Factorial Structure of the Serbian Version of the Clinical Assessment Interview for Negative Symptoms - Evidence for Three Factors of Negative Symptoms.

Ivan Ristić,Bojana Savić,Nađa P Marić,Stefan Jerotić,Manuela Russo,Tatjana Voskresenski,Nikolina Jovanović,Vuk Vuković,Mirjana Zebić

doi:10.3389/fpsyg.2020.570356

Abstract

Introduction: Negative symptoms are a common occurrence in patients with psychosis spectrum disorders. Previous analysis of the latent structure of the Clinical Assessment Interview for Negative Symptoms (CAINS) – which was developed to advance the assessment of negative symptomatology – showed two underlying sub-domains (Motivation and Pleasure; Expression). Recent findings indicate that a more complex structure might be more applicable. Aim: To evaluate the psychometric properties of the Serbian version of the CAINS in a sample of outpatients (N = 67) with psychosis spectrum disorders. Materials and Methods: Negative symptoms and general level of psychopathology were assessed with Serbian translations of the CAINS, the 53-item version of the Brief Symptom Inventory (BSI), and the 24-item version of the Brief Psychiatric Rating Scale (BPRS). Principal component analysis (PCA) was carried out on the CAINS items, and correlation analyses were done to assess its convergent and discriminant validity. Results: Our results showed an excellent internal consistency (Cronbach’s alpha = 0.92). PCA revealed a three-component solution consisting of Expressiveness and Motivation for Social and Family Relationships (Factor 1), Motivation for Vocational Activities (Factor 2), and Motivation for Recreation (Factor 3). Convergent validity was supported by significant correlations with the Negative symptoms domain of the BPRS (Factor 1, 0.695, p < 0.01; Factor 2, 0.352, p < 0.05; Factor 3, 0.452, p < 0.01). When assessing discriminant validity, weak correlations were found with BPRS and BSI scores. Conclusion: The Serbian version of CAINS is a valid, reliable and useful tool for the assessment of negative symptomatology. Our findings support a three-factor structure of CAINS, which indicates that the construct is more complex than envisaged by the original conceptualization of two distinct factors.

Highlights

Negative symptoms are a common occurrence in patients with psychosis spectrum disorders
The sample size was considered adequate for Principal component analysis (PCA) based on the recommended minimum participant-to-item ratio of 5:1 (Gorsuch, 1990) with the total number of participants (n = 67) exceeding the recommended value of 65
The 13 items of the Clinical Assessment Interview for Negative Symptoms (CAINS) were subjected to PCA (Table 2)

Summary

Introduction

Negative symptoms are a common occurrence in patients with psychosis spectrum disorders. Previous factor analyses of symptoms related to schizophrenia revealed several clusters of symptoms, the most robust being positive and negative dimensions (Lenzenweger et al, 1989) These dimensions were evident in schizophrenia, they were reported with lesser degrees of severity in the general population (Maric et al, 2004). One study found that while adaptive life skills are mostly predicted by cognitive functioning, negative symptoms affected primarily interpersonal skills (Bowie et al, 2006). Both cognitive status and negative symptoms were significantly associated with functional outcome

Objectives

Methods

Results

Conclusion