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The Distinction of Positive and Negative Symptoms

The Failure of a Two-Dimensional Model

Published online by Cambridge University Press:  02 January 2018

Stephan Arndt*
Affiliation:
Department of Psychiatry and Department of Preventive Medicine and Environmental Health, College of Medicine, University of Iowa, 500 Newton Road, Iowa City, Iowa 52242, USA
Randall J. Alliger
Affiliation:
Department of Psychiatry, University of Iowa
Nancy C. Andreasen
Affiliation:
Department of Psychiatry, University of Iowa
*
* Correspondence

Abstract

The distinction of positive and negative symptoms in describing schizophrenic patients has become popular. It presupposes that symptoms cluster in two dimensions, fitting together not only theoretically but empirically. Factor analysis of three published studies of 93, 62 and 52 schizophrenic patients and a large pooled sample showed that more than two distinct dimensions are required to categorise symptoms in schizophrenia. This result is consistent across methods and samples, and with previous literature. The added dimensionality resulted from a splitting of the positive symptom domain into more distinct factors.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1982) Negative symptoms in schizophrenia: definition and validation. Archives of General Psychiatry, 39, 784788.Google Scholar
Andreasen, N. C. (1988) Brain imaging: applications in psychiatry. Science, 239, 13811388.CrossRefGoogle ScholarPubMed
Andreasen, N. C. (1990) Magnetic resonance imaging of the brain in schizophrenia. Archives of General Psychiatry, 47, 3544.Google Scholar
Andreasen, N. C. & Olsen, S. (1982) Negative versus positive schizophrenia: definition and validation. Archives of General Psychiatry, 39, 789794.CrossRefGoogle Scholar
Andreasen, N. C. Swayze, V. W. II Flaum, M. et al (1991) Ventricular enlargement in schizophrenia evaluated with CT scanning: effects of gender, age, and stage of illness. Archives of General Psychiatry (in press).CrossRefGoogle Scholar
Bilder, R. M. Mukherjee, S. Rleder, R. O. et al (1985) Symptomatic and neuropsychological components of defect status. Schizophrenia Bulletin, 11, 409419.CrossRefGoogle Scholar
Cliff, N. (1988) The eigenvalues-greater-than-one rule and the reliability of components. Psychological Bulletin, 103, 276279.Google Scholar
Comrey, A. L. (1978) Common methodological problems in factor analytic studies. Journal of Consulting and Clinical Psychology, 46, 648659.Google Scholar
Crow, T. J. (1980) Positive and negative schizophrenic symptoms and the role of dopamine. British Journal of Psychiatry, 137, 383386.CrossRefGoogle ScholarPubMed
Crow, T. J. (1985) The two syndrome concept: origins and current status. Schizophrenia Bulletin, 11, 471486.Google Scholar
Crow, T. J. (1989) A current view of the type II syndrome: age of onset, intellectual impairment, and the meaning of structural changes in the brain. British Journal of Psychiatry, 155, 1520.Google Scholar
Gorsuch, R. L. (1974) Factor Analysis. Philadelphia: W. B. Saunders.Google Scholar
Guadagnoli, E. & Velicer, W. F. (1988) Relation of sample size to the stability of component patterns. Psychological Bulletin, 103, 265275.CrossRefGoogle Scholar
Hughlings Jackson, J. (1931) Selected Writings (ed. Taylor, J.). London: Hodder & St ought on.Google Scholar
Johnstone, E. C. Crow, T. J. Ferrier, N. et al (1983) Adverse effects of anticholinergic medication on positive schizophrenic symptoms. Psychological Medicine, 13, 513527.CrossRefGoogle ScholarPubMed
Johnstone, E. C. Owens, D. G. C. Frith, C. D. et al (1987) The relative stability of positive and negative features in chronic schizophrenia. British Journal of Psychiatry, 150, 6064.CrossRefGoogle ScholarPubMed
Kane, J. M. & Mayerhoff, D. (1989) Do negative symptoms respond to pharmacological treatment? British Journal of Psychiatry, 155, 115118.Google Scholar
Lenzenweger, M. F. Dworkin, R. H. & Wethington, E. (1989) Models of positive and negative symptoms in schizophrenia: an empirical evaluation of latent structures. Journal of Abnormal Psychology, 98, 6270.Google Scholar
Liddle, P. F. (1987) The symptoms of chronic schizophrenia: a re-examination of the positive-negative dichotomy. British Journal of Psychiatry, 151, 145151.Google Scholar
Lindenmayer, J. Kay, S. R. & Friedman, C. (1986) Negative and positive schizophrenic syndromes after the acute phase: a prospective follow-up. Comprehensive Psychiatry, 27, 276286.CrossRefGoogle ScholarPubMed
Pfohl, B. & Winokur, G. (1982) The evolution of symptoms in institutionalized hebephrenic/catatonic schizophrenics. British Journal of Psychiatry, 141, 567572.CrossRefGoogle ScholarPubMed
Pfohl, B. & Winokur, G. (1983) The micropsychopathology of hebephrenic/catatonic schizophrenia. Journal of Nervous and Mental Disease, 171, 296300.Google Scholar
Pogue-Geile, M. F. (1989) The prognostic significance of negative symptoms in schizophrenia. British Journal of Psychiatry, 155, 123127.Google Scholar
Sommers, A. A. (1985) “Negative symptoms”: conceptual and methodological problems. Schizophrenia Bulletin, 11, 364373.Google Scholar
Tatsuoka, M. M. (1971) Multivariate Analysis: Techniques for Educational and Psychological Research. New York: John Wiley and Sons. Google Scholar
Thiemann, S. Csernansky, J. G. & Berger, P. A. (1987) Rating scales in research: the case of negative symptoms. Psychiatry Research, 20, 4755.Google Scholar
Volkow, N. D. Wolf, A. P. Gelder, P. V. et al (1967) Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia. American Journal of Psychiatry, 144, 151158.Google Scholar
Walker, E. F. Harvey, P. D. & Perlman, D. (1988) The positive/negative symptom distinction in psychoses: a replication and extension of previous findings. Journal of Nervous and Mental Disease, 6, 359363.Google Scholar
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