Negative symptoms such as reduced ability to experience of pleasure, lack of motivation and diminished ability to express emotional responses for relevant social interaction are strongly correlated with clinical and functional outcomes of schizophrenia. However, these symptoms usually respond poorly to conventional treatment. It is still not clearly known for the origins, mechanisms and factor structure of negative symptoms.
Adopting the second-generation clinical assessments of negative symptoms, Dr. Raymond Chan’s team from the NACN Laboratory, CAS Key Laboratory of Mental Health, the Institute of Psychology, Chinese Academy of Sciences and Prof. Zheng-hui Yi’ team from Shanghai Mental Health Center, and collaborators from Hong Kong Special Administrative Region of China have conducted a study to specifically examine the latent structure of negative symptoms in schizophrenia patients. They administered the Brief Negative Symptom Scale (BNSS) and the Clinical Assessment Interview for Negative Symptoms (CAINS) to 305 patients with schizophrenia. Then they performed confirmatory factor analysis to test for different 4 competing models of negative symptoms of schizophrenia based on these two second-generation negative symptoms clinical tools. Their findings showed that the 2-factor model, i.e., motivation and pleasure (MAP) and the diminished expression (EXP), had the best data fit over the other competing models. Using the CAINS alone, they found that the 2-factor model showed the best fit compared with other models. Using the BNSS alone, the 2-factor model appeared again as the best fit model in patients with schizophrenia. Moreover, when the items of both the CAINS and the BNSS were entered into the CFA, the 2-factor model remained to have the best model fitting than other competing models.
Taken together, these findings consistently suggest that the 2-factor model is a robust factor structure for negative symptoms, and this construct appears to be very stable across the two clinical assessment tools. Dr. Chan’s team is now undertaking a series of studies to examine whether the MAP and EXP factors would also be exhibited in other psychiatric disorders such as bipolar disorders and major depressive disorders. The identification of a consistent 2-factor latent structure of negative symptoms across clinical diagnoses could promote further research to study the clinical manifestations and neural mechanisms underlying the EXP and MAP factors in different psychiatric disorders.
This study was a joint collaboration from Prof. YI Zheng-hui from Shanghai Mental Health Center. LI Shuaibiao, LIU Chao and ZHANG Jianbiao are the co-first authors, and Prof. Yi and Dr. Chan are the co-corresponding authors. The study was supported by grants from the Jiangsu Provincial Key Research and Development Program, the Science Foundation of Shanghai Mental Health Centre, the CAS Key Laboratory of Mental Health, Institute of Psychology, the Philip K. H. Wong Foundation, the Natural Science Foundation Project of Shanghai "Science and Technology Innovation Action Plan", the Medical Cross Research Fund Project of "Star of Jiao Tong University" of Shanghai Jiao Tong University, and the Open Project Program of Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education.
This paper has been online since August 29, 2022 from Schizophrenia Research:
Li, S. B.#, Liu, C.#, Zhang, J. B.#, Wang, L. L., Hu, H. X., Chu, M. Y., Wang, Y., Lv, Q. Y., Lui, S. S. Y., Cheung E. F. C., Yi. Z. H.*, Chan, R. K. C.* (2022). Revisiting the latent structure of negative symptoms in schizophrenia: Evidence from two second-generation clinical assessments. Schizophrenia Research, 248, 131-139.
Institute of Psychology
Chinese Academy of Sciences
Beijing 100101, China.