Cross-cultural Validation of the 5-Factor Structure of Negative Symptoms in Schizophrenia.
Ahmed, Anthony O
Hartmann-Riemer, Matthias N
Garcia-Portilla, Maria Paz
Gold, James M
Allen, Daniel N
Strauss, Gregory P
Oxford University Press
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Ahmed, A. O., Kirkpatrick, B., Galderisi, S., Mucci, A., Rossi, A., Bertolino, A., Rocca, P., et al. (2019). Cross-cultural Validation of the 5-Factor Structure of Negative Symptoms in Schizophrenia.. Schizophrenia Bulletin, 45 (2), 305-314. https://doi.org/10.1093/schbul/sby050
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.
External DOI: https://doi.org/10.1093/schbul/sby050
This record's URL: https://www.repository.cam.ac.uk/handle/1810/290964