A multisite investigation of the reliability of the Scale for the Assessment of Negative Symptoms

Abstract

The results suggest that the Scale for the Assessment of Negative Symptoms has good reliability and is a useful instrument for the measurement of negative symptoms in multisite clinical studies. The internal reliability of the Alogia, Avolition-Apathy, and Inattention subscales could be improved by replacing some items and including additional items.

What do we really know about blunted vocal affect and alogia? A meta-analysis of objective assessments

“…Large effect sizes were noted in each study (i.e., differences in d were 3.39, 3.05, 4.25 and 0.80 for Alpert et al, 2000; Cohen et al, 2008; Tavano et al, 2008 and St-Hilaire et al, 2008 respectively. A summary of findings from this meta-analysis, anchored by the d values computed by Emmerson et al (2009) and Mueser et al (1994) as well as those reported in Hoekert et al (2007), are plotted in Figure 2.…”

“…Notes: Increasing scores on the y-axis reflect abnormally higher vocal expression (i.e., patients versus controls); (lit) refers to comparison of data presented in Emmerson et al, (2009) and Mueser et al, (1994); “Hoekert et al, (2007)” refers to a prior meta-analysis examining behavioral-based ratings analysis of vocal expression in schizophrenia; “Present study” refers to effect sizes computed from the present meta-analysis.…”

“…Nonetheless, there is reason to think that it is profound. In comparing SANS global scores from a recent meta-analysis of nonpsychiatric individuals (i.e., M = 1.39, SD = 1.63 for healthy adults; n = 213; Emmerson et al, 2009) to SANS global scores from a large, multisite psychometric study (i.e., M = 12.04, SD = 1.66; n = 207; Mueser et al, 1994), one finds a difference on the order of six standard deviations (Cohen’s d = 6.48). Negative symptom rating scales have also been found, within schizophrenia samples, to be stable over time, and correlated with a broad range of functional, outcome, premorbid, neurocognitive, neurobiological, genetic and other variables (Buchanan, 2007; Kirkpatrick and Galderisi, 2008).…”

“…The present article conducted a review of studies employing acoustic analyses of natural speech in patients with schizophrenia with two specific aims in mind: a) to evaluate the magnitude of objective deficits in schizophrenia across a wide range of vocal characteristics – thus providing insight into which aspect(s) of vocal expression are most affected in schizophrenia, and b) to clarify how vocal expression deficits differ as a function of acoustic analytic and symptom rating scales (when employed in the same study). Regarding this second point, the magnitude of vocal deficits using data for the Emmerson et al, meta-analysis (2009) and multisite psychometric study (Mueser et al, 1994) are quite large (i.e., Cohen’s d values of 4.09, 3.42 and 4.39 for SANS Lack of Vocal Inflections, Poverty of Speech and Increased Latency of Speech ratings respectively). A recent meta-analysis (Hoekert et al, 2007) of six studies of vocal expression also bears mention here.…”

Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study

“…This specific finding of elevated anhedonia-asociality and avolition-apathy for the “stable-poor” class—but no differences between classes in the other negative symptoms domains—may extend prior findings of an association between poor premorbid functioning and elevated negative symptoms in general (Schmael et al, 2007). Previous comprehensive factor analytic studies of the SANS have found that the anhedonia-asociality and avolition-apathy subscales cluster together in an overall “social amotivation” factor in patients with schizophrenia (Mueser et al, 1994; Sayers et al, 1996) and first-episode psychosis (Malla et al, 2002). Consistent with the current findings, Sayers and colleagues also found that the “social amotivation” factor was associated with the existence of child behavior problems, poor premorbid functioning, and poor social adjustment.…”