Avolition and expressive deficits capture negative symptom phenomenology: implications for DSM-5 and schizophrenia research.
Avolition and expressive deficits capture negative symptom phenomenology: implications for DSM-5 and schizophrenia research.
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DOI：
10.1016/j.cpr.2010.09.002
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发表时间：
2011-02
影响因子：
12.8
通讯作者：
Malaspina, Dolores
中科院分区：
文献类型：
--
作者：
Messinger, Julie W.;Tremeau, Fabien;Antonius, Daniel;Mendelsohn, Erika;Prudent, Vasthie;Stanford, Arielle D.;Malaspina, Dolores
DSM-5公式提供了一个机会，以完善阴性症状评估，这对精神分裂症的诊断至关重要。这篇综述追溯了神经精神病学中消极症状概念的历史，从19世纪最早的概念化开始。它提供了相关文献来区分不同类型的阴性症状。虽然国家心理健康研究所的一项共识倡议提出有五个独立的负面症状领域，但我们对个别项目的审查显示，不超过三个负面症状领域。事实上，对单独的消极症状量表进行的众多因素分析通常只发现两个领域：1)表达缺陷，包括情感、语言和副语言表达；2)日常生活和社会活动的丧失。我们认为，与其他阴性症状结构相比，关注表达缺陷和撕裂对于诊断、治疗考虑和研究目的将是最有效的。我们建议在DSM-5标准中将这两个领域作为单独的维度进行评估。
The DSM-5 formulation presents an opportunity to refine the negative symptom assessments that are crucial for a schizophrenia diagnosis. This review traces the history of negative symptom constructs in neuropsychiatry from their earliest conceptualizations in the 19th century. It presents the relevant literature for distinguishing between different types of negative symptoms. Although a National Institute of Mental Health consensus initiative proposed that there are five separate negative symptom domains, our review of the individual items demonstrates no more than three negative symptom domains. Indeed, numerous factor analyses of separate negative symptom scales routinely identify only two domains: 1) expressive deficits, which include affective, linguistic and paralinguistic expressions, and 2) avolition for daily-life and social activities. We propose that a focus on expressive deficits and avolition will be of optimum utility for diagnosis, treatment-considerations, and research purposes compared to other negative symptom constructs. We recommend that these two domains should be assessed as separate dimensions in the DSM-5 criteria.
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