The challenges of fitting an item response theory model to the Social Anhedonia Scale

Using machine learning to understand social isolation and loneliness in schizophrenia, bipolar disorder, and the community

Social disconnection, including objective social isolation and subjective loneliness, is linked to substantial health risks. Yet, little is known about the predictors of social disconnection in individuals with mental illness. Here, we used machine learning to identify predictors of social isolation and loneliness in schizophrenia (N = 72), a psychiatric condition associated with social disconnection. For comparison, we also included two other groups: a psychiatric comparison sample of bipolar disorder (N = 48) and a community sample enriched for social isolation (N = 151). We fitted statistical models of social isolation and loneliness within and across groups. Each model included five candidate predictors: social avoidance motivation, depression, nonsocial cognition, social anhedonia, and social cognition. The results showed that social anhedonia explained unique variance in social isolation and loneliness in all samples, suggesting that it contributes to social isolation and loneliness broadly. However, nonsocial cognition explained unique variance in social isolation only within schizophrenia. Thus, social anhedonia could be a potential intervention target across populations, whereas nonsocial cognition may play a unique role in determining social disconnection in schizophrenia.

Social cognition and social motivation in schizophrenia and bipolar disorder: are impairments linked to the disorder or to being socially isolated?

BACKGROUND

People with schizophrenia on average are more socially isolated, lonelier, have more social cognitive impairment, and are less socially motivated than healthy individuals. People with bipolar disorder also have social isolation, though typically less than that seen in schizophrenia. We aimed to disentangle whether the social cognitive and social motivation impairments observed in schizophrenia are a specific feature of the clinical condition v. social isolation generally.

METHODS

We compared four groups (clinically stable patients with schizophrenia or bipolar disorder, individuals drawn from the community with self-described social isolation, and a socially connected community control group) on loneliness, social cognition, and approach and avoidance social motivation.

RESULTS

Individuals with schizophrenia (n = 72) showed intermediate levels of social isolation, loneliness, and social approach motivation between the isolated (n = 96) and connected control (n = 55) groups. However, they showed significant deficits in social cognition compared to both community groups. Individuals with bipolar disorder (n = 48) were intermediate between isolated and control groups for loneliness and social approach. They did not show deficits on social cognition tasks. Both clinical groups had higher social avoidance than both community groups.

CONCLUSIONS

The results suggest that social cognitive deficits in schizophrenia, and high social avoidance motivation in both schizophrenia and bipolar disorder, are distinct features of the clinical conditions and not byproducts of social isolation. In contrast, differences between clinical and control groups on levels of loneliness and social approach motivation were congruent with the groups' degree of social isolation.

Using the Beck Depression Inventory to Assess Anhedonia: A Scale Validation Study

Anhedonia is central to several psychological disorders and a frequent target of psychosocial and pharmacological treatments. We evaluated the psychometric properties of two widely used anhedonia measures derived from the Beck Depression Inventory: a 3-item (BDI-Anh3) and a 4-item version (BDI-Anh4). We evaluated these measures in a large undergraduate sample, a community sample, and a clinical sample. Both the BDI-Anh3 and the BDI-Anh4 showed adequate internal consistency, with BDI-Anh4 performing somewhat better, across the three samples. Both measures showed good convergent and discriminant validity, even after controlling for shared variance with other items on the BDI. These findings indicate that both measures have sufficient reliability and validity to support their use by researchers and clinicians.

Neuroimaging of social motivation during winning and losing: Associations with social anhedonia across the psychosis spectrum

BACKGROUND

Individuals with psychosis spectrum disorders (PSD) have difficulty developing social relationships. This difficulty may reflect reduced response to social feedback involving functional alterations in brain regions that support the social motivation system: ventral striatum, orbital frontal cortex, insula, dorsal anterior cingulate cortex, and amygdala. Whether these alterations span PSD is unknown.

METHODS

71 individuals with PSD, 27 unaffected siblings, and 37 control participants completed a team-based fMRI task. After each trial, participants received performance feedback paired with the expressive face of a teammate or opponent. A 2 × 2 (win versus loss outcome x teammate versus opponent) repeated measures ANOVA by group was performed on activation in the five key regions of interest during receipt of feedback.

RESULTS

Across groups, three social motivation regions, ventral striatum, orbital frontal cortex, and amygdala, showed sensitivity to feedback (significant main effect of outcome), with greater activation during win versus loss trials, regardless of whether the feedback was from a teammate or opponent. In PSD, ventral striatum and orbital frontal cortex activation to win feedback was negatively correlated with social anhedonia scores.

CONCLUSIONS

Patterns of neural activation during social feedback were similar in PSD, their unaffected siblings, and healthy controls. Across the psychosis spectrum, activity in key social motivation regions during social feedback was associated with individual differences in social anhedonia.

Intact differentiation of responses to socially-relevant emotional stimuli across psychotic disorders: An event-related potential (ERP) study

Event-related potential (ERP) studies of motivated attention in schizophrenia typically show intact sensitivity to affective vs. non-affective images depicting diverse types of content. However, it is not known whether this ERP pattern: 1) extends to images that solely depict social content, (2) applies across a broad sample with diverse psychotic disorders, and (3) relates to self-reported trait social anhedonia. We examined late positive potential (LPP) amplitudes to images involving people that were normatively pleasant (affiliative), unpleasant (threatening), or neutral in 97 stable outpatients with various psychotic disorders and 38 healthy controls. Both groups showed enhanced LPP to pleasant and unpleasant vs. neutral images to a similar degree, despite lower overall LPP in patients. Within the patients, there were no significant LPP differences among subgroups (schizophrenia vs. other psychotic disorders; affective vs. non-affective psychosis) for the valence effect (pleasant/unpleasant vs. neutral). Higher social anhedonia showed a small, significant relation to lower LPP to pleasant images across all groups. These findings suggest intact motivated attention to social images extends across psychotic disorder subgroups. Dimensional transdiagnostic analyses revealed a modest association between self-reported trait social anhedonia and an LPP index of neural sensitivity to pleasant affiliative images.

On the Choice of the Item Response Model for Scaling PISA Data: Model Selection Based on Information Criteria and Quantifying Model Uncertainty

In educational large-scale assessment studies such as PISA, item response theory (IRT) models are used to summarize students' performance on cognitive test items across countries. In this article, the impact of the choice of the IRT model on the distribution parameters of countries (i.e., mean, standard deviation, percentiles) is investigated. Eleven different IRT models are compared using information criteria. Moreover, model uncertainty is quantified by estimating model error, which can be compared with the sampling error associated with the sampling of students. The PISA 2009 dataset for the cognitive domains mathematics, reading, and science is used as an example of the choice of the IRT model. It turned out that the three-parameter logistic IRT model with residual heterogeneity and a three-parameter IRT model with a quadratic effect of the ability θ provided the best model fit. Furthermore, model uncertainty was relatively small compared to sampling error regarding country means in most cases but was substantial for country standard deviations and percentiles. Consequently, it can be argued that model error should be included in the statistical inference of educational large-scale assessment studies.

Evaluating the item-level factor structure of anhedonia

BACKGROUND

Anhedonia has long been theorized to be a multidimensional construct, focusing on domains of reward stimuli and temporal relationship to reward. However, little empirical work has directly examined whether there is support for this assertion.

METHODS

The study used data from young adults from four independent samples (n = 2098). Participants completed multiple measures of anhedonia.

RESULTS

We used rigorous conducted exploratory and confirmatory factor analyses on items from six commonly used anhedonia measures to examine dimensions underlying anhedonia. Results suggested a four-factor solution with factors reflecting social reward, social disinterest, status/achievement, and physical/natural reward. The identified factors reflected broad content domains of pleasure, but not specific reward processes. The four factors were modestly associated with one another, suggesting a weak common underlying anhedonia trait that manifests across multiple dimensions. Factor scores were associated with personality measures, reward-related indices, and depression symptoms, supporting the validity of the factors.

LIMITATIONS

Participants were all young adults and we assessed anhedonia only at the level of self-report.

CONCLUSION

Anhedonia is a multidimensional construct. However, the dimensions of anhedonia only distinguish domains of, but not temporal processes of anhedonia. Future work should continue to refine the structures underlying the construct of anhedonia through iterative theory- and data-driven research and examine associations between anhedonia and clinical outcomes.

Don’t Use a Bifactor Model Unless You Believe the True Structure Is Bifactor

The current article provides a response to concerns raised by Dombrowski, McGill, Canivez, Watkins, & Beaujean (2020) regarding the methodological confounds identified by Decker, Bridges, Luedke, and Eason (2020) for using a bifactor (BF) model and Schmid–Leiman (SL) procedure in previous studies supporting a general factor of intelligence (i.e., “g”). While Dombrowski et al. (2020) raised important theoretical and practical issues, the theoretical justification for using a BF model and SL procedure to identify cognitive dimensions remain unaddressed, as well as significant concerns for using these statistical methods as the basis for informing the use of cognitive tests in clinical applications.

A novel construct of anhedonia revealed in a Chinese sample via the Revised Physical and Social Anhedonia Scales

BACKGROUND

Anhedonia is a core clinical symptom of mental disorders. The Revised Physical Anhedonia Scale (RPAS) and the Revised Social Anhedonia Scale (RSAS) have been applied in clinical and non-clinical samples since 1980s. However, the construct of a unified RPAS&RSAS for comprehensive measurement of anhedonia has never been explored. Therefore, the purpose of our study was to examine the factor structure of the unified RPAS&RSAS among undergraduates and clinical patients.

METHODS

A total of 3435 undergraduates from two universities and 294 clinical patients with mental disorders had completed the Chinese version of the RPAS and the RSAS. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were each conducted to reveal the constructs of the RPAS and the RSAS. CFA was used to evaluate first- and second-order models for the unified RPAS&RSAS in undergraduates and clinical patients. The internal consistency and test-retest reliability of the RPAS and the RSAS were also evaluated.

RESULTS

EFA and CFA indicated 2-factor structures for RPAS and RSAS, with the factors being defined as anticipatory anhedonia and consummatory anhedonia. The second-order model of the unified RPAS&RSAS in the undergraduates and clinical patients both had satisfactory fit index values (Undergraduate sample: CFI = 0.901, TLI = 0.899, RMSEA = 0.055, SRMR = 0.086; Clinical sample: CFI = 0.922, TLI = 0.911, RMSEA = 0.052, SRMR = 0.078). The psychometric robustness of the RPAS&RSAS were confirmed by high internal consistency and test-retest reliability values.

CONCLUSIONS

The unified RPAS&RSAS with a second-order structure was confirmed in both undergraduates and clinical samples in Chinese. The construct of anhedonia was refreshed as covering physical and social domains, and each of them includes both anticipatory and consummatory components.

Habenular and striatal activity during performance feedback are differentially linked with state-like and trait-like aspects of tobacco use disorder

The habenula, an epithalamic nucleus involved in reward and aversive processing, may contribute to negative reinforcement mechanisms maintaining nicotine use. We used a performance feedback task that differentially activates the striatum and habenula and administered nicotine and varenicline (versus placebos) to overnight-abstinent smokers and nonsmokers to delineate feedback-related functional brain alterations both as a function of smoking trait (smokers versus nonsmokers) and drug administration state (drug versus placebo). Smokers showed less striatal responsivity to positive feedback, an alteration not mitigated by drug administration, but rather correlated with trait-level addiction severity. Conversely, nicotine administration reduced habenula activity following both positive and negative feedback among abstinent smokers, but not nonsmokers, and increased habenula activity among smokers correlated with elevated state-level tobacco cravings. These outcomes highlight a dissociation between neurobiological processes linked with the dependence severity trait and the nicotine withdrawal state. Interventions simultaneously targeting both aspects may improve currently poor cessation outcomes.

Social Withdrawal Among Individuals Receiving Psychiatric Care: Derivation of a Scale Using Routine Clinical Assessment Data to Support Screening and Outcome Measurement

Social withdrawal is a symptom experienced by individuals with an array of mental health conditions, particularly those with schizophrenia and mood disorders. Assessments of social withdrawal are often lengthy and may not be routinely integrated within the comprehensive clinical assessment of the individual. This study utilized item response and classical test theory methods to derive a Social Withdrawal Scale (SWS) using items embedded within a routine clinical assessment, the RAI-Mental Health (RAI-MH). Using data from 60,571 inpatients in Ontario, Canada, a common factor analysis identified seven items from the RAI-MH that measure social withdrawal. A graded response model found that six items had acceptable discrimination parameters: lack of motivation, reduced interaction, decreased energy, flat affect, anhedonia, and loss of interest. Summing these items, the SWS was found to have strong internal consistency (Cronbach's alpha = 0.82) and showed a medium to large effect size (d = 0.77) from admission to discharge. Fewer individuals with high SWS scores participated in social activity or reported having a confidant compared to those with lower scores. Since the RAI-MH is available across clinical subgroups in several jurisdictions, the SWS is a useful tool for screening, clinical decision support, and evaluation.

Motor skills assessments: support for a general motor factor for the Movement Assessment Battery for Children-2 and the Bruininks-Oseretsky Test of Motor Proficiency-2

OBJECTIVE

To evaluate the construct validity and model-based reliability of general and specific contributions of the subscales of the Movement Assessment Battery for Children-2 (MABC-2) and Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) when evaluating motor skills across a range of psychiatric disorders.

METHODS

Confirmatory factor analysis (CFA) and bifactor analysis were conducted on BOT-2 data from 187 elementary school students (grades 1 to 6) (mean age: 113 ± 20 months; boys: n = 117, 62.56%) and on MABC-2 data from 127 elementary school students (grade 1) (mean age: 76 ± 2 months; boys: n = 58, 45.67%).

RESULTS

The results of the CFA fit the data for multidimensionality for the BOT-2 and presented poor fit indices for the MABC-2. For both tests, the bifactor model showed that the reliability of the subscales was poor.

CONCLUSIONS

The BOT-2 exhibited factorial validity with a multidimensional structure among the current samples, but the MABC-2 showed poor fit indices, insufficient to confirm its multidimensional structure. For both tests, most of the reliable variance came from a general motor factor (M-factor), therefore the scoring and reporting of subscale scores were not justified for both tests.

Ideal Point Modeling of Non-cognitive Constructs: Review and Recommendations for Research

Most psychological measurement models assume a monotonically increasing relation between the latent trait and the probability of responding. These models have historically been based on the measurement of abilities (e.g., cognitive), which have dominance properties. However, they are less appropriate for the measurement of non-cognitive constructs, or self-reported typical behaviors (e.g., attitudes, emotions, interests, personality), which have historically been assumed to have ideal point properties, or a nonmonotonic relation between the latent trait and the probability of responding. In this paper, we review the literature on ideal point modeling of non-cognitive constructs to present a theoretical framework that can help guide researchers on pertinent factors that may influence ideal point responding when assessing non-cognitive constructs. We also review the practical implications of not using ideal point response models for non-cognitive constructs and propose areas for research in non-cognitive construct assessment.

The Relationship of Motivation and Neurocognition with Functionality in Schizophrenia: A Meta-analytic Review

The role that neurocognition plays in functionality in schizophrenia has been widely examined, although in recent years increasing attention has been paid to the influence of motivation instead. This study provides a review of the relationship of neurocognition and motivation with functionality in schizophrenia, taking into account objective/subjective functionality assessment, demographic variables, and the different terms used when referring to motivation. A search of electronic databases identified 34 studies that met the inclusion criteria for review. Correlation coefficients between motivation and functionality and between neurocognition and functionality were extracted. For a better understanding, potential moderator variables were also extracted. Meta-analysis showed that both motivation and neurocognition assessments were strongly associated with functioning, with correlations between motivation and functional outcomes being stronger. However, more than three-quarters of the variance in outcome remained unexplained by the moderating factors examined. The paper concludes with recommendations for clinical practice and future research.

Psychometric Properties of a Short Version of the Impulsiveness Questionnaire UPPS-P in a Brazilian Adult Sample: Invariance for Effects of Age, Sex and Socioeconomic Status and Subscales Viability

Five different facets or domains of impulsivity (lack of Perseverance, lack of Premeditation, Sensation Seeking, Positive and Negative Urgency) have been detected in undergraduate students by means of a short, 20-item version of the Impulsive Behavior Scale UPPS-P. The present cross-sectional study examined the psychometric properties of a Brazilian version of this short scale (SUPPS-P) in a non-clinical sample of 510 individuals with a larger age range (10–72 years) and from varying socioeconomic strata (SES). We also investigated: (a) differential item functioning according to age, sex and socioeconomic status; (b) whether these demographic factors affected participants’ responses (population heterogeneity); and (c) if using scores directly derived from respondents’ answers (raw scores) reflected the 5 distinguishable impulsiveness domains out of the structural equation modeling environment (bifactor model). We showed that the short UPPS-P version replicated factor structures, internal consistency across domains and inter-scale correlations found in prior studies, and confirmed the psychometric separability of the 5 impulsiveness domains. Only three out of the 20 items showed differential item functioning. Higher Positive and Negative Urgency and lack of Premeditation were reported by men and impulsiveness decreases with age in all domains except lack of Premeditation. SES did not influence results. The viability of using raw scores to assess the five domains was not confirmed via bifactor modeling. The use of a general composite score was psychometrically acceptable. We conclude that, in the structural equation modeling environment, the SUPPS-P is a reliable instrument to assess multiple impulsivity domains in non-clinical community samples in different cultural settings. However, out of this statistical environment, viability was only found for a general factor of impulsivity.

Psychopathic features across development: Assessing longitudinal invariance among Caucasian and African American youths

OBJECTIVES

Psychopathy is associated with severe forms of antisocial and violent behavior in adults. There is also a rapidly growing body of research focused on extending features of adult psychopathy downward to youth. To date however, the degree to which these features can be consistently and comparatively assessed at these younger ages, remains unclear. This study addresses this issue by investigating measurement invariance of underlying features of psychopathy across childhood and adolescence in a racially diverse sample of youth.

METHODS

Three cohorts of youth (n =1517) were assessed annually from childhood to adolescence (ages ~7-16). Underlying features of psychopathy commonly assessed in youth (e.g. lack of guilt, impulsivity) were examined within a longitudinal bi-factor framework using multi-dimensional item-response theory (IRT) techniques. Differential item functioning was used to assess invariance across development and participant's race (African-American and Caucasian), using two distinct approaches: (1) traditional item-response theory (IRT) methods; and (2) a recently developed Bayesian structural equation modeling (BSEM) approach.

RESULTS

Psychopathy features assessed in this study exhibited measurement consistency across development (~ages 7-16) and were found to tap into the same underlying construct as intended across measurement occasions, and equivalently for African-American and Caucasian youth. Results were similar when assessed using traditional IRT procedures for longitudinal invariance testing and when implementing the more recent BSEM methodology.

CONCLUSIONS

Findings provide the first evidence that features of psychopathy can be assessed consistently in youth and improve our understanding of important developmental and sociocultural factors associated these features during earlier periods of development.

Negative symptoms and the formation of social affiliative bonds in schizophrenia

Negative symptoms in schizophrenia are characterized by deficits in normative experiences and expression of emotion, and they are associated with poor social functioning. Negative symptoms relating to deficits in motivation and pleasure may hinder the development of affiliative bonds. The current study used a novel procedure to examine the relation between negative symptoms and the development of social affiliation within a laboratory setting. Fifty-five men (35 controls; 20 with a schizophrenia spectrum disorder) completed three Social Affiliation Enhancement Tasks with an experimenter partner. Self-reported affiliation and affect ratings were assessed before and after the affiliative interaction. Across groups, social affiliation and positive affect increased following the interactive tasks. However, the schizophrenia group reported less positive and more negative affect than controls. Within individuals with schizophrenia, negative symptoms reflecting motivation and pleasure deficits and self-reported social anhedonia were associated with less affiliative feelings of interpersonal closeness and less willingness to interact. Additionally, these self-reported reactions to the interaction partner were significantly related to social functioning in the community. These findings indicate that though individuals with schizophrenia can form affiliative bonds, the extent to which this is possible may be limited by negative symptoms relating to motivation and pleasure. Additional research will be necessary to examine just how these negative symptoms interfere with social affiliation.

Differential Item Functioning of the Full and Brief Wisconsin Schizotypy Scales in Asian, White, Hispanic, and Multiethnic Samples and Between Sexes

The Wisconsin Schizotypy Scales, including their brief versions, are among the most commonly used self-report measures of schizotypy. Although they have been used extensively in many ethnic groups, few studies have examined their differential item functioning (DIF) across groups. The current study included 1,056 Asian, 408 White, 476 Multiethnic, and 372 Hispanic undergraduates. Unidimensional models of the brief Magical Ideation Scale and Perceptual Aberration Scales fit the data well. For both scales, global tests of measurement invariance provided mixed evidence, but few of the items displayed DIF across ethnicities or between sexes within a multiple indicator multiple causes model. For the full versions of the scales and the brief Revised Social Anhedonia Scale, multiple indicator multiple causes models within an exploratory structural equation modeling framework found that few of the items had DIF. These findings suggest that some of the items may have different psychometric properties across groups, but most items do not.

Categorizing and assessing negative symptoms

PURPOSE OF REVIEW

To provide a review on studies published in the last year relevant to the categorization and assessment of negative symptoms.

RECENT FINDINGS

Recent research supported the validity of the 'deficit/non-deficit schizophrenia' categorization. Few studies confirmed the validity of the category 'persistent negative symptoms', whereas no recent study explored the validity of the category 'predominant negative symptoms'. The two-factor structure of the negative dimension is supported by studies reporting different correlates for the two subdomains: diminished expression and avolition/apathy. The need to further split avolition/apathy in two distinct components, that is anhedonia and amotivation, is confirmed in recent papers. Additional approaches to the assessment of negative symptoms have been proposed, including the self-assessment of negative symptoms, and the evaluation of negative symptoms in daily life and their assessment by means of computerized analyses.

SUMMARY

Negative symptoms represent an unmet need in the care of schizophrenia, as they are associated to poor response to available treatments and to poor functional outcome. Their accurate categorization and assessment represent a major challenge for research on neurobiological substrates and new treatment strategies.

Future Research Directions in the Positive Valence Systems: Measurement, Development, and Implications for Youth Unipolar Depression

The Positive Valence Systems (PVS) have been introduced by the National Institute of Mental Health as a domain to help organize multiple constructs focusing on reward-seeking behaviors. However, the initial working model for this domain is strongly influenced by adult constructs and measures. Thus, the present review focuses on extending the PVS into a developmental context. Specifically, the review provides some hypotheses about the structure of the PVS, how PVS components may change throughout development, how family history of depression may influence PVS development, and potential means of intervening on PVS function to reduce onsets of depression. Future research needs in each of these areas are highlighted.

Evidence for the Discriminant Validity of the Revised Social Anhedonia Scale From Social Anxiety

Social anhedonia and social anxiety are two constructs with similar behaviors including avoidance of and withdrawal from social situations. In three studies, the current research aimed to test whether social anhedonia could be discriminated from social anxiety using the most common measure of social anhedonia, the Revised Social Anhedonia Scale (RSAS). In Study 1, an item-level factor analysis of the RSAS found two factors: Social Apathy/Aversion and Social Withdrawal. In Study 2, this two-factor structure was confirmed in a separate sample. In Study 3, a model with social anhedonia and anxiety scale scores loading on separate factors fit better than a model with social anhedonia and anxiety loading on a single factor. Social anhedonia and anxiety displayed differential associations with negative schizotypy and emotion processing. Findings suggest that the RSAS is successful in measuring social anhedonia distinct from social anxiety.

A comparison of psychometric and convergent validity for social anhedonia and social closeness

Social anhedonia is an important construct that describes individual differences in preferences for interacting in and experiencing pleasure from social interactions and has been a central construct in the schizotypy literature. The description of social anhedonia is very similar to that of social closeness from the personality literature. However, no published studies have directly compared associations between social anhedonia and social closeness with an array of other measures of anhedonia, personality, and depression. The present study examined the internal psychometrics of primary measures of social anhedonia and social closeness; the bivariate association between social anhedonia and social closeness; and the associations between these target constructs and measures of individual differences in a large sample of undergraduate students (mean age = 20.53 years; 76.3% were women). We found that (a) social anhedonia and social closeness were strongly correlated; (b) the unidimensional measurement model for social closeness was stronger than that for social anhedonia; (c) the pattern of associations for social closeness and social anhedonia with measures of physical anhedonia, personality, and depressive symptoms were substantively identical; and (d) a collection of items from both measures assessed information across a wider range of social anhedonia than either instrument alone. Thus, given the similar patterns of validity against multiple criteria social anhedonia and social closeness appear to be representing very similar constructs. The Social Closeness scale provides complementary information to the social anhedonia dimension. Our results provide recommendations for instrument selection when normative or elevated levels of social anhedonia are intended to be assessed. (PsycINFO Database Record

Factor Analysis of the Preschool Behavioral and Emotional Rating Scale for Children in Head Start Programs

Strength-based assessment of behaviors in preschool children provides evidence of emotional and behavioral skills in children, rather than focusing primarily on weaknesses identified by deficit-based assessments. The Preschool Behavioral and Emotional Rating Scales (PreBERS) is a normative assessment of emotional and behavioral strengths in preschool children. The PreBERS has well-established reliability and validity for typically developing children as well as children with identified special education needs, but this has not yet been established for children in Head Start programs, who tend to be at high risk for development of emotional and behavioral concerns. This study explores the factorial validity of the PreBERS scores for a large sample of children participating in Head Start programs around the United States. Results not only confirm the fit of the four-factor model of the PreBERS for this population, but also demonstrate the application of a bifactor model to the structure of the PreBERS which, in turn, allows for the computation of model-based reliability estimates for the four subscales (Emotional Regulation, School Readiness, Social Confidence, Family Involvement) and overall strength index score. The implications suggest that the PreBERS items are reliable scores that can be used to identify behavioral strengths in preschool children in Head Start, and support planning of interventions to selectively address component skills to promote child social and academic success.

Social Reward in Youth at Risk for Depression: A Preliminary Investigation of Subjective and Neural Differences

OBJECTIVE

Offspring of depressed parents are at risk for developing depression at rates higher than the general population. One potential mechanism linking parent and offspring depression involves attenuated reward function. Despite the importance of social incentives for adolescents, no previous studies have relied on active social incentive reward paradigms in youth at risk for depression. The present study examined differences in youth self- and parent-report measures of and neural response to social reward between youth of mothers with and those of mothers without a history of depression.

METHODS

Imaging data were collected on 10 youth with a depressed parent and 23 youth without depressed parent, which included a task examining neural response to social rewards. Youth and parents also completed self-report measures of social reward.

RESULTS

Offspring of depressed parents had lower levels of parent-reported affiliation and reduced neural response to social reward in the ventral striatum and anterior cingulate cortex than offspring of parents without a history of depression. Higher parent-reported affiliation was associated with greater ventral striatal response to social reward. Data suggest that risk status differences in ventral striatal response to social acceptance may be accounted for by affiliation. No differences were found in youth self-reports of behavior.

CONCLUSIONS

The results suggest that attenuated response to social reward, assessed through neurobiology and behavior, may be mechanistically linked to the etiology and pathophysiology of depression. Targeting social interest and engagement may be a new direction in preventing the onset of depressive disorders in youth.

Social affiliation and negative symptoms in schizophrenia: Examining the role of behavioral skills and subjective responding

Schizophrenia is characterized by profound impairment in the motivation for social affiliation. Negative symptoms are associated with such impairment but the contribution of behavioral skill deficits is unclear. In this study we utilized a novel video paradigm to assess performance-based affiliative behavioral skills in individuals with schizophrenia (N=48) and community controls (N=29). Individuals with schizophrenia displayed significant impairment in behavioral affiliative skills compared to controls; however, in response to the affiliative interaction the groups did not differ on self-reported affective responding, appraisal of the interaction partner, or desire to interact with the partner in the future. Importantly, within the patient group more severe negative symptoms (particularly those related to motivation and pleasure) were associated with poorer affiliative social skills and this relationship was independent of instrumental (non-social) skills, depression or positive symptoms. More severe negative symptoms were also associated with less positive affect in response to the interaction and less positive appraisals of the interaction partner. Self-reported social anhedonia was related to patients' diminished willingness to interact with the partner in the future. These results demonstrate that negative symptoms in schizophrenia are related to both affiliative skill deficits and less affiliative subjective responses to interaction partners.

Anhedonia in the psychosis risk syndrome: associations with social impairment and basal orbitofrontal cortical activity

Background/Objectives:

Anhedonia is associated with poor social function in schizophrenia. Here, we examined this association in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders, taking into account social anxiety. We then explored correlations between anhedonia and basal metabolic activity in selected forebrain regions implicated in reward processing.

Methods:

In 62 CHR individuals and 37 healthy controls, we measured social adjustment (Social Adjustment Self-Report Scale), social and physical anhedonia (Chapman Revised Anhedonia Scales), and social anxiety (Social Anxiety Scale for Adolescents) in cross-section. In a subgroup of 25 CHR individuals for whom high-spatial-resolution basal-state functional magnetic resonance imaging data were available, we also assessed correlations of these socio-affective constructs with basal cerebral blood volume in orbitofrontal cortex and related regions involved in reward processing.

Results:

Relative to controls, CHR individuals reported social impairment, greater social and physical anhedonia, and more social anxiety, exhibiting impairments comparable to schizophrenia. Regression analyses showed that anhedonia predicted social impairment and correlated negatively with basal cerebral blood volume within the orbitofrontal cortex (all P’s<0.05).

Conclusions:

Anhedonia and social anxiety are prominent in CHR individuals. Trait-like anhedonia may be a core phenotype related to orbitofrontal cortical function that, independent of symptoms, predicts social impairment. These data provide a rationale for interventions that target anhedonia and related activity in orbitofrontal cortical circuits in CHR individuals.

Motivation and effort in individuals with social anhedonia

It has been proposed that anhedonia may, in part, reflect difficulties in reward processing and effortful decision making. The current study aimed to replicate previous findings of effortful decision making deficits associated with elevated anhedonia and expand upon these findings by investigating whether these decision making deficits are specific to elevated social anhedonia or are also associated with elevated positive schizotypy characteristics. The current study compared controls (n=40) to individuals elevated on social anhedonia (n=30), and individuals elevated on perceptual aberration/magical ideation (n=30) on the Effort Expenditure for Rewards Task (EEfRT). Across groups, participants chose a higher proportion of hard tasks with increasing probability of reward and reward magnitude, demonstrating sensitivity to probability and reward values. Contrary to our expectations, when the probability of reward was most uncertain (50% probability), at low and medium reward values, the social anhedonia group demonstrated more effortful decision making than either individuals high in positive schizotypy or controls. The positive schizotypy group only differed from controls (making less effortful choices than controls) when reward probability was lowest (12%) and the magnitude of reward was the smallest. Our results suggest that social anhedonia is related to intact motivation and effort for monetary rewards, but that individuals with this characteristic display a unique and perhaps inefficient pattern of effort allocation when the probability of reward is most uncertain. Future research is needed to better understand effortful decision making and the processing of reward across a range of individual difference characteristics.

Item response theory-based measure of global disability in multiple sclerosis derived from the Performance Scales and related items

BACKGROUND

The eight Performance Scales and three assimilated scales (PS) used in North American Research Committee on Multiple Sclerosis (NARCOMS) registry surveys cover a broad range of neurologic domains commonly affected by multiple sclerosis (mobility, hand function, vision, fatigue, cognition, bladder/bowel, sensory, spasticity, pain, depression, and tremor/coordination). Each scale consists of a single 6-to-7-point Likert item with response categories ranging from "normal" to "total disability". Relatively little is known about the performances of the summary index of disability derived from these scales (the Performance Scales Sum or PSS). In this study, we demonstrate the value of a combination of classical and modern methods recently proposed by the Patient-Reported Outcome Measurement Information System (PROMIS) network to evaluate the psychometric properties of the PSS and derive an improved measure of global disability from the PS.

METHODS

The study sample included 7,851adults with MS who completed a NARCOMS intake questionnaire between 2003 and 2011. Factor analysis, bifactor modeling, and item response theory (IRT) analysis were used to evaluate the dimension(s) of disability underlying the PS; calibrate the 11 scales; and generate three alternative summary scores of global disability corresponding to different model assumptions and practical priorities. The construct validity of the three scores was compared by examining the magnitude of their associations with participant's background characteristics, including unemployment.

RESULTS

We derived structurally valid measures of global disability from the PS through the proposed methodology that were superior to the PSS. The measure most applicable to clinical practice gives similar weight to physical and mental disability. Overall reliability of the new measure is acceptable for individual comparisons (0.87). Higher scores of global disability were significantly associated with older age at assessment, longer disease duration, male gender, Native-American ethnicity, not receiving disease modifying therapy, unemployment, and higher scores on the Patient Determined Disease Steps (PDDS).

CONCLUSION

Promising, interpretable and easily-obtainable IRT scores of global disability were generated from the PS by using a sequence of traditional and modern psychometric methods based on PROMIS recommendations. Our analyses shed new light on the construct of global disability in MS.

Behavioral approach and avoidance in schizophrenia: an evaluation of motivational profiles

Schizophrenia is associated with motivational deficits that interfere with a wide range of goal directed activities. Despite their clinical importance, our current understanding of these motivational impairments is limited. Furthermore, different types of motivational problems are commonly seen among individuals within the broad diagnosis of schizophrenia. The goal of the current study was to examine whether clinically meaningful subgroups could be identified based on approach and avoidance motivational tendencies. We measured these tendencies in 151 individuals with schizophrenia. Although prior studies demonstrate elevated BIS sensitivity in schizophrenia at the overall group level, none have explored various combinations of BIS/BAS sensitivities within this disorder. Cluster analyses yielded five subgroups with different combinations of low, moderate, or high BIS and BAS. The subgroups had interpretable differences in clinically rated negative symptoms and self-reported anhedonia/socio-emotional attitudes, which were not detectable with the more commonly used linear BIS/BAS scores. Two of the subgroups had significantly elevated negative symptoms but different approach/avoidance profiles: one was characterized by markedly low BIS, low BAS and an overall lack of social approach motivation; the other had markedly high BIS but moderate BAS and elevated social avoidance motivation. The two subgroups with relatively good clinical functioning showed patterns of BAS greater than BIS. Our findings indicate that there are distinct motivational pathways that can lead to asociality in schizophrenia and highlight the value of considering profiles based on combined patterns of BIS and BAS in schizophrenia.

Anhedonia: a concept analysis

Anhedonia presents itself in a myriad of disease processes. To further develop our understanding of anhedonia and effective ways to manage it, the concept requires clear boundaries. This paper critically examined the current scientific literature and conducted a concept analysis of anhedonia to provide a more accurate and lucid understanding of the concept. As part of the concept analysis, this paper also provides model, borderline, related, and contrary examples of anhedonia.

The Clinical Assessment Interview for Negative Symptoms (CAINS): final development and validation

OBJECTIVE

A major barrier to developing treatments for negative symptoms has been measurement concerns with existing assessment tools. Fulfilling the top recommendation of the National Institute of Mental Health's Consensus Development Conference on Negative Symptoms, the Clinical Assessment Interview for Negative Symptoms (CAINS) was developed using an iterative, empirical approach, and includes items assessing motivation, pleasure, and emotion expression. The authors employed multiple analytic techniques to develop the CAINS and here provide final development and validation results.

METHOD

The CAINS structure, interrater agreement, test-retest reliability, and convergent and discriminant validity were assessed in a large and diverse sample of 162 outpatients with schizophrenia or schizoaffective disorder recruited from four sites.

RESULTS

Three items with poor psychometric properties were removed, resulting in a 13-item CAINS. The CAINS factor structure was replicated, demonstrating two modestly correlated scales: expression (four items) and motivation/pleasure (nine items). The scales demonstrated good internal consistency, test-retest stability, and interrater agreement. Strong convergent validity was demonstrated by linkages with other negative symptom measures, self-report scales of sociality, pleasure, and motivation, and coded facial expressions. Discriminant validity was shown by independence from depression, medication side effects, and cognition. Notably, the CAINS scales were related to real-world vocational, independent living, and social/familial functioning.

CONCLUSIONS

The CAINS is an empirically developed and evaluated measure of negative symptoms. Findings indicate that the CAINS is brief yet comprehensive and employable across a wide range of research and clinical contexts.

Psychometric properties and validity of short forms of the Wisconsin Schizotypy Scales in two large samples

The Wisconsin Schizotypy Scales (WSS) have been widely used in the study of clinical and non-clinical samples. However, researchers often find the length of the scales prohibitive. The present study examined the reliability and validity of recently developed 15-item short forms of the Perceptual Aberration, Magical Ideation, Physical Anhedonia, and Revised Social Anhedonia Scales in two large samples of non-clinically ascertained young adults. The scales demonstrated good reliability and correlated highly with the original scales. The validity of the scales was assessed by comparing the association of the original and shortened WSS with interview measures of psychotic-like and schizophrenia-spectrum symptoms and impaired functioning, as well as with questionnaire measures of personality and social impairment. The associations of the shortened WSS with the interview and questionnaire measures were comparable in terms of statistical significance and effect size with the associations of the original scales. The present findings provide the first demonstration of the validity of the shortened WSS and support their use in the study of schizotypy.