Factor structure and internal consistency of the Clinical Assessment Interview for Negative Symptoms (CAINS) on a sample of persons with psychotic disorders in Bosnia and Herzegovina

Alma Džubur Kulenović,Selman Repišti,Nikolina Jovanović,Emina Ribić,Eldina Smajic Mešević,Tamara Radojičić

doi:10.1007/s00702-021-02435-8

Abstract

The assessment of negative symptoms is crucial for development of adequate therapeutic interventions. This is a challenging task due to complex clinical presentation and lack of reliable and valid instruments. This study examined the psychometric characteristics of the Clinical Assessment Interview for Negative Symptoms (CAINS). The sample consisted of 81 persons with schizophrenia or schizoaffective disorder recruited from two health institutions in the Sarajevo Canton: the Clinical Center of the University of Sarajevo and the Psychiatric Hospital of the Sarajevo Canton. The 13 CAINS items grouped into four factors (expression, motivation and satisfaction in the recreational domain, motivation and satisfaction with social relationships, motivation and satisfaction with job and education). The four-factor solution accounted for 87.83% of the variance of manifest items. The reliabilities of extracted factors were as follows: for motivation and satisfaction with social relationships α = 0.897, for motivation and satisfaction with job and education α = 0.961, for Motivation and satisfaction in the recreation domain α = 0.981, and for expression α = 0.938. The highest correlation between factors was found between Motivation and satisfaction with recreation and Motivation and satisfaction with social relationships. On the other hand, the lowest correlation was found between motivation and satisfaction with social relations and motivation and satisfaction with job and education. In conclusion, the study showed that the latent structure of CAINS is adequate, clearly interpretable, and consisted of four factors. The measure can be used for assessment of the negative symptoms in outpatients with psychosis in Bosnia and Herzegovina.

Highlights

Schizophrenia is a chronic and severe mental disorder that affects more than 20 million people worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators 2018)
The results indicate that Clinical Assessment Interview for Negative Symptoms (CAINS) is short but comprehensive and usable in a wide variety of research and clinical settings (Kring et al 2013)
Patients met diagnostic criteria based on the structured clinical interview for DSM-IV disorders (SCID; First et al 1997) The exclusion criteria were diagnosis of an organic brain disorder and presence of a serious cognitive deficit

Summary

Introduction

Schizophrenia is a chronic and severe mental disorder that affects more than 20 million people worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators 2018). People with schizophrenia can often hear or see things that do not exist (hallucinations), have erroneous beliefs (delusions), or talk in an incoherent, intermittent, or incomprehensible way (disorganized speech). Those symptoms are defined as positive symptoms of schizophrenia. Burden, and worse long-term outcomes, to a greater extent than positive symptoms (Horan et al 2011). Despite their clinical relevance, therapeutic modalities did not have an unique approach to addressing negative symptoms for many years. A switch to a second-generation antipsychotic should be considered for patients who are treated with a first-generation antipsychotic; adding antidepressant to antipsychotic treatment can be a valuable option, as well as social skills training and cognitive remediation for patients who show cognitive impairment

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Conclusion