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Factor structure of the Albanian version of the Clinical Assessment Interview for Negative Symptoms (CAINS): Associations with the Brief Symptoms Inventory (BSI)

Published Online: 30 May 2020
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Received: 17 Jan 2020
Accepted: 03 May 2020
Journal Details
License
Format
Journal
First Published
16 Apr 2017
Publication timeframe
2 times per year
Languages
English
INTRODUCTION

Measurement and assessment of symptoms across different types of psychotic disorders, such as schizophrenia, bipolar affective disorder, schizoaffective disorder, and psychotic depression is difficult due to heterogeneity in presentation and outcome. A misleading assessment may lead to ineffective treatments, which in turn influences functional decline, illness chronicity, and iatrogenic physical illness (Clark, Schubert, Olagunju, Lyrtzis, & Baune, 2018). As such, good quality mental health care for psychotic patients is characterized by a detailed and broad assessment of patient problems and needs. To facilitate this type of in-depth assessment of negative symptoms in psychotic disorders, an extraordinary range of measures have been produced (Martins, Carvalho, Castilho, Pereira, & Macedo, 2015). Among the most frequently used of these measures are the Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein, & Opler, 1987), the Scale for the Assessment of Negative Symptoms (SANS; Andreasen, 1982), and the Negative Symptom Assessment (NSA; Alphs, Summerfelt, Lann, & Mueller, 1989). However, these measures have many limitations (Daniel, 2013; Blanchard, Kring, Horan, & Gur, 2011; Kirkpatrick, Fenton, Carpenter, & Marder, 2006; Lincoln, Dollfus, & Lyne, 2017; Stahl & Buckley, 2007). Notably, these assessments don’t include all negative symptoms, since knowledge about schizophrenia and other psychotic disorders has progressed from the time these instruments were developed (Blanchard & Cohen, 2005; Montgomery & Zwieten-Boot, 2007). Another reported limitation is the focus on behavioural aspects and inclusion of cognitive functions, for example, ‘attention’ in SANS and ‘stereotyped thinking’ and ‘abstract thinking’ in PANSS (Harvey, Koren, Reichenberg, & Bowie, 2006). Thus, longevity, complexity, and inability to differentiate between ‘anticipatory’ and ‘consummatory’ anhedonia are additional criticisms of these commonly used measures (Blanchard et al., 2011; Kumari, Malik, Florival, Manalai, & Sonje, 2017).

To address these limitations, a new instrument called Clinical Assessment Interview for Negative Symptoms was developed (CAINS; Horan, Kring, Gur, Reise, & Blanchard, 2011; Kirkpatrick et al., 2006; Kring, Gur, Blanchard, Horan, & Reise, 2013). CAINS assesses five negative symptoms: asociality, avolition, anhedonia, blunted affect, and alogia. It provides two scales that are scored separately, Motivation and Pleasure (Social, Work & School, Recreation; nine items), and Expression (four items). Items are rated on a 5-point scale (0–4), where ‘0’ indicates that the symptom is absent while ‘4’ indicates that the symptom is severe. Importantly, items that measure anhedonia only take the past week and the next week into consideration (consummatory and anticipatory; Blanchard, Gur, Horan, & Kring, 2012). Regarding the psychometric properties, CAINS is considered to be a reliable measure: internal consistency scores for the total CAINS were satisfactory in the initial study (Forbes et al., 2010), while subsequent studies have shown that the scales have good internal consistency, test-retest reliability, and inter-rater agreement (Horan et al., 2011; Kring et al., 2013). Additionally, CAINS has been shown to be reliable across different cultures and languages (Chan et al., 2015; Engel, Fritzsche, & Lincoln, 2014; Hosakova, Viktorova, Lecbych, & Hosak, 2017; Rekhi et al., 2019).

When compared with other instruments that measure the same construct, CAINS was shown to have good convergent validity: both CAINS scales were correlated with the negative symptom subscale of Brief Symptom Rating Scale (BPRS; Overall & Gorham, 1962) and with the subscales of SANS (Kring et al., 2013). In support of convergent validity, both CAINS scales were highly correlated with the PANSS negative subscale (Engel, Fritzsche, & Lincoln, 2014). The discriminant validity of CAINS was demonstrated by analysing if it was correlated with scales with which it was not expected to be correlated. Empirical evidence showed good discriminant validity by insignificant correlations with PANSS positive subscale and Calgary Depression Scale for Schizophrenia (CDSS; Addington, Addington, & Schissel, 1990) total score (Blanchard et al., 2017; Rekhi et al., 2019).

Two initial studies that analysed CAINS found a two-factor structure (Horan et al., 2011; Kring et al., 2013). The two modestly correlated scales were named: (1) Motivation and Pleasure and (2) Expression. The two-factor solution was also validated in a German population (n = 53; Engel, Fritzsche, & Lincoln, 2014), a Chinese population (n = 68; Chan et al., 2015), and a Spanish population (n = 100; Valiente-Gomez et al., 2015). Conversely, Rekhi and colleagues (2019) reported a four-component model in their study, in which they re-named the scales motivation-pleasure (MAP) social, MAP vocational, MAP recreational, and EXP (expression). The authors justified this result by considering the study of Ahmed and colleagues (2018), which indicated that two-factor models do not fit the data sufficiently well. However, further research is needed to clarify this discrepancy in results.

Although there is growing evidence suggesting that CAINS captures individual variation among psychotic patients in different countries (Rekhi et al., 2019; Hosakova, Viktorova, Lecbych, & Hosak, 2017), translating and using the measure in other countries without examining its psychometric properties is not recommended and might bias the interpretation of results. Therefore, the first goal of this study was to identify the factor structure of the Albanian version of CAINS. We expected to find the two-factor structure as in previous studies (Horan et al., 2011; Kring et al., 2013). The second goal was to extend previous research and examine the relations between CAINS and Brief Symptom Inventory (BSI, Derogatis, 1993) that covers psychological distress and psychopathology. Based on the previous studies, we expected to find a positive relation between individual factors measured by CAINS and BSI scales.

METHODS
Participants

Convenience samples were drawn from the clinical populations of two Community Mental Health Centres (CMHC) in Pristina and Ferizaj (Kosovo) and from one integrated community housing in Ferizaj. To meet the inclusion criteria, participants: a) were aged between 18 and 65 years old; b) were in a psychiatric treatment for at least 3 months; c) had a clinical diagnosis of psychosis or related disorder (i.e.: ICD-10 F20–29, F31); d) were not planned to be discharged from mental health services for the next 3 months; and e) were capable of giving informed consent.

In total, 106 participants met the inclusion criteria. The participants’ age ranged from 18 to 40 years (M = 22, SD = 1.75). The majority were men (N = 73, 68%), diagnosed with schizophrenia (N = 101, 97.2%), and unemployed (N = 95, 90%). About half of the patients (42.7%) reported elementary school as their highest level of education (Table 1). Family demographic background information was available for all of the patients. In total, 102 patients were of Albanian ethnicity and one was of Ashkali ethnicity, but spoke Albanian fluently.

Study participants’ sociodemographic and clinical characteristics

Age, years (mean [SD])Study participantsN = 106 (100%)
22 (SD 1.75)
Gender (N, %)
Male(73, 68%)
Female(33, 32%)
Marital status (N, %)
Single/divorced/widowed(65, 61%)
In a relationship/married(41, 39%)
Employment (N, %)
Unemployed(95, 90%)
Employed(11, 10%)
Education (N, %)
No formal education, primary school(44, 41.5%)
Secondary school(52, 49%)
College, university(7, 6.6%)
Clinical diagnosis (N, %)
ICD-10 F20–29103 (97.2%)
ICD-10 F313 (2.8%)
Ethical considerations

All procedures in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by Hospital and University Clinical Centre of Kosovo – Ethics Committee 2019–85. All study participants signed informed consent forms prior to their participation in the study.

The patients who agreed to be involved in the study met with researchers who checked if the patients met the eligibility criteria and invited them to sign a consent form. Researchers explained the study to the patient and provided all relevant information, including risks, benefits, and confidentiality. Once a patient provided written informed consent, researchers proceeded to completing the assessment. During the course of the study, patients received their routine treatment from the mental health care services.

There were no specific risks from participating in the study, however, some participants taking part in assessment and interviews might become upset due to recalling distressing personal experiences, mental, physical health, and/or social functioning problems. In the unexpected event that any patient appeared highly stressed or upset, the research activity would be terminated and a clinician contacted.

Procedure

The current study is a part of the European Commission funded IMPULSE project (grant number 779334), which aims to improve the care of people with psychotic disorders in several south-eastern European countries (Jovanovic et al, 2019). Patients who agreed to be involved in this study met with researchers who verified that patients met the eligibility criteria and invited them to sign a consent form. All researchers were trained in consenting procedures as well as administering CAINS and BSI. The interclass correlation coefficient for the CAINS measure was 0.843.

After written informed consent was obtained, researchers proceeded with the assessment, which included socio-demographic and clinical characteristics, together with CAINS and BSI administration. All measures were translated into the Albanian language following the procedure of translation and back-translation suggested for cross-cultural research (Brislin, 1970). The back-translated version of each questionnaire was compared to the original one by the team of Albanian researchers, to resolve any discrepancy in complying with the validation guideline (Beaton et al., 2000; Arafat et al., 2016). The assessment took approximately 1 hour per patient. All patients were interviewed individually during a weekday in a quiet area in their Community Mental Health Centre.

Measures

Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013) was used to assess the severity of five negative symptoms: asociality, avolition, anhedonia, affective flattening, and alogia. Each item (e.g., Motivation for Close Family/Spouse/Partner Relationships) was scored on a 5-point scale ranging from symptoms being absent (0) to severe (4). Higher scores reflect greater impairment. CAINS is comprised of two scales: the Motivation and Pleasure scale, which consisted of nine items, and the Expression scale with four items.

The Brief Symptom Inventory (BSI; Derogatis, 1993) consisted of 53 items covering nine symptom dimensions: Somatization, Obsession-Compulsion, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, and Psychoticism. Respondents ranked each feeling item (e.g., ‘Feeling others are to blame for most of your troubles’) on a 5-point scale ranging from not at all (0) to extremely (4). Rankings characterized the intensity of distress during the past seven days and higher scores reflected higher impairment.

Both instruments were translated into the Albanian language and back-translated into English for the purpose of this study.

Statistical analysis

First, descriptive statistical values of the main variables were calculated. Next, principal component analysis of CAINS was conducted in order to check its construct validity. Lastly, correlational analysis was performed in order to investigate the convergent validity of CAINS subscales based on their relationships with the relevant BSI items. Additionally, Cronbach’s alpha (α) coefficients were calculated as indicators of the CAINS subscales internal consistency (as part of a reliability check).

RESULTS

Table 1 presents the number and percentage of patients with each diagnosis type.

Table 2 displays descriptive statistics of the BSI subscales. All sample-wide subscale means were greater than 1 point, except for Hostility, which has a mean of 0.72.

Descriptive statistical values of BSI subscales

ScalesMSDMinMax
Somatization1.100.9003.86
Obsession-compulsion1.450.9103.50
Interpersonal sensitivity1.391.0704.00
Depression1.280.9403.83
Anxiety1.270.9904.00
Hostility0.720.7803.80
Phobic anxiety1.041.0404.00
Paranoid Ideation1.271.0103.80
Psychoticism1.280.9503.40

Note: The scores for each of the scales were calculated by adding up item responses and dividing the sum by the number of items that belong to that specific scale.

As Table 3 shows, all values of Cronbach’s alpha coefficient were greater than 0.700. Therefore, all BSI scales could be considered internally consistent.

The results of BSI reliability check: Internal consistency of its nine scales

ScalesNumber of itemsCronbach’s alpha (α)
Somatization70.807
Obsession-compulsion60.717
Interpersonal Sensitivity40.727
Depression60.786
Anxiety60.819
Hostility50.739
Phobic anxiety50.836
Paranoid Ideation50.757
Psychoticism50.703

Variance explained by the extracted components (CAINS)

ComponentSums of Squared Loadings (Extraction)Sums of Squared Loadings (Rotation)
Total% of VarianceCumulative %Total
15.08339.10339.1033.891
21.99115.31654.4193.510
31.42510.95865.3773.538
41.2119.31474.6922.175

According to Kaiser-Guttman’s criterion (i.e., eigen-value >1), four components were extracted. They accounted for 74.69% of manifest data variance. Additionally, Promax rotation was applied, allowing components to correlate with each other.

Cattell’s scree plot could give additional justification for the four-factor solution. It is apparent that the most pronounced elbow of the plot resides at four components (see Figure 1).

Figure 1

Cattell’s scree plot (CAINS)

In Table 5, all factor loadings of CAINS items on primary components are greater than 0.35 and less than this value on other components. Hence, the obtained component (factor) solution seems interpretable and satisfactory. The first extracted component was Expression and includes items 10 to 13. The second one was Social Motivation and Pleasure (MAP), operationalized by items 1 to 4. The next one was Recreational Motivation and Pleasure (items 7 to 9) and the last extracted component was Work and School MAP (items 5 and 6). In accordance with the results of PCA, it turned out that CAINS could be regarded as a valid measure of motivation and pleasure in various life domains (social, recreational, and work/school domains).

Pattern matrix (CAINS)

CAINS itemsExpressionMAP - SocialMAP – RecreationalMAP – Vocational
11. Vocal expression0.925−0.029−0.0890.032
13. Quantity of speech0.885−0.003−0.0660.067
10. Facial expression0.881−0.0850.096−0.034
12. Expressive gestures0.8110.1200.079−0.067
3. Frequency of Pleasurable Social Activities – Past Week−0.1000.956−0.1170.062
4. Frequency of Expected Pleasurable Social Activities – Next Week0.1030.889−0.157−0.034
2. Motivation for Close Friendships & Romantic Relationships−0.0690.6280.1820.020
1. Motivation for Close Family/Spouse/Partner Relationships0.0930.4980.280−0.023
9. Frequency of Expected Pleasurable Recreational Activities – Next Week0.003−0.2800.9470.072
8. Frequency of Pleasurable Recreational Activities – Past Week−0.0090.1610.840−0.114
7. Motivation for Recreational Activities−0.0090.2110.7400.069
6. Frequency of Expected Pleasurable Work & School Activities – Next Week−0.0890.0050.0220.940
5. Motivation for Work & School Activities0.1240.0370.0080.862

Results shown in Table 6 reflect a very good internal consistency of not only each of the CAINS scales, but also of CAINS inventory itself (α = 0.860).

CAINS – reliability check

SubscalesNumber of itemsCronbach’s α
Expression40.907
MAP Social40.786
MAP Recreational30.823
MAP Work & School20.808
CAINS (overall)130.860

Note. MAP stands for Motivation and Pleasure.

In Table 7, descriptive statistical values of CAINS subscales are presented. In addition, Table 8 contains CAINS scales’ mutual correlations. The strongest relationship was that of Social Motivation and Pleasure with Work & School MAP (r = 0.498, p < 0.001). All coefficients are statistically significant, indicating that all CAINS scales correlate with one another.

Descriptive statistical values of CAINS subscales

SubscalesMinMaxMSD
Expression03.501.260.92
Social MAP04.001.660.97
Recreational MAP04.002.991.14
Work & School MAP04.001.391.00

CAINS scales’ mutual correlations

ScalesSocial MAPRecreational MAPWork & School MAP
Expression0.366***0.297**0.353***
Social MAP0.248*0.498***
Recreational MAP0.288**

Note:

p <0.05,

p <0.01,

p <0.001

Clinical Assessment Interview for Negative Symptoms (CAINS): The results of Principal Component Analysis (PCA)

Interestingly, none of the BSI scales was significantly correlated with Expression. However, all of them were low to moderate correlations with deficits in motivation and pleasure within the social domain of life. Recreational Motivation and Pleasure was significantly correlated only with Hostility (r = 0.205, p < 0.05). Finally, deficits in motivation and pleasure for work and school were correlated with higher scores on Somatization (r = 0.337, p < 0.001), Paranoid Ideation (r = 0.277, p < 0.01), Hostility (r = 0.262, p < 0.01), Depression (r = 0.255, p < 0.01), Interpersonal Sensitivity (r = 0.252, p < 0.05), and Phobic Anxiety (r = 0.237, p < 0.05). The abovementioned coefficients of correlation are presented in Table 9.

Correlations between CAINS and BSI subscales

BSI subscalesCAINS subscales
ExpressionSocial MAPRecreational MAPWork & School MAP
Somatization0.1310.396***0.1260.337***
Obsession-compulsion0.1030.278**0.1950.140
Interpersonal Sensitivity-0.0090.251*0.1400.252*
Depression0.0860.362***0.1850.255**
Anxiety0.1070.238*0.1230.159
Hostility0.0680.239*0.205*0.262**
Phobic anxiety0.1070.208*0.1810.237*
Paranoid Ideation0.0320.304**0.1180.277**
Psychoticism0.0720.222*0.1740.156

Note:

p < 0.05,

p < 0.01,

p < 0.001

DISCUSSION

The purpose of this study was to investigate the psychometric properties of Clinical Assessment Interview for Negative Symptoms (CAINS) in the Albanian language. Moreover, the current study was aimed to identify the relationships between factors derived from CAINS and several dimensions of Brief Symptoms Inventory (BSI). We expected to find the two-factor structure, as previously reported by Chan et al. (2015), Valiente-Gomez et al. (2015) and Engel et al. (2014); however, our results did not support such a hypothesis. In contrast to previous studies that found Expression and Motivation and Pleasure as two major factors, our results revealed four components: expression (four items), social motivation and pleasure (four items), recreational motivation and pleasure (three items), and work and school motivation and pleasure (two items). Our findings replicated the component of expression; however, the items on motivation and pleasure were grouped clearly into three different components. The internal consistency of these four subscales and of the overall measure was very good, ranging from 0.78 to 0.90.

Our finding of the four-factor structure can be explained by the nature of reporting for CAINS assessment of symptoms. For example, the dimension of expression has a greater number of items observed by clinicians, whereas anhedonia and asociality tend to be patient-reported, and can be grouped into more than one domain (Elis, 2013; Rekhi et al., 2019). Motivation and pleasure may be different for different types of activities, although this is speculative at this stage. For example, people diagnosed with psychotic disorders may indicate different levels of motivation and pleasure for work and school compared with the level of the motivation and pleasure they may experience in recreational activities.

In addition to the results of our study, there is also an increasing body of evidence for more than two factors in the structure of CAINS in other cultures. For example, very similar results were reported in the factor structure of CAINS in Singapore (Rekhi at al., 2019), where the same components were named as expression, vocational MAP, recreational MAP, and social MAP. Thus, it may be that culture plays a substantial role in factor structure of CAINS, since most of the exploratory studies of CAINS so far come from Western cultures. Findings from other cultures might be related to different appraisal of emotional situations, which are influenced by different socio-cultural practices (Rekhi, et al., 2019). As an example, Kosovo might be considered as a collectivist society, which tends to assess emotions in terms of social worth, taking external factors into account rather than just one’s inner world. In Kosovo and in other similarly collectivistic societies, emotions are evaluated more often in terms of self-other relationships rather confined to subjectivity (Mesquite, 2001). This type of emotional evaluation, however, highlights one of CAINS main limitations, which is the tendency to evaluate functioning rather than negative symptoms (Garcia-Portilla et al., 2015).

Further support for our findings comes from studies that critically analyse the two-dimensional model of assessments that measure negative symptoms (Ahmed et al., 2018; Blanchard & Cohen, 2005). These studies not only suggest a multidimensional structure, but conclude that the two-factor solution has been summarized too early, before rigorous, complete analyses could be done. Moreover, evidence for the two-factor solution comes from studies that have used only exploratory factor analysis (EFA), which is known for the limitations, especially the fact that researcher has a priori assumption that any indicator may be associated with any factor. Ahmed et al. (2018) and Rekhi et al. (2019) aimed to improve this limitation and found five- and four-factor structures, respectively. It is important to mention that the study by Ahmed and colleagues (2018) was conducted with samples from different cultures and languages.

Strauss and colleagues (2018) carried out a confirmatory factor analysis (CFA) in order to, among other things, check the construct validity of CAINS. Their analysis confirmed the existence of the following five first-order factors: Anhedonia, Asociality, Avolition, Blunted affect, and Alogia, corresponding to the DSM-5 conceptualization of negative symptoms. The second-order factors were MAP and EXP. However, the discrepancy between our results and those of Strauss and colleagues can be explained by several factors. First, the authors assumed that the latent structure of the CAINS could be best described by the five aforementioned dimensions (despite the authors of CAINS structuring the items of the instrument in a different way). Second, one of the factors (Alogia) saturated only one item (which indicates that it is a so-called trivial factor). Third, the authors did not test the four-factor model fit (although CAINS actually consists of four parts). Fourth, the sociodemographic background of their participants was quite different compared with the sample in our study. Finally, their sample was comprised of patients diagnosed with schizophrenia, whereas our sample included patients with psychotic disorders (which is a broader category).

In addition to the factor structure, the convergent validity of CAINS was shown by positive association of two factors (Social MAP and Vocational MAP) with all subscales of BSI. Surprisingly, we did not find correlations between expression and recreational MAP with the BSI subscales. This could be taken as indication that expression and recreational MAP can distinguish negative symptoms from other symptoms that might relate to specific disorders or symptoms of depression or anxiety.

This study has several limitations. First, the sample of this study could be considered small, which decreases the statistical power, and might have affected and the factor structure results in turn. Thus, replication with larger samples is necessary to generalize the present findings. Another limitation is the lack of other negative symptoms’ assessments, which could be used to assess its convergent validity. In addition to that, we did not use the interrater reliability, due to limitations in time and resources. As such, it will be important for future studies to address these limitations and further explore the factor structure of negative symptoms among psychotic patients.

This study provides relevant implications for research, policy, and practice. The study confirms that CAINS is a valid measure of motivation and pleasure in various life domains (social, recreational, and work/school) in the Albanian language. As such, this measure can be used in studies that aim to investigate the relationships between negative symptoms and other important mental health outcomes in Kosovo and across other Albanian speaking countries, where mental health research is still scarce. Replication of the current findings with larger samples would represent an important step in confirming the CAINS factor structure in the Albanian language. Future studies using CAINS can be used to understand the factors that influence negative symptoms among people diagnosed with psychotic disorders, which in turn may result in better strategies and intervention programs. By using CAINS to obtain data about negative symptoms, clinicians can develop and support structured and clinician-supervised activities for psychotic patients, aiming to decrease their negative symptoms and enhance their quality of life. Our findings on the four-factor structure of CAINS could be considered as a detailed and broad assessment of psychotic patients, which may lead to effective and more specific psychiatric treatment and psychotherapy for psychotic patients.

Figure 1

Cattell’s scree plot (CAINS)
Cattell’s scree plot (CAINS)

Descriptive statistical values of CAINS subscales

SubscalesMinMaxMSD
Expression03.501.260.92
Social MAP04.001.660.97
Recreational MAP04.002.991.14
Work & School MAP04.001.391.00

Descriptive statistical values of BSI subscales

ScalesMSDMinMax
Somatization1.100.9003.86
Obsession-compulsion1.450.9103.50
Interpersonal sensitivity1.391.0704.00
Depression1.280.9403.83
Anxiety1.270.9904.00
Hostility0.720.7803.80
Phobic anxiety1.041.0404.00
Paranoid Ideation1.271.0103.80
Psychoticism1.280.9503.40

CAINS – reliability check

SubscalesNumber of itemsCronbach’s α
Expression40.907
MAP Social40.786
MAP Recreational30.823
MAP Work & School20.808
CAINS (overall)130.860

j.gp-2020-0013.tab.019.w2aab3b7b1b1b6b1ab2b3ab6b3b6Aa

PJESA 8 - Frekuenca e aktiviteteve rekreative të kënaqshme - Java e kaluar

0 = Nuk ka deficit: Të paktën (3) lloje të ndryshme të përvojave të kënaqshme, e përjetuar çdo ditë.

1 = Deficit i dobët: Së paku (3) lloje të ndryshme të përvojave të kënaqshme, të përjetuara më shumë ditë sesa jo.

2 = Deficit i moderuar: 1 ose 2 lloje të ndryshme të përvojave të kënaqshme, të përjetuara më shumë ditë se sa jo.

3 = Deficit mesatarisht i rëndë: 1 lloj i përvojës së kënaqshme, të përjetuar vetëm disa ditë.

4 = Deficiti i rëndë: Nuk ka përvoja të këndshme.

j.gp-2020-0013.tab.012.w2aab3b7b1b1b6b1ab2b3ab4b2c19Aa

E hënëE marteE mërkureE enjteE premteE shtunë

The results of BSI reliability check: Internal consistency of its nine scales

ScalesNumber of itemsCronbach’s alpha (α)
Somatization70.807
Obsession-compulsion60.717
Interpersonal Sensitivity40.727
Depression60.786
Anxiety60.819
Hostility50.739
Phobic anxiety50.836
Paranoid Ideation50.757
Psychoticism50.703

j.gp-2020-0013.tab.016.w2aab3b7b1b1b6b1ab2b3ab5b2c14Aa

PJESA 6 – Frekuenc a e punës së pritshme të kënaqshme dhe aktiviteteve shkollore - Javën e ardhshme

0 = Nuk ka deficit: Priten shumë (7 ose më shumë) përvoja të pëlqyeshme.

1 = Deficit e lehtë: Priten kënaqësi nga disa përvoja të kënaqshme (5–6).

2 = Deficit i moderuar: Priten kënaqësi nga pak a shumë (3–4) përvoja të pëlqyeshme.

3 = Deficit mesatarisht e rëndë: Priten disa përvoja të kënaqshme (1–2).

4 = Deficit i rëndë: Nuk priten përvoja të këndshme.

Pattern matrix (CAINS)

CAINS itemsExpressionMAP - SocialMAP – RecreationalMAP – Vocational
11. Vocal expression0.925−0.029−0.0890.032
13. Quantity of speech0.885−0.003−0.0660.067
10. Facial expression0.881−0.0850.096−0.034
12. Expressive gestures0.8110.1200.079−0.067
3. Frequency of Pleasurable Social Activities – Past Week−0.1000.956−0.1170.062
4. Frequency of Expected Pleasurable Social Activities – Next Week0.1030.889−0.157−0.034
2. Motivation for Close Friendships & Romantic Relationships−0.0690.6280.1820.020
1. Motivation for Close Family/Spouse/Partner Relationships0.0930.4980.280−0.023
9. Frequency of Expected Pleasurable Recreational Activities – Next Week0.003−0.2800.9470.072
8. Frequency of Pleasurable Recreational Activities – Past Week−0.0090.1610.840−0.114
7. Motivation for Recreational Activities−0.0090.2110.7400.069
6. Frequency of Expected Pleasurable Work & School Activities – Next Week−0.0890.0050.0220.940
5. Motivation for Work & School Activities0.1240.0370.0080.862

j.gp-2020-0013.tab.010.w2aab3b7b1b1b6b1ab2b3ab4b2b8Aa

Pika 1 - Motivimi për marrëdhënie të ngushta familjare / bashkëshortore / partnere

0 = Nuk ka deficit: SHUMË I/E INTERESUAR dhe vlerëson shumë lidhjet familjare të ngushta si një nga pjesët më të rëndësishme të jetës. Është shumë i/e motivuar të jetë në kontakt me familjen. Fillon rregullisht dhe vazhdon në ndërveprime me familjen dhe në mënyrë aktive angazhohet në këto ndërveprime; kohët e mira dhe të këqija diskutohen hapur.

1 = Deficiti i dobët: PËRGJITHËSISHT I/E INTERESUAR në dhe vlerëson lidhjet e ngushta familjare edhe pse përgjigja sugjeron një reduktim të vogël apo të diskutueshëm. Në përgjithësi dëshiron dhe është i/e motivuar për të mbajtur kontakt me familjen. Ka një marrëdhënie të ngushtë me anëtarët e familjes në të cilën mund të diskutohen kohët e mira dhe të këqija. Deficit i butë në fillimin dhe këmbënguljen në ndërveprime të rregullta me familjen - përgjithësisht të angazhuar në mënyrë aktive kur ndodhin ndërveprime.

2 = Deficiti i moderuar: DISI I/E INTERESUAR në marrëdhëniet familjare dhe i/e konsideron ato disi të rëndësishme. Ndonjëherë mund të humbasë lidhjet e ngushta me familjen, por është disi i/e motivuar për të kërkuar bashkëveprim me familjen. Deficit i dukshëm në inicimin dhe angazhimin e vazhdueshëm në ndërveprime; diskutimi i kohëve të mira dhe të këqija është i kufizuar. Ndërveprimet me anëtarët e familjes mund të ndodhin, por janë kryesisht sipërfaqësore dhe pjesëmarrja karakterizohet më së miri si “kalimi i lëvizjeve”; ndërveprimet kanë më shumë gjasa të iniciohen nga familja me përfshirjen kryesisht pasive të personit.

3 = Deficit mesatarisht i rëndë: PAK INTERES në marrëdhëniet familjare dhe nuk përshkruan lidhjet familjare si të rëndësishme. Nuk përshkruan aspak motivime dhe përpjekje minimale për të pasur marrëdhënie të ngushta familjare. Rrallë ka diskutime për kohë të mira dhe të këqija me anëtarët e familjes. Kontakti dhe angazhimi me familjen është sipërfaqësor dhe pasive me pothuajse të gjitha fillimet dhe përpjekjet për t’u angazhuar që vijnë nga të tjerët.

4 = Deficiti i rëndë: PA INTERES në marrëdhëniet familjare dhe nuk i konsideron aspak të rëndësishme. Preferon të jetë vetëm dhe nuk është aspak i motivuar të jetë me familjen. Nëse personi e sheh familjen, ajo bëhet në mënyrë të pahijshme, pasive dhe pa asnjë interes.

j.gp-2020-0013.tab.020.w2aab3b7b1b1b6b1ab2b3ab6b4b5Aa

PJESA 9 - Shpeshtësia e aktiviteteve të kënaqshme rekreative të pritshme - Javën e ardhshme

0 = Nuk ka deficit: Priten shumë (7 ose më shumë) përvoja të këndshme.

1 = Deficit i lehtë: Priten kënaqësi nga disa përvoja të këndshme (5–6).

2 = Deficit i moderuar: Priten kënaqësi nga një pak a shumë (3–4) përvoja të këndshme.

3 = Deficit mesatarisht i rëndë: Priten disa përvoja të këndshme (1–2).

4 = Deficit i rëndë: Nuk priten përvoja të këndshme.

CAINS scales’ mutual correlations

ScalesSocial MAPRecreational MAPWork & School MAP
Expression0.366***0.297**0.353***
Social MAP0.248*0.498***
Recreational MAP0.288**

j.gp-2020-0013.tab.023.w2aab3b7b1b1b6b1ab2b3ab7b4b2Aa

PIKA - 12 GjesteT ekspresive apo shprehëse

0 = Pa deficit: brenda kufijve normal; përdor gjeste të shpeshta gjatë intervistës.

1 = Deficit i butë: RËNIE E VOGEL në frekuencën e gjesteve shprehëse, me gjeste të kufizuara në disa pjesë të intervistës.

2 = Deficit i moderuar: RËNIE E DALLUAR në frekuencën e gjesteve shprehëse, me mungesë gjestesh gjatë disa pjesëve të intervistës.

3 = Deficit mesatarisht i rëndë: MUNGESA E KONSIDERUESHME e gjesteve ekspresive, me vetëm disa gjeste gjatë shumicës së intervistës.

4 = Deficit i rëndë: MUNGESË TOTALE E gjesteve ekspresive.

j.gp-2020-0013.tab.021.w2aab3b7b1b1b6b1ab2b3ab7b2b2Aa

PIKA 10 - Shprehja e fytyrës

0 = Pa deficit: brenda kufijve normal; shprehje të shpeshta gjatë intervistës.

1 = Deficit i butë: RËNIE E VOGËL në frekuencën e shprehjeve të fytyrës, me shprehje të kufizuara të fytyrës gjatë disa pjesëve të intervistës.

2 = Deficit i moderuar: RËNIE E DALLUESHME në frekuencën e shprehjeve të fytyrës, me shprehjet e fytyrës së zvogëluar gjatë disa pjesëve të intervistës.

3 = Deficit mesatarisht i rëndë: MUNGESË E MADHE e shprehjeve të fytyrës, me vetëm disa ndryshime në shprehjen e fytyrës përgjatë shumicës së intervistës.

4 = Deficiti i rëndë: MUNGESë TOTALE e shprehjeve të fytyrës përgjatë intervistës.

j.gp-2020-0013.tab.022.w2aab3b7b1b1b6b1ab2b3ab7b3b2Aa

Pika 11 - Shprehja Vokale

0 = Nuk ka deficit: brenda kufijve normal. Ndryshim normal në intonacion vokal gjatë intervistës. Të folurit është ekspresiv dhe i animuar.

1 = Deficit i butë: RËNIE E VOGËL në intonacion vokal. Variacioni në intonacion ndodh me një intonacion të kufizuar gjatë disa pjesëve të intervistës.

2 = Deficit i moderuar: RËNIE E DALLUESHME në intonacion vokal. Intonacion i zvogëluar gjatë disa pjesëve të intervistës. Pjesa më e madhe e të folurit mungon në ndryshueshmëri në intonacion, por ndryshimet prozodike ndodhin në disa pjesë të intervistës.

3 = Deficit mesatarisht i rëndë: RËNIE E KONSIDERUESHME e intonacionit vokal me vetëm disa ndryshime në intonacion përgjatë shumicës së intervistës. Pjesa më e madhe e fjalimit është e sheshtë dhe mungon ndryshueshmëria, vetëm shkalla e izoluar e ndryshimit prozodik.

4 = Deficit i rëndë: MUNGESË TOTALE e ndryshimit në intonacion vokal me fjalën karakteristike të sheshtë ose monotone gjatë gjithë intervistës.

j.gp-2020-0013.tab.011.w2aab3b7b1b1b6b1ab2b3ab4b2c15Aa

Pika 2 - Motivimi për miqësitë e ngushta dhe marrëdhëniet romantike

0 = Nuk ka deficit: SHUME I/E INTERESUAR në dhe vlerësom shumë miqësitë/marrëdhëniet romantike si një nga pjesët më të rëndësishme të jetës. Shumë i/e motivuar për t’u angazhuar në miqësi. Fillon rregullisht dhe vazhdon në ndërveprime me miqtë / partnerin dhe angazhohet në mënyrë aktive në këto ndërveprime; kohët e mira dhe të këqija diskutohen hapur.

1 = Deficit i dobët: PËRGJITHSHISHT I/E INTERESUAR në dhe vlerëson miqësitë / marrëdhëniet romantike edhe pse përgjigja sugjeron një reduktim të vogël apo të diskutueshëm. Në përgjithësi dëshiron dhe është i/e motivuar të angazhohet në miqësi. Ka miqësi / marrëdhënie në të cilën mund të diskutohen kohët e mira dhe të këqija, edhe pse kjo mund të jetë më pak e qëndrueshme. Deficit i butë në inicimin ose angazhimin e vazhdueshëm gjatë ndërveprimeve me miqtë / partnerin. Nëse nuk ka miq / marrëdhënie, mungon shoqëria mik / marrëdhëniet romantike, është e motivuar të ketë miq / marrëdhënie dhe bën përpjekje për të kërkuar shokë / marrëdhënie.

2 = Deficit i moderuar: DISI I/E INTERESUAR në marrëdhëniet miqësore / romantike dhe i konsideron ato shumë të rëndësishme. Ndonjëherë mund të humbasë lidhjet e ngushta me miqtë / partnerin dhe është disi i motivuar që të ketë miq / partner. Deficitet e dukshme në inicimin dhe vazhdimisht angazhimin në ndërveprime; diskutimi i kohëve të mira dhe të këqija është i kufizuar. Ndërveprimet me miqtë / partnerin romantik mund të ndodhin, por janë kryesisht sipërfaqësore; ndërveprimet fillojnë nga të tjerët me përfshirjen kryesisht pasive të personit. Nëse nuk ka asnjë mik / marrëdhënie romantike, është disi i motivuar që të ketë miq / partner dhe rrallë, nëse ndonjëherë kërkon shokë / partner.

3 = Deficit mesatarisht i rëndë: PAK INTERES në marrëdhënie miqësore / romantike dhe nuk përshkruan miqtë / partnerin si të rëndësishëm. Nuk e përshkruan aspak motivimin për të pasur miqësi, dhe preferon të jetë vetëm. Kontaktimi dhe angazhimi me të tjerët është sipërfaqësor dhe pasiv me pothuajse të gjitha iniciativat dhe përpjekjet për t’u angazhuar që vijnë nga të tjerët.

4 = Deficiti i rëndë: JO INTERES në marrëdhëniet miqësore / romantike dhe nuk i konsideron ato aspak të rëndësishme. Preferon të jetë vetëm dhe nuk është aspak i motivuar që të ketë miq / partner.

Study participants’ sociodemographic and clinical characteristics

Age, years (mean [SD])Study participantsN = 106 (100%)
22 (SD 1.75)
Gender (N, %)
Male(73, 68%)
Female(33, 32%)
Marital status (N, %)
Single/divorced/widowed(65, 61%)
In a relationship/married(41, 39%)
Employment (N, %)
Unemployed(95, 90%)
Employed(11, 10%)
Education (N, %)
No formal education, primary school(44, 41.5%)
Secondary school(52, 49%)
College, university(7, 6.6%)
Clinical diagnosis (N, %)
ICD-10 F20–29103 (97.2%)
ICD-10 F313 (2.8%)

Variance explained by the extracted components (CAINS)

ComponentSums of Squared Loadings (Extraction)Sums of Squared Loadings (Rotation)
Total% of VarianceCumulative %Total
15.08339.10339.1033.891
21.99115.31654.4193.510
31.42510.95865.3773.538
41.2119.31474.6922.175

j.gp-2020-0013.tab.014.w2aab3b7b1b1b6b1ab2b3ab4b2c27Aa

PJESA 4 - Frekuenca e aktiviteteve sociale të pritshme të kënaqshme - Javën e ardhshme

0 = Nuk ka deficit: Priten shumë (7 ose më shumë) përvoja tëkënaqshme.

1 = Deficit i lehtë: Priten kënaqësi nga disa përvoja të kënaqshme (5–6).

2 = Deficit i moderuar: Priten kënaqësi pak a shumë (3–4) përvoja të pëlqyeshme.

3 = Deficit mesatarisht i rëndë: Priten disa përvoja të kënaqshme (1–2).

4 = Deficit i rëndë: Nuk priten përvoja të këndshme.

j.gp-2020-0013.tab.018.w2aab3b7b1b1b6b1ab2b3ab6b3b5Aa

AktivitetiE hënëE martëE mërkurëE enjteE premte

j.gp-2020-0013.tab.013.w2aab3b7b1b1b6b1ab2b3ab4b2c21Aa

Pika 3 - Shpeshtësia e aktiviteteve shoqërore të kënaqshme - Java e kaluar

0 = Nuk ka deficit: kënaqësi përjetuar çdo ditë.

1 = Deficitet e lehtë: Kënaqësi përjetuar 5–6 ditë.

2 = Deficiti i moderuar: kënaqësi përjetuar 3–4 ditë.

3 = Deficitet mesatarisht e rëndë: kënaqësi e përjetuar 1–2 ditë.

4 = Deficiti i rëndë: Nuk është raportuar asnjë kënaqësi.

j.gp-2020-0013.tab.017.w2aab3b7b1b1b6b1ab2b3ab6b2b6Aa

PJESA 7 - Motivimi për aktivitetet rekreative

0 = Nuk ka deficit: Personi është shumë I/E MOTIVUAR për të kërkuar hobi dhe aktivitete rekreative; inicion dhe vazhdon në hobi dhe aktivitete rekreative në baza të rregullta.

1 = Deficiti i dobët: Personi është PËRGJITHËSISHT I/E MOTIVUAR për të kërkuar hobi dhe aktivitete rekreative; një deficit i butë në fillimin dhe këmbënguljen; mund të fillojë me një hobi, por me këmbëngulje të moderuar.

2 = Deficiti i moderuar: Personi është DISI I/E MOTIVUAR për të kërkuar hobi dhe aktivitete rekreative; deficiti i dukshëm në fillimin; mund të ketë filluar disa aktivitete dhe / ose të mos vazhdojë për shumë kohë. Të tjerët kishin më shumë gjasa për të iniciuar hobi apo aktivitete.

3 = Deficitet mesatarisht e rëndë: Personi është PAK I/E MOTIVUAR për të kërkuar hobi dhe aktivitete rekreative; deficiti i dukshëm në inicimin dhe këmbënguljen; mund të ketë nisur disa aktivitete dhe të mos vazhdojë për shumë kohë. Të tjerët kishin më shumë gjasa të iniconin hobi/

4 = Deficiti i rëndë: Personi nuk është gjithnjë i motivuar për të kërkuar hobi dhe aktivitete rekreative; mungesa pothuajse totale e inicimit dhe këmbënguljes në hobi apo aktivitete rekreative.

Correlations between CAINS and BSI subscales

BSI subscalesCAINS subscales
ExpressionSocial MAPRecreational MAPWork & School MAP
Somatization0.1310.396***0.1260.337***
Obsession-compulsion0.1030.278**0.1950.140
Interpersonal Sensitivity-0.0090.251*0.1400.252*
Depression0.0860.362***0.1850.255**
Anxiety0.1070.238*0.1230.159
Hostility0.0680.239*0.205*0.262**
Phobic anxiety0.1070.208*0.1810.237*
Paranoid Ideation0.0320.304**0.1180.277**
Psychoticism0.0720.222*0.1740.156

j.gp-2020-0013.tab.015.w2aab3b7b1b1b6b1ab2b3ab5b2b6Aa

PJESA 5 - Motivimi për punë dhe aktivitetet e shkollës

0 = Nuk ka deficit: Personi është shumë i/e MOTIVUAR për të kërkuar punë ose shkollë, apo mundësi të reja në punë ose në shkollë; në kërkim të vendeve të punës dhe shkollës në baza të rregullta.

1 = Deficiti i dobët: Personi është PËRGJITHËSISHT I/E MOTIVUAR për të kërkuar punë ose shkollë ose mundësi të reja në punë ose në shkollë; një deficit i butë në fillimin dhe këmbënguljen; mund të raportohen raste të inicimit, por me këmbëngulje të moderuar.

2 = Deficiti i moderuar: Personi është DISI I/E MOTIVUAR për të kërkuar punë ose shkollë ose mundësi të reja në punë ose në shkollë; deficiti i dukshëm në fillimin; mund të kenë iniciuar aktivitete, por kanë nevojë për përkujtues në raste të shumta dhe / ose nuk kanë filluar ndonjë aktivitet të ri dhe / ose nuk kanë vazhduar për shumë kohë.

3 = Deficitet mesatarisht e rëndë: Personi është PAK I/E MOTTIVUAR për të kërkuar punë ose shkollë ose mundësi të reja në punë ose në shkollë; deficiti i dukshëm në inicimin; mund të ketë nevojë për përkujtesa të vazhdueshme dhe / ose të iniciojë disa aktivitete; nuk ka vazhduar për shumë kohë.

4 = Deficiti i rëndë: Personi NUK ËSHTË ASPAK I/E MOTIVUAR për të kërkuar punë / shkollë; mungesa pothuajse totale e inicimit dhe këmbënguljes në punë, në shkollë ose në kërkimin e punës.

j.gp-2020-0013.tab.024.w2aab3b7b1b1b6b1ab2b3ab7b5b2Aa

PIKA - 13 Sasia e fjalës

0 = Nuk ka deficit: SHUMA NORMALE e fjalëve gjatë gjithë intervistës. Përgjigjet sigurojnë informacion të mjaftueshëm me përpunimin e shpeshtë spontan.

1 = Deficit i butë: RËNIE E VOGËL në sasinë e fjalëve, me përgjigje të shkurtra gjatë disa pjesëve të intervistës.

2 = Deficit i moderuar: RËNIE E DALLUESHME në sasinë e fjalëve, me përgjigje të shkurtra gjatë disa shumicës së intervistës.

3 = Deficit mesatarisht i rëndë: RËNIE E KONSIDERUESHME e të folurit, me përgjigje shumë të shkurtra (vetëm disa fjalë) në përgjigjet gjatë shumicës së intervistës.

4 = Deficit i rëndë: Të gjitha ose pothuajse të gjitha përgjigjet janë një ose dy fjalë gjatë gjithë intervistës.

Addington, D., Addington, J., & Schissel, B. (1990). A depression rating scale for schizophrenics. Schizophrenia research, 3(4), 247–251AddingtonD.AddingtonJ.SchisselB.1990A depression rating scale for schizophrenicsSchizophrenia research34247251Search in Google Scholar

Ahmed, A. O., Kirkpatrick, B., Galderisi, S., Mucci, A., Rossi, A., Bertolino, A., ... & Hartmann-Riemer, M. N. (2018). Cross-cultural validation of the 5-factor structure of negative symptoms in schizophrenia. Schizophrenia bulletin, 45(2), 305–31.AhmedA. O.KirkpatrickB.GalderisiS.MucciA.RossiA.BertolinoA.Hartmann-RiemerM. N.2018Cross-cultural validation of the 5-factor structure of negative symptoms in schizophreniaSchizophrenia bulletin45230531Search in Google Scholar

Alphs, L., Summerfelt, A., Lann, H., & Muller, R.J. (1989). The Negative Symptom Assessment: a new instrument to assess negative symptoms of schizophrenia. Psychopharmacology Bulletin, 25, 159–1.AlphsL.SummerfeltA.LannH.MullerR.J.1989The Negative Symptom Assessment: a new instrument to assess negative symptoms of schizophreniaPsychopharmacology Bulletin251591Search in Google Scholar

Andreasen, N. C. (1989). The Scale for the Assessment of Negative Symptoms (SANS): conceptual and theoretical foundations. The British Journal of Psychiatry, 155(S7), 49–52AndreasenN. C.1989The Scale for the Assessment of Negative Symptoms (SANS): conceptual and theoretical foundationsThe British Journal of Psychiatry155S74952Search in Google Scholar

Blanchard, J. J., & Cohen, A. S. (2005). The structure of negative symptoms within schizophrenia: implications for assessment. Schizophrenia bulletin, 32(2), 238–245.BlanchardJ. J.CohenA. S.2005The structure of negative symptoms within schizophrenia: implications for assessmentSchizophrenia bulletin322238245Search in Google Scholar

Blanchard, J. J., Bradshaw, K. R., Garcia, C. P., Nasrallah, H. A., Harvey, P. D., Casey, D., ... & Nuechterlein, K. H. (2017). Examining the reliability and validity of the Clinical Assessment Interview for Negative Symptoms within the Management of Schizophrenia in Clinical Practice (MOSAIC) multisite national study. Schizophrenia research, 185, 137–143.BlanchardJ. J.BradshawK. R.GarciaC. P.NasrallahH. A.HarveyP. D.CaseyD.NuechterleinK. H.2017Examining the reliability and validity of the Clinical Assessment Interview for Negative Symptoms within the Management of Schizophrenia in Clinical Practice (MOSAIC) multisite national studySchizophrenia research185137143Search in Google Scholar

Blanchard, J. J., Gur, R. E., Horan, W. P., & Kring, A. M. (2013). Manual for the clinical assessment interview for Negative symptoms (CAINS).BlanchardJ. J.GurR. E.HoranW. P.KringA. M.2013Manual for the clinical assessment interview for Negative symptoms (CAINS)Search in Google Scholar

Blanchard, J. J., Kring, A. M., Horan, W. P., & Gur, R. (2011). Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophrenia. Schizophrenia bulletin, 37(2), 291–299BlanchardJ. J.KringA. M.HoranW. P.GurR.2011Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophreniaSchizophrenia bulletin372291299Search in Google Scholar

Chan, R. C., Shi, C., Lui, S. S., Ho, K. K., Hung, K. S., Lam, J. W., ... & Yu, X. (2015). Validation of the Chinese version of the Clinical Assessment Interview for Negative Symptoms (CAINS): a preliminary report. Frontiers in psychology, 6, 7.ChanR. C.ShiC.LuiS. S.HoK. K.HungK. S.LamJ. W.YuX.2015Validation of the Chinese version of the Clinical Assessment Interview for Negative Symptoms (CAINS): a preliminary reportFrontiers in psychology67Search in Google Scholar

Clark, S. R., Schubert, K. O., Olagunju, A. T., Lyrtzis, E. A., & Baune, B. T. (2018). Cognitive and Functional Assessment of Psychosis Stratification Study (CoFAPSS): Rationale, Design and Characteristics. Frontiers in psychiatry, 9, 662.ClarkS. R.SchubertK. O.OlagunjuA. T.LyrtzisE. A.BauneB. T.2018Cognitive and Functional Assessment of Psychosis Stratification Study (CoFAPSS): Rationale, Design and CharacteristicsFrontiers in psychiatry9662Search in Google Scholar

Daniel, D. G. (2013). Issues in selection of instruments to measure negative symptoms. Schizophrenia research, 150 (2–3), 343–345DanielD. G.2013Issues in selection of instruments to measure negative symptomsSchizophrenia research1502–3343345Search in Google Scholar

Derogatis, L. R. (1983). BSI Brief Symptom Inventory: Administration, Scoring and Procedure Manual (4thEd.) Minneapolis, MN: National Computer Systems.DerogatisL. R.1983BSI Brief Symptom Inventory: Administration, Scoring and Procedure Manual4th Ed.Minneapolis, MNNational Computer SystemsSearch in Google Scholar

Elis, O., Caponigro, J.M.,& Kring, A.M., 2013. Psychosocial treatments for negative symptoms in schizophrenia: current practices and future directions. Clinical Psychological Review, 33(8),914–928.ElisO.CaponigroJ.M.KringA.M.2013Psychosocial treatments for negative symptoms in schizophrenia: current practices and future directionsClinical Psychological Review338914928Search in Google Scholar

Engel, M., Fritzsche, A., & Lincoln, T. M. (2014). Validation of the German version of the clinical assessment interview for negative symptoms (CAINS). Psychiatry research, 220(1–2), 659–663.EngelM.FritzscheA.LincolnT. M.2014Validation of the German version of the clinical assessment interview for negative symptoms (CAINS)Psychiatry research2201–2659663Search in Google Scholar

Forbes, C., Blanchard, J. J., Bennett, M., Horan, W. P., Kring, A., & Gur, R. (2010). Initial development and preliminary validation of a new negative symptom measure: The Clinical Assessment Interview for Negative Symptoms (CAINS). Schizophrenia Research, 124(1–3), 36–42.ForbesC.BlanchardJ. J.BennettM.HoranW. P.KringA.GurR.2010Initial development and preliminary validation of a new negative symptom measure: The Clinical Assessment Interview for Negative Symptoms (CAINS)Schizophrenia Research1241–33642Search in Google Scholar

Garcia-Portilla, M. P., Garcia-Alvarez, L., Saiz, P. A., Al-Halabi, S., Bobes-Bascaran, M. T., Bascaran, M. T., ... & Bobes, J. (2015). Psychometric evaluation of the negative syndrome of schizophrenia. European archives of psychiatry and clinical neuroscience, 265(7), 559–566.Garcia-PortillaM. P.Garcia-AlvarezL.SaizP. A.Al-HalabiS.Bobes-BascaranM. T.BascaranM. T.BobesJ.2015Psychometric evaluation of the negative syndrome of schizophreniaEuropean archives of psychiatry and clinical neuroscience2657559566Search in Google Scholar

Harvey, P.D., Koren, D., Reichenberg, A., & Bowie, C.R. (2006). Negative symptoms and deficits: what is the nature of their relationship?. Schizophrenia bulletin, 32(2), 250–258HarveyP.D.KorenD.ReichenbergA.BowieC.R.2006Negative symptoms and deficits: what is the nature of their relationship?Schizophrenia bulletin322250258Search in Google Scholar

Horan, W. P., Kring, A. M., Gur, R. E., Reise, S. P., & Blanchard, J. J. (2011). Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS). Schizophrenia research, 132(2–3), 140–145.HoranW. P.KringA. M.GurR. E.ReiseS. P.BlanchardJ. J.2011Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS)Schizophrenia research1322–3140145Search in Google Scholar

Hosakova, K., Viktorova, L., Lecbych, M., & Hosak, L. (2017). Clinical Assessment Interview for Negative Symptoms: Validation of the Czech Version. Poster session presented at the 13th World Congress of Biological Psychiatry, Copenhagen.HosakovaK.ViktorovaL.LecbychM.HosakL.2017Clinical Assessment Interview for Negative Symptoms: Validation of the Czech VersionPoster session presented at the 13th World Congress of Biological PsychiatryCopenhagenSearch in Google Scholar

Jovanovic, N., Francis, J., Maric, N. P., Arenliu, A., Barjaktarov, S., Kulenovic, A., Injac, L., Feng, Y., & Novotni, A. (2019). Implementing a psychosocial intervention DIALOG+ for patients with psychotic disorders in low and middle income countries in South Eastern Europe: protocol for a hybrid effectiveness-implementation cluster randomized clinical trial (IMPULSE), Global Psychiatry (published online ahead of print). doi: https://doi.org/10.2478/gp-2019-0020JovanovicN.FrancisJ.MaricN. P.ArenliuA.BarjaktarovS.KulenovicA.InjacL.FengY.NovotniA.2019Implementing a psychosocial intervention DIALOG+ for patients with psychotic disorders in low and middle income countries in South Eastern Europe: protocol for a hybrid effectiveness-implementation cluster randomized clinical trial (IMPULSE)Global Psychiatry(published online ahead of print).https://doi.org/10.2478/gp-2019-0020Open DOISearch in Google Scholar

Kirkpatrick, B., Fenton, W. S., Carpenter, W. T., & Marder, S. R. (2006). The NIMH-MATRICS consensus statement on negative symptoms. Schizophrenia bulletin, 32(2), 214–219.KirkpatrickB.FentonW. S.CarpenterW. T.MarderS. R.2006The NIMH-MATRICS consensus statement on negative symptomsSchizophrenia bulletin322214219Search in Google Scholar

Kay, S.R., Fiszbein, A., Opler, L. A. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. (1987). Schizophrenia Bulletin, 13, 261–276.KayS.R.FiszbeinA.OplerL. A.The Positive and Negative Syndrome Scale (PANSS) for schizophrenia1987Schizophrenia Bulletin13261276Search in Google Scholar

Kring, A. M., Gur, R. E., Blanchard, J. J., Horan, W. P., & Reise, S. P. (2013). The clinical assessment interview for negative symptoms (CAINS): final development and validation. American Journal of Psychiatry, 170(2), 165–172.KringA. M.GurR. E.BlanchardJ. J.HoranW. P.ReiseS. P.2013The clinical assessment interview for negative symptoms (CAINS): final development and validationAmerican Journal of Psychiatry1702165172Search in Google Scholar

Kumari, S., Malik, M., Florival, C., Manalai, P., & Sonje, S. (2017). An assessment of five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS). Journal of addiction research & therapy, 8(3). 324.KumariS.MalikM.FlorivalC.ManalaiP.SonjeS.2017An assessment of five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS)Journal of addiction research & therapy83324Search in Google Scholar

Lincoln, T.M., Dollfus, S., & Lyne, J. (2017). Current developments and challenges in the assessment of negative symptoms. Schizophrenia research, 186, 8–18LincolnT.M.DollfusS.LyneJ.2017Current developments and challenges in the assessment of negative symptomsSchizophrenia research186818Search in Google Scholar

Martins, M. J., Carvalho, C., Castilho, P., Pereira, A. T., & Macedo, A. (2015). The ‘Clinical Interview for Psychotic Disorders’ (CIPD): Development and expert evaluation. International Journal of Clinical Neurosciences and Mental Health, (2), 7.MartinsM. J.CarvalhoC.CastilhoP.PereiraA. T.MacedoA.2015The ‘Clinical Interview for Psychotic Disorders’ (CIPD): Development and expert evaluationInternational Journal of Clinical Neurosciences and Mental Health27Search in Google Scholar

Mesquita, B. (2001). Emotions in collectivist and individualist contexts. Journal of Personality and Social Psychology, 80(1), 68–74.MesquitaB.2001Emotions in collectivist and individualist contextsJournal of Personality and Social Psychology8016874Search in Google Scholar

Montgomery, S. A., & van Zwieten-Boot, B. (2007). ECNP consensus meeting. Negative, depressive and cognitive symptoms of schizophrenia. Nice, March 2004. European Neuropsychopharmacology, 17(1), 70–77.MontgomeryS. A.van Zwieten-BootB.2007ECNP consensus meeting. Negative, depressive and cognitive symptoms of schizophrenia. Nice, March 2004European Neuropsychopharmacology1717077Search in Google Scholar

Overall, J. E., & Gorham, D. R. (1962). The brief psychiatric rating scale. Psychological reports, 10(3), 799–812.OverallJ. E.GorhamD. R.1962The brief psychiatric rating scalePsychological reports103799812Search in Google Scholar

Rekhi, G., San Ang, M., Yuen, C. K. Y., Ng, W. Y., & Lee, J. (2019). Assessing negative symptoms in schizophrenia: Validity of the clinical assessment interview for negative symptoms in Singapore. Schizophrenia research, 206, 177–182.RekhiG.San AngM.YuenC. K. Y.NgW. Y.LeeJ.2019Assessing negative symptoms in schizophrenia: Validity of the clinical assessment interview for negative symptoms in SingaporeSchizophrenia research206177182Search in Google Scholar

Stahl, S. M., Buckley, P.F. (2007). Negative symptoms of schizophrenia: a problem that will not go away. Acta Psychiatrica Scandinavica, 115 (1), 4–11.StahlS. M.BuckleyP.F.2007Negative symptoms of schizophrenia: a problem that will not go awayActa Psychiatrica Scandinavica1151411Search in Google Scholar

Strauss, G. P., Nuñez, A., Ahmed, A. O., Barchard, K. A., Granholm, E., Kirkpatrick, B., Gold, J. M., & Allen, D. N. (2018). The latent structure of negative symptoms in schizophrenia. JAMA Psychiatry, 75, 1271–1279.StraussG. P.NuñezA.AhmedA. O.BarchardK. A.GranholmE.KirkpatrickB.GoldJ. M.AllenD. N.2018The latent structure of negative symptoms in schizophreniaJAMA Psychiatry7512711279Search in Google Scholar

Valiente-Gómez, A., Mezquida, G., Romaguera, A., Vilardebò, I., Andrés, H., Granados, B., ... & Bernardo, M. (2015). Validation of the Spanish version of the Clinical Assessment for Negative Symptoms (CAINS). Schizophrenia research, 166 (1–3), 104–109.Valiente-GómezA.MezquidaG.RomagueraA.VilardebòI.AndrésH.GranadosB.BernardoM.2015Validation of the Spanish version of the Clinical Assessment for Negative Symptoms (CAINS)Schizophrenia research1661–3104109Search in Google Scholar

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