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Positive-negative symptom assessment in schizophrenia: Psychometric issues and scale comparison

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Abstract

The positive-negative distinction has emerged as a meaningful basis for understanding the heterogeneity of schizophrenia and treatment alternatives, but its delineation requires carefully devised, well validated techniques. This article considers the psychometric requisites for such an instrument and describes 30 criteria associated with operationalization, scale construction, and standardization. Six prominent positive-negative scales are compared on these criteria, and most are found deficient in terms of: a formalized interview procedure; detailed definitions for levels of symptom severity; exclusion of “secondary” negative symptoms; comparative scales to assess positive symptoms, depression, and global severity of illness; broad sampling of negative symptoms; large scale standardization studies; and determination of multiple facets of reliability and validity. The Positive and Negative Syndrome Scale (PANSS) is described as an effort to approach these principles of test standardization, and its clinical and research applications are discussed.

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Authors and Affiliations

  1. Schizophrenia Research Program, Department of Psychiatry (Psychology and Neuropsychiatry), Albert Einstein College of Medicine/Montefiore Medical Center, USA

    Stanley R. Kay Ph.D. (Associate Clinical Professor and Chief)

  2. Bronx Psychiatric Center, 1500 Waters Place, 10461, Bronx, New York

    Stanley R. Kay Ph.D. (Associate Clinical Professor and Chief)

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  1. Stanley R. Kay Ph.D.
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This article is based in part on a paper by the author that was presented before the 143rd Annual Meeting of the American Psychiatric Association, New York, May 1990.

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Kay, S.R. Positive-negative symptom assessment in schizophrenia: Psychometric issues and scale comparison. Psych Quart 61, 163–178 (1990). https://doi.org/10.1007/BF01064966

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