Cross-Cultural Validation of the 5-Factor Structure of Negative Symptoms in Schizophrenia
Document Type
Article
Publication Date
4-18-2018
Publication Title
Schizophrenia Bulletin
Volume
45
Issue
2
First page number:
305
Last page number:
314
Abstract
Objective Negative symptoms are currently viewed as having a 2-dimensional structure, with factors reflecting diminished expression (EXP) and motivation and pleasure (MAP). However, several factor-analytic studies suggest that the consensus around a 2-dimensional model is premature. The current study investigated and cross-culturally validated the factorial structure of BNSS-rated negative symptoms across a range of cultures and languages. Method Participants included individuals diagnosed with a psychotic disorder who had been rated on the Brief Negative Symptom Scale (BNSS) from 5 cross-cultural samples, with a total N = 1691. First, exploratory factor analysis was used to extract up to 6 factors from the data. Next, confirmatory factor analysis evaluated the fit of 5 models: (1) a 1-factor model, 2) a 2-factor model with factors of MAP and EXP, 3) a 3-factor model with inner world, external, and alogia factors; 4) a 5-factor model with separate factors for blunted affect, alogia, anhedonia, avolition, and asociality, and 5) a hierarchical model with 2 second-order factors reflecting EXP and MAP, as well as 5 first-order factors reflecting the 5 aforementioned domains. Results Models with 4 factors or less were mediocre fits to the data. The 5-factor, 6-factor, and the hierarchical second-order 5-factor models provided excellent fit with an edge to the 5-factor model. The 5-factor structure demonstrated invariance across study samples. Conclusions Findings support the validity of the 5-factor structure of BNSS-rated negative symptoms across diverse cultures and languages. These findings have important implications for the diagnosis, assessment, and treatment of negative symptoms.
Keywords
Negative symptoms; 5 factors; Anhedonia; Avolition; Asociality; Alogia; Blunted affect; Brief Negative Symptoms Scale (BNSS); Confirmatory factor analysis; Exploratory factor analysis
Disciplines
Psychiatric and Mental Health
Language
english
Repository Citation
Ahmed, A. O.,
Kirkpatrick, B.,
Galderisi, S.,
Mucci, A.,
Rossi, A.,
Bertolino, A.,
Rocca, P.,
Maj, M.,
Kaiser, S.,
Bischof, M.,
Hartmann-Riemer, M. N.,
Kirschner, M.,
Schneider, K.,
Garcia-Portilla, M. P.,
Mane, A.,
Bernardo, M.,
Fernandez-Egea, E.,
Jiefeng, C.,
Jing, Y.,
Shuping, T.,
Gold, J. M.,
Allen, D. N.,
Strauss, G. P.
(2018).
Cross-Cultural Validation of the 5-Factor Structure of Negative Symptoms in Schizophrenia.
Schizophrenia Bulletin, 45(2),
305-314.
http://dx.doi.org/10.1093/schbul/sby050