Validation of the Brief Negative Symptom Scale and its association with functioning

Ang, Mei San; Rekhi, Gurpreet; Lee, Jimmy

doi:10.1016/j.schres.2019.04.005

Cited by 48 publications

(26 citation statements)

References 62 publications

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“…Although the items in Anhedonia, Avolition, and Asociality subscales loaded to the same factor in a previous factor analysis in BNSS 9,18,24,26,27 and CAINS, 13 recent studies revealed that five or more factor models fit better than two-factor models in BNSS and CAINS. 28,[33][34][35] This is in line with the following idea in the original NIMH report: "The five domains may have separate neurobiological substrates and may represent separate therapeutic targets." 5 Some of the neurobiological tasks exploring the biological basis specific to the each of the five domains have been adopted in clinical studies.…”

Section: Discussionsupporting

confidence: 74%

<p>Pilot Validation Study of the Japanese Translation of the Brief Negative Symptoms Scale (BNSS)</p>

Hashimoto

Toyomaki

Oka

et al. 2019

NDT

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The brief negative symptoms scale (BNSS) is a concise instrument used to assess negative symptoms of subjects with schizophrenia covering five domains of negative symptoms and is suitable for use in clinical, experimental, and epidemiological settings. The original and translated version of BNSS has thus far been shown to have adequate psychometric properties. This study aimed to examine internal consistency, inter-rater and test-retest reliability, discriminant and convergent validity, and factor structure of the Japanese version of BNSS. Patients and methods: The assessment was performed by 11 raters using interview videos of nine subjects. Reliability was calculated with Cronbach's alpha for internal consistency and intra class correlation coefficient (ICC) for inter-rater reliability. Pearson's correlation coefficients were calculated to estimate the test-retest reliability. In addition to BNSS, Scale for assessment of negative symptoms (SANS) and scale for assessment of positive symptoms (SAPS) was obtained to assess the convergent and discriminant validity. Factor structure was assessed using principle factor analysis. Results: The Japanese BNSS showed excellent internal consistency (Cronbach's alpha=0.95), inter-rater reliability (intra class correlation coefficient=0.97), and test-retest reliability (r=0.94, p<0.001). The convergent validity shown by correlation with SANS total score (r=0.87, p<0.001) and discriminant validity shown by correlation with SAPS total score (r=0.17, p=−0.68) were also good. Principal factor analysis revealed a two-factor structure of BNSS, although the loading of each item differed from that in the literature. Conclusion: Our pilot study demonstrated that Japanese BNSS had good psychometric properties which were achieved with relatively brief training. Further studies with more subjects and raters with various backgrounds recruited from multiple sites are warranted.

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Section: Discussionsupporting

confidence: 74%

<p>Pilot Validation Study of the Japanese Translation of the Brief Negative Symptoms Scale (BNSS)</p>

Hashimoto

Toyomaki

Oka

et al. 2019

NDT

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“…Additionally, more severe BNSS EE, BNSS Blunted Affect and BNSS Alogia were also found to be associated with lower salary. BNSS EE and its domains were shown to be associated with cognition (32,61). A common cognitive factor might partially explain the associations between BNSS EE and salary, which was evidenced by their weaker associations after controlling for PANSS Cognition.…”

Section: Discussionmentioning

confidence: 96%

“…Each item was rated from "0: No impairment" to "6: Severe deficit". A second-order five-factor model was supported by factor analyses, in which Anhedonia, Asociality and Avolition belong to Motivation and Pleasure (MAP) factor and Blunted Affect and Alogia cluster into Emotional Expressivity (EE) factor (31,32). Summation method was used to compute the factor scores.…”

Section: Assessmentsmentioning

confidence: 99%

Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition

2020

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Objective: Employment was associated with recovery in individuals with schizophrenia. Our study aimed to delineate the vocational profile and investigate factors associated with likelihood of employment in individuals with schizophrenia. Materials and Methods: 276 community dwelling outpatients with schizophrenia were recruited; 274 completed the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS). Information on employment status, work outcomes and demographics were collected. Occupation was coded in accordance with the Singapore standard occupational classification. Either BNSS Motivation and Pleasure (MAP) and Emotional Expressivity (EE) or BNSS five-factor (Anhedonia, Asociality, Avolition, Blunted Affect, Alogia) were examined with PANSS factors and demographics in logistic regression with employment status and working full-time as outcome variables. Results: One-hundred and twenty-seven (46.01%) participants were employed; 65 (51.18%) worked full-time. In the model with BNSS MAP-EE, MAP (OR=0.897, CI=0.854-0.941) and presence of physical comorbidity (OR=0.533, CI=0.304-0.937) were associated with reduced likelihood of employment; female sex (OR=0.286, CI=0.128-0.637) was associated with working part-time. In the model with BNSS fivefactor, Avolition (OR=0.541, CI=0.440-0.666), and PANSS Positive (OR=0.924, CI=0.855-0.997) were associated with reduced likelihood of employment; female sex (OR=0.289, CI=0.126-0.662) and Avolition (OR=0.644, CI=0.475-0.872) were associated with working part-time. Discussion: Our study described the vocational profile and correlates of employment in a developed urban Asian country. Negative symptoms, particularly MAP and Avolition, positive symptoms, and physical comorbidity reduced an individual's likelihood of employment, while female sex and Avolition were associated with working part-time. Efforts to identify and address these factors are necessary to encourage employment in individuals with schizophrenia.

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“…This item is the subject of controversy, some authors considering that it is not consistent with the definition of negative symptoms [105], others supporting that might help to differentiate primary and enduring symptoms from secondary negative symptoms [140]. BNSS was designed for easy application in the context of clinical trials or clinical routines and has excellent psychometric properties in schizophrenia [28,113] and in bipolar disorders (76). It has been translated and validated into 29 languages [141], notably Danish [142], Polish [143], German [144], Brazilian [68,145], and Spanish [146].…”

Section: Second Generation Scalesmentioning

confidence: 99%

“…Besides the limitations previously suggested, motor retardation and active social avoidance should not be considered as negative symptoms since they might be more related to extrapyramidal symptoms, depression, suspiciousness, or social anxiety. Finally, no single negative symptom factor from PANSS has achieved broad consensus, neither NSFS, even if it has been widely used in many trials, nor the most replicated negative factor including N2, N3, N4, N6, and G7 [111][112][113].…”

Section: First-generation Scalesmentioning

confidence: 99%

EPA guidance on assessment of negative symptoms in schizophrenia

et al. 2021

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Background. During the last decades, a renewed interest for negative symptoms (NS) was brought about by the increased awareness that they interfere severely with real-life functioning, particularly when they are primary and persistent. Methods. In this guidance paper, we provide a systematic review of the evidence and elaborate several recommendations for the conceptualization and assessment of NS in clinical trials and practice. Results. Expert consensus and systematic reviews have provided guidance for the optimal assessment of primary and persistent negative symptoms; second-generation rating scales, which provide a better assessment of the experiential domains, are available; however, NS are still poorly assessed both in research and clinical settings. This European Psychiatric Association (EPA) guidance recommends the use of persistent negative symptoms (PNS) construct in the context of clinical trials and highlights the need for further efforts to make the definition of PNS consistent across studies in order to exclude as much as possible secondary negative symptoms. We also encourage clinicians to use secondgeneration scales, at least to complement first-generation ones. The EPA guidance further recommends the evidence-based exclusion of several items included in first-generation scales from any NS summary or factor score to improve NS measurement in research and clinical settings. Self-rated instruments are suggested to further complement observer-rated scales in NS assessment. Several recommendations are provided for the identification of secondary negative symptoms in clinical settings. Conclusions. The dissemination of this guidance paper may promote the development of national guidelines on negative symptom assessment and ultimately improve the care of people with schizophrenia.

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Validation of the Brief Negative Symptom Scale and its association with functioning

Cited by 48 publications

References 62 publications

<p>Pilot Validation Study of the Japanese Translation of the Brief Negative Symptoms Scale (BNSS)</p>

<p>Pilot Validation Study of the Japanese Translation of the Brief Negative Symptoms Scale (BNSS)</p>

Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition

EPA guidance on assessment of negative symptoms in schizophrenia

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