Social skills performance assessment among older patients with schizophrenia

Objective: Social functioning is an important outcome dimension in schizoph renia. Measures of social skills frequently rely on self-report, and most m easures which directly assess social functioning are time consuming. Here w e 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 s ocial 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 standar dized role plays, one requiring introduction to a stranger and another requ iring assertive behavior with their landlord. Ratings in eight areas rangin g from;social appropriateness' to 'grooming' were made. Results: SSPA requi red about 12 min to complete both role play and ratings, and had excellent interrater reliability, and good test-retest reliability. Patients demonstr ated significantly greater disability in all areas of social functioning co mpared with NCs. Social performance was related to severity of negative sym ptoms and cognitive deficits, but not that of positive or depressive sympto ms. SSPA scores were significantly correlated with health-related quality o f well-being and observed performance on activities of daily Living, but no t to a self-reported measure of social functioning. Conclusion: The SSPA is a reliable and useful instrument. Direct assessment of social skills may p rovide a more accurate picture of functioning than self-report measures amo ng patients who frequently lack insight into their own behavior. (C) 2001 E lsevier Science B.V. All rights reserved.