Initial development and preliminary validation of a new negative symptom measure: The Clinical Assessment Interview for Negative Symptoms (CAINS)

Abstract

As part of an ongoing scale development process, this study provides an initial examination of the psychometric properties and validity of a new interview-based negative symptom instrument, the Clinical Assessment Interview for Negative Symptoms (CAINS), in outpatients with schizophrenia or schizoaffective disorder (N = 37). The scale was designed to address limitations of existing measures and to comprehensively assess five consensus-based negative symptoms: asociality, avolition, anhedonia (consummatory and anticipatory), affective flattening, and alogia. Results indicated satisfactory internal consistency reliability for the total CAINS scale score and promising inter-rater agreement, with clear areas identified in need of improvement. Convergent validity was evident in general agreement between the CAINS and alternative negative symptom measures. Further, CAINS subscales significantly correlated with relevant self-report emotional experience measures as well as with social functioning. Discriminant validity of the CAINS was strongly supported by its small, non-significant relations with positive symptoms, general psychiatric symptoms, and depression. These preliminary data on an early beta-version of the CAINS provide initial support for this new assessment approach to negative symptoms and suggest directions for further scale development.

Psychometric evaluation of the negative syndrome of schizophrenia

“…Based on its preliminary versions, the CAINS-beta [38] and the CAINS-beta2 [39], and taking a multistep data-analytic approach, the authors developed and validated the final version of the CAINS [2]. In this process, the scale underwent several changes: the number of items was reduced from 23 to 13 as was the number of negative symptoms assessed (asociality was not included in the final CAINS as a separate dimension), the original 7-point Likert rating scale was reduced to a 5-point scale, and its conceptual approach was changed from a negative (amotivation, anhedonia, blunted affect and alogia) to a positive one (motivation, pleasure, emotion expression and speech).…”

Efficacy and safety of oxytocin augmentation therapy for schizophrenia: an updated systematic review and meta-analysis of randomized, placebo-controlled trials

“…Positive symptoms were measured using the PANSS positive subscale scores [8,12,27,31], the Scale for the Assessment of Positive Symptoms (SAPS) [2] total scores [5], and the BPRS positive subscale scores [20]. Negative symptoms were measured using the PANSS negative subscale scores [8,12,27,31], the Scale for the assessment of negative symptoms (SANS) [1] total scores [5,20], the clinical assessment interview for negative symptoms (CAINS) [11] total scores [7], and the PANSS general subscale scores [8,12,31]. Secondary safety outcomes were discontinuation due to adverse events or inefficacy.…”

The Negative Symptoms of Schizophrenia: Category or Continuum?

“…The resulting Brief Negative Symptom Scale is a 13-item instrument primarily for use in clinical trials [20]. The Clinical Assessment Interview for Negative Symptoms aims at a comprehensive assessment of negative symptoms including objective measures of behavior and subjective patient experience [21]. …”

“…One important issue for this type of research regards the assessment instruments. The available assessment instruments with a specific focus on negative symptoms were validated for patients with schizophrenia, and this continues to be the case for the instruments resulting from the MATRICS initiative [21]. This might not result in a serious problem with respect to the constructs assessed, which seem to be stable across disease categories.…”