS Kay, 1991); Beck depression inventory (BDI Beck et al, 1996), and a self-rated Quality of Life Scale assessing degree of impairment in work, social life, and home responsibilities on a 10-point Likert scale. In addition, a case manager completed the SLOF.…”

Section: Methodsmentioning

confidence: 99%

“…Participants also completed the wide range achievement test (WRAT Wilkinson, 1993) reading subtest as an estimate of their premorbid intelligence . The UCSD performance-based skills assessment battery (UPSA Patterson et al, 2001a) is designed to directly assess functional capacity among people with severe mental illness. This test measures performance in a number of domains of everyday functioning through the use of props and standardized performance situations.…”

Section: Methodsmentioning

confidence: 99%

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Self-assessment of functional status in schizophrenia

Bowie

Twamley

Anderson

et al. 2007

Journal of Psychiatric Research

247

172

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With new treatments targeting features of schizophrenia associated with functional disability, there is a need to evaluate the validity of ratings of everyday outcomes. It is unknown whether patients can validly self-report on aspects of their functional status, which would be a potentially economical method for obtaining outcome data. In this study, 67 older schizophrenia outpatients provided self-ratings of everyday real-world functioning using the specific levels of functioning scale (SLOF). They were also administered assessments of neuropsychological performance, performance-based measures of functional capacity and social skills, clinical symptoms, and quality of life. Case managers, unaware of other ratings, also generated SLOF ratings. Based on discrepancy scores, participants were categorized as accurate raters (n = 24), underestimators (n = 16), or overestimators (n = 27) of their functional status as compared to case managers' ratings. Patients' self-rated functional status was correlated with their subjective quality of life, but remarkably unassociated with case manager ratings of functional status or their own performance on functional capacity or social skills measures. Case manager ratings, however, were highly correlated with performance on functional capacity and social skills measures. Patients who underestimated their real world performance had better cognitive skills and greater self-rated depression than those who overestimated. Accurate raters demonstrated greater social skills than both overestimators and underestimators, while overestimators were most cognitively and functionally impaired. Accurate ratings of everyday outcomes in schizophrenia may require systematic observation of real world outcomes or performance-based measures, as self-reports were inconsistent with objective information.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Self-assessment of functional status in schizophrenia

Bowie

Twamley

Anderson

et al. 2007

Journal of Psychiatric Research

247

172

View full text Add to dashboard Cite

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“…Cognitive abilities are associated with functional capacity and community outcomes (Evans et al, 2003;Twamley et al, 2002;Patterson et al, 2001;Green and Nuechterlein, 1999;Green, 1996;Green et al, 2000), and may also affect life satisfaction. Poorer cognitive performance and self-reported functional status (e.g., unmarried, lower social functioning, smaller social support network) are correlated with lower subjective QOL (Corrigan and Buican, 1995;Norman et al, 2000;Lehman et al, 1983a).…”

Section: Predictors Of Subjective Qolmentioning

confidence: 99%

“…In the current study, we used an extensive interview measure that evaluates subjective and objective QOL separately (the Quality of Life Interview; Lehman, 1988). Furthermore, unlike previous work, we used a performance-based measure of functional capacity (the UCSD Performance-Based Skills Assessment; Patterson et al, 2001) because many individuals with schizophrenia are not accurate raters of their own community functioning abilities (Bowie et al, 2006). This instrument goes beyond asking about activity participation (i.e., objective QOL) by having the examinee perform tasks necessary for independent living (e.g., grocery shopping, paying a bill, and planning a bus route).…”

Section: The Current Studymentioning

confidence: 99%

“…The UCSD Performance-Based Skills Assessment (UPSA; Patterson et al, 2001), a 30-minute measure using role-play tasks, was used to assess functional capacity in five areas: Recreational Activity Planning (e.g., planning outings); Financial Management (e.g., counting change and writing checks to pay bills); Communication (e.g., using a telephone for emergency and non-emergency purposes); Transportation Planning (e.g., using a public transportation system); and Household Chores (e.g., preparing a shopping list when given a recipe and shopping for items in a mock grocery store). Skills reflect general abilities necessary for independent community living.…”

Section: Functional Capacity Assessment-mentioning

confidence: 99%

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Subjective and objective quality of life in schizophrenia

Narvaez¹,

Twamley²,

McKibbin³

et al. 2008

Schizophrenia Research

226

139

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Objective-Quality of life (QOL) is considered an important outcome in the treatment of schizophrenia, but the determinants of QOL are poorly understood in this population. Furthermore, previous studies have relied on combined measures of subjective QOL (usually defined as life satisfaction) and objective QOL (usually defined as participation in activities and relationships). We examined separately the clinical, functional, and cognitive predictors of subjective and objective QOL in outpatients with schizophrenia. We hypothesized that better subjective QOL would be associated with less severe negative and depressive symptoms, better objective QOL, and greater everyday functioning capacity, and that better objective QOL would be associated with less severe negative and depressive symptoms, better cognitive performance, and greater functional capacity.Method-Participants included 88 outpatients with schizophrenia or schizoaffective disorder who completed a comprehensive series of assessments, including measures of positive, negative, and depressive symptoms; performance-based functional skills; a neuropsychological battery; and an interview measure of subjective and objective QOL.Results-In the context of multiple predictor variables, more severe depressive symptoms and better neuropsychological functioning were independent predictors of worse subjective QOL. More severe negative symptoms predicted worse objective QOL. Functional capacity variables were not associated with subjective or objective QOL.Conclusion-Treatments to improve QOL in schizophrenia should focus on negative symptoms and depressive symptoms.

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From Perception to Functional Outcome in Schizophrenia

Green¹,

Hellemann²,

Horan³

et al. 2012

Arch Gen Psychiatry

348

297

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Context Schizophrenia remains a highly disabling disorder, but the specific determinants and pathways that lead to functional impairment are not well understood. It is not known whether these key determinants of outcome lie on one or multiple pathways. Objective This study evaluated theoretically-based models of pathways to functional outcome starting with early visual perception. The intervening variables were previously established determinants of outcome drawn from two general categories: ability (i.e., social cognition and functional capacity) and beliefs / motivation (i.e., defeatist beliefs, expressive and experiential negative symptoms). We evaluated an integrative model in which these intervening variables formed a single pathway to poor outcome. Design This was a cross-sectional study that applied structural equation modeling to evaluate the relationships among determinants of functional outcome in schizophrenia. Setting Assessments were conducted at a Veterans Administration (VA) Medical Center. Participants One hundred ninety one clinically-stable outpatients with schizophrenia or schizoaffective disorder were recruited from the community. Results A measurement model showed that the latent variables of perception, social cognition, and functional outcome were well-reflected by their indicators. An initial untrimmed structural model with functional capacity, defeatist beliefs, and expressive and experiential negative symptoms had good model fit. A final trimmed model was a single path running from perception to ability to motivational variables to outcome. It was more parsimonious and had better fit indices than the untrimmed model. Further, it could not be improved by adding or dropping connections that would change the single path to multiple paths. The indirect effect from perception to outcome was significant. Conclusions The final structural model was a single pathway running from perception to ability to beliefs / motivation to outcome. Hence, both ability and motivation appear to be needed for community functioning, and can be modeled effectively on the same pathway.

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UCSD Performance-Based Skills Assessment: Development of a New Measure of Everyday Functioning for Severely Mentally Ill Adults

Cited by 677 publications

References 56 publications

Self-assessment of functional status in schizophrenia

Self-assessment of functional status in schizophrenia

Subjective and objective quality of life in schizophrenia

From Perception to Functional Outcome in Schizophrenia

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