Marc Corbière

Investigating self-esteem in individuals with schizophrenia: Relevance of the Self-Esteem Rating Scale-Short Form

Studies investigating self-esteem in individuals with severe mental illness, either as a treatment goal, outcome or correlate to other variables, have increased over the past few years. One of the main difficulties in assessing self-esteem is the assessment itself, often measuring global and stable self-esteem as in the Rosenberg Self-Esteem Scale, or requiring extensive training and long interviews. The present article aims at demonstrating the relevance of the French and English versions of the Self-Esteem Rating Scale-Short Form with individuals with severe mental illness. The instruments reliability and validity were investigated in a sample of 250 French Canadian college students, 247 British college students and three samples of English- or French-speaking individuals with severe mental illness (N=254, N=150 and N=171). Confirmatory factor analysis revealed that a shorter version of the instrument (20 items), with a positive and a negative self-esteem factor, had a great validity for all the samples studied. The Self-Esteem Rating Scale-Short Form, with its positive and negative self-esteem subscales, appears to be a valid and reliable self-esteem measure for individuals with mental health problems. Limitations of this study and future directions are discussed.

Change in quality of life of people with stroke over time : True change or response shift?

In many studies, assessments of change in self-report measures such as health-related quality of life must account for potential response shift, including reconceptualization and changes in internal standards of measurement. Objective: The objective of our study was to compare healthy controls and individuals with stroke on the extent to which changes in internal standards and reconceptualization of health related quality of life (HRQL) occurs over the first 6 months post-stroke. Methods: Confirmatory factor analysis was used to assess invariance of the SF-36 measurement model over time among 238 individuals with stroke and 392 controls, separately. This procedure assessed changes over time in the factor loadings, variances, and covariances of responses, and compared the extent of change between individuals with stroke and those in the control group. In addition a multisample comparison was made between individuals with stroke and members of the control group at the first evaluation in order to assess invariance of the SF-36 measurement model between the groups. The controls were considered to be a ‘proxy’ for the stroke cohort prior to the stroke. Results: We found no evidence of reconceptualization and changes in internal standards over time when the groups were assessed separately. There was a significant difference in the factor covariances (reconceptualization) between the two groups at the time of the first evaluation. However, measurement error was also significant for this comparison. Conclusion: This study indicates that the improvement in HRQL over time is real rather than a result of reconceptualization or a recalibration. If response shift does occur with stroke it is likely to be mediated by the event itself and not the recovery process.

Initial Depression Severity and the Trajectory of Recovery Following Cognitive-Behavioral Intervention for Work Disability

Introduction: The present study examined the recovery trajectories of a group of mildly depressed and moderately-severely depressed injured workers enrolled in a 10-week community-based rehabilitation program. Methods: A sample of 168 individuals (75 women, 93 men) with a disabling musculoskeletal pain condition participated in the research. On the basis of BDI-II (1) scores at pre-treatment assessment, patients were classified as either mildly (BDI-II =9–16; N=68) or moderately-severely depressed (BDI-II >16; N: 100). Results: Both groups showed significant reductions in depression, but individuals in the (initially) moderately-severely depressed group were more likely to score in the depressed range of the BDI-II at post-treatment than individuals who were initially mildly depressed. For the mildly depressed group, early treatment reductions in pain catastrophizing, and perceived disability predicted improvement in depression scores. For the moderately-severely depressed group, none of the early treatment changes predicted improvement in depression; only late treatment reductions in pain catastrophizing and fear of movement/re-injury predicted improvement in depression. Chi-square analysis revealed that patients who were no longer depressed at post-treatment had the highest probability of returning to work (91%), followed by (post-treatment) mildly depressed patients (60%), and finally (post-treatment) moderately-severely depressed patients (26%), χ2=38.9, p < 0.001. Conclusion: In order to maximize return to work potential, the content, structure and duration of rehabilitation programs requires modification as a function of the injured workers level of the depression severity.

Perceptions of Barriers to Employment, Coping Efficacy, and Career Search Efficacy in People with Mental Illness:

The Barriers to Employment and Coping Efficacy Scale (BECES) and the Career Search Efficacy Scale (CSES) were designed to assist people in their work integration process. The BECES was specifically developed for people with mental illness. Although the CSES was not specifically designed for people with mental illness, its items appear relevant for such clients seeking work. This article reports the construct and convergent validities of these two questionnaires as well as the internal consistency pertaining to each of their subscales. The BECES and CSES demonstrated satisfactory results regarding their validity and reliability with people suffering from mental illness registered in vocational programs. Practical guidelines based on this experience are discussed.

Do people with a first episode of psychosis differ in personality profiles

UNLABELLED Studies on personality profiles in psychosis typically report certain personality traits as linked to the disorder. OBJECTIVES To determine if individuals with a first episode of psychosis: 1) differ from a non-clinical group on the five factor model of personality; 2) all present with similar personality profiles; 3) hold stable personality traits over time. METHOD 79 individuals with a first episode of psychosis were recruited. RESULTS The first episodes significantly differed from the control group on all five personality dimensions. Results also revealed three personality profiles, one linked to psychotic symptoms. Moreover, personality traits of the first episodes showed stability over time.

Intrusion errors in explicit memory: Their differential relationship with clinical and social outcome in chronic schizophrenia

Introduction. Memory deficits might account for clinical and adaptive differences between groups of patients with chronic schizophrenia. We investigated the qualitative factors of memory that influence clinical and social status. Methods. Psychosocial functioning, clinical symptoms, and memory function were assessed in 99 patients at four time points over a 16-month period using recall scores for semantically related words, unrelated words, paired associated learning, and word span. An initial cluster analysis using symptom assessment data from all four time points divided the sample into three groups: patients with low symptoms ratings that remained stable throughout the study period (low symptom-stable group—LSSG; N=51); patients with initially high symptoms ratings that subsequently improved (high symptom-improved group—HSIG; N=32); and patients with initially high symptoms ratings that deteriorated during the follow-up (high symptom-deteriorated group—HSDG; N=16). Results. Memory was better preserved in LSSG compared to HSIG and HSDG patients. Recall performance was generally better for semantically related words than for unrelated words but the difference between LSSG and the two other groups was more constant over time for semantically related words. Extra-list errors variable was positively correlated with three PANSS measures (r=.25−.47). Also, the extra-list errors scores were correlated with the Magical Ideation Scale (r=.34–.39). Memory scores (global explicit, unrelated, related) were significantly and positively correlated with independent living skills (r=.26–.55) and the extra-list errors were negatively correlated with both social support and independent living skills (r=−.29 and r=−.46, respectively). All groups showed a reduction in extraneous false recognition errors/intrusions (FRIs) over time with the HSIG showing the greater change. HSIG and HSDG patients committed slightly more FRIs in recall tasks (extraneous information) than LSSG patients. Conclusion. Memory performance is better in patients presenting with less severe symptomatology. The extent to which FRIs reduce over time in patients with schizophrenia is a novel finding.