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Validating a Brief Version of the Mental Health Recovery Measure for Individuals With Schizophrenia
Nikki Panasci Armstrong, Ph.D.; Amy N. Cohen, Ph.D.; Gerhard Hellemann, Ph.D.; Christopher Reist, M.D.; Alexander S. Young, M.D., M.S.H.S.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300215
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Dr. Armstrong is with the San Francisco Veterans Affairs Medical Center (VAMC) (e-mail: nikki.armstrong@va.gov). At the time of this study, she was with the VAMC Los Angeles, California, where Dr. Young is affiliated. Dr. Cohen is with the VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC) at the VAMC Los Angeles. Dr. Hellemann is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, where Dr. Cohen and Dr. Young are also affiliated. Dr. Reist is with the VA Desert Pacific MIRECC at the Long Beach VA Healthcare Center, Long Beach, California, and the Department of Psychiatry and Human Behavior, University of California, Irvine.

Copyright © 2014 by the American Psychiatric Association


Objective  This study explored the psychometric properties of the 30-item Mental Health Recovery Measure (MHRM) and a brief, ten-item version of the scale (MHRM-10) in a large, multisite sample of individuals with schizophrenia.

Methods  The sample consisted of 795 veterans with schizophrenia or schizoaffective disorder diagnoses who were receiving mental health services in one of eight Veterans Health Administration medical centers across four regions of the United States. Exploratory factor analysis was used to examine the factor structure of the MHRM and to select the most appropriate ten items for the brief measure. Correlations of the MHRM and the MHRM-10 with measures of quality of life, satisfaction with mental health services, symptom severity, and functioning were computed to further establish construct validity. Cronbach’s alpha was used to assess the internal reliability of the MHRM and MHRM-10.

Results  Factor analysis resulted in an interpretable single-factor solution. The MHRM-10 was established by selecting the ten items with the highest factor loading scores. MHRM and MHRM-10 total scores correlated strongly and positively with quality-of-life measures (overall, leisure, general health, and daily activities) and negatively with depressive mood. Negligible correlations existed between the MHRM instruments and measures of functioning and satisfaction with services. Both instruments demonstrated excellent internal consistency.

Conclusions  This study provides initial support for use of the MHRM-10 as a brief, valid, and reliable assessment of perceived recovery among individuals with schizophrenia and one that may be easily used in routine care.

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Table 1Baseline characteristics of 795 veterans with schizophrenia or schizoaffective disorder
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Table 2Exploratory factor analysis of the Mental Health Recovery Measure
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Table 3Characteristics of the Mental Health Recovery Measure (MHRM) and the MHRM-10
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a Possible MHRM-10 scores range from 0 to 40 and possible MHRM scores range from 0 to 120, with higher scores indicating higher perceived mental health recovery.

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b Reliability estimates for the spirituality, self-empowerment, basic functioning, overcoming stuckness, and advocacy/enrichment domains could not be calculated for the MHRM-10 because of reduction or deletion of items in those domains.

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Table 4Mental Health Recovery Measure (MHRM) and MHRM-10 correlations (Pearson r) with other recovery-relevant measures
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a Mental Illness Research, Education and Clinical Centers Global Assessment of Functioning

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*p<.05, **p<.01, two-tailed



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