Validation of the UCSD Performance-based Skills Assessment (UPSA) in Hispanics with and without schizophrenia

Abstract

The UCSD Performance-based Skills Assessment (UPSA) is a widely used measure of functional capacity with strong reliability and validity. However there is a lack of psychometric data on Hispanics. The purpose of this study was to determine the impact of acculturation and education on UPSA performance among 62 Hispanic participants with schizophrenia or schizoaffective disorder and 46 healthy comparison subjects. Functional capacity was measured using the UPSA. Acculturation was measured using the Acculturation Rating Scale for Mexican Americans (ARSMA). Independent t-tests indicated that participants with schizophrenia had significantly lower UPSA total scores and scored lower on all UPSA sub-scales relative to the comparison group. Multiple regression also indicated that education and acculturation were significant predictors of UPSA total scores. These data provide a better understanding of UPSA scores in Hispanics with and without schizophrenia, and suggest that education and acculturation adjustments may be required to improve interpretation of test results.

Construct validity, sensitivity and specificity of the USCD Performance-based Skill Assessment 2 in a mixed Portuguese sample

“…Moreover, while the convenience sampling method used in the current study requires caution in the generalization of findings. Nevertheless, it is important to highlight that the general psychometric characteristics and functional milestones in the current study is similar to those found in several UPSA studies in Western countries, particularly to those using samples of inand outpatients with schizophrenia and controls in studies (Garcia-Portilla et al, 2013;Keefe et al, 2016;Mantovani et al, 2015;Mausbach et al, 2016;Patterson et al, 2001). Overall findings suggest a good integrity and robustness of the UPSA set measures in general, and the UPSA-2-PT.…”

“…In addition, more important than the language nuances between Portuguese native-speakers, it is important to emphasize the need to adapt the tasks as much as possible to the cultural specificities and daily routines, which can differ considerably between European and American countries. This was verified in the English and Spanish versions of the UPSA, when administered to Hispanic populations (Garcia-Portilla et al, 2013;Mausbach et al, 2016). Providing equivalent but ecologically valid measures is also of utmost important considering the increased mobility of European, American and African Portuguese-native speakers worldwide.…”

“…This approach provides significant advantages, as increased ecological validity and objectivity, and the flexibility of adaptation to different cultural contexts, while maintaining task and scoring integrity. For this reason, performance-based assessment has been an important approach to the evaluation of the functional capacity in patients suffering with all kinds of impairing diseases, like Dementia, Mild Cognitive Impairment, Bipolar Disorder and Schizophrenia and Schizoaffective disorders (Becattini-Oliveira, Dutra, Spenciere de Oliveira Campos, de Araujo, & Charchat-Fichman, 2018;Garcia-Portilla et al, 2013;Mausbach et al, 2016).…”

“…Previous studies have shown the importance of using the translated and adapted tasks when assessing participants from different cultural backgrounds or in their native language (Garcia-Portilla et al, 2013;Mantovani et al, 2015;Mausbach et al, 2016), and studying their psychometric properties in different populations is an important step in assuring scores comparability and test integrity across versions. Most studies on the validity of the UPSA did not include inter-rater reliability, an important aspect that should be excluded from the factors that may influence variability in scores across different versions of the UPSA and few have analyzed the sensitivity and specificity of scores and suggested possible cutoff points to functional capacity (Becattini-Oliveira et al, 2018).…”

Validation of a performance‐based assessment of cognitive functional ability in Parkinson's disease

“…A potential remedy for this limitation may be the development of a wearable tracker or app-based assessment of cognitive functional abilities in real time. The UPSA also lacks alternate full versions, though there are brief 66 and computerized 67 versions of the test, and it has been translated into Spanish, 68 Portuguese, 69 and Japanese. 70 Finally, given the cross-sectional design of this study, we were unable to explore the psychometric properties of responsiveness and minimal clinically important difference for the UPSA.…”