Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS)

• Published in: Schizophrenia research Vol. 132; no. 2; pp. 140 - 145
• Main Authors: Horan, William P, Kring, Ann M, Gur, Raquel E, Reise, Steven P, Blanchard, Jack J
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.11.2011; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Clinical trials; Experience; Expression; Factor Analysis, Statistical; Female; Humans; Male; Medical sciences; Middle Aged; Negative symptoms; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics - methods; Psychopathology. Psychiatry; Psychoses; Psychotic Disorders - diagnosis; Psychotic Disorders - physiopathology; Psychotic Disorders - psychology; Rating scale; Reproducibility of Results; Schizophrenia; Schizophrenia - diagnosis; Schizophrenia - physiopathology; Schizophrenic Psychology; Young Adult; Schizophrenia; Clinical trials; Experience; Negative symptoms; Expression; Rating scale; Human; Evaluation scale; Psychometrics; Psychosis; Test validation; Negative symptom; Clinical interview; Clinical trial; Clinical investigation; Test construction
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/j.schres.2011.06.030

Abstract Progress in the development of new pharmacological and psychosocial treatments for the negative symptoms of schizophrenia is impeded by limitations of available assessment instruments. The multi-site Collaboration to Advance Negative Symptom Assessment in Schizophrenia (CANSAS) was established to develop and validate a new clinical rating scale using a transparent, iterative, and data-driven process. The Clinical Assessment Interview for Negative Symptoms (CAINS) was designed to address limitations of existing measures and assess consensus-based sub-domains, including asociality, avolition, anhedonia, affective blunting, and alogia. The structure and psychometric properties of the CAINS were evaluated in a sample of 281 schizophrenia and schizoaffective outpatients at four sites. Converging structural analyses indicated that the scale was comprised of two moderately correlated factors — one reflecting experiential impairments (diminished motivation and enjoyment of social, vocational, and recreational activities) and one reflecting expressive impairments (diminished non-verbal and verbal communication). Item-level analyses revealed generally good distributional properties, inter-rater agreement, discriminating anchor points, and preliminary convergent and discriminant validity. Results indicate that the CAINS is a promising new measure for quantifying negative symptoms in clinical neuroscience and treatment studies. Results guided item modification or deletion, and the reliability and validity of the revised, shorter version of the CAINS is in the final phase of development within the CANSAS project.