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- Title
External validation of the five domains of negative symptoms: Focus on cognition, functional capacity, and real-world functioning.
- Authors
Giordano, Giulia M.; Sanmarchi, Francesco; Mucci, Armida; Rucci, Paola; Brando, Francesco; Caporusso, Edoardo; Giuliani, Luigi; Melillo, Antonio; Pezzella, Pasquale; Bucci, Paola; Rocca, Paola; Rossi, Alessandro; Bertolino, Alessandro; Rossi, Rodolfo; Pergola, Giulio; Galderisi, Silvana; Maj, Mario
- Abstract
Background. The conceptualization of negative symptoms (NS) in schizophrenia is still controversial. Recent confirmatory factor-analytic studies suggested that the bi-dimensional model (motivational deficit [MAP] and expressive deficit [EXP]) may not capture the complexity of NS structure, which could be better defined by a five-factor (five NS domains) or a hierarchical model (five NS domains as first-order factors, and MAP and EXP, as second-order factors). A validation of these models is needed to define the structure of NS. To evaluate the validity and temporal stability of the five-factor or the hierarchical structure of the brief negative symptom scale (BNSS) in individuals with schizophrenia (SCZ), exploring associations between these models with cognition, social cognition, functional capacity, and functioning at baseline and at 4 years follow-up. Methods. Clinical variables were assessed using state-of-the-art tools in 612 SCZ at two-time points. The validity of the five-factor and the hierarchical models was analyzed through structural equation models. Results. The two models had both a good fit and showed a similar pattern of associations with external validators at the two-time points, with minor variations. The five-factor solution had a slightly better fit. The associations with external validators favored the five-factor structure. Conclusions. Our findings suggest that both five-factor and hierarchical models provide a valid conceptualization of NS in relation to external variables and that five-factor solution provides the best balance between parsimony and granularity to summarize the BNSS structure. This finding has important implications for the study of pathophysiological mechanisms and the development of new treatments.
- Subjects
FUNCTIONAL status; STRUCTURAL equation modeling; COGNITION; SOCIAL perception; PEOPLE with schizophrenia
- Publication
European Psychiatry, 2024, Vol 67, Issue 1, p1
- ISSN
0924-9338
- Publication type
Article
- DOI
10.1192/j.eurpsy.2023.2478