Social Functioning Questionnaire Research Articles

The evaluation of the social functioning of schizophrenia patients followed up in the health center My El Hassan of Kenitra, Morocco

BackgroundDifficulties in interacting in and adapting to the social world are the central complaint faced by patients with schizophrenia. These people are often socially isolated, unemployed and may find it difficult to live independently.AimThis study aims to evaluate the social functioning of schizophrenic patients, and to highlight the various factors associated with the alteration of the social functioning of schizophrenic patients.MethodsWe conducted a prospective descriptive and analytical study of a population of 72 patients with schizophrenia. These are patients between 19 and 59 years old, clinically stabilized, diagnosed and followed at the My EL Hassan health center in Kenitra (Morocco). Symptom assessment is measured using a standardized Positive and Negative Syndrome Scale (PANSS), and social functioning is assessed using a Social Functioning Questionnaire (SFQ).ResultsStatistical analysis shows that of 72 schizophrenic patients, 33.3% had good social functioning, 59.7% had moderate social functioning, while 6.9% of patients had altered social functioning (the average score of all SFQ items less than 2.4). 6.9% with altered social functioning, are patients aged 19 to 49, were male (p < 0.35), come from an urban areas (p < 0.17), without professional activity (p < 0.00), and have a progressive onset of the disease (p < 0.31). 5.5% (n = 4) of them were single (p < 0.12), caught this disease at an age greater than or equal to 20 years, and have the mixed type of symptoms (positive/negative) (p < 0.15). The altered social functioning of our patients is correlated to five factors: professional activity (p < 0.00), family situation (p < 0.03), family care (p < 0.02), family awareness (p < 0.01), and the negative subtype of psychotic symptomatology (p < 0.02).ConclusionThis study underlines the interest of psycho-social treatment as specific care which would complement symptomatic treatment and improve the social functioning of patients with schizophrenia.

Transtornos pelo uso de substâncias e funcionamento social sob uma perspectiva ocupacional: um pré e pós estudo

Abstract Introduction Improvements in the social functioning (SF) of people experiencing substance use disorders (SUD) can occur even without use discontinuation. Occupational Therapy (OT) performs multifaceted work on it. Objective This study analyzes the SF of people experiencing SUD before and after treatment and the contributions of OT. Method A pre and post-study before and after starting treatment for SUD in a Psychosocial Care Centre - Alcohol and other Drugs (CAPS-AD) in Brasilia, Brazil - was conducted with 35 clients based on an SF questionnaire. A measure of the participant's SF improvement was defined as the difference between the SF before treatment (SFpre) with the SF after treatment (SFafter). The association between SF and sociodemographic variables/drug/previous treatment was verified by linear regression; all analyses considered a significance level &lt;5%. Results Most of the 35 participants were male (83%), 30-49 years old (77%), attended elementary school (57%), unemployed (57%), single (46%), Black (40%), had been treated previously (60%) and had present alcohol use disorder (46%). Overall, people undergoing treatment significantly improved their SF. Multivariate analysis showed that Whites improved their SF more (mean of 18.8± 10.4) than Pardos/Blacks (10.8± 8.7; 14.1± 6.4), and the improvement in SF was lower for participants who were taking treatment for the first time (10.3± 5.7) compared with those who had previous treatment (17.2± 9.4). Conclusion Treatment in CAPS-AD improved the SF of people experiencing SUD, and the OT professional is a key agent in improving SF due to its performance and approach to clients in vulnerable contexts.

Fatigue and Quality of Life in Children with Chronic Kidney Disease.

Background: This study investigates the effect of chronic kidney disease (CKD) stage on fatigue and health-related quality of life (HRQoL) in the pediatric population. Material and Methods: The PedsQL (Pediatric Quality of Life Inventory) Multidimensional Fatigue Scale (subcategories: general, sleep/rest, and cognitive fatigue) and HRQoL Generic Core Scales (subcategories: physical, emotional, social, and school functioning) questionnaires were completed by 30 patients aged from 7 to 18 years old with CKD stage 2–4, CKD stage 5 on dialysis (CKD 5D), and kidney transplantation (KTx), as well as their parents. Results: Both low “Total Fatigue” and “Total HRQoL” scores were reported in 16.7% of patients. “Sleep/Rest Fatigue”, “Emotional Functioning”, and “School functioning” were the lowest scored subcategories. CKD 5D/KTx patients presented lower “Sleep/Rest Fatigue” (p = 0.022) and, more frequently, low “School Functioning” scores (p = 0.029). The “Total HRQoL” score was correlated to the “Total Fatigue” score (rs = 0.625, p < 0.001). A low “Sleep/Rest Fatigue” score was associated with low “Physical Functioning”, “School Functioning”, and “Total HRQoL” scores (p = 0.016, p = 0.001, and p = 0.047 respectively). Parents’ HRQoL score was lower than patients’ score on “Physical Functioning” (p = 0.040) and “School Functioning” subcategories (p = 0.045). Conclusions: Fatigue and disturbed HRQoL are mostly observed in CKD 5D and KTx pediatric patients, and are associated with sleep disorders and school dysfunction. Fatigue affects HRQoL, which is perceived as more deteriorated by the patients’ parents.

Prediction of anxiety, depression and social function among mothers of NICU-hospitalized infants compared to healthy infants’ mothers in Baqiyatallah and Imam Hossein Hospitals

The main objective of this research is to predict anxiety, depression and social function of NICU-hospitalized infants’ mothers compared to healthy infants; mothers. The methodology of research is descriptive in type of correlative and causative-comparative. Population included all mothers of NICU-hospitalized infants and healthy infants’ mothers in two Tehran Hospitals from June 2018 to September 2019. The main sample size was randomly selected. Sample size was calculated as 120 at this level based on Cochran’s table. The instruments were Beck’s (1969) anxiety and depression inventories, and Lekomet et al. (2014) social functioning questionnaire (SFQ). Data was analyzed using analysis of variance, multivariate and step-wise regression. The results implied that those NICU-hospitalized infants’ mothers experienced higher levels of depression and anxiety than healthy infants’ mothers. Moreover, formers had lower social functioning than latters. On the other hand, depression and anxiety were suitable predictors of mother’ social functioning and there was a significant relationship between depression and social functioning mediated by mother’s anxiety

Mental Health Knowledge, Anticipated Discrimination and Social Functioning Among Women Living with Psychosocial Disability in Rural Kenya

Levels of mental health awareness in rural Kenya remain very low with higher levels of stigma and discrimination towards people with psychosocial disabilities, especially for women. This study aimed to describe the levels and correlates of mental health knowledge, discrimination and social functioning among rural women with psychosocial disabilities in Kenya. We randomly recruited 25 women living with psychosocial disabilities in a rural county. Mental health knowledge was measured by Mental Health Knowledge Schedule (MAKS), anticipated discrimination was measured by Questionnaire on Anticipated Discrimination while social functioning was measured using the Social Functioning questionnaire. The mean age of study participants was 36.6 ± 3.0 and the mean score of MAKS was 21.9 ± 30. The most endorsed item was referring a friend with mental illness to a professional to seek help. The prevalence of low social functioning was 64%. In terms of identification of mental illness, majority (88%) identified depression as a mental illness. Higher mental health knowledge was associated with a higher level of education (p = 0.012), being self-employed as opposed to unemployed (p = 0.018) and earning monthly income (p = 0.023). The most frequent reason for anticipated discrimination was friends and neighbors knowing about their mental health problems (24.0%). Anticipated discrimination was associated with participants who had ever been treated for a mental health problem (p = 0.05). Poor social functioning was significantly correlated with the number of years lived with disability (p < 0.001). Poor mental health awareness and discrimination against people with psychosocial disabilities limit their functioning, health-seeking and recovery in Kenya. There is need for prioritization of mental health services and increased mental health awareness to improve health-seeking behavior, social participation and recovery for persons with psychosocial disabilities.

Symptom remission and functional outcome in an Egyptian sample of patients with schizophrenia

BackgroundThe ultimate treatment goal of schizophrenia is regaining patients’ pre-morbid function.ResultsNinety-three outpatients with schizophrenia, diagnosed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders—fourth edition (DSM-IV), were recruited, of whom 35 patients (37.6%) had achieved the remission severity criteria, whereas 58 patients (62.4%) failed to fulfill the criteria for remission. The functional aspects were examined by the Global Assessment of Functioning scale (GAF) and the Social Functioning Questionnaire (SFQ). Predictors of outcome were examined by applying binary logistic regression analysis. Patients who fulfilled those specific criteria for remission showed a favorable outcome in the assessed areas, regarding GAF and social functioning in society. Lack of judgment or insight item of PANSS showed significantly good functional outcomes.ConclusionThe results suggest that the remission concept has important implications for the treatment of schizophrenia. Remission seems to be associated with better functional capabilities. However, this does not necessarily mean that remitted patients have “adequate” functioning, especially regarding the social skills domain.

The impact of owning a hearing dog on quality of life, hearing handicap, and social functioning: an Australian cohort

Objective To determine the impact of owning a hearing dog on self-reported hearing handicap, quality of life (QoL), and social functioning. Design Group comparison study design, utilising five surveys (General Information Survey, Hearing Information Survey, Hearing Handicap Inventory for the Elderly/Adults, Medical Outcomes Survey, and Social Functioning Questionnaire). Study sample 23 respondents from the 2019 Australian Lions Hearing Dog waitlist (controls) and 58 respondents from all clients who had received a hearing dog through the Australian Lions Hearing Dog service (cases). Results No significant difference was found in Hearing Handicap Inventory or Social Functioning Questionnaire scores between the groups, although there was a tendency for improvement with dog ownership. The owner group scored significantly lower than the waitlist group on three Medical Outcomes Survey sub-items (general health, physical functioning, and role limitations due to physical health), along with total health-related QoL. These results contrasted with the broad emotional and psychosocial benefits identified through thematic analysis of responses. Conclusions It is feasible, yet not certain, that owning a hearing dog may bring a reduction in hearing handicap, as well as emotional and social benefits to the QoL of individuals, but it also appears to be associated with poorer perception of health.

Gaming Disorder in Adults with Autism Spectrum Disorder

Gaming disorder (GD) is a clinical addiction to video or internet games. This study investigated whether GD symptoms are heightened in adults with autism spectrum disorder (ASD) in comparison to a control group, and explored predictors of GD in 230 adults with ASD and 272 controls. The relationship between GD and gelotophobia was examined. Measures included the Ten-Item Internet Gaming Disorder Test, GELOPH < 15 >, Autism Spectrum Quotient-10 items, Inventory of Parent and Peer attachment, Emotional Regulation Questionnaire, Social Functioning Questionnaire (SFQ) and the NEO-FFI-3. Individuals in the ASD group showed significantly higher symptoms of GD. Peer-attachment, emotional regulation and extraversion significantly predicted GD scores. Gelotophobia and GD were related to each other with a small effect size.

Is social function a good proxy measure of personality disorder?

Personality assessment may be helped by proxy measures. To examine the assessment of social functioning in relationship to personality disorder. Secondary analysis of data from three clinical studies, following deliberate self-harm (n= 460), cognitive behaviour therapy for health anxiety (n= 444) and a 30-year follow-up of 200 anxious/depressed patients. Social function and personality were assessed using the Social Functioning Questionnaire (SFQ) and the Personality Assessment Schedule, with its ICD-11 modification. A 5-item short version of the SFQ, the Short Social Functioning Questionnaire (SSFQ), was also developed. The SFQ score in the first two studies (area under curve [AUC] 0.64 and 0.65) partly predicted personality status; in the third study, this achieved close agreement (AUC SFQ 0.85 [95% CI 0.8-0.9]; AUC SSFQ 0.84 [95% CI 0.78-0.89]). In all studies, social function deteriorated linearly with increasing personality pathology. Cut-off points of 4 on the SSFQ and 7 on the SFQ had high sensitivity (SSFQ 82%-90%; SFQ 82%-83%) and acceptable specificity (SSFQ 66%-75%; SFQ 69%-75%) in identifying personality disorder in the third study. Social functioning recorded in either a 5-item or 8-item self-rating is a useful proxy measure of personality disturbance and may be the core of disorder.

How does the postoperative medial arch height influence the patient reported outcomes of stage Ⅱ acquired adult flatfoot deformity?

BackgroundThis study aimed to assess how the postoperative medial arch height influenced postoperative patient-reported clinical outcomes after surgery for stage Ⅱ acquired adult flatfoot deformity. MethodsA total of 30 feet of 30 patients (7 males, 23 females) who underwent surgery for stage Ⅱ acquired adult flatfoot deformity and could be followed up for at least 2 years were included. The average age at surgery was 60.0 (standard deviation, 13.0) years, and the average follow-up period was 40 (standard deviation, 15.4) months. Among them, 16 patients underwent lateral column lengthening and 14 patients did not. Patient-reported clinical outcomes were evaluated using the Self-Administered Foot Evaluation Questionnaire. Radiographic alignment was evaluated by the talonavicular coverage angle, lateral talo-1st metatarsal angle, medial cuneiform height, medial cuneiform to 5th metatarsal height, and calcaneal pitch. The correlation between postoperative Self-Administered Foot Evaluation Questionnaire and radiographic alignment was assessed with Pearson's correlation analysis. ResultsSelf-Administered Foot Evaluation Questionnaire and radiographic alignment significantly improved postoperatively in all patients (P < 0.0001). In patients with severe deformity who needed lateral column lengthening, lateral talo-1st metatarsal angle was negatively and medial cuneiform to 5th metatarsal height was positively correlated with physical functioning Self-Administered Foot Evaluation Questionnaire subscales (r = −0.56 and 0.55), and medial cuneiform height was positively correlated with physical functioning, social functioning and general health Self-Administered Foot Evaluation Questionnaire subscales (r = 0.70, 0.55 and 0.73, respectively). ConclusionPostoperative medial arch height could influence physical functioning, social functioning, and general health in patients with severe stage II adult-acquired flatfoot deformity.

Social functioning questionnaires of adolescents born preterm show average profiles and attenuated sex differences.

Prematurity has been shown to affect social competence in children and adults. Our aim was to evaluate profiles of self-reported social behaviours and loneliness in preterm- and term-born adolescents. Preterm (≤1500g and, or, <32 gestational weeks)- and term-born infants were recruited in Turku University Hospital from 2001 to 2006. The Multisource Assessment of Children's Social Competence Scale and the Peer Network and Dyadic Loneliness Scale were completed at the age of 11. Profiles of social competence and loneliness were labelled as low, average or high. A total of 172 preterm-born and 134 term-born adolescents returned the questionnaires. Most frequently, preterm adolescents reported a profile of average social competence and average levels of loneliness. Preterm-born boys reported a profile of low social functioning less often (preterm-born 36% vs. term-born 54%), and preterm-born girls reported a profile of high social functioning less frequently (preterm-born 26% vs. term-born 37%) than same-sex controls. Sex differences in social functioning profiles were smaller in preterm than term-born adolescents. The majority of young adolescents born preterm reported a high or average social functioning profile irrespective of sex. Prematurity seems to level out differences between the sexes.

Life Accomplishment, Social Functioning and Participation of South-Eastern Nigerians with Lower Limb Amputation

Purpose: For a better understanding of the possible impact of impairments and disabilities on the life of individuals with lower limb amputation,it is important to explore the levels of Life Accomplishment (LA), Social Functioning and Participation (SFP) among them.The present study, set in South-Eastern Nigeria, aimed to study these levels and the influence of selected clinical and demographic variables on these constructs. Method: This cross-sectional survey involved 60 individuals with lower limb amputation (46 unilateral, 14 bilateral) recruited from all the five South-Eastern Nigerian States. The Social Functioning Questionnaire (SFQ), Participation Scale and Life Habit Questionnaire were used for measuring levels of social functioning, social participation and life accomplishment, respectively. Data was analysed using descriptive statistics of frequency count, percentages, mean and standard deviation. Mann-Whitney U and Kruskal-Wallis tests were used to test the hypotheses. Alpha level was set at 0.05. Results: Most of the participants (51.7%-58.3%) had low levels of social functioning across SFQ domains. Most of them (61.7%) had severe participation restrictions, and they all had reduced life accomplishments. Participants with bilateral amputation had poorer levels of social functioning (P Conclusion and Implications: Low social functioning, severe participation restrictions, and reduced life accomplishments were prevalent among individuals with lower limb amputation, particularly amongthose with bilateral and above-knee amputations. There is a need to routinely evaluate the studied constructs among individuals with lower limb amputation. The provision of prosthetic aids may help to improve their levels of life accomplishment, social functioning and participation.

Neurophysiological and Psychological Predictors of Social Functioning in Patients with Schizophrenia and Bipolar Disorder.

ObjectiveThe aim of this study is to examine social functioning in patients with schizophrenia and bipolar disorder and explore the psychological and neurophysiological predictors of social functioning. MethodsTwenty-seven patients with schizophrenia and thirty patients with bipolar disorder, as well as twenty-five healthy controls, completed measures of social functioning (questionnaire of social functioning), neurocognition (Verbal fluency, Korean-Auditory Verbal Learning Test), and social cognition (basic empathy scale and Social Attribution Task-Multiple Choice), and the childhood trauma questionnaire (CTQ). For neurophysiological measurements, mismatch negativity and heart rate variability (HRV) were recorded from all participants. Multiple hierarchical regression was performed to explore the impact of factors on social functioning. ResultsThe results showed that CTQ-emotional neglect significantly predicted social functioning in schizophrenia group, while HRV-high frequency significantly predicted social functioning in bipolar disorder patients. Furthermore, emotional neglect and HRV-HF still predicted social functioning in all of the subjects after controlling for the diagnostic criteria. ConclusionOur results implicated that even though each group has different predictors of social functioning, early traumatic events and HRV could be important indicators of functional outcome irrespective of what group they are.

Experienced and Anticipated Discrimination and Social Functioning in Persons With Mental Disabilities in Kenya: Implications for Employment

Introduction: Persons with mental illness experience social life restriction and stigma that may have implications for their work ability. The aims of this study are (i) to report experienced and anticipated discrimination and social functioning in persons with mental disabilities in Kenya and (ii) to investigate the association between experienced and anticipated discrimination, social functioning, and employment in this population.Materials and Methods: Cross-sectional study design where we randomly recruited 72 persons with mental illness through two networks of persons with psychosocial disabilities in Kenya. Experienced and anticipated discrimination were measured using the Discrimination and Stigma Scale version 12 (DISC 12) while social functioning was measured using the Social Functioning questionnaire (SFQ).Results: Experienced discrimination was reported by 81.9% in making or keeping friends, 69.7 and 56.3% in finding or keeping job, respectively, and 63.3% in dating or having an intimate relationship. Anticipated discrimination stopped 59.2% from applying for work, 40.8% from applying for education or training courses, and 63.4% from having a close personal relationship. Females reported an overall higher experienced discrimination than males. Unemployed participants had slightly increased rates of experienced and anticipated discrimination (9.5 vs. 9.1 and 2.5 vs. 2.3, respectively) (p > 0.05), while there was a significant association between impaired social functioning and unemployment [14.0 vs. 11.2 (p = 0.037)].Conclusion: The rates of experienced and anticipated discrimination faced by persons with mental disabilities in Kenya is high and with significant gender disparity. Although no strong associations were observed between experienced and anticipated discrimination and employment, impaired social functioning of persons with mental disabilities seems to have implications for employment. Further research is essential to understand the predictors of the discrimination and measures to reduce them in persons with psychosocial disabilities.

Impact of a culturally adapted behavioural family psychoeducational programme in patients with schizophrenia in Egypt

Objective: To study the effect of a culturally adapted, structured family intervention on symptom severity, medication attitudes and knowledge, social functioning and quality of life in patients with schizophrenia.Methods: Thirty subjects with schizophrenia were selected to receive 14 sessions of a culturally adapted behavioural family psychoeducational programme (BFPEP). Another 30 subjects received standard treatment as usual (STU) for 6 months. Pre- and post-intervention outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory 10-item scale (DAI-10), Quality of Life Scale (QLS) and Social Functioning Questionnaire (SFQ).Results: There was a no significant difference between BFPEP and STU at baseline on all measures. There was a significant difference (p < .05) between pre- and post-treatment scores for BFPEP on all measures, a significant difference (p < .05) between pre- and post-treatment scores for STU on all measures (favouring pre-treatment scores) and a significant difference (p < .05) favouring BFPEP over STU on all measures post-treatment.Conclusions: These results demonstrate the feasibility and effectiveness of implementing family therapy psychoeducational interventions in different cultural settings, with relatively minor modifications. This may have implications for mental health policy makers to make available such programmes for patients and mental health professionals.

Physical multimorbidity and loneliness: A population-based study.

Multimorbidity has been linked to a variety of negative outcomes although as yet, there has been little research on its association with loneliness. This study examined the association between physical multimorbidity (≥ 2 physical diseases) and loneliness in the general population and its potential mediators. Data came from the Adult Psychiatric Morbidity Survey 2007 (N = 7403, aged ≥16 years). Information was obtained on 20 doctor diagnosed physical conditions that were present in the previous year. An item from the Social Functioning Questionnaire (SFQ) was used to obtain information on loneliness. Multivariable logistic regression analysis was used to examine associations. An increasing number of physical diseases was associated with higher odds for loneliness. Compared to no physical diseases, the odds ratio (OR) (95% confidence interval: CI) for loneliness increased from 1.34 (1.13–1.59) to 2.82 (2.11–3.78) between one and ≥5 physical diseases. This association was particularly strong in the youngest age group (i.e. 16–44 years). The loneliness-physical multimorbidity association was significantly mediated by stressful life events (% mediated 11.1%-30.5%), anxiety (30.2%), and depression (15.4%). Physical multimorbidity is associated with increased odds for loneliness. Prospective research is now needed to further elucidate this association and the factors that underlie it.

Effectiveness of Social Skills Training Program on Social Functioning and Severity of Symptoms Among Patients with Schizophrenia

This study aimed at evaluating the effectiveness of socials kills training program on social functioning and severity of symptoms among newly admitted schizophrenic Patients. Quasi-experimental design (pre-posttest-groups) was utilized in this study. The present study was conducted at Al-Abbassia hospital for mental health. Purposive random sample consisted of 40 schizophrenic patients which were selected from six inpatient wards of newly admitted patients. Three tools were used to collect the data for the current study, Personal and medical data sheet, social functioning questionnaire and positive & negative symptoms scale (PANSS). A constructed social skills training Program was designed to help patients to develop and promote necessary skills for effective communication and interaction with others that needed for improved his/her functioning and independent living. This program was implemented over 15 sessions, three sessions per week and each session lasted about 60-90 minutes. Pre, and post assessment were carried out for the same group (self-control group). The current study results revealed that, overall significant effects of social skills training program regarding improving patients’ social functioning and decreasing severity of symptoms. There was statistically significant difference between pre, and post assessment regarding dependent variables. A statistically significant positive correlation were detected between dependent variables and patients’ related variables such as age, compliance with medication, with whom the patient stays, and numbers of previous hospital admissions. So, the study concluded that, the social skills training program was effective with newly admitted schizophrenics’ patients concerning enhancing patients, social functioning and reducing severity of symptoms. The study recommended that, social skill training program should be integrated as an intervention in conjunction with pharmacological therapy without contraindications and it can maximize the effect.

Development and validation of the Vellore Occupational Therapy Evaluation Scale to assess functioning in people with mental illness.

Available occupational therapy assessment scales focus on specific areas of functioning. There is a need for comprehensive evaluation of diverse aspects of functioning in people with mental illness. To develop a comprehensive assessment scale to evaluate diverse aspects of functioning among people with mental illness and to assess its validity and reliability. Available instruments, which evaluate diverse aspects of functioning in people with mental illness, were retrieved. Relevant items, which evaluate specific functions, were selected by a committee of mental health experts and combined to form a comprehensive instrument. Face and content validity and feasibility were assessed and the new instrument was piloted among 60 patients with mental illness. The final version of the instrument was employed in 151 consecutive clients, between 18 and 60 years of age, who were also assessed using Global Assessment of Functioning (GAF), Occupational Therapy Task Observation Scale (OTTOS), Social Functioning Questionnaire (SFQ), Rosenberg Self Esteem Scale (RSES) and Pai and Kapur Family Burden Interview Schedule (FBIS) by two therapists. The inter-rater reliability and test-retest reliability of the new instrument (Vellore Occupational Therapy Evaluation Scale (VOTES)) were also evaluated. The new scale had good internal consistency (Cronbach's alpha = .817), inter-rater reliability .928 (.877-.958) and test-retest reliability .928 (.868-.961). The correlation between the general behaviour domain (Pearson's Correlation Coefficient [PCC] = -.763, p = .000), task behaviour (PCC = -.829, p = .000), social skills (PCC = -.351, p = .000), intrapersonal skills (PCC = -.208, p = .010), instrumental activities of daily living (IADL) (PCC = -.329, p = .038) and leisure activities (PCC = -.433, p = .005) scores of VOTES with the corresponding domains in the scales used for comparison was statistically significant. The correlation between the total score of VOTES and the total scores of OTTOS, SFQ and RSES was also statistically significant suggesting convergent validity. The correlation between the total score of VOTES with the total score of FBI is not statistically significant, implying good divergent validity. VOTES seems to be a promising tool to assess overall functioning of people with mental illness.

Psychoeducation with problem-solving (PEPS) therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning

If effective, less intensive treatments for people with personality disorder have the potential to serve more people. To compare the clinical effectiveness and cost-effectiveness of psychoeducation with problem-solving (PEPS) therapy plus usual treatment against usual treatment alone in improving social problem-solving with adults with personality disorder. Multisite two-arm, parallel-group, pragmatic randomised controlled superiority trial. Community mental health services in three NHS trusts in England and Wales. Community-dwelling adults with any personality disorder recruited from community mental health services. Up to four individual sessions of psychoeducation, a collaborative dialogue about personality disorder, followed by 12 group sessions of problem-solving therapy to help participants learn a process for solving interpersonal problems. The primary outcome was measured by the Social Functioning Questionnaire (SFQ). Secondary outcomes were service use (general practitioner records), mood (measured via the Hospital Anxiety and Depression Scale) and client-specified three main problems rated by severity. We studied the mechanism of change using the Social Problem-Solving Inventory. Costs were identified using the Client Service Receipt Inventory and quality of life was identified by the European Quality of Life-5 Dimensions questionnaire. Research assistants blinded to treatment allocation collected follow-up information. There were 739 people referred for the trial and 444 were eligible. More adverse events in the PEPS arm led to a halt to recruitment after 306 people were randomised (90% of planned sample size); 154 participants received PEPS and 152 received usual treatment. The mean age was 38 years and 67% were women. Follow-up at 72 weeks after randomisation was completed for 62% of participants in the usual-treatment arm and 73% in the PEPS arm. Intention-to-treat analyses compared individuals as randomised, regardless of treatment received or availability of 72-week follow-up SFQ data. Median attendance at psychoeducation sessions was approximately 90% and for problem-solving sessions was approximately 50%. PEPS therapy plus usual treatment was no more effective than usual treatment alone for the primary outcome [adjusted difference in means for SFQ -0.73 points, 95% confidence interval (CI) -1.83 to 0.38 points; p = 0.19], any of the secondary outcomes or social problem-solving. Over the follow-up, PEPS costs were, on average, £182 less than for usual treatment. It also resulted in 0.0148 more quality-adjusted life-years. Neither difference was statistically significant. At the National Institute for Health and Care Excellence thresholds, the intervention had a 64% likelihood of being the more cost-effective option. More adverse events, mainly incidents of self-harm, occurred in the PEPS arm, but the difference was not significant (adjusted incidence rate ratio 1.24, 95% CI 0.93 to 1.64). There was possible bias in adverse event recording because of dependence on self-disclosure or reporting by the clinical team. Non-completion of problem-solving sessions and non-standardisation of usual treatment were limitations. We found no evidence to support the use of PEPS therapy alongside standard care for improving social functioning of adults with personality disorder living in the community. We aim to investigate adverse events by accessing centrally held NHS data on deaths and hospitalisation for all PEPS trial participants. Current Controlled Trials ISRCTN70660936. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 52. See the NIHR Journals Library website for further project information.

Efficacy of a Facial Emotion Training Program for Children and Adolescents with Autism Spectrum Disorders

Twenty-five high-functioning, verbal children and adolescents with autism spectrum disorders (ASD; age range 8–15 years) who demonstrated a facial emotion recognition deficit were block randomized to an active intervention (n = 12) or waitlist control (n = 13) group. The intervention was a modification of a commercially-available, computerized, dynamic facial emotion training tool, the MiX by Humintell©. Modifications were introduced to address the special learning needs of individuals with ASD and to address limitations in current emotion recognition programs. Modifications included: coach-assistance, a combination of didactic instruction for seven basic emotions, scaffold instruction which included repeated practice with increased presentation speeds, guided attention to relevant facial cues, and imitation of expressions. Training occurred twice each week for 45–60 min across an average of six sessions. Outcome measures were administered prior to and immediately after treatment, as well as after a delay period of 4–6 weeks. Outcome measures included (a) direct assessment of facial emotion recognition, (b) emotion self-expression, and (c) generalization through emotion awareness in videos and stories, use of emotion words, and self-, parent-, and teacher-report on social functioning questionnaires. The facial emotion training program enabled children and adolescents with ASD to more accurately and quickly identify feelings in facial expressions with stimuli from both the training tool and generalization measures and demonstrate improved self-expression of facial emotion.