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Positive and Negative Symptoms: Assessment and Validity

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Negative Versus Positive Schizophrenia

Abstract

During the past decade, the study of the assessment and validity of negative symptoms has been restored to its rightful place in the realm of psychopathology. During the 1970s and early 1980s, negative symptoms were scarcely allowed in live in the servant’s quarters. Instead, they were neglected and ignored, while positive symptoms were raised to a position of pride and popularity because of their presumed superior reliability. Positive symptoms were, therefore, made the foundation of the definition of schizophrenia in the Research Diagnostic Criteria (Spitzer et al. 1978) and Diagnostic and Statistical Manual (DSM)-III (American Psychiatric Association 1980) and DSM-III-R (American Psychiatric Association 1987), and they were also given great prominence in the Present State Examination (Wing et al. 1974) and CATEGO (Wing et al. 1974). This state of affairs was in direct contradiction to the work of the historic scholars of psychopathology, Kraepelin (1919) and Bleuler (1916), who both saw negative symptoms as the core feature of schizophrenia. During the past decade, however, clinicians and investigators have returned again to this earlier perspective. Many now agree that negative symptoms (either referred to by that name or by other terms such as the apathy syndrome, the defect state, or the residual state) are the most important and the most handicapping symptoms that patients suffering from schizophrenia experience.

This research was supported in part by NIMH grants MH 31593, MH 40856, and MHCRC 43271, The Nellie Ball Trust Fund, Iowa State Bank & Trust Company, Trustee, and a Research Scientist Award, MH 00625.

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References

  • American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (DSM-III-R). American Psychiatric Association, Washington

    Google Scholar 

  • American Psychiatric Association and Committee on Nomenclature and Statistics (1980) Diagnostic and statistical manual of mental disorders (DSM-III). American Psychiatric Association, Washington

    Google Scholar 

  • Andreasen NC (1979a) Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability. Arch Gen Psychiatry 36:1315–1321

    Article  PubMed  CAS  Google Scholar 

  • Andreasen NC (1979b) Thought, language, and communication disorders. II. Diagnostic significance. Arch Gen Psychiatry 36:1325–1330

    Article  PubMed  CAS  Google Scholar 

  • Andreasen NC (1979c) Affective flattening and the criteria for schizophrenia. Am J Psychiatry 136:944–947

    PubMed  CAS  Google Scholar 

  • Andreasen NC (1982) Negative symptoms in schizophrenia: definition and reliability. Arch Gen Psychiatry 39:784–788

    Article  PubMed  CAS  Google Scholar 

  • Andreasen NC (1983) The scale for the assessment of negative symptoms (SANS). University of Iowa, Iowa City

    Google Scholar 

  • Andreasen NC (1984) The scale for the assessment of positive symptoms (SAPS). University of Iowa, Iowa City

    Google Scholar 

  • Andreasen NC (1985) Comprehensive assessment of symptoms and history (CASH). University of Iowa, Iowa City

    Google Scholar 

  • Andreasen NC (1988) Brain imaging: applications in psychiatry. Science 239:1381–1388

    Article  PubMed  CAS  Google Scholar 

  • Andreasen NC (1990a) Positive and negative symptoms: historical and conceptual aspects. In: Andreasen NC (ed) Modern problems of pharmacopsychiatry: positive and negative symptoms and syndromes. Karger, Basle, pp 1–42

    Google Scholar 

  • Andreasen NC (1990b) Methods for assessing positive and negative symptoms. In: Andreasen NC (ed) Modern problems of pharmacopsychiatry: positive and negative symptoms and syndromes. Karger, Basle, pp 73–88

    Google Scholar 

  • Andreasen NC, Grove WM (1986) Evaluation of positive and negative symptoms in schizophrenia. Psychiatr Psychobiol 1(2): 108–121

    Google Scholar 

  • Andreasen NC, Smith MR, Jacoby CG, Dennert JW, Olsen SA (1982) Ventricular enlargement in schizophrenia: definition and prevalence. Am J Psychiatry 139:292–296

    PubMed  CAS  Google Scholar 

  • Andreasen NC, Ehrhardt JC, Swayze VW, Alliger R, Yuh WTC, Cohen G, Ziebell S (1990a) Magnetic resonances imaging of the brain in schizophrenia: the pathophysiological significance of structural abnormalities. Arch General Psychiatry 47:35–44

    Article  CAS  Google Scholar 

  • Andreasen NC, Swayze VW, Flaum M, Alliger R, Cohen G (1990b) Ventricular abnormalities in affective disorders: clinical and demographic correlated. Am J Psychiatry 147: 893–900, 1990

    PubMed  CAS  Google Scholar 

  • Andreasen NC, Swayze VW, Flaum M, Yates WR, Arndt S, McChesney C (1990c) Ventricular enlargement in schizophrenia evaluated with computed tomographic scanning: effects of gender, age, and stage of illness. Arch Gen Psychiatry 47:1008–1015, 1990

    Article  PubMed  CAS  Google Scholar 

  • Arndt S, Alliger RJ, Andreasen NC (1990) The distinction of positive and negative symptoms: The failure of a two-dimensional model. Br J Psychiatry 158:317–322, 1991

    Article  Google Scholar 

  • Barnes TRE, Curson DA, Liddle PF, Patel M (1989a) The nature and prevalence of depression in chronic schizophrenia inpatients. Br J Psychiatry 154:486–491

    Article  PubMed  CAS  Google Scholar 

  • Barnes TRE, Liddle PF, Curson DA, Patel M (1989b) Negative symptoms, tardive dyskinesia and depression in chronic schizophrenia. Br J Psychiatry 155: (supplement 7) 99–103

    Google Scholar 

  • Berman KF, Zec RF, Weinberger DR (1986) Physiologic dysfunction of dorsolateral pre-frontal cortex in schizophrenia. II. Role of neuroleptic treatment, attention, and mental effort. Arch Gen Psychiatry 43:126–135

    Article  PubMed  CAS  Google Scholar 

  • Bilder RM, Mukherjee S, Rieder RO, Pandurangi AK (1985) Symptomatic and neuropsychological components of defect states. Schizophr Bull 11:409–419

    PubMed  CAS  Google Scholar 

  • Bleuler E (1916) Physisch und psychisch in der Pathologie. Z Gesamte Neurol Psychiatr 30:426–475

    Article  Google Scholar 

  • Buchsbaum MS, Haier RJ (1987) Functional and anatomical brain imaging: impact on schizophrenia research. Schizophr Bull 13:115–132

    PubMed  CAS  Google Scholar 

  • Buchsbaum MS, Holcomb HH, Kessler R et al. (1983) Lateralized asymmetries in glucose uptake assessed by positron emission tomography in patients with schizophrenia and normal controls. In: Flor-Henry P, Gruzelier J (eds) Laterality and psychopathology. Elsevier, Amsterdam, pp 559–568

    Google Scholar 

  • Buchsbaum MS, Capelletti J, Ball R et al. (1984) Positron emission tomographic image measurement in schizophrenia and affective disorders. Ann Neurol [Suppl] 15 : S157– S165

    Article  PubMed  Google Scholar 

  • Crow TJ (1980) Molecular pathology of schizophrenia: more than one disease process? Br Med J 280:66–68

    Article  PubMed  CAS  Google Scholar 

  • Dworkin RH, Lenzenweger MF (1984) Symptoms and the genetics of schizophrenia: implications for diagnosis. Am J Psychiatry 141:1541–1546

    PubMed  CAS  Google Scholar 

  • Fuster J (1989) The prefrontal cortex: anatomy, physiology and neuropsychology of the frontal lobe, 2nd edn. Raven, New York

    Google Scholar 

  • Gur RE, Gur RC, Skolnick BE et al. (1985) Brain function in psychiatric disorders. III. Regional cerebral blood flow in unmedicated schizophrenics. Arch Gen Psychiatry 42:329–334

    Article  PubMed  CAS  Google Scholar 

  • Gur RE, Resnick SM, Alavi A et al. (1987a) Regional brain function in schizophrenia. I. A positron emission tomography study. Arch Gen Psychiatry 44:119–125

    Article  PubMed  CAS  Google Scholar 

  • Gur RE, Resnick SM, Gur RC et al. (1987b) Regional brain function in schizophrenia. II. Repeated evaluation with positron emission tomography. Arch Gen Psychiatry 44:126– 129

    Article  PubMed  CAS  Google Scholar 

  • Humbert M, Salvador L, Segui J, Obiols J, Obiols JD (1986) Estudio interfiabilidad version espanola evaluacion de sintomas positivos y negativos. Rev Dep Psiquiatr Fac Med Univ Barcelona 13:28–36

    Google Scholar 

  • Ingvar DH, Franzen G (1974) Abnormalities of cerebral blood flow distribution in patients with chronic schizophrenia. Acta Psychiatr Scand 50:425–462

    Article  PubMed  CAS  Google Scholar 

  • Johnstone EC, Owens DGC, Crow TJ, Jagoe R (1981) A CT study of 188 patients with schizophrenia, affective psychosis and neurotic illness. Biol Psychiatry 9:237–240

    Google Scholar 

  • Johnstone EC, Owens DGC, Firth CD, Crow TJ (1986) The relative stability of positive and negative features in chronic schizophrenia. Br J Psychiatry 150:60–64

    Article  Google Scholar 

  • Kay SR, Opler LA, Fiszbein A (1986) Significance of positive and negative symptoms in chronic schizophrenia. Br J Psychiatry 149:439–448

    Article  PubMed  CAS  Google Scholar 

  • Kraepelin E (1919) Dementia praecox and paraphrenia. Livingstone, Edinburgh

    Google Scholar 

  • Krawiecka M, Goldberg D, Vaughan M (1977) A standardized psychiatric assessment for rating chronic psychiatric patients. Acta Psychiatr Scand 55: 299–308

    Article  PubMed  CAS  Google Scholar 

  • Lewine RRJ, Fogg L, Meitzer HY (1983) Assessment of negative and positive symptoms in schizophrenia. Schizophr Bull 9: 368–376

    PubMed  CAS  Google Scholar 

  • Liddle PF (1984) Schizophrenic symptoms, cognitive performance and neurological dysfunction. 2nd Bi-Annual Winter Workshop on Schizophrenia, Davos

    Google Scholar 

  • Liddle PF (1987) The symptoms of chronic schizophrenia. A re-examination of the positivenegative dichotomy. Br J Psychiatr 151:145–151

    Article  CAS  Google Scholar 

  • Marks RC, Luchins DJ (1990) Relationship between brain imaging findings in schizophrenia and psychopathology: a review of the literature relating to positive and negative symptoms. In: Andreasen NC (ed) Modern problems of pharmacopsychiatry: positive and negative symptoms and syndromes. Karger, Basle, pp 89–123

    Google Scholar 

  • McGlashan TH (1991) The positive/negative distinction in schizophrenia: review of natural history validators. Arch Gen Psychiatry (in press)

    Google Scholar 

  • Moscarelli M, Maffei C, Cesana BM (1987) An international perspective on assessment of negative and positive symptoms in schizophrenia. Am J Psychiatry 144:1595–1598

    PubMed  CAS  Google Scholar 

  • Ohta T, Okazaki Y, Anzai N (1984) Reliability of the japanese version of the scale for the assessment of negative symptoms (SANS). Jpn J Psychiatry 13:999–1010

    Google Scholar 

  • Overall J, Gorham D (1962) Brief psychiatric rating scale. Psychol Rep 10:799–812

    Google Scholar 

  • Pearlson GD, Garbacz DJ, Breakey WR, Ahn HS, DePaulo JR (1984) Lateral ventricular enlargement associated with persistent unemployment and negative symptoms in both schizophrenia and bipolar disorder. Psychiatry Res 12:1–9

    Article  PubMed  CAS  Google Scholar 

  • Pearlson GD, Garbacz DJ, Moberg PJ, Ahn HS, DePaulo JR (1985) Symptomatic, familial, perinatal, and social correlates of computerized axial tomography (CAT) changes in schizophrenics and bipolars. J Nerv Ment Dis 173:42–50

    Article  PubMed  CAS  Google Scholar 

  • Pfohl B, Winokur G (1983) The micropsychopathology of hebephrenic/catatonic schizophrenia. J Nerv Ment Dis 171:296–300

    Article  PubMed  CAS  Google Scholar 

  • Phillips M (1987) Scale for the assessment of negative symptoms and scale for the assessment of positive symptoms, Chinese version. National Center for Psychiatric Training, Shashi Psychiatric Hospital, Shashi, Hubei

    Google Scholar 

  • Pogue-Geile MF, Harrow M (1984) Negative and positive symptoms in schizophrenia and depression: a follow-up. Schizophr Bull 10: 371–387

    PubMed  CAS  Google Scholar 

  • Pogue-Geile MF, Harrow M (1985) Negative symptoms in schizophrenia: their longitudinal course and prognostic importance. Schizophr Bull 11:427–439

    PubMed  CAS  Google Scholar 

  • Robins E, Guze SB (1970) Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry 126: 983–987

    PubMed  CAS  Google Scholar 

  • Siris SG, Adan F, Cohen M, Mandeli J, Aronson A, Casey E (1988) Postpsychotic depression and negative symptoms: an investigation of syndromal overlap. Am J Psychiatry 145:1532–1537

    PubMed  CAS  Google Scholar 

  • Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 35:773–782

    Article  PubMed  CAS  Google Scholar 

  • Weinberger DR (1988) Schizophrenia and the frontal lobe. Top Neurol Sci 11:367–370

    Article  CAS  Google Scholar 

  • Weinberger DR, Berman KF, Zec RF (1986) Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow (rCBF) evidence. Arch Gen Psychiatry 43:114–124

    Article  PubMed  CAS  Google Scholar 

  • Wing JK (1974) A standard form of psychiatric present state examinations (PSE) and a method for standardizing the classification of symptoms. In Psychiatric epidemiology. Oxford University Press, London

    Google Scholar 

  • Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, London

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, The University of Iowa, Iowa City, IO, 52242, USA

    V. W. Swayze

Authors
  1. N. C. Andreasen
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  2. M. Flaum
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  3. S. Arndt
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  4. R. Alliger
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  5. V. W. Swayze
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Editor information

Editors and Affiliations

  1. Psychiatrische Universitätsklinik, Sigmund-Freud-Straße 25, W-5300, Bonn, Germany

    Andreas Marneros

  2. Department of Psychiatry, University of Iowa, 500 Newton Road, Iowa City, IO, 52242, USA

    Nancy C. Andreasen MD., Ph. D.

  3. Harvard Departments of Psychiatry and Epidemiology, Brockton/West Roxbury VA Medical Center, 940 Belmont Street, Brockton, MA, 02401, USA

    Ming T. Tsuang MD., Ph. D., D. Sc.

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© 1991 Springer-Verlag Berlin Heidelberg

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Andreasen, N.C., Flaum, M., Arndt, S., Alliger, R., Swayze, V.W. (1991). Positive and Negative Symptoms: Assessment and Validity. In: Marneros, A., Andreasen, N.C., Tsuang, M.T. (eds) Negative Versus Positive Schizophrenia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76841-5_3

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  • DOI: https://doi.org/10.1007/978-3-642-76841-5_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-76843-9

  • Online ISBN: 978-3-642-76841-5

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