PDF(Sci-hub)
Abstract：
Negative symptoms are prevalent in the prodromal and first-episode phases of psychosis and highly predictive of poor clinical outcomes (eg, liability for conversion and functioning). However, the latent structure of negative symptoms is unclear in the early phases of illness. Determining the latent structure of negative symptoms in early psychosis (EP) is of critical importance for early identification, prevention, and treatment efforts. In the current study, confirmatory factor analysis was used to evaluate latent structure in relation to 4 theoretically derived models: 1. a 1-factor model, 2. a 2-factor model with expression (EXP) and motivation and pleasure (MAP) factors, 3. a 5-factor model with separate factors for the 5 National Institute of Mental Health (NIMH) consensus development conference domains (blunted affect, alogia, anhedonia, avolition, and asociality), and 4. a hierarchical model with 2 second-order factors reflecting EXP and MAP, as well as 5 first-order factors reflecting the 5 consensus domains. Participants included 164 individuals at clinical high risk (CHR) who met the criteria for a prodromal syndrome and 377 EP patients who were rated on the Brief Negative Symptom Scale. Results indicated that the 1- and 2-factor models provided poor fit for the data. The 5-factor and hierarchical models provided excellent fit, with the 5-factor model outperforming the hierarchical model. These findings suggest that similar to the chronic phase of schizophrenia, the latent structure of negative symptom is best conceptualized in relation to the 5 consensus domains in the CHR and EP populations. Implications for early identification, prevention, and treatment are discussed.
摘要：
阴性症状在精神病的前驱和首发阶段普遍存在，并且高度预测不良的临床结果（例如，转换和运作的责任)。然而,在疾病的早期阶段，阴性症状的潜在结构尚不清楚。确定早期精神病（EP）阴性症状的潜在结构对于早期识别至关重要。预防,和治疗努力。在目前的研究中,验证性因素分析用于评估与4种理论推导模型相关的潜在结构：1。1因素模型，2.具有表达(EXP)和动机和快乐(MAP)因素的双因素模型，3.5个国家精神卫生研究所(NIMH)共识发展会议领域的5个因素模型(钝化影响，alogia,快感缺失,废除,和相关性)，和4。具有反映EXP和MAP的2个二阶因子的分层模型，以及反映5个共识域的5个一阶因子。参与者包括164名符合前驱综合征标准的临床高风险（CHR）患者和377名在简短阴性症状量表上进行评级的EP患者。结果表明，1因子和2因子模型对数据的拟合度较差。5因素和分层模型提供了极好的拟合，五因素模型优于分层模型。这些发现表明，与精神分裂症的慢性期相似，阴性症状的潜在结构最好与CHR和EP人群中的5个共有域相关。对早期识别的影响，预防,和治疗进行了讨论。
