Psychometric Properties and Clinical Utility of the Texas Functional Living Scale Short Form in Individuals with Schizophrenia

Abstract

BACKGROUND: Schizophrenia is a chronic mental disorder presenting with psychotic and cognitive symptoms that lead to impairments in independent living and psychosocial functioning. Individuals with schizophrenia demonstrate cognitive deficits in areas of attention, executive functioning, memory, and language. Additionally, schizophrenia has been associated with impairments in activities of daily living (ADLs) such as toileting and the ability to feed one’s self and instrumental activities of daily living (IADLs) such as taking medication, financial management, communication, and transportation. METHODS: Twenty-six participants diagnosed with schizophrenia or schizoaffective disorders were recruited from the University of Texas Southwestern Medical Center’s Division of Translational Neuroscience of Schizophrenia’s IRB approved Database Registry for Psychotic Disorders and completed a neuropsychological test battery which included the Texas Functional Living Scale (TFLS) and University of California San Diego (UCSD) Performance-based Skills Assessment (UPSA). IBM SPSS Statistics (SPSS v. 19.0) was used to perform Pearson correlation coefficients and multiple regression analyses to identify which subscale(s) of the TFLS had the highest predictive ability for examining IADLs to create a possible short form and to identify which subscales of the TFLS long form have the strongest correlation to neurocognitive measures used in the study. The present pilot study used the Type I error rate at .10; a 90% confidence interval. RESULTS: Results of the analysis indicated that the Time and Money Calculation subscales of the TFLS long form significantly correlated with more neurocognitive measures than the UPSA. Specifically, these two subscales had a higher number of moderate to strong correlations with the neurocognitive measures compared to the UPSA. Results also indicated the TFLS short form to have a stronger correlation with the UPSA (r =.59, p < .003) compared to baseline correlations of the TFLS long form and the UPSA (r = .34, p < .112), which suggests that the Time and Money Calculations subscales of the TFLS can be used as a valid short form of the TFLS in the assessment of IADLS in schizophrenia. DISCUSSION: Overall, the short form of the TFLS appears to be a valuable addition to standard neuropsychological assessment batteries given its numerous correlations with neurocognitive measures. Results also suggest that the TFLS short form is a stronger measure for detecting IADL impairments compared to its original long form and the UPSA.