Psychometric properties of the mock interview rating scale for schizophrenia and other serious mental illnesses

BackgroundOver the past 10 years, job interview training has emerged as an area of study among adults with schizophrenia and other serious mental illnesses who face significant challenges when navigating job interviews. The field of mental health services research has limited access to assessments of job interview skills with rigorously evaluated psychometric properties.ObjectiveWe sought to evaluate the initial psychometric properties of a measure assessing job interview skills via role-play performance.MethodsAs part of a randomized controlled trial, 90 adults with schizophrenia or other serious mental illnesses completed a job interview role-play assessment with eight items (and scored using anchors) called the mock interview rating scale (MIRS). A classical test theory analysis was conducted including confirmatory factor analyses, Rasch model analysis and calibration, and differential item functioning; along with inter-rater, internal consistency, and test-retest reliabilities. Pearson correlations were used to evaluate construct, convergent, divergent, criterion, and predictive validity by correlating the MIRS with demographic, clinical, cognitive, work history measures, and employment outcomes.ResultsOur analyses resulted in the removal of a single item (sounding honest) and yielded a unidimensional total score measurement with support for its inter-rater reliability, internal consistency, and test-retest reliability. There was initial support for the construct, convergent, criterion, and predictive validities of the MIRS, as it correlated with measures of social competence, neurocognition, valuing job interview training, and employment outcomes. Meanwhile, the lack of correlations with race, physical health, and substance abuse lent support for divergent validity.ConclusionThis study presents initial evidence that the seven-item version of the MIRS has acceptable psychometric properties supporting its use to assess job interview skills reliably and validly among adults with schizophrenia and other serious mental illnesses.Clinical Trial RegistrationNCT03049813

Mental health provider perspectives of the COVID-19 pandemic impact on service delivery: a focus on challenges in remote engagement, suicide risk assessment, and treatment of psychosis

Abstract Background The COVID-19 pandemic has been impacting the need, utilization, and delivery of mental health services with greater challenges being faced by clients and providers. With many clients facing reduced access to services and social isolation, a focus on suicide risk assessment and prevention is critical. Concern is particularly increased for clients with schizophrenia spectrum disorders given data show suicide rates are disproportionately high for those with psychosis in comparison to the general population. Provider perspectives of challenges in service delivery are needed to inform efforts to improve access, feasibility, and quality of mental health care throughout the evolving pandemic. This study explored mental health provider perspectives of client challenges in service utilization and provider challenges in service delivery, including remote engagement, suicide risk assessment, and treatment of psychosis. Methods Data were collected from social work mental health providers (n = 12) in United States community mental health setting. Providers consented to participate and responded to questions about service delivery experiences in late 2020 and in relation to COVID-19. Demographic and practice-related provider data were explored descriptively using SPSS and qualitative data using open coding and grounded theory methods in Dedoose. Results Among the 9 providers who engaged in remote service delivery, 7 (77.8%) experienced challenges in remote engagement with clients and 8 (88.9%) experienced challenges in treatment of psychosis. Among the 7 providers who engaged in remote suicide assessment, 4(57%) experienced challenges. Qualitative themes emerged including logistic (e.g., technology access and use), engagement (e.g., virtual rapport-building and limited remote services), and clinical (e.g., difficulty assessing suicide risk, internal stimuli, abnormal involuntary movement, and affect) challenges in service delivery. Conclusions Provider perspectives are essential to inform efforts to build resources and problem-solve challenges and barriers that both providers and clients face throughout various shifts in mental health service delivery. Findings emphasize the need to troubleshoot client access to technology, bolster support for providers to prevent burnout, and greater provider training to improve skills in remote engagement, assessment, and treatment, particularly in relation to psychosis and suicide prevention. Study implications are not only critical for the evolving COVID-19 pandemic, but also in preparation for ongoing shifts in service delivery as technology evolves.http://deepblue.lib.umich.edu/bitstream/2027.42/173788/1/12913_2022_Article_8106.pd

The indirect effect of bullying on adolescent self-rated health through mental health: A gender specific pattern

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153317/1/2019Zhangetal.CYSR3.pd

Depression moderates the relationships between hallucinations, delusions, and suicidal ideation: The cumulative effect of experiencing both hallucinations and delusions

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153319/1/2019BornheimerZhangetalJPR.pd

Longitudinal predictors of stigma in first‐episode psychosis: Mediating effects of depression

AimStigma is commonly experienced among individuals with schizophrenia spectrum disorders and has been shown to be a barrier to help‐seeking and behavioural service utilization. Given the established relationships between stigma, barriers to treatment, and poorer psychiatric outcomes including depression and psychotic symptoms, we examined the relationships between symptoms of depression, positive and negative symptoms, and the emergence of stigma longitudinally among a sample of first‐episode of psychosis (FEP) participants in the United States.MethodsData were obtained from the Recovery After an Initial Schizophrenia Episode project of National Institute of Mental Health’s Early Treatment Program. Participants (n = 404) included adults between ages 15 and 40 with schizophrenia or other psychotic disorders based on the DSM‐IV. Data were analysed using structural equation modelling (SEM).ResultsFindings indicated that increased positive and negative symptoms independently related to greater symptoms of depression at baseline. Furthermore, increased positive symptoms and symptoms of depression at baseline independently related to the emergence of greater stigma being experienced over time.ConclusionsConsidering the role that symptoms of depression played as a factor explaining the relationships between positive and negative symptoms and emergence of stigma over time among individuals in FEP, and symptoms of depression is important predictor of stigma and may furthermore present as a viable and less stigmatizing initial treatment target in the early course of a psychotic disorder.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167103/1/eip12935_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167103/2/eip12935.pd

Cognitive behavioral therapy for primary care depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153320/1/2019ZhangetalJBM.pd

The effectiveness of four empirically supported psychotherapies for primary care depression and anxiety: A systematic review and meta-analysis

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153296/1/2019ZhangetalJAD.pd