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The Clinical Assessment Interview for Negative Symptoms (CAINS): Final Development and Validation
Open accessAbstract
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.
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“Other forms of disorders, i.e. schizophrenia and bipolar disorder, can be evaluated with screenings such as the Clinical Assessment Interview for Negative Symptoms (CAINS) [60], Brief Negative Symptom Scale (BNSS) [61], the Social Skills Performance Assessment (SSPA) [53], and several others that measure the effects of thought and mood disorders.”
From A Review of Automated Speech and Language Features for Assessment of Cognitive and Thought Disorders (2020) · cites this paper as [60]
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Items 101–200 of 726
The Emotion Paradox of Anhedonia in Schizophrenia: Or Is It?
Strauss, G. P. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbs192 · Cited by 64
Network Controllability in Transmodal Cortex Predicts Positive Psychosis Spectrum Symptoms
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“Future work could use dedicated instruments for assessing negative PS symptoms such as the Clinical Assessment Interview for Negative Symptoms (85).”
Self-citationPsychometric evaluation of the negative syndrome of schizophrenia
García‐Portilla, M. P., García-Álvarez, L., Sáiz, P. A., Al‐Halabí, S., Bobes-Bascarán, T., Bascarán, T., Muñiz, J., & Bobes, J. (2015) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-015-0595-z · Cited by 63
“[2] on the lack of agreement between the CAINS and the selfreport measures of pleasure and motivation (see the CAINS section).”
BackgroundMethodInfluentialStrauss, G. P., Vertinski, M., Vogel, S. J., Ringdahl, E. N., & Allen, D. N. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.12.014 · Cited by 63
Levine, S. Z., & Leucht, S. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.09.002 · Cited by 63
Relationship between effortful motivation and neurocognition in schizophrenia
Bismark, A. W., Thomas, M. L., Tarasenko, M. A., Shiluk, A. L., Rackelmann, S. Y., Young, J. W., & Light, G. A. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.06.042 · Cited by 63
“Othermore recently developed measures of negative symptoms such as the Clinical Assessment Interview for Negative Symptoms (CAINS) may provide more sensitivity to detecting symptom-behavior relationships (Kring et al., 2013).”
BackgroundCulbreth, A. J., Moran, E. K., Kandala, S., Westbrook, A., & Barch, D. M. (2020) · Clinical Psychological Science · doi:10.1177/2167702620901558 · Cited by 62
“These factors are now reflected in two subscales of the CAINS: the Motivation and Pleasure Subscale (MAP) and Expressive Subscale (Horan et al., 2011; Kring et al., 2013).”
BackgroundBodén, R., Bengtsson, J., Thörnblom, E., Struckmann, W., & Persson, J. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.04.053 · Cited by 66
Neural Basis of Anhedonia and Amotivation in Patients with Schizophrenia: The Role of Reward System
Lee, J. S., Jung, S., Park, I. H., & Kim, J. (2015) · Current Neuropharmacology · doi:10.2174/1570159x13666150612230333 · Cited by 66
“Recently, the Collaboration to Advance Negative Symptom Assessment in Schizophrenia (CANSAS) project has led to the development of the Clinical Assessment Interview for Negative Symptoms (CAINS), which employs a two-factor structure of expression (consisting of 4 items) and motivation/pleasure (consisting of 9 items)…”
MethodThe translational study of apathy—an ecological approach
Cathomas, F., Hartmann-Riemer, M. N., Seifritz, E., Pryce, C. R., & Kaiser, S. (2015) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00241 · Cited by 61
Subthreshold Psychotic Symptoms in 22q11.2 Deletion Syndrome
Tang, S. X., Yi, J. J., Moore, T. M., Calkins, M. E., Kohler, C. G., Whinna, D. A., Souders, M. C., Zackai, E. H., McDonald‐McGinn, D. M., Emanuel, B. S., et al. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.05.009 · Cited by 61
“Similar findings have been reported both in patients with 22q11DS and nondeleted patients with schizophrenia.(21,40) It is also noteworthy that although the SOPS was rationally designed with “positive,” “negative,” and “disorganized” groups of symptoms, the original subscale categories deviate somewhat from the factor…”
Self-citationHarvey, P. D., Khan, A., & Keefe, R. S. E. (2017) · PubMed Central · Cited by 59
Moran, E. K., Culbreth, A. J., Kandala, S., & Barch, D. M. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000461 · Cited by 61
Jang, S.-K., Choi, H.-I., Park, S., Eunju, J., Lee, G., Cho, Y. I., & Choi, K. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00707 · Cited by 60
Tabak, N. T., Horan, W. P., & Green, M. F. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.07.030 · Cited by 59
“…patients were administered the MATRICS Consensus Cognitive Battery (MCCB; Nuechterlein et al., 2008) and two symptom rating interviews; the Positive and Negative Syndrome Scale (PANSS; Kay et al., 1987) and the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013).”
Self-citationThe association of neurocognitive impairment with diminished expression and apathy in schizophrenia
Hartmann-Riemer, M. N., Hager, O. M., Kirschner, M., Bischof, M., Kluge, A., Seifritz, E., & Kaiser, S. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.10.032 · Cited by 58
“Kring et al. (2013) and Gur et al. (2015) reported no significant correlations using the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013).”
MethodResultInfluentialValidation of the Spanish version of the Clinical Assessment for Negative Symptoms (CAINS)
Valiente-Gómez, A., Mezquida, G., Romaguera, A., Vilardebò, I., Andrés, H., Granados, B., Larrubia, J., Pomarol‐Clotet, E., McKenna, P. J., Sarró, S., et al. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.06.006 · Cited by 57
“This finding is similar tofindingswith the English language version (Horan et al., 2011; Kring et al., 2013) and the Chinese version (Chan et al., 2015), although it should be noted that in Kring et al.'s (2013) original study, the first factor corresponded to the CAINS-Exp scale, whereas in our…”
BackgroundMethodResultInfluentialVocal expression in schizophrenia: Less than meets the ear.
Cohen, A. S., Mitchell, K. R., Docherty, N. M., & Horan, W. P. (2016) · Journal of Abnormal Psychology · doi:10.1037/abn0000136 · Cited by 57
“Third, the reliance on the BPRS is a limitation – as it lacks the specificity of other symptom-rating scale based negative symptom measures (Kirkpatrick et al., 2011; Kring et al., 2013).”
BackgroundSelf-citationThe course of negative symptom in first episode psychosis and the relationship with social recovery
Gee, B., Hodgekins, J., Fowler, D. G., Marshall, M., Everard, L., Lester, H. E., Jones, P. B., Amos, T., Singh, S. P., Sharma, V. K., et al. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.04.017 · Cited by 60
“the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013)) have sought to address these”
InfluentialEdwards, C. J., Garety, P., & Hardy, A. (2019) · Psychological Medicine · doi:10.1017/s0033291719002381 · Cited by 54
Mezquida, G., Cabrera, B., Bioque, M., Amoretti, S., Lobo, A., González-Pinto, A. M., Espliego, A., Corripio, I., Vieta, E., Castro‐Fornieles, J., et al. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.01.047 · Cited by 55
Jiang, Y., Duan, M., Chen, X., Zhang, X., Gong, J., Dong, D., Li, H., Yi, Q., Wang, S., Wang, J., et al. (2018) · International Journal of Neural Systems · doi:10.1142/s0129065718500326 · Cited by 56
Chang, W. C., Strauss, G. P., Ahmed, A. O., Wong, S. C. Y., Chan, J. K. N., Lee, E. H. M., Chan, S. K. W., Hui, C. L. M., James, S. H., Chapman, H. C., et al. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa129 · Cited by 55
Giordano, G. M., Caporusso, E., Pezzella, P., & Galderisi, S. (2022) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2022.2092402 · Cited by 59
“Although they currently represent the best available measures of negative symptoms in this population, as they are adapted, such as BNSS and CAINS or are developed specifically for HR subjects, such as PINS, further studies are needed to confirm their sensitivity to detect negative symptoms in HR subjects [1,48].”
BackgroundMethodInfluentialValidation of the German version of the Clinical Assessment Interview for Negative Symptoms (CAINS)
Engel, M., Fritzsche, A., & Lincoln, T. M. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.07.070 · Cited by 54
“Kring et al. (2013) showed promising test–retest reliability (across 2- to 3-week period) in an initial test of stability.”
BackgroundMethodResultInfluentialLei, W., Li, N., Deng, W., Li, M., Huang, C., Ma, X., Wang, Q., Guo, W., Li, Y., Jiang, L., et al. (2015) · Scientific Reports · doi:10.1038/srep12994 · Cited by 56
Pelletier‐Baldelli, A., Strauss, G. P., Visser, K. H., & Mittal, V. A. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.01.055 · Cited by 54
Neuroprogression across the Early Course of Psychosis
Lewandowski, K. E., Sylvain Bouix, A., Öngür, D., & Shenton, M. E. (2020) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20200002 · Cited by 51
“The Clinical Assessment Interview for Negative Symptoms (CAINS): final development and validation.”
MethodGalatzer‐Levy, I. R., Abbas, A., Koesmahargyo, V., Yadav, V., Pérez-Rodríguez, M. M., Rosenfield, P., Patil, O., Dockendorf, M. F., Moyer, M., Shipley, L. A., et al. (2021) · JMIR Formative Research · doi:10.2196/26276 · Cited by 53
“Additionally, the PANSS has well-documented shortcomings as a measurement tool for negative symptoms, and future work should conduct correlations with additional scales such as the Clinical Assessment Interview for Negative Symptoms or the Brief Negative Symptom Scale [60-63].”
MethodReduced Neural Sensitivity to Social vs Nonsocial Reward in Schizophrenia
Lee, J., Jimenez, A. M., Reavis, E. A., Horan, W. P., Wynn, J. K., & Green, M. F. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sby109 · Cited by 54
Self-citationKhan, A., Liharska, L. E., Harvey, P. D., Atkins, A. S., Ulshen, D., & Keefe, R. S. E. (2017) · PubMed Central · Cited by 53
Abplanalp, S. J., BRAFF, D. L., Light, G. A., Nuechterlein, K. H., Green, M. F., Gur, R. C., Gur, R. E., Stone, W. S., Greenwood, T. A., Lazzeroni, L. C., et al. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.2386 · Cited by 55
Self-citationFervaha, G., Duncan, M., Foussias, G., Agid, O., Faulkner, G., & Remington, G. J. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.07.023 · Cited by 60
Negative symptoms, past and present: A historical perspective and moving to DSM-5
Malaspina, D., Walsh‐Messinger, J., Gäebel, W., Smith, L. M., Gorun, A., Prudent, V., Antonius, D., & Trémeau, F. (2013) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2013.10.018 · Cited by 52
“Since then, four new rating scales for negative symptoms have been published: the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013), the Brief Negative Symptom Scale (Strauss et al.”
BackgroundMethodInfluentialPainter, J. M., & Kring, A. M. (2016) · Journal of Abnormal Psychology · doi:10.1037/abn0000151 · Cited by 55
“Means on the CAINS MAP and EXP scales (see Table 1) were comparable with those in the CAINS validation sample (Kring et al., 2013).”
Self-citationImpaired introspective accuracy in schizophrenia: an independent predictor of functional outcomes
Silberstein, J., & Harvey, P. D. (2018) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2018.1549985 · Cited by 52
Bation, R., Magnin, C., Poulet, E., Mondino, M., & Brunelin, J. (2021) · Schizophrenia · doi:10.1038/s41537-021-00138-3 · Cited by 53
Dissecting negative symptoms in schizophrenia: Opportunities for translation into new treatments
Foussias, G., Siddiqui, I., Fervaha, G., Agid, O., & Remington, G. J. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114562092 · Cited by 55
“, 2011); and the Clinical Assessment Interview for Negative Symptoms (CAINS) (Kring et al., 2013).”
BackgroundInfluentialThe relationship between negative symptom subdomains and cognition
Lim, J., Lee, S.-A., Lam, M., Rapisarda, A., Kraus, M., Keefe, R. S. E., & Lee, J. (2016) · Psychological Medicine · doi:10.1017/s0033291716000726 · Cited by 53
“…domains, some studies found that DEE tended to be more strongly associated with cognition than social avolition (SA) (Liemburg et al. 2013; HartmannRiemer et al. 2015) while another study demonstrated no significant associations between negative symptom subdomains and cognition (Kring et al. 2013).”
ResultValidation of Turkish version of brief negative symptom scale
Nazlı, I. P., Ergül, C., Aydemır, Ö., Chandhoke, S., Üçok, A., & Gönül, A. S. (2016) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2016.1207086 · Cited by 51
“Both of these scales have strong inter-rater, test–retest reliability, validity and internal consistency (Kirkpatrick et al. 2011; Kring et al. 2013).”
BackgroundNegative symptoms in schizophrenia
Mahintamani, T., Mitra, S., Kavoor, A. R., & Nizamie, S. (2016) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_30_15 · Cited by 50
Garety, P. A., Edwards, C., Ward, T., Emsley, R., Huckvale, M. A., McCrone, P., Rus‐Calafell, M., Fornells‐Ambrojo, M., Gumley, A. I., Haddock, G., et al. (2021) · Trials · doi:10.1186/s13063-021-05301-w · Cited by 53
Rossell, S. L., Francis, P. S., Galletly, C. A., Harris, A. W. F., Siskind, D. J., Berk, M., Bozaoglu, K., Dark, F. L., Dean, O. M., Liu, D., et al. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-1030-3 · Cited by 49
“In the baseline assessment participants will be screened for the presence of negative symptoms with the PANSS and CAINS and only included in the study if they score PANSS >60 total or have at least two negative symptom items of >4.”
MethodInfluentialPredictors of current functioning and functional decline in schizophrenia
Joseph, J., Kremen, W. S., Franz, C. E., Glatt, S. J., van de Leemput, J., Chandler, S. D., Tsuang, M. T., & Twamley, E. W. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.01.038 · Cited by 51
“, 1990) and Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013)may better disentangle the relationships among patient perceptions, negative and depressive symptoms, and functioning.”
Vigor, Effort-Related Aspects of Motivation and Anhedonia
Treadway, M. T., & Salamone, J. D. (2022) · Current topics in behavioral neurosciences · doi:10.1007/7854_2022_355 · Cited by 50
Chan, R. C. K., eShi, C., Lui, S. S. Y., Ho, K. K. Y., Hung, K. S. Y., Lam, J. W. S., Wang, Y., Cheung, E. F. C., & Yu, X. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00007 · Cited by 46
“The Chinese version of the CAINS showed a consistent two-factor structure, namely the “expression” and the “motivation–pleasure” factors, with the original version (Kring et al., 2013) and the German version (Engel et al., 2014).”
BackgroundMethodInfluentialThe valuation of social rewards in schizophrenia.
Catalano, L. T., Heerey, E. A., & Gold, J. M. (2018) · Journal of Abnormal Psychology · doi:10.1037/abn0000366 · Cited by 47
“For the CAINS, we examined the motivation and pleasure (MAP) and expression (EXP) scales (Blanchard & Cohen, 2006; Horan et al., 2011).”
InfluentialSaleh, Y., Jarratt-Barnham, I., Petitet, P., Fernandez-Egea, E., Manohar, S. G., & Husain, M. (2023) · Molecular Psychiatry · doi:10.1038/s41380-023-02232-7 · Cited by 45
Pillny, M., Schlier, B., & Lincoln, T. M. (2020) · Schizophrenia Research · doi:10.1016/j.schres.2020.03.059 · Cited by 53
Savill, M., Orfanos, S., Reininghaus, U., Wykes, T., Bentall, R. P., & Priebe, S. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.06.017 · Cited by 47
“Although the scale can provide a single summary score, the authors recommend reporting the emotional experience and emotional expression subscales seperately given the evidence that they are measuring distinct constructs (Kring et al., 2013).”
BackgroundMethodDevoe, D. J. A., Braun, A., Seredynski, T., & Addington, J. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000273 · Cited by 49
Horan, W. P., Targum, S. D., Claxton, A., Kaul, I., Yohn, S. E., Marder, S. R., Miller, A., & Brannan, S. K. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.08.001 · Cited by 46
Self-citationThe power to resist: The relationship between power, stigma, and negative symptoms in schizophrenia
Campellone, T. R., Caponigro, J. M., & Kring, A. M. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.11.020 · Cited by 45
“…explained by two independent factors: motivation/ pleasure and emotional expressivity (Blanchard and Cohen, 2006; Foussias and Remington, 2010; Kring et al., 2013), Motivation/pleasure encompasses the engagement in and pleasure derived from goal-directed behavior across social, vocational,…”
BackgroundMethodSelf-citationChang, W. C., Kwong, V. W. Y., Hui, C. L. M., Chan, S. K. W., Lee, E. H. M., & Chen, E. Y. H. (2017) · Psychological Medicine · doi:10.1017/s0033291716003044 · Cited by 46
“Adoption of the recently developed negative symptom rating instruments that incorporate items to assess internal experience of motivation (Kirkpatrick et al. 2011; Kring et al. 2013) could minimize such measurement bias and the potential inflated associations.”
BackgroundDeRosse, P., Nitzburg, G. C., Blair, M., & Malhotra, A. K. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.10.018 · Cited by 47
“…demonstrated that negative symptoms can be separated into two broad dimensions: a motivational dimension consisting of avolition, anhedonia and asociality and an expressivity dimension consisting of blunted affect and alogia (Blanchard and Cohen, 2006; Kirkpatrick et al., 2006; Kring et al., 2013).”
The Prevalence of Negative Symptoms Across the Stages of the Psychosis Continuum
Sauvé, G., Brodeur, M. B., Shah, J. L., & Lepage, M. (2018) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000184 · Cited by 46
Parrish, E. M., Depp, C. A., Moore, R. C., Harvey, P. D., Mikhael, T., Holden, J. L., Swendsen, J. D., & Granholm, E. L. (2020) · Schizophrenia Research · doi:10.1016/j.schres.2020.10.002 · Cited by 46
Motivational Deficits and Negative Symptoms in Schizophrenia: Concepts and Assessments
Reddy, L. F., Horan, W. P., & Green, M. F. (2015) · Current topics in behavioral neurosciences · doi:10.1007/7854_2015_379 · Cited by 48
Self-citationHofmann, S. G., Fang, A., & Brager, D. N. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.05.039 · Cited by 44
“, 1989); for psychotic symptom outcomes— Clinical Assessment Interview for Negative Symptoms (Kring et al., 2013), Positive and Negative Syndrome Scale (Kay et al.”
BackgroundRetractedBehavioral approach and avoidance in schizophrenia: An evaluation of motivational profiles
Reddy, L. F., Green, M. F., Rizzo, S., Sugar, C. A., Blanchard, J. J., Gur, R. E., Kring, A. M., & Horan, W. P. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.07.047 · Cited by 53
“Participants were recruited at four sites as part of a larger study designed to validate a new negative symptom instrument (Kring et al., 2013).”
MethodSelf-citationDoes cannabidiol have a role in the treatment of schizophrenia?
Gururajan, A., & Malone, D. T. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.06.022 · Cited by 51
“Instead we propose that clinicians transition to using newer scales such as the Clinical Assessment for Negative Symptoms (CAINS) (Kring et al., 2013) and the Schizophrenia Cognition Rating Scale (SCoRS) (Keefe et al., 2006).”
Categorizing and assessing negative symptoms
Bucci, P., & Galderisi, S. (2017) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000322 · Cited by 45
Zheng, W., Zhu, X.-M., Zhang, Q.-E., Yang, X.-H., Cai, D.-B., Li, L., Li, X.-B., Ng, C. H., Ungvari, G. S., Ning, Y.-P., et al. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.12.007 · Cited by 45
Zhu, T., Wang, Z., Zhou, C., Fang, X., Huang, C., Xie, C., Ge, H., Zheng, Y., Zhang, X., & Chen, J. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.957685 · Cited by 47
Gur, R. E., March, M. E., Calkins, M. E., Weittenhiller, L. P., Wolf, D. H., Turetsky, B. I., & Gur, R. C. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.05.037 · Cited by 46
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript This pattern is consistent with results of the validation study in adults with chronic schizophrenia with scales tapping similar domains (Kring et al., 2013).”
BackgroundResultInfluentialSelf-citationBlanchard, J. J., Bradshaw, K., Garcia, C. P., Nasrallah, H. A., Harvey, P. D., Casey, D. E., Csoboth, C. T., Hudson, J. I., Julian, L. J., Lentz, E. L., et al. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.01.011 · Cited by 44
“However, our results are consistent with the findings of Kring et al. (2013), who did use a more stringent independent rater design to evaluate the CAINS.”
BackgroundMethodResultInfluentialSelf-citationLlerena, K., Reddy, L. F., & Kern, R. S. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.06.001 · Cited by 44
“This study was designed to examine whether participants' job obtainment status (workers vs. non-workers) differed on experiential and expressive negative symptoms, and to explore whether experiential and expressive negative symptoms were differentially related to work outcomes (weeksworked, hoursworked,wages earned) i…”
BackgroundInfluentialAlterations in facial expressivity in youth at clinical high-risk for psychosis.
Gupta, T., Haase, C. M., Strauss, G. P., Cohen, A. S., & Mittal, V. A. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000413 · Cited by 44
Progress in the Study of Negative Symptoms
Kirkpatrick, B. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbt158 · Cited by 43
Unseen Affective Faces Influence Person Perception Judgments in Schizophrenia
Kring, A. M., Siegel, E. H., & Barrett, L. F. (2014) · Clinical Psychological Science · doi:10.1177/2167702614536161 · Cited by 42
“We assessed affect-related symptoms using the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013), which assesses diminished motivation, anticipatory and consummatory pleasure across social, work, and recreational domains (Motivation and Pleasure Scale) as well as diminished outward express…”
Self-citationXie, D., Shi, H., Lui, S. S. Y., Shi, C., Li, Y., Ho, K. K. Y., Hung, K. S. Y., Li, W., Yi, Z., Cheung, E. F. C., et al. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sby013 · Cited by 43
Self-citationChang, W. C., Chu, A. O. K., Treadway, M. T., Strauss, G. P., Chan, S. K. W., Lee, E. H. M., Hui, C. L. M., Suen, Y. N., & Chen, E. Y. H. (2019) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2019.03.006 · Cited by 52
Amoretti, S., Verdolini, N., Mezquida, G., Rabelo‐da‐Ponte, F. D., Cuesta, M. J., Pina‐Camacho, L., Gómez-Ramiro, M., De‐la‐Cámara, C., González-Pinto, A. M., Díaz‐Caneja, C. M., et al. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.01.095 · Cited by 43
Martins, D., Paduraru, M., & Paloyelis, Y. (2021) · British Journal of Pharmacology · doi:10.1111/bph.15451 · Cited by 42
“…Symptoms (SAPS) (Minas et al., 1994)), negative symptoms (measured with the PANSS, Clinical Assessment Interview for Negative Symptoms (CAINS) (Kring et al., 2013) and Scale for Assessment of Negative Symptoms (SANS) (Andreasen, 1989)) and general symptoms (measured exclusively with the…”
MethodAn ecological examination of loneliness and social functioning in people with schizophrenia.
Culbreth, A. J., Barch, D. M., & Moran, E. K. (2021) · Journal of Abnormal Psychology · doi:10.1037/abn0000706 · Cited by 44
“…Assessment Interview for Negative Symptoms [CAINS] and the Brief Negative Symptom Scale [BNSS]) have furthered the conceptualization of asociality by separately assessing both social behavior, as well as interest and motivation for social interaction (Kirkpatrick et al., 2011; Kring et al., 2013).”
BackgroundMethodNarkhede, S. M., Luther, L., Raugh, I. M., Knippenberg, A. R., Esfahlani, F. Z., Sayama, H., Cohen, A. S., Kirkpatrick, B. W., & Strauss, G. P. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbab134 · Cited by 42
Psychosis superspectrum I: Nosology, etiology, and lifespan development
Jonas, K. G., Cannon, T. D., Docherty, A. R., Dwyer, D., Gur, R. C., Gur, R. E., Nelson, B., Reininghaus, U., & Kotov, R. (2024) · Molecular Psychiatry · doi:10.1038/s41380-023-02388-2 · Cited by 45
Self-citationEmotion Regulation Predicts Everyday Emotion Experience and Social Function in Schizophrenia
Moran, E. K., Culbreth, A. J., & Barch, D. M. (2017) · Clinical Psychological Science · doi:10.1177/2167702617738827 · Cited by 42
New Standards for Negative Symptom Assessment: Table 1.
Carpenter, W. T., Blanchard, J. J., & Kirkpatrick, B. W. (2015) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv160 · Cited by 42
Self-citationStiekema, A. P. M., Liemburg, E. J., van der Meer, L., Castelein, S., Stewart, R. E., van Weeghel, J., Aleman, A., & Bruggeman, R. (2016) · PLoS ONE · doi:10.1371/journal.pone.0149785 · Cited by 41
“Efforts have been made in developing scales which reliably measure both subdomains of negative symptoms [56,57].”
BackgroundValidation of accelerometry as a digital phenotyping measure of negative symptoms in schizophrenia
Strauss, G. P., Raugh, I. M., Zhang, L., Luther, L., Chapman, H. C., Allen, D. N., Kirkpatrick, B. W., & Cohen, A. S. (2022) · Schizophrenia · doi:10.1038/s41537-022-00241-z · Cited by 48
What gets in the way of social engagement in schizophrenia?
Weittenhiller, L. P., Mikhail, M. E., Mote, J., Campellone, T. R., & Kring, A. M. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i1.13 · Cited by 45
Self-citationŠagud, M., Madžarac, Z., Erjavec, G. N., Filipčić, I. Š., Mikulić, F. L., Rogić, D., Bradaš, Z., Janović, M. B., & Pivac, N. (2023) · Biomolecules · doi:10.3390/biom13020297 · Cited by 46
“In fact, the relationship between motivational CAINS items and real-world functioning was previously observed in SCZ [67] and a negative association was demonstrated between motivational, but not expressive dimension, and functional outcome [68], and lower CAINS social factor scores were associated with a higher likel…”
MethodInfluentialFulford, D., Piškulić, D., Addington, J., Kane, J. M., Schooler, N. R., & Mueser, K. T. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx096 · Cited by 44
Sabé, M., Zhao, N., Crippa, A., Strauss, G. P., & Kaiser, S. (2021) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyab020 · Cited by 41
Demyttenaere, K., Leenaerts, N., Acsai, K., Sebe, B., Laszlovszky, I., Barabássy, Á., Fonticoli, L., Szatmári, B., Earley, W. R., Németh, G., et al. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.2241 · Cited by 43
“A recommendation was given to develop new rating scales for the assessment of negative symptoms, which led to the development of the Brief Negative Symptom Scale (BNSS) [15] and the Clinical Assessment Interview for Negative Symptoms (CAINS) [16], leading to a consensus on which symptoms are negative symptoms: avoliti…”
BackgroundHu, H., Lau, W. Y. S., Eugenia, P., Hung, K. S. Y., Chen, S.-Y., Cheng, K., Cheung, E. F. C., Lui, S. S. Y., & Chan, R. C. K. (2022) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac017 · Cited by 40
Granholm, E. L., Holden, J. L., Dwyer, K., Mikhael, T., Link, P. C., & Depp, C. A. (2020) · JMIR Mental Health · doi:10.2196/24406 · Cited by 40
“The CAINS-MAP [5] subscale was the primary negative symptom outcome measure.”
BackgroundMethodInfluentialSiegrist, K., Millier, A., Amri, I., Aballéa, S., & Toumi, M. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.11.039 · Cited by 41
“The research question was defined as follows: “is social contact an element in the presumed vicious circle, associated with more negative symptoms and particularly more emotional withdrawal, and with deterioration of psychosocial functioning and quality of life?” As there is no real therapeutic option today (Buchanan,…”
Blanchard, J. J., Andrea, A. M., Orth, R. D., Savage, C. L. G., & Bennett, M. E. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112857 · Cited by 38
Self-citationCella, M., Tomlin, P., Robotham, D., Green, P. A., Griffiths, H., Stahl, D. R., & Valmaggia, L. (2022) · Schizophrenia Research · doi:10.1016/j.schres.2022.07.013 · Cited by 38
Galderisi, S., Färden, A., & Kaiser, S. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.04.046 · Cited by 38
Mote, J., Gard, D. E., Gonzalez, R., & Fulford, D. (2019) · PLoS ONE · doi:10.1371/journal.pone.0223003 · Cited by 38
Brain Structural Signatures of Negative Symptoms in Depression and Schizophrenia
Chuang, J.-Y., Murray, G. K., Metastasio, A., Segarra, N., Tait, R. J., Spencer, J., Ziauddeen, H., Dudas, R. B., Fletcher, P. C., & Suckling, J. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00116 · Cited by 38
“Interestingly, structural analysis of all the items in the CAINS revealed two major elements of negative symptoms similar to our findings, termed by the CAINS researchers as “expression,” a measure of behavioral, social, and emotional expression, and “motivation and pleasure” (3).”
BackgroundResultTest–Retest Reliability of Common Measures of Eating Disorder Symptoms in Men Versus Women
Forbush, K. T., Hilderbrand, L. A., Bohrer, B. K., & Chapa, D. A. N. (2017) · Assessment · doi:10.1177/1073191117700267 · Cited by 37
Anticipated pleasure for positive and negative social interaction outcomes in schizophrenia
Campellone, T. R., & Kring, A. M. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.084 · Cited by 39
“Given that the CAINS is a newer assessment instrument, we compared the scores for each CAINS subscale to those from the validation paper that contained a large, diverse, and representative sample of people with schizophrenia (n = 162; Kring et al., 2013).”
MethodInfluentialSelf-citationMeasurement of negative and depressive symptoms: Discriminatory relevance of affect and expression
Richter, J., Hölz, L., Hesse, K., Wildgruber, D., & Klingberg, S. (2018) · European Psychiatry · doi:10.1016/j.eurpsy.2018.09.008 · Cited by 37
“Convergent and discriminant validity (also to depressive symptoms) was established [19].”
BackgroundSocial Motivation in Schizophrenia: What’s Effort Got to Do With It?
Catalano, L. T., & Green, M. F. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad090 · Cited by 35
McCleery, A., Mathalon, D. H., Wynn, J. K., Roach, B. J., Hellemann, G. S., Marder, S. R., & Green, M. F. (2019) · Psychological Medicine · doi:10.1017/s0033291718004087 · Cited by 35
“Each rater achieved a median intraclass correlation coefficient (ICC) of 0.80 or higher across all BPRS, CAINS, and RFS.”
MethodInfluentialEngel, M., & Lincoln, T. M. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.11.001 · Cited by 34
“The validity and reliability of the German version of the CAINS [3] were comparable to the original version of the CAINS [6].”
MethodResultInfluential
Metadata
- Authors
- Kring, A. M., Gur, R. E., Blanchard, J. J., Horan, W. P., & Reise, S. P.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Psychiatry
- Published
- 2013-02
- Volume
- 170
- Issue
- 2
- Pages
- 165-172
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3785242
- OpenAlex
- W2131925003
- Cited by
- 726
- References
- 43
- Citations by year
- 2026: 55 · 2025: 55 · 2024: 51 · 2023: 62 · 2022: 62 · 2021: 48 · 2020: 70 · 2019: 51 · 2018: 61 · 2017: 46 · 2016: 52 · 2015: 51 · 2014: 37 · 2013: 24
- FWCI
- 38.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01mh082782-03, 5r01mh082890-03)
- National Institute of Mental Health (1R01MH082890, R01-MH082890, R01-MH082782, R01MH082839, R01MH082783, 1R01MH082782)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- negative symptoms, schizophrenia, schizoaffective disorder, motivation, pleasure, emotional expression, interview assessment, psychometric validation, factor structure, convergent validity, discriminant validity, vocational functioning, independent living, social functioning
- MeSH terms
- Adult, Female, Humans, Interview, Psychological, Male, Middle Aged, Motivation, Outpatients, Psychiatric Status Rating Scales, Psychological Tests, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Social Behavior, Socioeconomic Factors, Volition, Reproducibility of Results, Expressed Emotion, Diagnostic and Statistical Manual of Mental Disorders, Pleasure, Anhedonia
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