Harvey Philip D, Khan Anzalee, Keefe Richard S E
Dr. Harvey is Professor of Psychiatry and Behavioral Sciences at University of Miami School of Medicine in Miami, Florida.
Dr. Khan is Senior Biostatistician at NeuroCog Trials and holds an appointment in the Psychopharmacology Research Program at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York.
Innov Clin Neurosci. 2017 Dec 1;14(11-12):18-22.
Reduced emotional experience and expression are two domains of negative symptoms. The authors assessed these two domains of negative symptoms using previously developed Positive and Negative Syndrome Scale (PANSS) factors. Using an existing dataset, the authors predicted three different elements of everyday functioning (social, vocational, and everyday activities) with these two factors, as well as with performance on measures of functional capacity. A large (n=630) sample of people with schizophrenia was used as the data source of this study. Using regression analyses, the authors predicted the three different aspects of everyday functioning, first with just the two Positive and Negative Syndrome Scale factors and then with a global negative symptom factor. Finally, we added neurocognitive performance and functional capacity as predictors. The Positive and Negative Syndrome Scale reduced emotional experience factor accounted for 21 percent of the variance in everyday social functioning, while reduced emotional expression accounted for no variance. The total Positive and Negative Syndrome Scale negative symptom factor accounted for less variance (19%) than the reduced experience factor alone. The Positive and Negative Syndrome Scale expression factor accounted for, at most, one percent of the variance in any of the functional outcomes, with or without the addition of other predictors. Reduced emotional experience measured with the Positive and Negative Syndrome Scale, often referred to as "avolition and anhedonia," specifically predicted impairments in social outcomes. Further, reduced experience predicted social impairments better than emotional expression or the total Positive and Negative Syndrome Scale negative symptom factor. In this cross-sectional study, reduced emotional experience was specifically related with social outcomes, accounting for essentially no variance in work or everyday activities, and being the sole meaningful predictor of impairment in social outcomes.
情感体验和表达的减少是阴性症状的两个方面。作者使用先前开发的阳性和阴性症状量表（PANSS）因子评估了阴性症状的这两个方面。利用现有的数据集，作者用这两个因子以及功能能力测量指标的表现预测了日常功能的三个不同要素（社交、职业和日常活动）。本研究使用了一个大型（n = 630）精神分裂症患者样本作为数据源。通过回归分析，作者首先仅用阳性和阴性症状量表的两个因子，然后用一个整体阴性症状因子预测了日常功能的三个不同方面。最后，作者将神经认知表现和功能能力作为预测指标加入分析。阳性和阴性症状量表中情感体验减少因子解释了日常社交功能中21%的方差变异，而情感表达减少则未解释任何方差变异。阳性和阴性症状量表的整体阴性症状因子解释的方差变异（19%）比单独的情感体验减少因子更少。阳性和阴性症状量表的情感表达因子在加入或未加入其他预测指标的情况下，在任何功能结果中最多解释1%的方差变异。用阳性和阴性症状量表测量的情感体验减少，通常称为“意志缺乏和快感缺失”，特别能预测社交结果方面的损害。此外，情感体验减少比情感表达或阳性和阴性症状量表的整体阴性症状因子能更好地预测社交损害。在这项横断面研究中，情感体验减少与社交结果特别相关，在工作或日常活动方面基本未解释方差变异，并且是社交结果损害的唯一有意义的预测指标。
