title: Predicting quality of life in adults with severe mental illness: Extending the International Classification of Functioning, Disability, and Health.
abstract: OBJECTIVE
  The International Classification of Functioning, Disability and Health (ICF) framework was used to investigate person-environment contextual factors, mental functioning, activity limitations, and participation as predictors of quality of life (QoL) in adults with severe mental illness (SMI).
  
  
  METHODS
  A quantitative descriptive design using multiple regression and correlational analyses was used. One hundred ninety-four individuals with SMI from 4 community-based mental health agencies in 2 states from Southern and Midwestern regions of the United States participated in the study. The criterion variable was QoL. Predictor variables comprised the ICF constructs: (a) demographics, (b) personal factors, (c) environmental factors, (d) mental functioning, (e) activity limitations, and (f) participation.
  
  
  RESULTS
  A majority of participants were White (60.3%) and not employed (59.8%). Half of them received Social Security Disability Income and/or Supplemental Security Income (50.0%). Correlations between QoL and the predictor variables ranged from small to large (r = .01 to .63, respectively). The final regression model accounted for 58% of the variance in QoL. After controlling for other factors, social competency, social support, societal stigma, psychological distress, cognitive dysfunction, activity limitations, and participation were found to be significant predictors of QoL in adults with SMI.
  
  
  CONCLUSIONS
  The study supports the use of the ICF to predict QoL for adults with SMI. Evidence-based treatments focused on increasing social competence, social support, and participation should be developed to promote rehabilitation outcomes and overall QoL.
authors.affiliation: Department of Rehabilitation Sciences, The University of Texas at El Paso.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sánchez
authors.affiliation: Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison.
authors.forename: David A
authors.initials: DA
authors.lastname: Rosenthal
authors.affiliation: Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison.
authors.forename: Timothy N
authors.initials: TN
authors.lastname: Tansey
authors.affiliation: Department of Counselor Education, Florida Atlantic University.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Frain
authors.affiliation: Department of Human Rehabilitative Services, University of Northern Colorado.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Bezyak
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D006304:Health Status; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D066107:Social Skills; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult