Validation D'un Questionnaire D'évaluation du Fonctionnement Social Des Personnes Ayant Des Troubles Mentaux Chroniques

Recognition of the crucial role of social adjustment in the assessment and understanding of major mental disorders is now well established. Deterioration of social relations is one of the criteria to diagnose schizophrenia according to the DSM-III-R. Recent findings (Bellack, Morrison, Wixted, & Mueser, 1990) suggest variable correlations between social adjustment and positive symptoms. This may indicate that the impairments in social functioning are not simply consequences of positive symptoms. Adequate assessment of social functioning is also needed to prescribe proper interventions and for planning purposes. This study was conducted in order to examine the psychometric properties of a modified version of the social adjustment scale (SAS-II). The French version of the SAS-II was modified to allow the assessment of social functioning in hospital settings and other supervised settings. Participants were 276 persons suffering from major mental disorders, mainly schizophrenia (57.4%). Respondents were selected in psychiatric hospitals, psychiatric units of general hospitals, and in the community. Five trained interviewers conducted interviews with the participants. Agreement between independent rates was strong, since 42 out of 45 items yielded intraclass correlations or kappa coefficients above .6. Testretest reliability was satisfactory. Alpha values ranged between,47 and,81, Validity was mainly assessed through discriminant analyses of the SAS-II scales with diagnostic groups and current program provision. Reliability and validity results confirmed the relevance of the modified version of the SAS-II for assessing individuals with severe psychiatric disorders in contact with psychiatric services. Recommendations for future development of the scale are proposed.

L'évaluation du fonctionnement social des personnes affigées de troubles mentaux est importante tant pour l'identification des services et programmes requis que pour l'avancement fondamental des connaissances. Il est en effet difficile de concevoir une réponse adéquate aux besoins des personnes manifestant des troubles mentaux sans efforts de définition et d'évaluation de leur fonctionnement social. À leur tour ces efforts doivent entraîner une meilleure prescription et planification des services et programmes offerts. Cette êtude rapporte les propriétés psychométriques de l'échelle d'adaptation sociale II (EAS-II) destinée à la mesure du fonctionnement social des personnes présentant des troubles mentaux graves et persistants. Les résultats de cette recherche suggèrent des corrélations interjuges et test-retest très satisfaisantes. En outre, suite à la construction des échelles de l'EAS-II, leur consistance interne et leur capacité convergente et discriminante se révélent adéquates. En conclusion des suggestions pour le développement futur de ce questionnaire sont formulées.