Clinical relevance of general and specific dimensions in bifactor models of psychotic disorders

Peralta, Víctor; Gil‐Berrozpe, Gustavo J.; Sánchez‐Torres, Ana M.; Cuesta, Manuel J.

doi:10.1002/wps.20879

Cited by 13 publications

(11 citation statements)

References 10 publications

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“…22,23 The evidence base for the two-and five-factor models The negative symptom structure has been widely investigated and exploratory factor analytic studies supported a two-factor model comprising a motivation and pleasure dimension (MAP, including avolition, asociality and anhedonia) and an expressive deficit dimension (EXP, including blunted affect and alogia). 4,[24][25][26] This model is consistent with the observation that different behavioural features, neurophysiological bases as well as clinical and social outcomes are associated with the two dimensions. 2,6,[27][28][29][30][31][32][33][34][35][36] However, evidence from recent multicentre studies utilising confirmatory factor analysis (CFA) has questioned the adequacy of this two-factor model.…”

supporting

confidence: 88%

The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in people with schizophrenia

Rucci,

Caporusso,

Sanmarchi

et al. 2023

BJPsych open

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Background The structure of negative symptoms of schizophrenia is still a matter of controversy. Although a two-dimensional model (comprising the expressive deficit dimension and the motivation and pleasure dimension) has gained a large consensus, it has been questioned by recent investigations. Aims To investigate the latent structure of negative symptoms and its stability over time in people with schizophrenia using network analysis. Method Negative symptoms were assessed in 612 people with schizophrenia using the Brief Negative Symptom Scale (BNSS) at baseline and at 4-year follow-up. A network invariance analysis was conducted to investigate changes in the network structure and strength of connections between the two time points. Results The network analysis carried out at baseline and follow-up, supported by community detection analysis, indicated that the BNSS's items aggregate to form four or five distinct domains (avolition/asociality, anhedonia, blunted affect and alogia). The network invariance test indicated that the network structure remained unchanged over time (network invariance test score 0.13; P = 0.169), although its overall strength decreased (6.28 at baseline, 5.79 at follow-up; global strength invariance test score 0.48; P = 0.016). Conclusions The results lend support to a four- or five-factor model of negative symptoms and indicate overall stability over time. These data have implications for the study of pathophysiological mechanisms and the development of targeted treatments for negative symptoms.

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supporting

confidence: 88%

The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in people with schizophrenia

Rucci,

Caporusso,

Sanmarchi

et al. 2023

BJPsych open

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“…This is in part due to cognitive differences between individuals with autism and the general population samples with which these measures were developed (e.g., metacognition and theory of mind; Grainger et al., 2014 ; Huggins, 2020 ; Zalla et al., 2015 ). There is also ongoing debate about the extent to which autism can be conceptualized as quantitative traits versus a categorical, clinical approach to classification (Peralta & Cuestra, 2007 ; Volkmar & McPartland, 2016 ). As such, the findings now require replication in individuals with diagnosed autism.…”

Section: Discussionmentioning

confidence: 99%

Emotion processing differences mediate the link between sex and autistic traits in young adulthood

et al. 2022

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Background:The male preponderance in autism diagnoses is widely reported, yet the psychological mechanisms (e.g., emotion processing) underlying this sex difference are poorly understood. Contributing to this gap in knowledge, most research has not been designed to investigate the intermediary (i.e., mediating) role of psychological processes in the relationship between sex and autism. Compounding this issue, concerns that autism measures are not reliably measuring the same constructs in males and females, and bias against females in clinical samples, make it difficult to investigate the psychological mechanisms underlying sex differences in autism.Methods: Over two cross-sectional studies, 1656 young adults from the general population reported their sex (as assigned at birth) and completed questionnaires indexing their emotion processing differences, as well as a measure of autistic traits suggested to tap into the same psychometric construct in males and females.Results: Emotion processing differences mediated the relationship between sex and autistic traits, whereby being male was associated with more emotion processing differences, which were subsequently linked with greater levels of autistic traits.There remained a direct effect of sex on autistic traits after accounting for emotion processing differences. Conclusions:Emotion processing differences are a potential psychological mechanism underpinning higher prevalence of autism in males, which may serve a compensatory function in females; for example, females may seek out emotioninducing experiences to help compensate for social-emotional difficulties. These findings inform our understanding of autism-related sex differences and have potential implications for clinical practice, where the need for sex-specific support and diagnostic processes is increasingly being recognised.

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“…“Disorganization” was the PANSS item P2, to avoid overlap with cognitive impairment. Since the PANSS is not considered an adequate instrument for the assessment of avolition, does not assess anhedonia, and the evaluation of asociality overlaps with measures of functioning [ 21 , 22 , 23 , 24 , 25 ], negative symptoms were measured by means of the Brief Negative Symptom Scale (BNSS) [ 26 ] that allows the identification of two separate factors: (a) avolition, consisting of anhedonia, asociality, and avolition and (b) expressive deficit, including blunted affect and alogia. The Italian version of the BNSS was validated as part of the Italian Network project [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Switching Antipsychotic Medications in People with Schizophrenia: A 4-Year Naturalistic Study

Cascino

Ceres

Monteleone

et al. 2022

JCM

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Although generally effective in ameliorating the core manifestations of schizophrenia, antipsychotics (APs) may lead to only suboptimal responses or may be associated with a variety of treatment-related adverse events which require additional treatment strategies. Under such clinical circumstances, switching APs represents a rational treatment option. The present study aimed to identify the variables that predict AP switch and to quantify the frequency of this phenomenon in people with schizophrenia in real-life. A secondary analysis was conducted on the data collected at baseline and at a 4-year follow-up from a large sample of community-dwelling Italian people with schizophrenia. Demographic and clinical variables as well as information about AP treatment were recorded at two time points. Over the 4-year period, 34.9% of the 571 participants switched the AP; in particular, 8.4% of participants switched from first-generation APs (FGAs) to second-generation APs or vice versa, while 8.2% of them switched to clozapine. Logistic regression models showed that combination of APs at baseline was negatively associated with AP switch, while treatment with FGAs and the presence of extrapyramidal symptoms at baseline were associated with AP class switch. Although the aim of the present study was not to assess predictors of clinical relapse in people with schizophrenia, we might speculate that switching APs represents a surrogate indicator of treatment failure in some patients and could lead into relapse, which is a costly aspect of schizophrenia management in both economic and human terms. The sooner such a negative outcome can be predicted and managed, the sooner the treatment can be optimized to avoid it.

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Clinical relevance of general and specific dimensions in bifactor models of psychotic disorders

Cited by 13 publications

References 10 publications

The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in people with schizophrenia

The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in people with schizophrenia

Emotion processing differences mediate the link between sex and autistic traits in young adulthood

Switching Antipsychotic Medications in People with Schizophrenia: A 4-Year Naturalistic Study

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