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Quality of Life Scale
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About Quality of Life Scale
Scale Name
Quality of Life Scale
Author Details
Douglas W. Heinrichs, Thomas E. Hanlon, and William T. Carpenter Jr.
Translation Availability
English
Background/Description
The Quality of Life Scale (QLS), developed by Heinrichs et al. (1984), is a 21-item clinician-administered scale designed to assess the deficit syndrome and quality of life in adults with schizophrenia, focusing on negative symptoms and functional impairments. Published in Schizophrenia Bulletin, the QLS evaluates four domains: Interpersonal Relations (8 items, e.g., social activity, intimacy), Instrumental Role Functioning (4 items, e.g., occupational role), Intrapsychic Foundations (7 items, e.g., sense of purpose, motivation), and Common Objects/Activities (2 items, e.g., engagement with everyday items). It is designed to capture functioning beyond symptom severity, emphasizing social and occupational deficits.
Clinicians rate items based on a semi-structured interview and observation over the past 4 weeks, using a 7-point Likert scale (0 = “Severe impairment” to 6 = “Normal functioning”). Total scores range from 0–126, with higher scores indicating better quality of life and less severe deficit symptoms. The QLS was validated with 55 outpatients with schizophrenia (mean age ≈ 30–40 years, ~60% male, U.S.-based), showing that lower scores (e.g., <60) were associated with chronic negative symptoms. It correlates with the Scale for the Assessment of Negative Symptoms (SANS; r ≈ 0.50–0.70) and social functioning measures (r ≈ 0.40–0.60). The scale is used in clinical psychology, psychiatry, and research to assess functional outcomes, monitor treatment effects, and guide rehabilitation in schizophrenia.
Administration, Scoring and Interpretation
- Obtain the scale from Heinrichs et al. (1984) or authorized sources (e.g., Schizophrenia Bulletin), ensuring ethical permissions.
- Explain to participants (adults with schizophrenia) that the clinician will assess their daily functioning and social engagement, emphasizing confidentiality and voluntary participation.
- Administer the 21-item scale via a semi-structured interview in a clinical setting, rating items based on patient reports and observations over the past 4 weeks.
- Estimated completion time is 30–45 minutes.
- Ensure a private, supportive environment; provide mental health resources (e.g., crisis hotlines) and adapt for accessibility (e.g., simplified language) if needed.
Reliability and Validity
The QLS demonstrates robust psychometric properties (Heinrichs et al., 1984; Bilker et al., 2003). Internal consistency is high (Cronbach’s alpha ≈ 0.88–0.93 for total score; 0.80–0.90 for subscales), based on samples of 55–103 patients with schizophrenia. Inter-rater reliability is strong (r ≈ 0.85–0.95 for total score, 0.80–0.90 for subscales). Test-retest reliability is moderate to high (r ≈ 0.70–0.85 over 3–4 weeks).
Convergent validity is supported by correlations with the SANS (r ≈ 0.50–0.70), Positive and Negative Syndrome Scale (PANSS negative subscale; r ≈ 0.45–0.65), and social adjustment measures (r ≈ 0.40–0.60). Factorial validity confirms a four-factor structure. Criterion validity is evidenced by its ability to differentiate deficit from non-deficit schizophrenia and sensitivity to psychosocial treatment changes. Pairing with measures like the PANSS or Social Functioning Scale enhances comprehensive assessment.
Available Versions
21-Items
Reference
Heinrichs, D. W., Hanlon, T. E., & Carpenter Jr, W. T. (1984). The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophrenia bulletin, 10(3), 388-398.
Important Link
Scale File:
Frequently Asked Questions
What does the Quality of Life Scale measure?
It measures quality of life and deficit syndrome severity in schizophrenia, focusing on interpersonal, role functioning, and intrapsychic domains.
Who is the target population?
Adults with schizophrenia.
How long does it take to administer?
Approximately 30–45 minutes.
Can it inform interventions?
Yes, it assesses functional impairments to guide rehabilitation and treatment planning.
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