Psychometric properties of performance-based measurements of functional capacity: Test-retest reliability, practice effects, and potential sensitivity to change

Performance-based measures of the ability to perform social and everyday living skills are being more widely used to assess functional capacity in people with serious mental illnesses such as schizophrenia and bipolar disorder. Since they are also being used as outcome measures in pharmacological and cognitive remediation studies aimed at cognitive impairments in schizophrenia, understanding their measurement properties and potential sensitivity to change is important. In this study, the test-retest reliability, practice effects, and reliable change indices of two different performance-based functional capacity measures, the UCSD Performance-Based Skills Assessment (UPSA) and Social Skills Performance Assessment (SSPA) were examined over several different retest intervals in two different samples of people with schizophrenia (n's=238 and 116) and a healthy comparison sample (n=109). These psychometric properties were compared to those of a neuropsychological assessment battery. Test-retest reliabilities of the long form of the UPSA ranged from r=63 to r=80 over follow-up periods up to 36. months in people with schizophrenia, while brief UPSA reliabilities ranged from r=66 to r=81. Test-retest reliability of the NP performance scores ranged from r=77 to r=79. Test-retest reliabilities of the UPSA were lower in healthy controls, while NP performance was slightly more reliable. SSPA test-retest reliability was lower. Practice effect sizes ranged from .05 to .16 for the UPSA and .07 to .19 for the NP assessment in patients, with HC having more practice effects. Reliable change intervals were consistent across NP and both FC measures, indicating equal potential for detection of change. These performance-based measures of functional capacity appear to have similar potential to be sensitive to change compared to NP performance in people with schizophrenia.