Department of Psychology, University of California, Berkeley, CA, USA.
Am J Psychiatry. 2013 Feb;170(2):165-72. doi: 10.1176/appi.ajp.2012.12010109.
A major barrier to developing treatments for negative symptoms has been measurement concerns with existing assessment tools. Fulfilling the top recommendation of the National Institute of Mental Health's Consensus Development Conference on Negative Symptoms, the Clinical Assessment Interview for Negative Symptoms (CAINS) was developed using an iterative, empirical approach, and includes items assessing motivation, pleasure, and emotion expression. The authors employed multiple analytic techniques to develop the CAINS and here provide final development and validation results.
The CAINS structure, interrater agreement, test-retest reliability, and convergent and discriminant validity were assessed in a large and diverse sample of 162 outpatients with schizophrenia or schizoaffective disorder recruited from four sites.
Three items with poor psychometric properties were removed, resulting in a 13-item CAINS. The CAINS factor structure was replicated, demonstrating two modestly correlated scales: expression (four items) and motivation/pleasure (nine items). The scales demonstrated good internal consistency, test-retest stability, and interrater agreement. Strong convergent validity was demonstrated by linkages with other negative symptom measures, self-report scales of sociality, pleasure, and motivation, and coded facial expressions. Discriminant validity was shown by independence from depression, medication side effects, and cognition. Notably, the CAINS scales were related to real-world vocational, independent living, and social/familial functioning.
The CAINS is an empirically developed and evaluated measure of negative symptoms. Findings indicate that the CAINS is brief yet comprehensive and employable across a wide range of research and clinical contexts.
开发治疗阴性症状的方法的主要障碍一直是对现有评估工具的测量关注。为了满足国家心理健康研究所负面症状共识发展会议的首要建议，临床负面症状评估访谈（CAINS）是使用迭代的、经验的方法开发的，包括评估动机、愉悦和情感表达的项目。作者采用了多种分析技术来开发 CAINS，并在此提供最终的开发和验证结果。
在从四个地点招募的 162 名患有精神分裂症或分裂情感障碍的门诊患者的大型和多样化样本中，评估了 CAINS 的结构、评定者间一致性、重测信度、聚合和判别效度。
去除了三个心理测量学特性较差的项目，得到了一个 13 项的 CAINS。CAINS 的因素结构得到了复制，表现出两个中等相关的量表：表达（四项）和动机/愉悦（九项）。这些量表表现出良好的内部一致性、重测稳定性和评定者间一致性。与其他阴性症状测量、社会性、愉悦和动机的自我报告量表以及编码的面部表情的联系证明了很强的聚合效度。与抑郁、药物副作用和认知的独立性证明了判别效度。值得注意的是，CAINS 量表与现实世界的职业、独立生活以及社会/家庭功能有关。
CAINS 是一种经过实证开发和评估的阴性症状测量工具。研究结果表明，CAINS 简短而全面，可在广泛的研究和临床环境中使用。
