Social functioning consists of the person’s ability to adapt to his or her social environment and its demands. This term refers to the ability to relate to other people, as well as to maintain these relationships, enjoy free time, take care of ourselves and be able to develop the roles that society expects of us.
In schizophrenia spectrum disorders, The deterioration of social functioning is a central aspect of the problem and can be detected early in the course of the disorder. Furthermore, this phenomenon persists even when the acute phase of the disease has passed. On the other hand, the literature shows how certain factors present in patients with schizophrenia spectrum disorders, such as childhood trauma, negative symptoms or certain personality traits, accentuate this deficit in social functioning.
Assessing social functioning in schizophrenia
It is evident then that adequately evaluating the social functioning of patients with schizophrenia spectrum disorders is of great importance, since This way, the most effective treatments can be provided for each patient’s specific situation.
But it is not only necessary to be able to effectively evaluate the deterioration of social functioning at the level of clinical practice, it is also necessary for research in this area and thus be able to understand in depth what are the factors and mechanisms that intervene and modulate this deterioration. .
For this evaluation there are psychometric tools, such as questionnaires or interviews, that help both the clinician and the researcher to know the degree of deficit in the social functioning of the patients.
Here we will name four of the most used instruments and review their characteristics (both in its structure and in relation to its psychometric characteristics). All of them have been adapted to Spanish and validated in a population with schizophrenia spectrum disorders.
1. Personal and social functioning scale (PSP)
This scale developed by Morosini, Magliano, Brambilla, Ugolini, and Pioli (2000) evaluates four areas of the patient’s social functioning : a) self-care; b) usual social activities; c) personal and social relationships; and d) disruptive and aggressive behaviors. It is scored by the clinician and includes a semi-structured interview to help obtain good information about each of the areas.
On this scale The 4 areas are scored using a 6-point Likert scale, ranging from 1 (absent) to 6 (very serious). Scores are obtained in each of the 4 areas, such that higher scores indicate worse functioning, and a global scale score in which higher values reflect better personal and social functioning.
The Spanish version of this instrument, developed by Garcia-Portilla et al., (2011), has an internal consistency of 0.87 and a test-retest reliability of 0.98. Therefore, it is a valid and reliable instrument to measure social functioning in patients with schizophrenia.
2. Social Functioning Scale (SFS)
The scale developed by Birchwood, Smith, Cochrane, Wetton, and Copestake (1990) evaluates social functioning in the last three months of the patient’s life with schizophrenia spectrum disorders, and can be administered either in the form of a self-reported questionnaire or in a semi-structured interview.
It consists of 78 items where seven subscales are measured: isolation, interpersonal behavior, prosocial activities, free time, independence-competence, independence-execution and employment-occupation. The Spanish version by Torres and Olivares (2005) presents high alpha coefficients (between 0.69 and 0.80) making it a valid, reliable and sensitive instrument.
3. Quality of Life Scale (QLS)
It is a semi-structured interview that contains 21 items, with a 7-point Likert scale. It was developed by Heinrichs, Hanlon, and Carpenter (1984) and evaluates 4 areas: a) intrapsychic functions; b) interpersonal relationships; c) instrumental role; and d) use of common objects and everyday activities.
This scale It is used both to measure the quality of life of patients and their socio-occupational functioning. The Spanish version adapted by Rodríguez, Soler, Rodríguez M., Jarne Esparcia, and Miarons, (1995) is a valid tool, with high internal consistency (0.963) and reliable.
4. WHO Disability Assessment Questionnaire (WHO-DAS-II)
This questionnaire, with different versions (36, 12 and 5 items), evaluates different areas of functioning: understanding and communicating with the world ability to manage one’s environment, personal care, relationships with other people, activities of daily living and participation in society.
Developed by Vázquez-Barquero et al., (2000), its usefulness, validity and reliability in patients with schizophrenia spectrum disorders was later corroborated by Guilera et al., (2012).
Bibliographic references:
Lysaker, PH, Meyer, PS, Evans, JD, Clements, CA, & Marks, KA (2001). Childhood Sexual Trauma and Psychosocial Functioning in Adults With Schizophrenia. Psychiatric Services, 52(11), 1485–1488.
Morosini, P.L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 101(4), 323–9. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10782554
Rodríguez, A., Soler, RM, Rodríguez M., A., Jarne Esparcia, AJ, & Miarons, R. (1995). Factorial study and adaptation of the Quality of Life in Schizophrenia Scale (QLS). Magazine of general and applied psychology: Magazine of the Spanish Federation of Psychology Associations. Spanish Federation of Psychology Associations.
Torres, A., & Olivares, JM (2005). Validation of the Spanish version of the Social Functioning Scale. Spanish Acts of Psychiatry, 33(4), pp. 216 – 220.
Vázquez-Barquero, JL, Vázquez Bourgón, E., Herrera Castanedo, S., Saiz, J., Uriarte, M., Morales, F., … Disabilities, GC en. (2000). Spanish language version of a new WHO disability assessment questionnaire (WHO-DAS-II): Initial development phase and pilot study. Spanish Acts of Psychiatry.
