Psychological Medicine

The Range of Impaired Functioning Tool (LIFE–RIFT): a brief measure of functional impairment

A. C. LEON a1c1, D. A. SOLOMON a1, T. I. MUELLER a1, C. L. TURVEY a1, J. ENDICOTT a1 and M. B. KELLER a1
a1 From the Department of Psychiatry, Cornell University Medical College, College of Physicians and Surgeons of Columbia University and New York State Psychiatric Institute New York, NY; Department of Psychiatry and Human Behavior, Brown University, Providence, RI: and Department of Preventive Medicine, University of Iowa, Iowa City, IA, USA


Background. The literature documents that functional impairment is associated with affective disorders. Nevertheless, the choice among thorough, yet brief, well-validated assessments of functional impairment is limited. The objective of this study was to evaluate the psychometric properties of a brief scale of functional impairment, the Range of Impaired Functioning Tool (LIFE–RIFT).

Method. The study sample included subjects who presented with major depressive disorder at intake into the NIMH Collaborative Depression Study (CDS). The LIFE–RIFT is composed of items that are included in the Longitudinal Interval Follow-up Evaluation (LIFE). The reliability and validity were examined using data from LIFE–RIFT assessments conducted at four points in time: 6, 12, 18 and 24 months after intake into the CDS.

Results. Cross-sectional one factor models accounted for the covariance structure among the four scale items. A longitudinal factor model, with an invariant factor structure over time, also fitted the data well and indicated that the scale items are measures of one construct, namely functional impairment. The internal consistency reliability of the scale was supported with alpha coefficients ranging from 0·81 to 0·83. The inter-rater reliability intraclass correlation coefficient (ICC) was 0·94. Mixed-effect linear regression models showed that those in episode were significantly more impaired than those in recovery. Furthermore, in analyses of predictive validity, impairment was positively associated with subsequent recurrence and negatively associated with subsequent recovery.

Conclusions. This psychometric evaluation provides empirical support for the reliability and validity of the LIFE–RIFT, a brief measure of functional impairment.

c1 Address for correspondence: Dr Andrew C. Leon, Cornell University Medical College, Department of Psychiatry, Box 140, 525 East 68th Street, New York NY 10021, USA.