Gender differences in social functioning in people with schizophrenia in psychosocial rehabilitation services using one-dimensional and multidimensional instruments.

Women with schizophrenia have shown better social and clinical functioning than men in several previous studies. The aim of this study was to assess gender differences in social functioning of people with a diagnosis of schizophrenia who are in psychosocial rehabilitation treatment in Catalonia, using several different one-dimensional and multidimensional measures of clinical and social functioning. Gender differences were found only in several daily life activities, in which women showed better functioning: independence-competence (p = 0.006) and independence-performance (p = 0.017). No other differences between genders were observed. Our results clearly suggest that women with schizophrenia undergoing the rehabilitation process could benefit as do men from psychosocial intervention in order to improve social skills and functioning.

Clinical symptoms and social functioning in schizophrenia.

INTRODUCTION: The aim of the present study was to assess the relationship between social functioning and clinical symptoms in people with schizophrenia, analyzing the influence of both global social functioning and the specific aspects of social functioning, assertiveness and communication skills in the explanation of type of symptoms. MATERIAL AND METHODS: A cross-sectional descriptive study composed of 125 people diagnosed with schizophrenia was performed. Patients were assessed with the Communication Skills Questionnaire (CSQ), the Gambrill and Richey Assertiveness Inventory (GR), the Global Assessment of Functioning Scale (GAF) and the Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale and the Clinical Global Impression scale for Schizophrenia (CGI-S). RESULTS: SOFAS, LSP and GR are related to each of the subscales and total scores of symptoms (p<0.05-0.001). The multiple regressions show that SOFAS and GR explained 59% of the total symptoms. SOFAS and GR, accounting for 65% of the variance, explain positive symptoms. GR and SOFAS explained 34% of the variance of negative symptoms. SOFAS, CSQ and LSP, accounting for 20% of the variance, explain depressive symptoms. SOFAS explained 46% of the variance of cognitive symptoms. CONCLUSIONS: Our findings suggest the usefulness of social functioning assessment in the explanation of clinical symptoms in people with schizophrenia. Moreover, our results point out that not only negative and cognitive symptoms, but also positive and depressive symptoms, should be taken into account in the rehabilitation process in order to improve patient adaptation in the community.

Usability of a Psychotherapeutic Interactive Gaming Tool Used in Facial Emotion Recognition for People with Schizophrenia.

The objective of the study was to test the usability of 'Feeling Master' as a psychotherapeutic interactive gaming tool with LEGO cartoon faces showing the five basic emotions, for the assessment of emotional recognition in people with schizophrenia in comparison with healthy controls, and the relationship between face affect recognition (FER), attributional style, and theory of mind (ToM), which is the ability to understand the potential mental states and intentions of others. Nineteen individuals with schizophrenia (SZ) and 17 healthy control (HC) subjects completed the 'Feeling Master' that includes five basic emotions. To assess social cognition, the group with schizophrenia was evaluated with the Personal and Situational Attribution Questionnaire (IPSAQ) for the assessment of attributional style and the Hinting Task (ToM). Patients with SZ showed significant impairments in emotion recognition and their response time appeared to be slower than the HC in the recognition of each emotion. Taking into account the impairment in the recognition of each emotion, we only found a trend toward significance in error rates on fear recognition. The correlations between correct response on the 'Feeling Master' and the hinting task appeared to be significant in the correlation of surprise and theory of mind. In conclusion, this study demonstrated that the 'Feeling Master' could be useful for the evaluation of FER in people with schizophrenia. These results sustain the notion that impairments in emotion recognition are more prevalent in people with schizophrenia and that these are related with impairment in ToM.

Clinical symptoms and social functioning in schizophrenia.

INTRODUCTION: The aim of the present study was to assess the relationship between social functioning and clinical symptoms in people with schizophrenia, analyzing the influence of both global social functioning and the specific aspects of social functioning, assertiveness and communication skills in the explanation of type of symptoms. MATERIAL AND METHODS: A cross-sectional descriptive study composed of 125 people diagnosed with schizophrenia was performed. Patients were assessed with the Communication Skills Questionnaire (CSQ), the Gambrill and Richey Assertiveness Inventory (GR), the Global Assessment of Functioning Scale (GAF) and the Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale and the Clinical Global Impression scale for Schizophrenia (CGI-S). RESULTS: SOFAS, LSP and GR are related to each of the subscales and total scores of symptoms (p<0.05-0.001). The multiple regressions show that SOFAS and GR explained 59% of the total symptoms. SOFAS and GR, accounting for 65% of the variance, explain positive symptoms. GR and SOFAS explained 34% of the variance of negative symptoms. SOFAS, CSQ and LSP, accounting for 20% of the variance, explain depressive symptoms. SOFAS explained 46% of the variance of cognitive symptoms. CONCLUSIONS: Our findings suggest the usefulness of social functioning assessment in the explanation of clinical symptoms in people with schizophrenia. Moreover, our results point out that not only negative and cognitive symptoms, but also positive and depressive symptoms, should be taken into account in the rehabilitation process in order to improve patient adaptation in the community.

Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents.

AIM: To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. METHODS: Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness (CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. RESULTS: The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. CONCLUSION: The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.

Spanish validation of the social stigma scale: Community Attitudes towards Mental Illness. / Validación al castellano de la escala de estigma social: Community Attitudes towards Mental Illness en población adolescente.

INTRODUCTION: The stigma against people with mental illness is very high. In Spain there are currently no tools to assess this construct. The aim of this study was to validate the Spanish version of the Community Attitudes towards Mental Illness questionnaire in an adolescent population, and determining its internal consistency and temporal stability. Another analysis by gender will be also performed. MATERIAL AND METHODS: A translation and back-translation of the Community Attitudes towards Mental Illness was performed. A total of 150 students of between 14 and 18 years-old were evaluated with this tool in two stages. Internal consistency was tested using Cronbach α; and intraclass correlation coefficient was used for test-retest reliability. Gender-stratified analyses were also performed. RESULTS: The Cronbach α was 0.861 for the first evaluation and 0.909 for the second evaluation. The values of the intraclass correlation coefficient ranged from 0.775 to 0.339 in the item by item analysis, and between 0.88 and 0.81 in the subscales. In the segmentation by gender, it was found that girls scored between 0.797 and 0.863 in the intraclass correlation coefficient, and boys scored between 0.889 and 0.774. CONCLUSIONS: In conclusion, the Community Attitudes towards Mental Illness is a reliable tool for the assessment of social stigma. Although reliable results have been found for boys and girls, our results found some gender differences in the analysis.

Validation of the Communication Skills Questionnaire (CSQ) in people with schizophrenia.

This present study describes the validation of the Communication Skills Questionnaire (CSQ) in people with schizophrenia. A total of 125 clinically stable people in rehabilitation treatment who were diagnosed with schizophrenia were included. For convergent and discriminant validity the following tests were administered; the Gambrill and Richie (GR) Assertiveness Inventory, the Social Functioning Scale (SFS), Life Skills Profile (LSP), Clinical Global Impression scale for schizophrenia (CGI-S) and the Global Assessment of Functioning (GAF) scale. Internal consistency of the CSQ had a Cronbach׳s alpha of 0.96. Test-retest reliability showed coefficients between 0.60 and 0.70. Convergent validity showed significant relations at p<0.0001 for all instruments assessed. None of the subscales used for assessing discriminant validity showed a significant correlation with the CSQ except for the CGI-S depression subscale. The instrument shows good psychometric properties and demonstrates that it is a useful instrument for evaluating communication skills in people with schizophrenia.

Clinical symptoms and social functioning in schizophrenia / Síntomas clínicos y funcionamiento social en la esquizofrenia

Introduction: The aim of the present study was to assess the relationship between social functioning and clinical symptoms in people with schizophrenia, analyzing the influence of both global social functioning and the specific aspects of social functioning, assertiveness and communication skills in the explanation of type of symptoms. Material and methods: A cross-sectional descriptive study composed of 125 people diagnosed with schizophrenia was performed. Patients were assessed with the Communication Skills Questionnaire (CSQ), the Gambrill and Richey Assertiveness Inventory (GR), the Global Assessment of Functioning Scale (GAF) and the Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale and the Clinical Global Impression scale for Schizophrenia (CGI-S). Results: SOFAS, LSP and GR are related to each of the subscales and total scores of symptoms (p<0.05–0.001). The multiple regressions show that SOFAS and GR explained 59% of the total symptoms. SOFAS and GR, accounting for 65% of the variance, explain positive symptoms. GR and SOFAS explained 34% of the variance of negative symptoms. SOFAS, CSQ and LSP, accounting for 20% of the variance, explain depressive symptoms. SOFAS explained 46% of the variance of cognitive symptoms. Conclusions: Our findings suggest the usefulness of social functioning assessment in the explanation of clinical symptoms in people with schizophrenia. Moreover, our results point out that not only negative and cognitive symptoms, but also positive and depressive symptoms, should be taken into account in the rehabilitation process in order to improve patient adaptation in the community. (AU)

Introducción: El objetivo del presente estudio fue evaluar la relación entre el funcionamiento social y los síntomas en las personas esquizofrénicas, analizando la influencia del funcionamiento social global y los aspectos específicos del funcionamiento social, la asertividad y las competencias de comunicación en la explicación del tipo de síntomas. Material y métodos: Se realizó un estudio descriptivo transversal integrado por 125 personas con diagnóstico de esquizofrenia. Se evaluó a los pacientes utilizando Communication Skills Questionnaire (CSQ), Gambrill and Richey Assertiveness Inventory (GR), Global Assessment of Functioning Scale (GAF) y Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale y Clinical Global Impression scale for Schizophrenia (CGI-S). Resultados: SOFAS, LSP y GR están relacionadas con cada una de las sub-escalas y puntuaciones totales de los síntomas (p<0,05-0,001). Las regresiones múltiples muestran que SOFAS y GR justifican el 59% de los síntomas totales. SOFAS y GR, que representan el 65% de la varianza, explican los síntomas positivos. GR y SOFAS justificaron el 34% de la varianza de síntomas negativos. SOFAS, CSQ y LSP, que representaron el 20% de la varianza, justificaron los síntomas depresivos. SOFAS justificó el 46% de la varianza de los síntomas cognitivos. Conclusiones: Nuestros hallazgos sugieren la utilidad de la evaluación del funcionamiento social para explicar los síntomas clínicos de las personas esquizofrénicas. Además, nuestros resultados apuntan que, no solo deberían considerarse en el proceso de rehabilitación los síntomas negativos y cognitivos, sino también los síntomas positivos y depresivos, a fin de mejorar la adaptación del paciente dentro de la comunidad. (AU)

Validación al castellano de la escala de estigma social: community Attitudes towards Mental Illness en población adolescente / Spanish validation of the social stigma scale: Community Attitudes towards Mental Illness

Introducción. El estigma hacia las personas con una enfermedad mental es muy elevado. En España no existen instrumentos actuales para evaluar este constructo. El objetivo del presente estudio es validar la versión española del cuestionario Community Attitudes towards Mental Illness en una población de adolescentes, estudiando la consistencia interna del instrumento, así como la estabilidad temporal. Este último análisis se realizará también por género. Material y métodos. Se llevó a cabo una traducción y retrotraducción del Community Attitudes towards Mental Illness. Se evaluaron con este instrumento un total de 150 alumnos de Enseñanza Secundaria Obligatoria, de entre 14 y 18 años, en 2 momentos. Se analizó la consistencia interna del instrumento mediante el α de Cronbach, y la fiabilidad test-retest con el coeficiente de correlación intraclase. Se realizaron análisis estratificados por género. Resultados. El α de Cronbach fue de 0,861 para la primera evaluación y de 0,909 para la segunda evaluación. Los valores del coeficiente de correlación intraclase oscilan entre 0,775-0,339 en el análisis de ítem por ítem, y entre 0,88-0,81 en las subescalas. En la segmentación por género encontramos que las puntuaciones en el coeficiente de correlación intraclase en el grupo de chicas está entre 0,797-0,863 y en los chicos entre 0,889-0,774. Conclusiones. En conclusión podemos afirmar que el Community Attitudes towards Mental Illness es un instrumento fiable para la evaluación del estigma social. A pesar de resultar fiable de la misma manera para chicos y para chicas, se han encontrado algunas diferencias en el análisis por género (AU)

Introduction. The stigma against people with mental illness is very high. In Spain there are currently no tools to assess this construct. The aim of this study was to validate the Spanish version of the Community Attitudes towards Mental Illness questionnaire in an adolescent population, and determining its internal consistency and temporal stability. Another analysis by gender will be also performed. Material and methods. A translation and back-translation of the Community Attitudes towards Mental Illness was performed. A total of 150 students of between 14 and 18 years-old were evaluated with this tool in two stages. Internal consistency was tested using Cronbach α; and intraclass correlation coefficient was used for test-retest reliability. Gender-stratified analyses were also performed. Results. The Cronbach α was 0.861 for the first evaluation and 0.909 for the second evaluation. The values of the intraclass correlation coefficient ranged from 0.775 to 0.339 in the item by item analysis, and between 0.88 and 0.81 in the subscales. In the segmentation by gender, it was found that girls scored between 0.797 and 0.863 in the intraclass correlation coefficient, and boys scored between 0.889 and 0.774. Conclusions. In conclusion, the Community Attitudes towards Mental Illness is a reliable tool for the assessment of social stigma. Although reliable results have been found for boys and girls, our results found some gender differences in the analysis (AU)

Validación de la versión española del inventario de asertividad Gambrill y Richey en población con diagnóstico de esquizofrenia / Validation of the Spanish version of the inventory of Gambrill and Richey assertiveness in people diagnosed with schizophrenia

Objetivo: Validar la versión española del Cuestionario de Asertividad de Gambrill y Richey en personas con esquizofrenia. Método: La muestra está compuesta por 125 personas con esquizofrenia en tratamiento en uno de los centros de rehabilitación psicosocial que participan en el estudio. Los instrumentos utilizados para valorar la validez discriminante y convergente son: el cuestionario de habilidades de comunicación(CSQ); la Escala de Funcionamiento Social(EFS); el Perfil de Habilidades de la Vida Cotidiana(LSP);la Escala de Impresión Clínica Global (ICG) y la Escala de Funcionamiento Global(GAF). Resultados: La consistencia interna del instrumento muestra un alfa de Cronbach de .935 en la escala total. Los coeficientes de correlación intraclase para valorar la consistencia temporal del instrumento oscilan entre .21 y .78. El instrumento muestra validez convergente con la escala CSQ y con las subescalas de comunicación y aislamiento social (p < .001-.05). Con el resto de subescalas de funcionamiento social muestra validez divergente. Con la CGI muestra validez divergente con la probabilidad de respuesta, sin embargo encontramos que hay validez convergente entre las subescalas de CGI y la subescala de grado de malestar del instrumento (p < .012-.042). Conclusiones: El instrumento muestra unas buenas características psicométricas y parece útil para la valoración de las habilidades sociales en una muestra de personas con esquizofrenia

Objective: To validate the Spanish version of the questionnaire Gambrill and Richey Assertiveness for people with schizophrenia. Method: he sample comprised a total of 125 people with schizophrenia on treatment in one of the psychosocial rehabilitation centers participating in the study. The instruments used to assess convergent and discriminant validity are the Communication Skills Questionnaire (CSQ); the Social Functioning Scale(SFS); the Life Skills Profile(LSP); the Clinical Global Impression Scale(CGI) and the Global Functioning Scale (GAF). Results: Internal consistency of the instrument shows a Cronbach alpha of .935 in the full scale. The intraclass correlation coefficients to assess the instrument's internal consistency ranged between .21 and .78. The instrument shows a convergent validity with CSQ scale and the subscales of communication and social isolation (p < .001-.05). With the rest of social functioning sub-scales shows divergent validity. With the CGI shows divergent validity with the probability of response, and convergent validity between the subscales of CGI and the degree of distress subscale of the instrument (p < .012-.042). Conclusions: The instrument shows good psychometric characteristics and appears useful for assessing social skills in a sample of people with schizophrenia