Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-16T17:04:55.522Z Has data issue: false hasContentIssue false

Positive, Negative, and Disorganisation Factors from the Schedule for Affective Disorders and Schizophrenia and the Present State Examination

A Three-Factor Solution

Published online by Cambridge University Press:  02 January 2018

Paul A. Thompson*
Affiliation:
Data Analysis and Statistics Section, Laboratory of Biological Psychiatry, B-68 Hanna Pavilion, Department of Psychiatry, Case Western Reserve University, 2040 Abington Road, Cleveland, Ohio 44106, USA
Herbert Y. Meltzer
Affiliation:
Laboratory of Biological Psychiatry, Case Western Reserve University
*
Correspondence

Abstract

The use of items from the Schedule for Affective Disorders and Schizophrenia and from the Present State Examination scales for assessing positive and negative symptoms in schizophrenia was examined using factor analysis. The factorial structure of the items which putatively assess positive and negative symptoms was examined. A three-factor solution was obtained with factors identified as: a negative symptom factor (factor 1); a positive symptom factor (factor 2); a ‘disorganisation’ factor (factor 3), consisting primarily of items related to disordered thinking. A solution which was highly similar in important loadings was obtained with an independent sample of patients. High correlations of the rotated factors with the external criteria supported the interpretations of the factors. The results indicate that symptoms generally classified as negative or positive are factorially independent. Furthermore, a disorganisation factor, consisting of items previously included in positive and negative symptoms factors, is necessary for a full representation of the factor structure.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1982) Negative symptoms in psychiatry: definition and reliability. Archives of General Psychiatry, 39, 784788.CrossRefGoogle ScholarPubMed
Andreasen, N. C. (1983a) Comprehensive Assessment of Symptoms and History (CASH). Iowa City: The University of Iowa.Google Scholar
Andreasen, N. C. (1983b) Scale for the Assessment of Negative Symptoms (SANS). Iowa City: The University of Iowa.Google Scholar
Andreasen, N. C. (1984) Scale for the Assessment of Positive Symptoms (SAPS). Iowa City: The University of Iowa.Google Scholar
Andreasen, N. C. (1985) Positive vs. negative schizophrenia: A critical evaluation. Schizophrenia Bulletin, 11, 381389.CrossRefGoogle ScholarPubMed
Andreasen, N. C. & Olsen, S. A. (1982) Negative vs. positive schizophrenia: definition and validation. Archives of General Psychiatry, 39, 789794.CrossRefGoogle Scholar
Andreasen, N. C. & Olsen, S. A., Flaum, M., Swayze, V. W. II, et al (1990) Positive and negative symptoms in schizophrenia: a critical appraisal. Archives of General Psychiatry, 47, 615621.CrossRefGoogle Scholar
Arndt, S., Alliger, R. J. & Andreasen, N. C. (1991) The distinction of positive and negative symptoms. The failure of a two-dimensional model. British Journal of Psychiatry, 158, 317322.CrossRefGoogle ScholarPubMed
Berrios, G. E. (1985) Positive and negative symptoms and Jackson: a conceptual history. Archives of General Psychiatry, 42, 9597.CrossRefGoogle Scholar
Bilder, R. M., Mukherjee, S., Rieder, R. O., et al (1985) Symptomatic and neuropsychological components of defect states. Schizophrenia Bulletin, 11, 409419.CrossRefGoogle ScholarPubMed
Carpenter, W. T. (1991) Psychopathology and common sense. Biological Psychiatry, 29, 735737.CrossRefGoogle ScholarPubMed
Carpenter, W. T., Buchanan, R. W. & Kirkpatrick, B. (1991) The concept of the negative symptoms in schizophrenia. In Negative Schizophrenic Symptoms: Pathophysiology and Clinical Implications (eds Greden, J. F. & Tandon, R.). Washington, DC: American Psychiatric Press.Google Scholar
Carroll, J. B. (1985) Exploratory factor analysis: a tutorial. In Current Topics in Human Intelligence, Volume I (ed. Detterman, D. K.). Norwood, NJ: Ablex.Google Scholar
Cattell, R. B. (1979) The Scientific Use of Factor Analysis in Behavioral and Life Sciences. New York: Plenum Press.Google Scholar
Cook, T. D. & Campbell, D. T. (1979) Quasi-experimentation: Design and Analysis for Field Settings. Boston, MA: Houghton-Mifflin.Google Scholar
Crow, T. J. (1980) The molecular pathology of schizophrenia: more than one disease process? British Medical Journal, 280, 6668.CrossRefGoogle ScholarPubMed
Czobor, P., Bitter, I. & Volavka, J. (1991) Relationship between the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms: a study of their correlation and redundancy. Psychiatry Research, 36, 129139.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. J. (1978) The diagnostic interview: the Schedule for Affective Disorders and Schizophrenia (SADS). Archives of General Psychiatry, 35, 837844.CrossRefGoogle Scholar
Everitt, B. S., Gourlay, A. & Kendall, R. (1971) An attempt at validation of traditional psychiatric syndromes by cluster analysis. British Journal of Psychiatry, 119, 399412.CrossRefGoogle ScholarPubMed
Fleiss, J. L., Gurland, B. J. & Cooper, J. E. (1971) Some contributions to the measurement of psychopathology. British Journal of Psychiatry, 119, 647656.CrossRefGoogle Scholar
Gibbons, R. D., Lewine, R. R. J., Davis, J. M., et al (1985) An empirical test of a Kraepelinian vs. a Bleulerian view of negative symptoms. Schizophrenia Bulletin, 11, 390396.CrossRefGoogle Scholar
Gur, R. E., Mozely, P. D., Resnick, S. M., et al (1991) Relations among clinical scales in schizophrenia. American Journal of Psychiatry, 148, 472478.Google ScholarPubMed
Harman, H. H. (1978) Modem Factor Analysis (3rd edn). Chicago, IL: The University of Chicago.Google Scholar
Jackson, J. H. (1887) Remarks on evolution and dissolution of the nervous system. Journal of Mental Science, 33, 2548.CrossRefGoogle Scholar
Johnson, M. H., Magaro, P. A. & Stern, S. L. (1986) Use of the SADS-C as a diagnostic and symptom severity measure. Journal of Consulting and Clinical Psychology, 54, 546551.CrossRefGoogle ScholarPubMed
Kay, S. R., Fiszbein, A., Lindenmayer, J. P., et al (1986) Positive and negative syndromes in schizophrenia as a function of chronicity. Acta Psychiatrica Scandinavica, 74, 507518.CrossRefGoogle ScholarPubMed
Krawiecka, M., Goldberg, D. & Vaughan, M. (1977) A standardized psychiatric assessment for rating chronic psychotic patients. Acta Psychiatrica Scandinavica, 55, 299308.CrossRefGoogle ScholarPubMed
Lenzenweger, M. F., Dworkin, R. H. & Wethington, E. (1989) Models of positive and negative symptoms in schizophrenia: an empirical evaluation of latent structures. Journal of Abnormal Psychology, 98, 6270.CrossRefGoogle ScholarPubMed
de Leon, J., Simpson, G. M. & Peralta, V. (1992) Positive and negative symptoms in schizophrenia: where are the data? Biological Psychiatry, 31, 431434.CrossRefGoogle ScholarPubMed
Lewine, R. R. J., Fogg, L. & Meltzer, H. Y. (1983) Assessment of negative and positive symptoms in schizophrenia. Schizophrenia Bulletin, 9, 368376.CrossRefGoogle ScholarPubMed
Liddle, P. F. (1987) The symptoms of chronic schizophrenia: a re-examination of the positive-negative dichotomy. British Journal of Psychiatry, 151, 145151.CrossRefGoogle ScholarPubMed
Liddle, P. F. (1990) Prefrontal and subcortical dysfunction in schizophrenia. In International Perspectives in Schizophrenia: Biological, Social and Epidemiological Findings (ed. Weller, M.), pp. 8591. London: John Libbey.Google Scholar
Liddle, P. F., & Barnes, T. R. E. (1990) Syndromes of chronic schizophrenia. British Journal of Psychiatry, 157, 558561.CrossRefGoogle ScholarPubMed
Lorr, M., Klett, C. J., McNair, O. M., et al (1962) Inpatient Multidimensional Psychiatric Scale (IMPS) Manual. Washington, DC: Veterans Administration.Google Scholar
Mackay, A. V. P. (1980) Positive and negative schizophrenic symptoms and the role of dopamine: Discussion, 1. British Journal of Psychiatry, 137, 379383.CrossRefGoogle Scholar
Meltzer, H. Y. (1985) Dopamine and negative symptoms in schizophrenia: critique of Type I-Type II hypotheses. In Controversies in Schizophrenia: Changes and Consistencies (ed. Alpert, M.), pp. 110136. New York: Guilford Press.Google Scholar
Meltzer, H. Y. & Stahl, S. M. (1976) The dopamine hypothesis of schizophrenia. Schizophrenia Bulletin, 2, 1976.CrossRefGoogle ScholarPubMed
Meltzer, H. Y. & Zureich, J. (1989) Negative symptoms in schizophrenia: a target of new drug development. In Clinical Pharmacology in Psychiatry: From Molecular Studies to Clinical Reality (eds Dahl, S. G. & Gram, L. F.), pp. 177. Berlin: Springer-Verlag.Google Scholar
Mortimer, A. M., Lund, C. E. & McKenna, P. J. (1990) The positive: negative dichotomy in schizophrenia. British Journal of Psychiatry, 157, 4149.CrossRefGoogle ScholarPubMed
Overall, J. E. & Gorham, D. (1962) The Brief Psychiatric Rating Scale (BPRS). Psychological Reports, 10, 149165.CrossRefGoogle Scholar
Peralta, V., de Leon, J. & Cuesta, M. J. (1992) Are there more than two syndromes in schizophrenia?: a critique of the positive-negative dichotomy. British Journal of Psychiatry, 161, 335343.CrossRefGoogle ScholarPubMed
Pogue-Geile, M. R. & Kesharam, M. S. (1991) Negative symptomatology in schizophrenia: syndrome and subtype status. In Schizophrenic Symptoms: Pathophysiology and Clinical Implications (eds Greden, J. F. & Tandon, R.). Washington, DC: American Psychiatric Press.Google Scholar
SAS Institute (1988) SAS/STAT User's Guide, Release 6.03 Edition. Cary, NC: SAS Institute.Google Scholar
Schuldberg, D., Quinlan, D. M., Morgenstern, H., et al (1991) Positive and negative symptoms in chronic psychiatric outpatients: reliability, stability and factor structure. Psychological Assessment, 2, 262268.CrossRefGoogle Scholar
Sommers, A. A. (1985) Negative symptoms: conceptual and methodological problems. Schizophrenia Bulletin, 11, 364373.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Fleiss, J. L., Endicott, J., et al (1967) Mental Status Schedule: properties of factor analytically derived scales. Archives of General Psychiatry, 16, 479493.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Fleiss, J. L., Endicott, J., Endicott, J., Fleiss, J. L., et al (1970) Psychiatric status schedule: a technique for evaluating psychopathology and impairment in role functioning. Archives of General Psychiatry, 23, 4155.CrossRefGoogle ScholarPubMed
Strauss, J. S., Carpenter, W. T. & Bartko, J. J. (1974) The diagnosis and understanding of schizophrenia: III. Speculations on the process that underlie schizophrenic symptoms and signs. Schizophrenia Bulletin, 11, 6169.CrossRefGoogle Scholar
Trimble, M. R. (1986) Positive and negative symptoms in psychiatry. British Journal of Psychiatry, 148, 587589.CrossRefGoogle ScholarPubMed
Wing, J. K., Birley, J. L. T. & Cooper, J. E. (1967) Reliability of a procedure for measuring and classifying “present psychiatric state”. British Journal of Psychiatry, 113, 499515.CrossRefGoogle ScholarPubMed
Wing, J. K., Birley, J. L. T. & Cooper, J. E., Cooper, J. E. & Sartorius, N. (1973) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.