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Cross-cultural Validation of the 5-Factor Structure of Negative Symptoms in Schizophrenia.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Ahmed, Anthony O 
Kirkpatrick, Brian 
Galderisi, Silvana 
Mucci, Armida 
Rossi, Alessandro 

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.

Description

Keywords

5 factors, Brief Negative Symptoms Scale (BNSS), alogia, anhedonia, asociality, avolition, blunted affect, confirmatory factor analysis, exploratory factor analysis, negative symptoms, Adult, China, Cross-Cultural Comparison, Factor Analysis, Statistical, Female, Germany, Humans, Italy, Male, Middle Aged, Psychiatric Status Rating Scales, Psychotic Disorders, Reproducibility of Results, Schizophrenia, Spain, United States

Journal Title

Schizophrenia Bulletin

Conference Name

Journal ISSN

1745-1701
1745-1701

Volume Title

45

Publisher

Oxford University Press