ArticleSchizophrenia bulletin2022
Two Factors, Five Factors, or Both? External Validation Studies of Negative Symptom Dimensions in Schizophrenia.
Article in Schizophrenia bulletin, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 39 citations in OpenAlex.
- Characterizing social motivation deficits in treatment-resistant schizophrenia: Evidence from social incentive performance.Psychiatry and clinical neurosciences · 2026Article
- Computerized assessments of emotional expression and emotional reactivity predict negative symptoms in individuals at clinical high-risk for psychosis.Psychological medicine · 2026Article
- Associations between negative symptoms and resting-state functional connectivity within social brain networks among individuals with early psychosis.Schizophrenia (Heidelberg, Germany) · 2026Article
- The kynurenine pathway in depression and schizophrenia: convergent signals, divergent states, and clinical signatures.EXCLI journal · 2026Review
- Preliminary Findings From an Augmented Reality (AR) App Delivering Recovery-Oriented Cognitive Therapy for Negative Symptoms in Schizophrenia.Early intervention in psychiatry · 2026Article
- Computerised adaptive testing across the paranoia continuum.BMJ mental health · 2025Article
- Inflammation is associated with avolition and reduced resting state functional connectivity in corticostriatal reward circuitry in patients with schizophrenia.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025Article
- Environmental deprivation is associated with reward processing impairments and negative symptoms in schizophrenia.Schizophrenia research · 2025Article
- Neuroanatomical Correlates of Negative Symptoms in Schizophrenia.bioRxiv : the preprint server for biology · 2025Article
- How do negative symptoms and social cognitive impairments overlap? Clustering analyses on patients living with schizophrenia-spectrum disorder.Social cognitive and affective neuroscience · 2025Article
- Assessment of Negative Symptoms in Schizophrenia: From the Consensus Conference-Derived Scales to Remote Digital Phenotyping.Brain sciences · 2025Review
- We need to make progress on blunted affect: A commentary.Schizophrenia research · 2024Article
- External validation of the five domains of negative symptoms: Focus on cognition, functional capacity, and real-world functioning.European psychiatry : the journal of the Association of European Psychiatrists · 2023Article
- The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in people with schizophrenia.BJPsych open · 2023Article
- Development and Validation of the Negative Symptom Inventory-Psychosis Risk.Schizophrenia bulletin · 2023Article
- Exploring negative symptoms heterogeneity in patients diagnosed with schizophrenia and schizoaffective disorder using cluster analysis.BMC psychiatry · 2023Article
- The Brief negative Symptom Scale (BNSS): a systematic review of measurement properties.Schizophrenia (Heidelberg, Germany) · 2023Review
- "Goals in Focus"-a targeted CBT approach for motivational negative symptoms of psychosis: study protocol for a randomized-controlled feasibility trial.Pilot and feasibility studies · 2023Article
- The Role of Two Factors of Negative Symptoms and Cognition on Social Functioning in Male Patients with Schizophrenia: A Mediator Model.Brain sciences · 2023Article
- Validation and reliability test of Chinese language patient-reported impact of symptoms in schizophrenia scale.Frontiers in psychiatry · 2023Article
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 3 countries.
Funding
Abstract
objectivesNegative symptom studies frequently use single composite scores as indicators of symptom severity and as primary endpoints in clinical trials. Factor analytic and external validation studies do not support this practice but rather suggest a multidimensional construct. The current study used structural equation modeling (SEM) to compare competing dimensional models of negative symptoms to determine the number of latent dimensions that best capture variance in biological, psychological, and clinical variables known to have associations with negative symptoms.
methodsThree independent studies (total n = 632) compared unidimensional, two-factor, five-factor, and hierarchical conceptualizations of negative symptoms in relation to cognition, psychopathology, and community functioning (Study 1); trait emotional experience and defeatist performance beliefs (Study 2); and glutamate and gamma-aminobutyric acid levels in the anterior cingulate cortex quantified using proton magnetic resonance spectroscopy (Study 3).
resultsSEM favored the five-factor and hierarchical models over the unidimensional and two-factor models regardless of the negative symptom measure or external validator. The five dimensions-anhedonia, asociality, avolition, blunted affect, and alogia-proved vital either as stand-alone domains or as first-order domains influenced by second-order dimensions-motivation and pleasure and emotional expression. The two broader dimensions sometimes masked important associations unique to the five narrower domains. Avolition, anhedonia, and blunted affect showed the most domain-specific associations with external variables across study samples.
conclusionsFive domains and a hierarchical model reflect the optimal conceptualization of negative symptoms in relation to external variables. Clinical trials should consider using the two dimensions as primary endpoints and the five domains as secondary endpoints.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.