Five-Factor Model of Schizophrenia Initial Validation

Montefiore Medical Center, New York, New York, United States
Journal of Nervous & Mental Disease (Impact Factor: 1.69). 12/1994; 182(11):631-8. DOI: 10.1097/00005053-199411000-00006
Source: PubMed


Schizophrenic psychopathology is heterogeneous and multidimensional. Various strategies have been developed over the past several years to assess and measure more accurately discrete domains of psychopathology. One of the more fruitful strategies to investigate more homogenous domains of psychopathology has been the positive-negative syndrome approach. However, this approach is unable to address a number of important issues. Most schizophrenics present a mixed syndrome; the criteria for what constitutes a positive and negative syndrome are variable; distinguishing primary from secondary negative symptoms can be difficult. In order to address some of these problems, we propose the introduction of a five-syndrome model based on a reanalysis of factor analytic procedures used on 240 schizophrenics assessed with the Positive and Negative Syndrome Scale. We present data on a five-factor solution that appears to best fit the psychopathological data and that is supported by three independent and comparable factor analyses; negative, positive, excitement, cognitive, and depression/anxiety domains of psychopathology give patients their individual mark. Data on internal consistency of the five factors and on initial validation using demographic and clinical variables are presented.

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    • "BDD and OCD groups only also completed the Brown Assessment of Beliefs Scale (BABS) (Eisen et al., 1998) and the Peters' Delusional Inventory (PDI) (Peters et al., 1999) to assess insight and delusionality, in addition to the Y-BOCS and BDD-YBOCS as noted above. Symptoms were assessed for the SCZ group with the Positive and Negative Syndrome Scale (PANSS) (Kay et al., 1987) which was scored using a 5 factor model that included orthogonal factors for positive, negative, cognitive, depression, and excitement symptoms (Lindenmayer et al., 1994a, 1994b, 1995a, 1995b). We also derived a separate disorganization factor (Cuesta and Peralta, 1995), and focused specifically on item P2, conceptual disorganization, given prior observed relationships between reduced PO, including CI, and reduced thought organization in SCZ (Uhlhaas and Silverstein, 2005; Silverstein and Keane, 2011). "
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    ABSTRACT: People with schizophrenia are impaired at organizing potentially ambiguous visual information into well-formed shape and object representations. This perceptual organization (PO) impairment has not been found in other psychiatric disorders. However, recent data on body dysmorphic disorder (BDD), suggest that BDD may also be characterized by reduced PO. Similarities between these groups could have implications for understanding the RDoC dimension of visual perception in psychopathology, and for modeling symptom formation across these two conditions. We compared patients with SCZ (n=24) to those with BDD (n=20), as well as control groups of obsessive-compulsive disorder (OCD) patients (n=20) and healthy controls (n=20), on two measures of PO that have been reliably associated with schizophrenia-related performance impairment. On both the contour integration and Ebbinghaus illusion tests, only the SCZ group demonstrated abnormal performance relative to controls; the BDD group performed similarly to the OCD and CON groups. In addition, on both tasks, the SCZ group performed more abnormally than the BDD group. Overall, these data suggest that PO reductions observed in SCZ are not present in BDD. Visual processing impairments in BDD may arise instead from other perceptual disturbances or attentional biases related to emotional factors. Copyright © 2015 Elsevier Ltd. All rights reserved.
    06/2015; 229(1-2). DOI:10.1016/j.psychres.2015.05.107
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    • "After extracting and specifying more than 20 alternative models from the literature, we compare the fit indices of the CFA models when data clustering is ignored or considered. Published models that include a smaller number of PANSS items, such as Peralta et al. (1992); Strauss et al. (1974); Kay and Sevy (1990); Peralta et al. (1994), and Lindenmayer et al. (1994a), were not estimated. The results in Table 5 reveal that none of the models fit the data acceptably when the clustering is ignored. "
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    ABSTRACT: Clinical assessments of the presence and severity of psychopathology are often collected by health care professionals in mental health services or clinical researchers trained to use semi-structured interviews. Clustering by interviewer or rater needs to be considered when performing psychometric analyses such as factor analysis or item response modelling as non-independence of observations arises in these situations. We apply more suitable multilevel methods to analyse ordinally scored Positive and Negative Syndrome Scale (PANSS) items. Our aim is to highlight the differences in results that occur when the data are analysed using a hierarchically sensitive approach rather than using a traditional (aggregated) analysis. Our sample (n = 507) consisted of patients diagnosed with schizophrenia who participated in a multi-centre randomized control clinical trial, the DIALOG study. Analyses reported and compared include an exploratory factor analysis as well as several recently published multifactor models re-estimated within a confirmatory analysis framework. Our results show that the fit of the model and the parsimony of the exploratory factor analysis (EFA) models indicated by the number of factors necessary to explain the inter-correlation among PANSS items improved significantly when data clustering is taken into account through multilevel analysis. Our modeling results support the pentagonal PANSS model first proposed by White et al. (1997). Copyright © 2014 John Wiley & Sons, Ltd.
    03/2014; 23(1). DOI:10.1002/mpr.1429
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    • "For the purposes of this study, we used factor analytically derived positive, negative, cognitive, and emotional discom-fort components of the PANSS [36]. Evidence supporting the use of factor analytic solutions for the PANSS has been reported by numerous other investigators [37]. Inter-rater reliability as assessed for raters in this study found good to excellent intra-class correlations on all scale scores with intra-class correlations ranging from 0.80 to 0.93. "
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    ABSTRACT: While research continues to document the impact of internalized stigma among persons with schizophrenia, little is known about the factors which promote stigma resistance or the ability to recognize and reject stigma. This study aimed to replicate previous findings linking stigma resistance with lesser levels of depression and higher levels of self-esteem while also examining the extent to which other factors, including metacognitive capacity and positive and negative symptoms, are linked to the ability to resist stigma. Participants were 62 adults with schizophrenia-spectrum disorders who completed self-reports of stigma resistance, internalized stigma, self-esteem, and rater assessments of positive, negative, disorganization, and emotional discomfort symptoms, and metacognitive capacity. Stigma resistance was significantly correlated with lower levels of acceptance of stereotypes of mental illness, negative symptoms, and higher levels of metacognitive capacity, and self-esteem. A stepwise multiple regression revealed that acceptance of stereotypes of mental illness, metacognitive capacity, and self-esteem all uniquely contributed to greater levels of stigma resistance, accounting for 39% of the variance. Stigma resistance is related to, but not synonymous with, internalized stigma. Greater metacognitive capacity, better self-esteem, and fewer negative symptoms may be factors which facilitate stigma resistance.
    Comprehensive psychiatry 01/2014; 55(4). DOI:10.1016/j.comppsych.2014.01.011 · 2.25 Impact Factor
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