Assessment of Lifespan Functioning Attainment (ALFA) scale: A quantitative interview for self-reported current and functional decline in schizophrenia - PubMed (original) (raw)

Assessment of Lifespan Functioning Attainment (ALFA) scale: A quantitative interview for self-reported current and functional decline in schizophrenia

Jamie Joseph et al. J Psychiatr Res. 2015 Jun.

Abstract

Schizophrenia has been characterized as a disorder with poor outcomes across various functional domains, especially social and occupational functioning. Although these outcomes have been investigated based on patients' current functioning, few studies have considered the assessment of functional outcomes across the lifespan in schizophrenia. We developed a novel and brief scale of adulthood lifespan functioning, the Assessment of Lifespan Functioning Attainment (ALFA). We assessed current functioning and percentage of pre- and post-psychosis onset engagement for five functional domains including paid employment, living independently, romantic partnerships, close friendships, and recreational engagement with others. Pre-to post-psychosis functional decline was observed for all domains, with paid employment having the greatest decline (d = 2.68) and living independently having the least decline (d = .59). Our exploratory factor analysis suggests that a single factor accounted for the most variance in Pre-Psychosis Functioning in ALFA domains. Two factors explain the majority of variance in Post-Psychosis Functioning and Pre-to-Post Psychosis Decline: a sociability factor (close friendships and recreational engagement with others) and an independence factor (paid employment, living independently, romantic relationships). To our knowledge, this is the first study to report on a self-reported quantitative assessment of adult lifespan functioning in schizophrenia. The ALFA scale may be a useful tool for future research on functional outcomes in schizophrenia.

Keywords: Employment; Functional outcome; Psychosis; Social functioning.

Published by Elsevier Ltd.

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Figures

Figure 1

Mean percent time ALFA domain engagement in younger vs. older study participants. The mean percentage of time of adulthood engagement for each ALFA domain was determined for younger vs. older study participants.

References

1. Addington D, Addington J, Maticka-Tyndale E. Assessing depression in schizophrenia: the Calgary Depression Scale. The British journal of psychiatry Supplement. 1993:39–44. -PubMed
1. Andreasen NC. Scale for the assessment of Negative Symptoms (SANS) University of Iowa; Iowa City, IA: 1983.
1. Andreasen NC. Scale for the Assessment of Positive Symptoms (SAPS) University of Iowa; Iowa City, IA: 1984.
1. Andreasen NC, Pressler M, Nopoulos P, Miller D, Ho BC. Antipsychotic dose equivalents and dose-years: a standardized method for comparing exposure to different drugs. Biological psychiatry. 2010;67:255–62. -PMC -PubMed
1. APA . Diagnostic and statistical manual of mental disorders. 4th ed., text rev. Washington: p. DC2000.

Assessment of Lifespan Functioning Attainment (ALFA) scale: A quantitative interview for self-reported current and functional decline in schizophrenia - PubMed (original) (raw)