Hostname: page-component-89b8bd64d-dvtzq Total loading time: 0 Render date: 2026-05-13T16:34:55.552Z Has data issue: false hasContentIssue false
  • English
  • Français

The Brief Negative Symptom Scale (BNSS): Independent validation in a large sample of Italian patients with schizophrenia

Published online by Cambridge University Press:  15 April 2020

A. Mucci ,
S. Galderisi ,
E. Merlotti ,
A. Rossi ,
P. Rocca ,
P. Bucci ,
G. Piegari ,
M. Chieffi ,
A. Vignapiano  and
M. Maj
A. Mucci
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
S. Galderisi*
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
E. Merlotti
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
A. Rossi
Affiliation:
Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, L’Aquila, Italy
P. Rocca
Affiliation:
Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
P. Bucci
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
G. Piegari
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
M. Chieffi
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
A. Vignapiano
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
M. Maj
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
*
⁎Corresponding author at: Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, Naples, 80138 Italy. Tel.: +390815666504. E-mail address: silvana.galderisi@gmail.com (S. Galderisi).
Get access

Abstract

Background

The Brief Negative Symptom Scale (BNSS) was developed to address the main limitations of the existing scales for the assessment of negative symptoms of schizophrenia. The initial validation of the scale by the group involved in its development demonstrated good convergent and discriminant validity, and a factor structure confirming the two domains of negative symptoms (reduced emotional/verbal expression and anhedonia/asociality/avolition). However, only relatively small samples of patients with schizophrenia were investigated. Further independent validation in large clinical samples might be instrumental to the broad diffusion of the scale in clinical research.

Methods

The present study aimed to examine the BNSS inter-rater reliability, convergent/discriminant validity and factor structure in a large Italian sample of outpatients with schizophrenia.

Results

Our results confirmed the excellent inter-rater reliability of the BNSS (the intraclass correlation coefficient ranged from 0.81 to 0.98 for individual items and was 0.98 for the total score). The convergent validity measures had r values from 0.62 to 0.77, while the divergent validity measures had r values from 0.20 to 0.28 in the main sample (n = 912) and in a subsample without clinically significant levels of depression and extrapyramidal symptoms (n = 496). The BNSS factor structure was supported in both groups.

Conclusions

The study confirms that the BNSS is a promising measure for quantifying negative symptoms of schizophrenia in large multicenter clinical studies.

Keywords

SchizophreniaNegative symptomsPrimary negative symptomsPoor emotion expressionAvolition

Information

Type
Original article
Information
European Psychiatry , Volume 30 , Issue 5 , July 2015 , pp. 641 - 647
Copyright
Copyright © Elsevier Masson SAS 2015

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.)

Article purchase

Temporarily unavailable

Footnotes

1

Italian Network for Research on Psychoses: Teresa Campana, Stefania De Simone, Olimpia Gallo, Rosa Giugliano, Mario Luciano, Valentina Montefusco, Giuseppe Plescia, Gaia Sampogna (University of Naples SUN, Naples); Ileana Andriola (University of Bari); Stefano Porcelli (University of Bologna); Alessandro Galluzzo (University of Brescia); Giulia Signorini, Viola Bulgari (IRCCS Fatebenefratelli, Brescia); Federica Pinna (University of Cagliari); Maria Salvina Signorelli (University of Catania); Massimo di Giannantonio (University of Chieti); Antonello Bellomo (University of Foggia); Pietro Calcagno (University of Genoa); Rita Roncone, Paolo Stratta (University of L’Aquila); Massimiliano Buoli (University of Milan); Patrizia Zeppegno (University of Eastern Piedmont, Novara); Valeria Giannunzio (University of Padua); Carlo Marchesi (University of Parma); Liliana Dell’Osso (University of Pisa); Chiara Squarcione, Anna Comparelli (Sapienza University of Rome); Cinzia Niolu (Tor Vergata University of Rome); Palmiero Monteleone (University of Salerno); Arianna Goracci (University of Siena); Cristiana Montemagni (University of Turin).

References

Addington, D., Addington, J., Maticka-Tyndale, E.. Assessing depression in schizophrenia: the Calgary Depression Scale. Br J Psychiatry 1993;22(Suppl.):39–44.CrossRefGoogle Scholar
Alphs, L.D., Summerfelt, A., Lann, H., Muller, R.J.. The negative symptom assessment: a new instrument to assess negative symptoms of schizophrenia. Psychopharmacol Bull 1989;25(2):159–163.Google ScholarPubMed
Andreasen, N.C.The scale for the assessment of negative symptoms (SANS). Iowa City, IA: The University of Iowa; 1984.Google Scholar
Berridge, K.C.. The debate over dopamine's role in reward: the case for incentive salience. Psychopharmacology (Berl) 2007;191(3):391–431.CrossRefGoogle ScholarPubMed
Blanchard, J.J., Cohen, A.S.. The structure of negative symptoms within schizophrenia: implications for assessment. Schizophr Bull 2006;32(2):238–245.CrossRefGoogle ScholarPubMed
Blanchard, J.J., Kring, A.M., Horan, W.P., Gur, R.. Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophrenia. Schizophr Bull 2011;37(2):291–299.CrossRefGoogle Scholar
Chang, W.C., Hui, C.L., Chan, S.K., Lee, E.H., Wong, G.H., Chen, E.Y.. Relationship between diminished expression and cognitive impairment in first-episode schizophrenia: a prospective three-year follow-up study. Schizophr Res 2014;152(1):146–151.CrossRefGoogle ScholarPubMed
Daniel, D.G.. Issues in selection of instruments to measure negative symptoms. Schizophr Res 2013;150(2–3):343–345.CrossRefGoogle ScholarPubMed
First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.Structured clinical interview for DSM-IV axis I disorders, clinician version (SCID-CV). Washington, DC: American Psychiatric Press, Inc.; 1996.Google Scholar
Foussias, G., Agid, O., Fervaha, G., Remington, G.Negative symptoms of schizophrenia: clinical features, relevance to real world functioning and specificity versus other CNS disorders. Eur Neuropsychopharmacol 2014;24(5):693–709.CrossRefGoogle ScholarPubMed
Galderisi, S., Maj, M.Deficit schizophrenia: an overview of clinical, biological and treatment aspects. Eur Psychiatry 2009;24(8):493–500.CrossRefGoogle ScholarPubMed
Galderisi, S., Bucci, P., Mucci, A., Kirkpatrick, B., Pini, S., Rossi, A., et al.Categorical and dimensional approaches to negative symptoms of schizophrenia: focus on long-term stability and functional outcome. Schizophr Res 2013;147(1):157–162.CrossRefGoogle ScholarPubMed
Galderisi, S., Rossi, A., Rocca, P., Bertolino, A., Mucci, A., Bucci, P., et al.The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia. World Psychiatry 2014;13(3):275–287.CrossRefGoogle ScholarPubMed
Gard, D.E., Kring, A.M., Gard, M.G., Horan, W.P., Green, M.F.Anhedonia in schizophrenia: distinctions between anticipatory and consummatory pleasure Schizophr Res 2007;93(1–3):253–260.CrossRefGoogle ScholarPubMed
Gerlach, J., Korsgaard, S., Clemmesen, P., Lauersen, A.M., Magelund, G., Noring, U., et al.The St. Hans Rating Scale for extrapyramidal syndromes: reliability and validity. Acta Psychiatr Scand 1993;87(4):244–252.CrossRefGoogle ScholarPubMed
Goff, D.C.Future perspectives on the treatment of cognitive deficits and negative symptoms in schizophrenia. World Psychiatry 2013;12(2):99–107.CrossRefGoogle Scholar
Harvey, P.D., Koren, D., Reichenberg, A., Bowie, C.R.Negative symptoms and cognitive deficits: what is the nature of their relationship?. Schizophr Bull 2006;32(2):250–258.CrossRefGoogle ScholarPubMed
Horan, W.P., Kring, A.M., Blanchard, J.J.Anhedonia in schizophrenia: a review of assessment strategies. Schizophr Bull 2006;32(2):259–263.CrossRefGoogle ScholarPubMed
Horan, W.P., Kring, A.M., Gur, R.E., Reise, S.P., Blanchard, J.J.Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS). Schizophr Res 2011;132(2–3):140–145.CrossRefGoogle Scholar
Kay, S.R., Fizbein, A., Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13(2):261–276.CrossRefGoogle Scholar
Kimhy, D., Yale, S., Goetz, R.R., McFarr, L.M., Malaspina, D.The factorial structure of the schedule for the deficit syndrome in schizophrenia. Schizophr Bull 2006;32(2):274–278.CrossRefGoogle Scholar
Kirkpatrick, B., Buchanan, R.W., McKenney, P.D., Alphs, L.D., Carpenter, W.T. Jr.The Schedule for the Deficit Syndrome: an instrument for research in schizophrenia. Psychiatry Res 1989;30(2):119–124.CrossRefGoogle Scholar
Kirkpatrick, B., Buchanan, R.W., Ross, D.E., Carpenter, W.T. Jr.A separate disease within the syndrome of schizophrenia. Arch Gen Psychiatry 2001;58(2):165–171.CrossRefGoogle ScholarPubMed
Kirkpatrick, B., Fenton, W.S., Carpenter, W.T., Marder, S.R.The NIMH MATRICS consensus statement on negative symptoms. Schizophr Bull 2006;32(2):214–219.CrossRefGoogle ScholarPubMed
Kirkpatrick, B., Fernandez-Egea, E., Garcia-Rizo, C., Bernardo, M.Differences in glucose tolerance between deficit and nondeficit schizophrenia. Schizophr Res 2009;107(2–3):122–127.CrossRefGoogle ScholarPubMed
Kirkpatrick, B., Strauss, G.P., Nguyen, L., Fischer, B.A., Daniel, D.G., Cienfuegos, A., et al.The Brief Negative Symptom Scale: psychometric properties. Schizophr Bull 2011;37(2):300–305.CrossRefGoogle ScholarPubMed
Knutson, B., Fong, G.W., Adams, C.M., Varner, J.L., Hommer, D.Dissociation of reward anticipation and outcome with event-related fMRI. Neuroreport 2001;12(17):3683–3687.CrossRefGoogle ScholarPubMed
Kring, A.M., Gur, R.E., Blanchard, J.J., Horan, W.P., Reise, S.P.The Clinical Assessment Interview for Negative Symptoms (CAINS): final development and validation. Am J Psychiatry 2013;170(2):165–172.CrossRefGoogle ScholarPubMed
Kurtz, M.M., Moberg, J.P., Ragland, J.D., Gur, R.C., Gur, R.E.Symptoms versus neurocognitive test performance as predictors of psychosocial status in schizophrenia: a 1- and 4-year prospective study. Schizophr Bull 2005;31(1):167–174.CrossRefGoogle ScholarPubMed
Levine, S.Z., Leucht, S.Psychometric analysis in support of shortening the Scale for the Assessment of Negative Symptoms. Eur Neuropsychopharmacol 2013;23:1051–1056.CrossRefGoogle ScholarPubMed
Levine, S.Z., Leucht, S.Attaining and sustaining remission of predominant negative symptoms. Schizophr Res 2013;143(1):60–64.CrossRefGoogle ScholarPubMed
Levine, S.Z., Leucht, S.Identifying clinically meaningful symptom response cut-off values on the SANS in predominant negative symptoms. Schizophr Res 2013;145(1–3):125–127.CrossRefGoogle ScholarPubMed
Levine, S.Z., Rabinowitz, J.Revisiting the 5 dimensions of the positive and negative syndrome scale. J Clin Psychopharmacol 2007;27(5):431–436.CrossRefGoogle ScholarPubMed
Maggini, C., Raballo, A.Exploring depression in schizophrenia. Eur Psychiatry 2006;21(4):227–232.CrossRefGoogle Scholar
Mané, A., García-Rizo, C., Garcia-Portilla, M.P., Bergé, D., Sugranyes, G., Garcia-Alvarez, L., et al.Spanish adaptation and validation of the Brief Negative Symptoms Scale. Compr Psychiatry 2014;55(7):1726–1729.CrossRefGoogle ScholarPubMed
Marder, S.R., Kirkpatrick, B.Defining and measuring negative symptoms of schizophrenia in clinical trials. Eur Neuropsychopharmacol 2014;24(5):737–743.CrossRefGoogle ScholarPubMed
Merlotti, E., Mucci, A., Bucci, P., Nardi, A., Galderisi, S.Italian version of the “Brief Negative Symptom Scale”. J Psychopathol 2014;20(2):199–215.Google Scholar
Messias, E., Kirkpatrick, B., Bromet, E., Ross, D., Buchanan, R.W., Carpenter, W.T. Jr., et al.Summer birth and deficit schizophrenia: a pooled analysis from 6 countries. Arch Gen Psychiatry 2004;61(10):985–989.CrossRefGoogle ScholarPubMed
Milev, P., Ho, B.C., Arndt, S., Andreasen, N.C.Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry 2005;162(3):495–506.CrossRefGoogle ScholarPubMed
Nakaya, M., Ohmori, K.A two-factor structure for the Schedule for the Deficit Syndrome in schizophrenia. Psychiatry Res 2008;158(2):256–259.CrossRefGoogle Scholar
Strauss, G.P., Hong, L.E., Gold, J.M., Buchanan, R.W., McMahon, R.P., Keller, W.R., et al.Factor structure of the Brief Negative Symptom Scale. Schizophr Res 2012;142(1–3):96–98.CrossRefGoogle ScholarPubMed
Strauss, G.P., Keller, W.R., Buchanan, R.W., Gold, J.M., Fischer, B.A., McMahon, R.P., et al.Next-generation negative symptom assessment for clinical trials: validation of the Brief Negative Symptom Scale. Schizophr Res 2012;142(1–3):88–92.CrossRefGoogle ScholarPubMed
van der Gaag, M., Hoffman, T., Remijsen, M., Hijman, R., de Haan, L., van Meijel, B., et al.The five-factor model of the Positive and Negative Syndrome Scale II: a ten-fold cross-validation of a revised model. Schizophr Res 2006;85(1–3):280–287.CrossRefGoogle ScholarPubMed
Wang, X., Yao, S., Kirkpatrick, B., Shi, C., Yi, J.Psychopathology and neuropsychological impairments in deficit and nondeficit schizophrenia of Chinese origin. Psychiatry Res 2008;158(2):195–205.CrossRefGoogle ScholarPubMed
White, L., Harvey, P.D., Opler, L., Lindenmayer, J.P.The PANSS Study Group. Empirical assessment of the factorial structure of clinical symptoms in schizophrenia. A multisite, multimodel evaluation of the factorial structure of the Positive and Negative Syndrome Scale. Psychopathology 1997;30(5):263–274.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.