The Global Functioning: Social and Role Scales-Further Validation in a Large Sample of Adolescents and Young Adults at Clinical High Risk for Psychosis
The Global Functioning: Social and Role Scales-Further Validation in a Large Sample of Adolescents and Young Adults at Clinical High Risk for Psychosis
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DOI：
10.1093/schbul/sby126
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发表时间：
2019-07-01
影响因子：
6.6
通讯作者：
Cornblatt, Barbara A.
中科院分区：
文献类型：
--
作者：
Carrion, Ricardo E.;Auther, Andrea M.;Cornblatt, Barbara A.
目的：评估成年精神分裂症患者功能的传统方法已被证明不足以评估出现在临床精神病高风险（CHR）的青少年和年轻人身上的问题。目前的研究对专门用于CHR个体的全球功能：社会（GF:Social）和角色（GF:Role）量表进行了扩展验证，并探讨了评分的可靠性和准确性，与其他已建立的临床测量值相比，得分的有效性，2年期间功能的稳定性以及精神病的预测能力。方法：755名CHR个体和277名健康对照（HC）参与者在基线完成GF：社会和角色量表，作为北美前驱期纵向研究（NAPLS2）的一部分。结果：两种量表均具有较高的信度和准确性。GF评分与其他已建立的临床测量指标之间的相关性显示出可接受的收敛效度和判别效度。此外，GF：社会和角色得分与阳性症状无关。即使在调整了年龄、智商和减弱的阳性症状后，与hc相比，CHR参与者在2年内表现出较大的社会和角色功能障碍。最后，与非转换者相比，CHR转换者在基线前的社会衰退更为明显。结论：GF量表可用于大规模的多地点研究，具有良好的量表间信度和准确性。随着时间的推移，CHR个体表现出社会和角色功能障碍，这与阳性症状严重程度无关。本研究的结果表明，社会衰退是一个特别有效的预测转换结果。
Objective: Traditional measures for assessing functioning with adult patients with schizophrenia have been shown to be insufficient for assessing the issues that occur in adolescents and young adults at clinical high risk (CHR) for psychosis. The current study provides an expanded validation of the Global Functioning: Social (GF:Social) and Role (GF:Role) scales developed specifically for use with CHR individuals and explores the reliability and accuracy of the ratings, the validity of the scores in comparison to other established clinical measures, stability of functioning over a 2-year period, and psychosis predictive ability. Methods: Seven hundred fifty-five CHR individuals and 277 healthy control (HC) participants completed the GF:Social and Role scales at baseline as part of the North American Prodrome Longitudinal Study (NAPLS2). Results: Inter-rater reliability and accuracy were high for both scales. Correlations between the GF scores and other established clinical measures demonstrated acceptable convergent and discriminant validity. In addition, GF:Social and Role scores were unrelated to positive symptoms. CHR participants showed large impairments in social and role functioning over 2-years, relative to the HCs, even after adjusting for age, IQ, and attenuated positive symptoms. Finally, social decline prior to baseline was more pronounced in CHR converters, relative to non-converters. Conclusions: The GF scales can be administered in a large-scale multi-site study with excellent inter-rater reliability and accuracy. CHR individuals showed social and role functioning impairments over time that were not confounded by positive symptom severity levels. The results of this study demonstrate that social decline is a particularly effective predictor of conversion outcome.