Observed Ward Behavior Strongly Associated with Real World Living Skills: An Analysis of Concurrent Validity between NOSIE and ILSI Charlie A. Davidson, Elizabeth A. Cook, Jeffrey R. Nolting, M.A., William D. Spaulding, Ph.D. University of Nebraska-Lincoln This study examined archival longitudinal data collected at the Lincoln Regional Center’s Community Transition Program, a 40-bed inpatient unit. Participants’diagnoses were generally those of schizophrenia spectrum disorders, bipolar disorder, and other severe mood or personality disorders. Data consisted of 3 and 6 month administrations of the NOSIE-30 and ILSI. The NOSIE-30 was collected weekly by direct care staff and reported monthly. The ILSI was completed at 3 and 6 months post-intake and then semi-annually, reflected performance during the most recent month, and was collected by multiple inpatient staff. Data were cleaned using square root and log transformations, and were winzorized whenever possible to minimize skewness. Data were analyzed using a series of Pearson’s correlations and stepwise regressions to assess full and partial correlations. Demographic covariates consisted of the following variables: years of education, number of previous hospitalizations, age of symptom onset, highest occupational functioning, and premorbid behavioral problems. These covariates were chosen because they had a large number of strong, significant correlations with NOSIE and ILSI variables. There were significant correlations between the NOSIE Total Assets score and the mean of the ILSI scores at 3 months, r =.60, p <.0001, and at 6 months, r =.52, p < In addition, there were a number of significant correlations between most of the NOSIE and ILSI subscales at both time points (see Figures 1 and 2 for significant r values). Without taking covariates into account, NOSIE subscales with the highest number of significant correlations with ILSI subscales at both 3 and 6 months were Daily Schedule Competence and Neatness. The NOSIE subscale with the fewest significant correlations with ILSI subscales at both times was Psychoticism. However, correlations were not always stable across time. The final models accounted for 30.8% (at 3 months) and 28.1% (at 6 months) of the variance in ILSI mean, and NOSIE Daily Schedule Competence was the best and only predictor included in these models. The standardized regression coefficients show a positive relationship between ILSI mean and daily schedule competence, which indicates that greater ability to adhere to a daily schedule is associated with higher ILSI overall mean. Factors such as years of education, number of previous hospitalizations, age of onset, premorbid behavioral problems, highest occupational functioning, and all other NOSIE subscales did not enter into the final models. As hypothesized, ward behaviors appear to be significantly related to real world living skills. NOSIE total and ILSI mean had moderate correlations at both 3 and 6 months, and there were a number of moderate correlations between NOSIE subscales and ILSI subscales at both 3 and 6 months. However, contrary to our hypothesis, it does not appear that demographic variables (at least the variables entered into the regression analyses in this study) significantly mediate the relationship between NOSIE subscales and ILSI mean. Daily Schedule Competence appears to be a strong predictor of ILSI mean, despite the inclusion of demographic variables in the analyses. This study demonstrates concurrent and construct validity of the NOSIE-30 and ILSI, which increases the clinical value of these measures. The concurrent and construct validity of the NOSIE-30 and ILSI appear to be relatively strong given that ratings of similar behaviors made by different clinical staff were moderately and significantly related. This study also has important implications for future analysis of ward behaviors in relation to real world living skills. Future studies should examine the relationship between NOSIE and ILSI subscales, totals, and means using a larger sample size. In addition, other possible covariates, such as symptom severity level, should be entered into regression analyses to determine if there are other variables that mediate the relationship between these variables. Finally, NOSIE and ILSI subscales, totals, and means should be entered into regression analyses as independent factors to predict outcome measures such as length of stay. Method Introduction Results Discussion Figure 1 Figure 2 NOSIE VariablesILSI Variables Positive: Dsc = Daily Schedule Competence Soc = Social Interest Neat = Neatness Negative: Irr = Irritability Psyc = Psychoticism Mot = Motor Retardation Total: Tot = Total (Positive – Negative) Ilsipe = Personal Management Ilsihy = Hygiene and Grooming Ilsicl = Clothing Ilsiin = Interpersonal Skills Ilsiho = Home Maintenance Ilsico = Cooking Ilsire = Resource Utilization Ilsiba = Basic Skills Ilsige = General Occupational Ilsimo = Money Management Ilsimean = Mean of ILSI scales