This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Methods, Meanings, and Mechanisms

Nancy C. Andreasen, MD, PhD; Stephan Arndt, PhD; Randall Alliger, PhD; Del Miller, PharmD, MD; Michael Flaum, MD

Arch Gen Psychiatry. 1995;52(5):341-351.

Abstract
Background
The "group of schizophrenias," normally referred to with a single nominative, is phenomenologically heterogeneous. Its symptoms represent multiple psychological domains, including perception, inferential thinking, language, attention, social interaction, emotion expression, and volition. Studies of psychopathology have simplified this complex array in several ways, one of which is a subdivision into positive and negative symptoms.

Methods
This study examined the positive vs negative distinction in a sample of 243 patients with schizophrenia or schizophreniform disorder who were evaluated with the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. A two-stage factor analysis was applied, beginning with a principal components analysis applying varimax rotation, followed by an extension analysis. The purpose of these analyses was to evaluate the correlational relationships of the various symptoms of schizophrenia.

Results
The results confirmed previous reports by our group and others suggesting that the symptoms of schizophrenia fall into three natural dimensions, as assessed by the correlational interrelationships: positive symptoms subdivide into psychotic and disorganized dimensions, while a third negative dimension also emerges.

Conclusion
Because these dimensions have impressive consistency across studies, future work must examine their relationship to clinically relevant concepts such as prognosis or etiology and examine four different aspects: longitudinal course, neural mechanisms, relationship to treatment, and interrelationships in other pathological conditions.

Author Affiliations
From the The Mental Health Clinical Research Center (Drs Andreasen, Arndt, Alliger, Miller, and Flaum), Department of Psychiatry (Drs Andreasen, Miller, and Flaum), and Department of Preventive Medicine and Environmental Health (Dr Arndt), The University of Iowa Hospitals and Clinics, College of Medicine, Iowa City.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

EEG Power Spectra Differentiate Positive and Negative Subgroups in Neuroleptic-Naive Schizophrenia Patients
John et al.
J. Neuropsychiatry Clin. Neurosi. 2009;21:160-172.
ABSTRACT | FULL TEXT  

Correlation of passivity symptoms and dysfunctional visuomotor action monitoring in psychosis
Schnell et al.
Brain 2008;131:2783-2797.
ABSTRACT | FULL TEXT  

Five-Year Follow-up of a Randomized Multicenter Trial of Intensive Early Intervention vs Standard Treatment for Patients With a First Episode of Psychotic Illness: The OPUS Trial
Bertelsen et al.
Arch Gen Psychiatry 2008;65:762-771.
ABSTRACT | FULL TEXT  

Smoking in Schizophrenia: Diagnostic Specificity, Symptom Correlates, and Illness Severity
Kotov et al.
Schizophr Bull 2008;0:sbn066v1-sbn066.
ABSTRACT | FULL TEXT  

Thalamic Shape Abnormalities in Individuals with Schizophrenia and Their Nonpsychotic Siblings
Harms et al.
J. Neurosci. 2007;27:13835-13842.
ABSTRACT | FULL TEXT  

Anhedonia in Schizophrenia: A Review of Assessment Strategies
Horan et al.
Schizophr Bull 2006;32:259-273.
ABSTRACT | FULL TEXT  

The Structure of Negative Symptoms Within Schizophrenia: Implications for Assessment
Blanchard and Cohen
Schizophr Bull 2006;32:238-245.
ABSTRACT | FULL TEXT  

A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness
Petersen et al.
BMJ 2005;331:602.
ABSTRACT | FULL TEXT  

Subgenual Prefrontal Cortex Volumes in Major Depressive Disorder and Schizophrenia: Diagnostic Specificity and Prognostic Implications
Coryell et al.
Am. J. Psychiatry 2005;162:1706-1712.
ABSTRACT | FULL TEXT  

Improving 1-year outcome in first-episode psychosis: OPUS trial
PETERSEN et al.
Br. J. Psychiatry 2005;187:s98-s103.
ABSTRACT | FULL TEXT  

First-Episode Psychosis: Psychopathology, Quality of Life, and Functional Outcome
Malla and Payne
Schizophr Bull 2005;31:650-671.
ABSTRACT | FULL TEXT  

Remission in Schizophrenia: Proposed Criteria and Rationale for Consensus
Andreasen et al.
Am. J. Psychiatry 2005;162:441-449.
ABSTRACT | FULL TEXT  

Predictive Values of Neurocognition and Negative Symptoms on Functional Outcome in Schizophrenia: A Longitudinal First-Episode Study With 7-Year Follow-Up
Milev et al.
Am. J. Psychiatry 2005;162:495-506.
ABSTRACT | FULL TEXT  

A Multidimensional Model of Obsessive-Compulsive Disorder
Mataix-Cols et al.
Am. J. Psychiatry 2005;162:228-238.
ABSTRACT | FULL TEXT  

Cognitive Enhancement Therapy for Schizophrenia: Effects of a 2-Year Randomized Trial on Cognition and Behavior
Hogarty et al.
Arch Gen Psychiatry 2004;61:866-876.
ABSTRACT | FULL TEXT  

Two-Year Outcome in First-Episode Schizophrenia: Predictive Value of Symptoms for Quality of Life
Ho et al.
Focus 2004;2:131-137.
ABSTRACT | FULL TEXT  

Normal P50 Gating in Unmedicated Schizophrenia Outpatients
Arnfred et al.
Am. J. Psychiatry 2003;160:2236-2238.
ABSTRACT | FULL TEXT  

Emotions in Unmedicated Patients With Schizophrenia During Evaluation With Positron Emission Tomography
Paradiso et al.
Am. J. Psychiatry 2003;160:1775-1783.
ABSTRACT | FULL TEXT  

Hippocampal Deformities in Schizophrenia Characterized by High Dimensional Brain Mapping
Csernansky et al.
Am. J. Psychiatry 2002;159:2000-2006.
ABSTRACT | FULL TEXT  

Summer Birth and Deficit Schizophrenia in Dumfries and Galloway, Southwestern Scotland
Kirkpatrick et al.
Am. J. Psychiatry 2002;159:1382-1387.
ABSTRACT | FULL TEXT  

The psychopathology, medical management and dental implications of schizophrenia
FRIEDLANDER and MARDER
Journal of the American Dental Association 2002;133:603-610.
ABSTRACT | FULL TEXT  

Glutamate and psychiatric disorders
Tsapakis and Travis
Adv. Psychiatr. Treat. 2002;8:189-197.
FULL TEXT  

Obsessive-Compulsive and Panic Symptoms in Patients With First-Admission Psychosis
Craig et al.
Am. J. Psychiatry 2002;159:592-598.
ABSTRACT | FULL TEXT  

Immediate and delayed effects of risperidone on cerebral metabolism in neuroleptic naive schizophrenic patients: correlations with symptom change
Ngan et al.
J. Neurol. Neurosurg. Psychiatry 2002;72:106-110.
ABSTRACT | FULL TEXT  

Twin study of symptom dimensions in psychoses
CARDNO et al.
Br. J. Psychiatry 2001;179:39-45.
ABSTRACT | FULL TEXT  

A Separate Disease Within the Syndrome of Schizophrenia
Kirkpatrick et al.
Arch Gen Psychiatry 2001;58:165-171.
ABSTRACT | FULL TEXT  

Failure to Confirm the 3 Domains Model of Psychosis
Dudgeon et al.
Arch Gen Psychiatry 2001;58:94-96.
FULL TEXT  

Depression in Schizophrenia: Perspective in the Era of "Atypical" Antipsychotic Agents
Siris
Am. J. Psychiatry 2000;157:1379-1389.
ABSTRACT | FULL TEXT  

Characteristics of Schizophrenia Among Persons With Severe or Profound Mental Retardation
Cherry et al.
Psychiatr. Serv. 2000;51:922-924.
ABSTRACT | FULL TEXT  

Congruence of Diagnoses 2 Years After a First-Admission Diagnosis of Psychosis
Schwartz et al.
Arch Gen Psychiatry 2000;57:593-600.
ABSTRACT | FULL TEXT  

Management of Negative Symptoms Among Patients With Schizophrenia Attending Multiple-Family Groups
Dyck et al.
Psychiatr. Serv. 2000;51:513-519.
ABSTRACT | FULL TEXT  

Cognitive Correlates of the Negative, Disorganized, and Psychotic Symptom Dimensions of Schizophrenia
O'Leary et al.
J. Neuropsychiatry Clin. Neurosi. 2000;12:4-15.
ABSTRACT | FULL TEXT  

Is There an Association Between Duration of Untreated Psychosis and 24-Month Clinical Outcome in a First-Admission Series?
Craig et al.
Am. J. Psychiatry 2000;157:60-66.
ABSTRACT | FULL TEXT  

Incremental Progress in Developmental Psychopathology: Simply Complex
Am. J. Psychiatry 1999;156:1495-1498.
FULL TEXT  

Longitudinal Study of Cognitive Function in First-Episode and Recent-Onset Schizophrenia
Gold et al.
Am. J. Psychiatry 1999;156:1342-1348.
ABSTRACT | FULL TEXT  

Empirical Validation of Primary Negative Symptoms: Independence From Effects of Medication and Psychosis
Kelley et al.
Am. J. Psychiatry 1999;156:406-411.
ABSTRACT | FULL TEXT  

Two-Year Outcome in First-Episode Schizophrenia: Predictive Value of Symptoms for Quality of Life
Ho et al.
Am. J. Psychiatry 1998;155:1196-1201.
ABSTRACT | FULL TEXT  

Depressive Signs and Symptoms in Schizophrenia: A Prospective Blinded Trial of Olanzapine and Haloperidol
Tollefson et al.
Arch Gen Psychiatry 1998;55:250-258.
ABSTRACT | FULL TEXT  

Homelessness Among Individuals With Psychotic Disorders Hospitalized for the First Time: Findings From the Suffolk County Mental Health Project
Herman et al.
Am. J. Psychiatry 1998;155:109-113.
ABSTRACT | FULL TEXT  

Characterization of Psychotic Conditions: Use of the Domains of Psychopathology Model
Ratakonda et al.
Arch Gen Psychiatry 1998;55:75-81.
ABSTRACT | FULL TEXT  

Therapeutic Efficacy of Olanzapine
Littrell and Littrell
J Am Psychiatr Nurses Assoc 1997;3:S8-S13.
ABSTRACT  

The Johns Hopkins University Collaborative Schizophrenia Study: An Epidemiologic-Genetic Approach to Test the Heterogeneity Hypothesis and Identify Schizophrenia Susceptibility Genes
Pulver et al.
Cold Spring Harb Symp Quant Biol 1996;61:797-814.
ABSTRACT  

A Longitudinal Study of Symptom Dimensions in Schizophrenia: Prediction and Patterns of Change
Arndt et al.
Arch Gen Psychiatry 1995;52:352-360.
ABSTRACT  

Signs and Symptoms: What Can They Tell Us About the Clinical Course and Pathophysiologic Processes of Schizophrenia?
Lieberman
Arch Gen Psychiatry 1995;52:361-363.
ABSTRACT