Skills Performance Assessment Research Articles

Functioning in Middle Aged and Older Patients With Schizophrenia and Depressive Symptoms: Relationship to Psychopathology

Depressive symptoms are common in middle aged and older patients with schizophrenia. The authors hypothesized that worse functioning in these patients would be associated with worse psychopathology. Outpatients with schizophrenia were > or =40 years old with subsyndromal depression and Hamilton Depression Rating Scale Scores of > or =8. Exclusions were dementia, two months of either mania or major depression or 1 month active substance abuse/dependence. The authors administered performance based functional assessments, the Positive and Negative Syndrome Scale of Schizophrenia [PANSS], and Calgary Depression Rating Scale. PANSS (-) scores were negatively correlated with the UCSD Performance Skills Based Assessment, Social Skills Performance Assessment and Medication Management Ability Assessment total error (MMAA) scores. Digit symbol scores served as a moderator of the relationship between MMAA and PANSS (-) scores. Negative symptoms were associated with functioning. The relationship between negative symptoms and medication errors seem to weaken in subjects with quicker processing speed.

Multivariate predictors of social skills performance in middle-aged and older out-patients with schizophrenia spectrum disorders

Cognitive impairment and negative symptoms are two of the primary features of schizophrenia associated with poor social functioning. We examined the relationships between clinical characteristics, specific cognitive abilities and social skills performance in middle-aged and older out-patients with schizophrenia and normal comparison subjects. One hundred and ninety-four middle-aged and older schizophrenia out-patients and 60 normal comparison subjects were administered a standardized, performance-based measure of social skills using role-plays of various social situations [Social Skills Performance Assessment (SSPA)] and measures of current level of social contact (the Lehman Quality of Life Interview), psychiatric symptom severity [the Positive and Negative Syndrome Scale (PANSS) and the Hamilton Depression Rating Scale (HAMD)], insight [the Birchwood Insight Scale (IS)] and cognitive functioning [the Mattis Dementia Rating Scale (DRS)]. Patients demonstrated worse social skills compared with normal subjects. Better performance on the SSPA was associated with having less severe positive and negative symptoms, fewer social contacts, and better attention, initiation/freedom from perseveration, visuospatial ability, abstraction ability and memory. After controlling for demographic, clinical and insight-related factors, abstraction ability was the strongest predictor of social skills performance, followed by frequency of social contact. Social functioning (as measured through direct observation of social skills performance) was related to cognitive ability in out-patients with schizophrenia. Addressing such cognitive impairment may help to improve social functioning and result in greater overall quality of life.

Suicidality in middle aged and older patients with schizophrenia and depressive symptoms: relationship to functioning and Quality of Life

Suicidality is a health concern in patients with schizophrenia. We examined the hypotheses: (1) Middle aged and older patients with schizophrenia, depressive symptoms and suicidality would exhibit worse quality of life and worse everyday functioning, social skills and medication management relative to those without suicidality; (2) higher levels of suicidality would be significantly associated with worse functioning, worse quality of life and older age. We examined 146 outpatients with schizophrenia and depression. Patients were at least 40 years old and were diagnosed with schizophrenia or schizoaffective disorder and had two or more depressive symptoms based on DSM-IV criteria for major depression. We assessed suicidality with the Intersept Suicide Scale (ISS) and functioning with the UCSD Performance-based Skills Assessment (UPSA), Social Skills Performance Assessment (SSPA), and Medication Management Ability Assessment (MMAA). Quality of life was assessed with the Heinrichs Quality of Life Scale (QLS). The mean age of patients was 52.4+ 6.9 years. Subjects with suicidality (ISS scores > 0) had lower QLS scores compared to those without suicidality. However, there were no differences in UPSA, SSPA nor MMAA scores between the two groups. In addition, based on Spearman's rho correlational analysis, there were significant associations of QLS scores with ISS scores (r = - 0.236) and with MMAA "total errors" scores (r = 0.174). Logistic regression demonstrated that only QLS scores predicted suicidality. Thirty-six percent of our sample had at least mild degrees of suicidality. Lower quality of life appears to be an important predictor of suicidality.

What is this thing called motivational interviewing?

What is this thing called motivational interviewing?

Reliability and validity of a performance-based measure of skills for communicating with doctors for older people with serious mental illness

Background: Older people with serious mental illnesses (SMI) have high rates of medical comorbidity and impaired social skills, including basic communication skills that are imperative for medical encounters.Aim: To examine two role-plays developed to evaluate communication in a health care visit.Method: A total of 152 people over age 50 with SMI were rated on two standardized medical visit role-plays.Results: This assessment had excellent inter-rater reliability and test-retest reliability. Performance was not related to gender or age, although participants with a mood disorder had better social skill performance than those with schizophrenia or schizoaffective disorder. Performance was strongly related to the Social Skills Performance Assessment (SSPA: Patterson et al., ), designed to assess basic communication skills in older people with SMI. Performance was also correlated with self-care skills, social functioning, number of medical visits within the past six months, and informant rating of the effect of physical condition on functioning.Conclusions: This assessment demonstrates acceptable psychometric properties, including reliability and convergent validity, and may be a useful tool to assess basic communication skills for discussing health care concerns.Declaration of interest: Participants in this study were participating in NIMH R01 MH62324: “Rehabilitation and Health Care for Elderly with SMI” (Bartels, PI).

Important Steps in the Development of Cognitive-Enhancing Drugs in Schizophrenia

Important Steps in the Development of Cognitive-Enhancing Drugs in Schizophrenia

Correlations of functional capacity and neuropsychological performance in older patients with schizophrenia: Evidence for specificity of relationships?

Background Neuropsychological (NP) performance is a consistent correlate of everyday functioning in schizophrenia, but it is unclear whether relationships between individual NP ability areas and domains of everyday functioning are general or specific. Assessments of real-world everyday functioning may be influenced by environmental and social factors (e.g., social security, disability status, opportunities and restrictions in living situations). This study examined the specificity of the relationships between different NP abilities and performance-based measures of social and living skills. Methods 181 ambulatory older (age> 50) patients with schizophrenia were examined with NP tests measuring episodic and working memory, executive functioning, verbal fluency, and processing speed. All subjects performed tasks examining social (Social Skills Performance Assessment: SSPA) and everyday living (UCSD Performance Based Skills Assessment: UPSA) skills. Results Using canonical analysis, the NP variables were used to predict the functional capacity measures. The analysis found that 37% of the variance in the functional capacity and NP measures was shared, X 2 (54) = 106.29, p < .001. Two canonical roots described the cognitive variables and the roots were differentially associated with everyday living and social skills. The root loading on processing speed, episodic memory, and executive functions were associated with UPSA scores, while the root loading on working and episodic memory and verbal fluency were associated most strongly with social competence. Implications Social and everyday living skills deficits in patients with schizophrenia may reflect generally independent domains of functional outcome, linked through cognitive performance. The data suggest that somewhat different cognitive processes are associated with these two domains of functional capacity, although there appears to be some overlap, which may be due to the nature of the NP tests employed.

Finding the standard degrees and levels to straighten the performance of some of the attacking skills in Basketball

Basketball is one of the games that are studied within the courses of the colleges and departments of the Physical Education in Iraq. It includes many defense and attacking skills, the assessment of the students' skills performance, for most teachers, depends on the individual evaluation and the personal experience. Thus, the importance of the research lies in finding the standard degrees and levels to straighten the performance of the students in the attacking skills in Basketball. Goals of the Research • Finding the standard degrees and levels to straighten the performance of the students in the attacking skills in Basketball. • Straightening the students’ level of performance according to the levels they achieve. The sample of the research included first class students in the Physical Education College- Dyala University, 2005-2006. The total number of the students included is (208) out of (256), those who failed or postponed or are players in clubs were excluded, the sample represents about (81%) of the original community. After presenting, analyzing and discussing the results, the researcher concludes the following: • The tests of Basketball Basic Skills correspond to the level of the sample of the research. • Most of the sample of the research was in an intermediate level. The researcher recommends the following: • The necessity to adopt these tests within the semester and final tests of the first classes, and also for those applying for seats in the Physical Education Colleges. • Adopting the standard degrees and levels of this study to straighten the performance of the first class students in the basketball basic skills.

On-the-job assessment of practical skills performance: experiences from a feasibility study

A pilot exercise throughout one deanery during a whole training year has shown that the on-the-job assessment of practical skills is both feasible and acceptable to the wider health-care team. There was, however, a lack of exposure by trainees to a small number of specific procedural skills.

Children’s acquisition and retention of safety skills: the Lifeskills program

Objectives: Assessment of safety skills performance and knowledge, to evaluate the education offered by the Lifeskills “Learning for Living” village, Bristol, UK which emphasizes interactive learning-by-doing. Design: Two quasi-experimental matched...

A Simulation-Based Acute Skills Performance Assessment for Anesthesia Training

In an earlier study, trained raters provided reliable scores for a simulation-based anesthesia acute care skill assessment. In this study, we used this acute care skill evaluation to measure the performance of student nurse anesthetists and resident physician trainees. The performance of these trainees was analyzed to provide data about acute care skill acquisition during training. Group comparisons provided information about the validity of the simulated exercises. A set of six simulation-based acute care exercises was used to evaluate 43 anesthesia trainees (28 residents [12 junior and 16 senior] and 15 student nurse anesthetists). Six raters scored the participants on each exercise using either a detailed checklist, key-action items, or a global rating. Trainees with the most education and clinical experience (i.e., senior residents) received higher scores on the simulation scenarios, providing some evidence to support the validity of the multi-scenario assessment. Trainees varied markedly in ability depending on the content of the exercise. In general, anesthesia providers demonstrated similar aptitude in managing each of the six simulated events. Most participants effectively managed ventricular tachycardia, but postoperative events such as anaphylaxis and stroke were more difficult for all trainees to promptly recognize and treat. Training programs could use a simulation-based multiple encounter evaluation to measure provider skill in acute care. A trainee's skill in managing critical events can be assessed using a multiple scenario simulation-based performance evaluation.

Retrogression of schizophrenia?

Objective: Social functioning is an important outcome dimension in schizophrenia. Measures of social skills frequently rely on self-report, and most measures which directly assess social functioning are time consuming. Here we describe a brief performance-based measure, the Social Skills Performance Assessment (SSPA), modified from an instrument published by Bellack et al. (Bellack, A., Morrison, R., Wixted, J., Mueser, K., 1990. An analysis of social competence in schizophrenia. Br. J. Psychiatry 156, 809–818). Method: 83 middle-aged and elderly patients with schizophrenia or schizoaffective disorder, and 52 normal comparison subjects (NCs) were rated on two standardized role plays, one requiring introduction to a stranger and another requiring assertive behavior with their landlord. Ratings in eight areas ranging from ‘social appropriateness’ to ‘grooming’ were made. Results: SSPA required about 12 min to complete both role play and ratings, and had excellent interrater reliability, and good test–retest reliability. Patients demonstrated significantly greater disability in all areas of social functioning compared with NCs. Social performance was related to severity of negative symptoms and cognitive deficits, but not that of positive or depressive symptoms. SSPA scores were significantly correlated with health-related quality of well-being and observed performance on activities of daily living, but not to a self-reported measure of social functioning. Conclusion: The SSPA is a reliable and useful instrument. Direct assessment of social skills may provide a more accurate picture of functioning than self-report measures among patients who frequently lack insight into their own behavior.

Utilizing cross‐cultural curricula to improve interpersonal job skills training

Presents a study that examined the effects of cross‐cultural instruction on the interpersonal job skills of students in secondary vocational programs. The population consisted of a treatment and a control group, with 65 students in each group. A pretest and posttest was administered. The experimental group received the intervention during a six‐week period. The dependent variable was generalizable interpersonal relations skills as measured by the generalizable interpersonal relations skills performance assessment. The independent variables included a cross‐cultural instructional intervention, gender, ethnicity, and school. The findings indicated that students receiving the cross‐cultural instructional intervention had significantly higher generalizable interpersonal relations skills achievement than students not receiving the intervention. Recommends that cross‐cultural instruction be integrated into vocational and industrial training curricula, including instructor preservice and inservice training. Also, trainers should closely link the benefits of cultural awareness to learners’ experiences at home and the work place; and to their personal and professional success.

Using Simulations and Standardized Patients in Intervention Research

Caregiving is both an art and a science; both knowledge and skills are necessary to improve the quality of care that professionals provide. Researchers are often limited in their assessment of skill performance due to inadequate and unrealistic measurement options. Simulation using standardized patients offers researchers an objective method to evaluate skill performance. This article describes the use of simulations by researchers in their quest to measure changes in violence prevention skills after an intervention program given to nurse assistants working in long-term care facilities.

Social skills performance assessment among older patients with schizophrenia

Objective: Social functioning is an important outcome dimension in schizophrenia. Measures of social skills frequently rely on self-report, and most measures which directly assess social functioning are time consuming. Here we describe a brief performance-based measure, the Social Skills Performance Assessment (SSPA), modified from an instrument published by Bellack et al. (Bellack, A., Morrison, R., Wixted, J., Mueser, K., 1990. An analysis of social competence in schizophrenia. Br. J. Psychiatry 156, 809–818). Method: 83 middle-aged and elderly patients with schizophrenia or schizoaffective disorder, and 52 normal comparison subjects (NCs) were rated on two standardized role plays, one requiring introduction to a stranger and another requiring assertive behavior with their landlord. Ratings in eight areas ranging from ‘social appropriateness’ to ‘grooming’ were made. Results: SSPA required about 12 min to complete both role play and ratings, and had excellent interrater reliability, and good test–retest reliability. Patients demonstrated significantly greater disability in all areas of social functioning compared with NCs. Social performance was related to severity of negative symptoms and cognitive deficits, but not that of positive or depressive symptoms. SSPA scores were significantly correlated with health-related quality of well-being and observed performance on activities of daily living, but not to a self-reported measure of social functioning. Conclusion: The SSPA is a reliable and useful instrument. Direct assessment of social skills may provide a more accurate picture of functioning than self-report measures among patients who frequently lack insight into their own behavior.

Assessing Physicians' Interpersonal Skills via Videotaped Encounters: A New Approach for the Royal College of General Practitioners Membership Examination

The Royal College of General Practitioners' Membership examination , the only postgraduate qualification in family medicine in the United Kingdom , has developed a direct assessment of candidates' interpersonal skills performance using videotaped consultations of the actual doctor - patient encounters . At present about 1 , 200 doctors are examined each year . The methodology has been developed and piloted over a period of eight years . The central tenet of the methodology is a clear definition , which is known both to the candidate and to the examiner , of the clinical and consulting competencies that are required to be demonstrated in order to pass the examination . The candidate is required to provide evidence of his or her competence usually by selecting appropriate patient encounters that demonstrate the fulfillment of the required performance criteria , effectively producing a portfolio of his or her communicative competence . The methodology is intended to encourage the learning and teaching of communication skills by making it part of an important examination and clearly defining the competencies required to pass . Reliability has been demon strated to be satisfactory and refinement of the marking processes is likely to improve this further .

Substance Abuse: Medical Student Awareness and Clinical Skills

Medical schoob continue to be challenged to provide effective curricula in substance abuse. Our study examined the perceived exposure of medical students to substance abuse topics. We found that the majority of upper-level students indicated a high level of exposure to substance abuse topics which are considered to be core knowledge by experts. Assessment of clinical skills performance using a standardized patient case, however, indicated that students were not able to demonstrate clinical proficiency in substance abuse topics despite their high level of perceived exposure to these topics.

Accuracy of self-reported symptoms in individuals with schizophrenia

Objective: Social functioning is an important outcome dimension in schizophrenia. Measures of social skills frequently rely on self-report, and most measures which directly assess social functioning are time consuming. Here we describe a brief performance-based measure, the Social Skills Performance Assessment (SSPA), modified from an instrument published by Bellack et al. (Bellack, A., Morrison, R., Wixted, J., Mueser, K., 1990. An analysis of social competence in schizophrenia. Br. J. Psychiatry 156, 809–818). Method: 83 middle-aged and elderly patients with schizophrenia or schizoaffective disorder, and 52 normal comparison subjects (NCs) were rated on two standardized role plays, one requiring introduction to a stranger and another requiring assertive behavior with their landlord. Ratings in eight areas ranging from ‘social appropriateness’ to ‘grooming’ were made. Results: SSPA required about 12 min to complete both role play and ratings, and had excellent interrater reliability, and good test–retest reliability. Patients demonstrated significantly greater disability in all areas of social functioning compared with NCs. Social performance was related to severity of negative symptoms and cognitive deficits, but not that of positive or depressive symptoms. SSPA scores were significantly correlated with health-related quality of well-being and observed performance on activities of daily living, but not to a self-reported measure of social functioning. Conclusion: The SSPA is a reliable and useful instrument. Direct assessment of social skills may provide a more accurate picture of functioning than self-report measures among patients who frequently lack insight into their own behavior.

Affect perception in schizophrenia

Objective: Social functioning is an important outcome dimension in schizophrenia. Measures of social skills frequently rely on self-report, and most measures which directly assess social functioning are time consuming. Here we describe a brief performance-based measure, the Social Skills Performance Assessment (SSPA), modified from an instrument published by Bellack et al. (Bellack, A., Morrison, R., Wixted, J., Mueser, K., 1990. An analysis of social competence in schizophrenia. Br. J. Psychiatry 156, 809–818). Method: 83 middle-aged and elderly patients with schizophrenia or schizoaffective disorder, and 52 normal comparison subjects (NCs) were rated on two standardized role plays, one requiring introduction to a stranger and another requiring assertive behavior with their landlord. Ratings in eight areas ranging from ‘social appropriateness’ to ‘grooming’ were made. Results: SSPA required about 12 min to complete both role play and ratings, and had excellent interrater reliability, and good test–retest reliability. Patients demonstrated significantly greater disability in all areas of social functioning compared with NCs. Social performance was related to severity of negative symptoms and cognitive deficits, but not that of positive or depressive symptoms. SSPA scores were significantly correlated with health-related quality of well-being and observed performance on activities of daily living, but not to a self-reported measure of social functioning. Conclusion: The SSPA is a reliable and useful instrument. Direct assessment of social skills may provide a more accurate picture of functioning than self-report measures among patients who frequently lack insight into their own behavior.