Cited by 726Schizophrenia research and treatmentPsychological Testing and AssessmentMental Health and Psychiatry

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The Clinical Assessment Interview for Negative Symptoms (CAINS): Final Development and Validation

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Kring, Ann M., Gur, Raquel E., Blanchard, Jack J., Horan, William P., Reise, Steven P.·2013·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2012.12010109PMC PMC3785242

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Abstract

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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“The development and validation of specialized instruments, such as the Clinical Assessment Interview for Negative Symptoms (CAINS) and the Brief Negative Symptom Scale (BNSS), represent important steps forward [45,46].”
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“Although the scale has previously been shown to yield good psychometric properties in ARMS sample (please also refer to Clinical Assessment Interview for Negative Symptoms, CAINS, which has recently been studied in ARMS sample) (Kring et al., 2013; Gur et al., 2015), itmaynot be optimal to adequately capture the subtl…”
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“Third, although the present study examined the PQ-N in relation to the TEPS and GCOS-CP, we did not examine the PQ-N in relation to other well-supported negative symptom scales or interviews, such as the CAINS (Kring et al., 2013); thus, it is possible the PQ-N would have higher convergent validity with other measures…”
BackgroundMethodResultInfluential
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BackgroundInfluential
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“The CAINS is a semi-structured interview, mainly performed by RB in this study, and a rating scale with items ranging from 0 (none) to 4 (severe), assessing motivation and pleasure (based on patient report), and emotional expression (based on observation of the patient during the interview) [34].”
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Self-citation
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InfluentialSelf-citation
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“For example, the measure of motivation with the largest correlation in both studies (MAP from the CAINS) asked about the frequency of pleasurable activities in the previous week, similar to some items from the community integration questionnaires.”
MethodInfluentialSelf-citation
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“33 We used the Peters Delusion Inventory (PDI) and General Conspiracists Belief (GCB) scale to evaluate unusual beliefs.”
Method
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Chang, W. C., Liu, J. T. T., Hui, C. L. M., Chan, S. K. W., Lee, E. H. M., Suen, Y. N., & Chen, E. Y. H. (2018) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-018-0918-y · Cited by 10
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Background
Revisiting the persistent negative symptoms proxy score using the Clinical Assessment Interview for Negative Symptoms
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“The CAINS offers an alternative means in identifying PNS patients in clinical trials that overcomes methodological and conceptual limitations of older scales.”
BackgroundMethodInfluential
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“…into negative symptoms is mostly based on standardized instruments – like the Scale for the Assessment of Negative Symptoms (SANS; Andreasen, 1989), Brief Negative Symptom Scale (BNSS; Kirkpatrick et al., 2010) or the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013).”
Method
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BackgroundMethod
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Self-citation
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“…symptoms (Kirkpatrick et al., 2006), new ‘sec-ond-generation ’ clinical assessment tools have been developed, with the most commonly used scales being the Brief Negative Symptom Scale (BNSS) (Kirkpatrick et al., 2011) and the Clinical Assessment Interview for Negative Symptoms (Kring et al., 2013).”
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“Moreover, the present study and a previous study 36 found that the MPSR was correlated with BAS, not BIS.”
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“As discussed elsewhere, it appears that the heterogeneity of apathy in terms of prognosis and causal factors has not received adequate and systematic attention [16] despite the development of new tools such as the Clinical Assessment Interview for Negative Symptoms (CAINS; [17]) and the Brief Negative Syndrome Scale (…”
Method
Negative Symptoms and Their Assessment in Schizophrenia and Related Disorders
Blanchard, J. J., Shan, L., Andrea, A. M., Savage, C. L. G., Kring, A. M., & Weittenhiller, L. P. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815012-2.00007-9 · Cited by 8
Self-citation
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“Raters coded social skill components across 4 domains using a 5-point Likert scale ranging from 1 (“very poor”) to 5 (“very good”): (1) Verbal/Conversational domain includes ratings of clarity, spontaneous conversation, positive valence, negative valence, and number of questions asked and word count assessed by totals…”
MethodSelf-citation
The interrelationships of motivation, positive symptoms, stigma, and role functioning in early psychosis
DeTore, N. R., Balogun‐Mwangi, O., Tepper, M. C., Cather, C., Russinova, Z. L., Lanca, M., & Mueser, K. T. (2021) · Early Intervention in Psychiatry · doi:10.1111/eip.13213 · Cited by 10
“There are several limitations to this study, namely the small sample size, and the exclusion of a more comprehensive negative symptom assessment such as the SANS (Andreasen, 1989) or the clinical assessment interview for negative symptoms (Kring et al., 2013).”
Background
Determinants of Clinical Recovery in Schizophrenia
Giordano, G. M., Galderisi, S., Pezzella, P., Perrottelli, A., & Bucci, P. (2022) · Comprehensive approach to psychiatry · doi:10.1007/978-3-030-98301-7_2 · Cited by 8
Do the negative symptoms of schizophrenia reflect reduced responsiveness to reward? Examination using a reward prediction error (RPE) task
Fuentes‐Claramonte, P., García‐León, M. Á., Salgado‐Pineda, P., Ramiro, N., Soler‐Vidal, J., Torres, M. L., Cano, R., Argila‐Plaza, I., Panicali, F., Sarri, C., et al. (2023) · Psychological Medicine · doi:10.1017/s0033291723000521 · Cited by 8
“Scores on individual CAINS items are summed to give an overall score, and also yield two subscale scores: motivation and pleasure Psychological Medicine (CAINS-MAP, 9 items) focuses on lack of motivation and anhe-donia, whereas expressivity (CAINS-EXP, 4 items) rates lack of facial expression and expressive gestures,…”
Method
Using video-annotation software to identify interactions in group therapies for schizophrenia: assessing reliability and associations with outcomes
Orfanos, S., Akther, S., Basit, M. A., McCabe, R., & Priebe, S. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1217-2 · Cited by 7
“Background Negative symptoms of schizophrenia are categorized along two dimensions: a reduction in expression, including lack of speech (alogia) and reduced facial expression (blunt affect); and a deficit in experiencing motivation (asociality) and pleasure (anhedonia) [1, 2].”
BackgroundInfluential
Chemosensory Anhedonia in Patients With Schizophrenia and Individuals With Schizotypy: A Questionnaire Study
Li, Z.-L., Huang, G., Li, Z., Li, S., Wang, Y.-L., Zhao, J., Wen, J., Hummel, T. R., & Zou, L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00481 · Cited by 8
“In future studies, the SANS or CAINS should be used to measure the negative symptoms of schizophrenia in more details.”
Background
Analyzing Generative AI and Machine Learning in Auto-Assessing Schizophrenia’s Negative Symptoms
Liu, C., Chan, Y.-H., Ho, M.-Y., Liu, C., Lu, M., Liao, Y.-A., Hsieh, M. H., & Tseng, Y. J. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf102 · Cited by 7
Modifiable predictors of self-reported and performance-based functioning in individuals with schizophrenia-spectrum disorders and high levels of negative symptoms
Mahmood, Z., Parrish, E. M., Keller, A. V., Lykins, H. C., Pickell, D., Granholm, E. L., & Twamley, E. W. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.04.039 · Cited by 7
The Therapeutic Role of Intermittent Theta Burst Stimulation in Schizophrenia
Salabat, D., Pourebrahimi, A., Mayeli, M., & Cattarinussi, G. (2024) · Journal of Ect · doi:10.1097/yct.0000000000000972 · Cited by 7
Decoding Early Psychoses: Unraveling Stable Microstructural Features Associated With Psychopathology Across Independent Cohorts
Wang, H. R., Liu, Z.-Q., Nakua, H., Hegarty, C. E., Thies, M. B., Patel, P. K., Schleifer, C. H., Boeck, T. P., McKinney, R. A., Currin, D. L., et al. (2024) · Biological Psychiatry · doi:10.1016/j.biopsych.2024.06.011 · Cited by 9
“Both HCP-EP and MEND cohorts revealed a number of negative symptoms that correlated with the neural signature within the dimension of diminished emotion expression (EXP) (35,36).”
Blunted Ventral Striatal Reactivity to Social Reward Is Associated with More Severe Motivation and Pleasure Deficits in Psychosis
Shackman, A. J., Smith, J. F., Orth, R. D., Savage, C. L. G., Didier, P. R., McCarthy, J. M., Bennett, M. E., & Blanchard, J. J. (2024) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae221 · Cited by 7
Self-citation
Negative Symptoms of Schizophrenia: Constructs, Burden, and Management
Barabássy, Á., Szatmári, B., Laszlovszky, I., & Németh, G. (2018) · InTech eBooks · doi:10.5772/intechopen.73300 · Cited by 7
“Asociality should not be defined in purely behavioral terms (whether the subject has social interactions and close relationships), but mainly as a reduction in motivation for social contacts (whether the subject values and desires social interactions and close social bonds) [7, 8]”
Background
Expanding the positivity offset theory of anhedonia to the psychosis continuum
Riehle, M., Pillny, M., & Lincoln, T. M. (2022) · Schizophrenia · doi:10.1038/s41537-022-00251-x · Cited by 7
Negative Symptom Domains in Children and Adolescents at Ultra-High Risk for Psychosis: Association With Real-Life Functioning
Giordano, G. M., Palumbo, D., Pontillo, M., Mucci, A., Galderisi, S., & Vicari, S. (2022) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgac025 · Cited by 7
Alpha Event-Related Desynchronization During Reward Processing in Schizophrenia
Fryer, S. L., Marton, T. F., Roach, B. J., Holroyd, C. B., Abram, S. V., Lau, K. J., Ford, J. M., McQuaid, J. R., & Mathalon, D. H. (2023) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2022.12.015 · Cited by 9
Childhood trauma and real-world social experiences in psychosis
Steenkamp, L. R., Parrish, E. M., Chalker, S. A., Badal, V. D., Pinkham, A. E., Harvey, P. D., & Depp, C. A. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2022.12.039 · Cited by 7
Evaluation of a new intrinsic and extrinsic motivation scale in youth with psychosis spectrum symptoms
Didier, P. R., Moore, T. M., Calkins, M. E., Prettyman, G. E., Levinson, T. G., Savage, C., Leme, L. F. V. D. M., Kohler, C. G., Kable, J. W., Satterthwaite, T. D., et al. (2023) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2023.152413 · Cited by 7
“To assess our scale’s utility with respect to understanding clinical amotivation, participants completed the interviewer-rated Clinical Assessment Interview for Negative Symptoms (CAINS) [79,80] with an interviewer blind to self-report results.”
MethodSelf-citation
The longitudinal course of schizophrenia: testosterone and progression of the negative symptoms
Sisek-Šprem, M., Gradiški, I. P., Žaja, N., & Herceg, M. (2019) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2019.1681509 · Cited by 7
“We did not used a specific scale to assess the negative symptoms, such as Brief Negative Symptoms Scale (BNSS) [62] or the Clinical ASSessment Interview for Negative Symptoms (CAINS) [63] nor the scale for severity of the illness, such as the Clinical Global Impressions scale (CGI) [64].”
Method
Retention of Value Representations Across Time in People With Schizophrenia and Healthy Control Subjects
Culbreth, A. J., Waltz, J. A., Frank, M. J., & Gold, J. M. (2020) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2020.05.009 · Cited by 7
Factorial Structure of the Serbian Version of the Clinical Assessment Interview for Negative Symptoms – Evidence for Three Factors of Negative Symptoms
Ristić, I., Jerotić, S., Zebić, M., Savić, B., Vuković, V., Russo, M., Voskresenski, T., Jovanović, N., & Marić, N. P. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.570356 · Cited by 7
“Instruments of Measurement The CAINS is a 13-item interview that is used to assess the presence and severity of negative symptoms (Kring et al., 2013).”
BackgroundMethod
Defining negative symptoms remission in schizophrenia using the Brief Negative Symptom Scale
Rekhi, G., Ang, M. S., Chan, Y. H., Fernández-Egea, E., Kirkpatrick, B. W., & Lee, J. (2021) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2021.05.003 · Cited by 7
Implementing a psychosocial intervention DIALOG+ for patients with psychotic disorders in low and middle income countries in South Eastern Europe: protocol for a hybrid effectiveness-implementation cluster randomized clinical trial (IMPULSE)
Jovanović, N., Francis, J., Marić, N. P., Arënliu, A., Bajraktarov, S., Kulenović, A. D., Stevović, L. I., Feng, Y., & Novotni, A. (2020) · GLOBAL PSYCHIATRY ARCHIVES · doi:10.52095/gpa.2020.1319 · Cited by 7
Validación española de la escala de evaluación de los síntomas negativos-16 (NSA-16) en pacientes con esquizofrenia
García-Álvarez, L., García‐Portilla, M. P., Sáiz, P. A., Fonseca‐Pedrero, E., Bobes-Bascarán, T., Gomar, J. J., Muñiz, J., & Bobes, J. (2018) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2018.03.001 · Cited by 7
Rationale and Challenges for a New Instrument for Remote Measurement of Negative Symptoms
Daniel, D. G., Cohen, A. S., Harvey, P. D., Velligan, D. I., Potter, W. Z., Horan, W. P., Moore, R. C., & Marder, S. R. (2024) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgae027 · Cited by 6
“11,14,39,40 Ratings are based upon the report of the patient and often collateral information from an informant.”
BackgroundSelf-citation
Systematic Review of Self-Assessment Scales for Negative Symptoms in Schizophrenia
Métivier, L., & Dollfus, S. (2025) · Brain Sciences · doi:10.3390/brainsci15020148 · Cited by 6
“…hetero-evaluation tools, such as the Brief Negative Syndrome Scale (BNSS) [16] or the Clinical Assessment Interview for Negative Symptoms (CAINS) [17], with self-assessment scales, such as the Self-evaluation of Negative Symptoms (SNS) [18] or the Motivation And Pleasure-Self Report (MAP-SR)…”
Motivation and Pleasure Domain Links to Social Function in College Students: A Network Analysis
Hu, H., Wang, L., Zhang, Y., Yang, H., Wang, Y., Wang, Y., Lui, S. S. Y., & Chan, R. C. K. (2025) · PsyCh Journal · doi:10.1002/pchj.70001 · Cited by 5
AVATAR Virtual Reality Social therapy (AVATAR_VRSocial) for distressing voices and their interference in social everyday life in early psychosis: protocol of a single-blind parallel group randomised controlled feasibility study
Rus‐Calafell, M., Luker, M., Marzinzik, M., Nguyen, P.-M., Schneider, S., Teismann, T., Ehrbar, N., Tas, E., Zhang, X. C., Edwards, C., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-098004 · Cited by 6
Cerebellar–Basal Ganglia Dysconnectivity in Schizophrenia: Insights into Motivational Deficits
Wang, X., Guo, X., Cai, X., Huang, B., Wang, Y., Pu, C., Yu, X., Lui, S. S. Y., & Chan, R. C. K. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf087 · Cited by 7
“Amotivation and anhedonia constitute the motivation dimension of SCZ’s negative symptoms, 1,2 which exacerbates SCZ-associated cognitive impairments, 3 leads to poor prognosis 4 and hinders functional recovery.”
Anhedonia and Negative Symptoms in First-Episode Psychosis: A Systematic Review and Meta-Analysis of Prevalence, Mechanisms, and Clinical Implications
Ricci, V., Sarni, A., Barresi, M., Remondino, L., & Maina, G. (2025) · Healthcare · doi:10.3390/healthcare13151796 · Cited by 6
“…approaches has further refined this taxonomy, with the development of next-generation assessment instruments such as the Brief Negative Symptom Scale (BNSS) and Clinical Assessment Interview for Negative Symptoms (CAINS) providing enhanced precision in measuring these constructs [9,10].”
Negative symptoms and resting-state functional connectivity across psychotic and mood disorders: A systematic literature review
Dalloul, N., van Huijgevoort, C., Belmont, J., & Barch, D. M. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106385 · Cited by 8
“Some newer methods, such as the Clinical Assessment Interview for Negative Symptoms (CAINS; Kring et al., 2013) include this categorization in their summary scores.”
Unchanged Cognitive Performance and Concurrent Prefrontal Blood Oxygenation After Accelerated Intermittent Theta-Burst Stimulation in Depression: A Sham-Controlled Study
Struckmann, W., Persson, J., Gingnell, M., Weigl, W., Wass, C., & Bodén, R. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.659571 · Cited by 6
Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: differences between males and females
Serra‐Navarro, M., Amoretti, S., Verdolini, N., Forte, M. F., Sánchez-Torres, A. M., Vieta, E., Clougher, D., Lobo, A., González-Pinto, A., Panadero, R., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.982583 · Cited by 6
“Future studies making use of newer and improved negative symptom scales — such as the Brief Negative Symptom Scale (BNSS) (79) or the Clinical Assessment Interview for Negative Symptoms (CAINS) (80) — may be more appropriate for their evaluation.”
Psychometric properties of the Fatigue Catastrophizing Scale in a general population and its clinical utility in schizophrenia and breast cancer patients
Laraki, Y., Merenciano, M., Michel, A., Lebrun, C., Capdevielle, D., & Raffard, S. (2023) · Fatigue Biomedicine Health & Behavior · doi:10.1080/21641846.2023.2293383 · Cited by 7
Emotional Contagion and Emotional Mimicry in Individuals with Schizophrenia: A Systematic Review
Parisi, M., Marín, L., Fauviaux, T., Aigoin, E., & Raffard, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13175296 · Cited by 7
“…is crucial that studies also test the association between both emotional contagion and emotional mimicry and more specific measures of positive and negative symptoms, such as the Revised Paranoid Thoughts Scale (R-GPTS) [97] and the Clinical Assessment Interview for Negative Symptoms (CAINS) [98].”
Background
Relationship between symptoms and family relationships in Veterans with serious mental illness
Haselden, M., Piscitelli, S., Drapalski, A. L., Medoff, D. R., Glynn, S. M., Cohen, A. N., & Dixon, L. B. (2016) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2015.08.0158 · Cited by 6
Reprint of: A review of negative symptom assessment strategies in youth at clinical high-risk for psychosis
Strauss, G. P., Pelletier‐Baldelli, A., Visser, K. F., Walker, E. F., & Mittal, V. A. (2021) · Schizophrenia Research · doi:10.1016/j.schres.2021.01.001 · Cited by 6
Anhedonia Relates to the Altered Global and Local Grey Matter Network Properties in Schizophrenia
Kim, B.-H., Kim, H. E., Lee, J. S., & Kim, J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10071395 · Cited by 6
“There is a possibility that these scales could not capture an aspect of anhedonia related to anticipatory reward as sensitively as the clinical assessment interview for negative symptoms (CAINS) [69].”
Validation of the French Clinical Assessment Interview for Negative Symptoms in a Sample of Stable French Individuals With Schizophrenia
Laraki, Y., Lebrun, C., Merenciano, M., Eisenblaetter, M., Attal, J., Macgregor, A., Décombe, A., Capdevielle, D., & Raffard, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.836600 · Cited by 6
The Impact of Antipsychotic Treatment on Neurological Soft Signs in Patients with Predominantly Negative Symptoms of Schizophrenia
Petrescu, C., Papacocea, I. R., Vîlciu, C., Mihalache, O. A., Vlad, D. M., Marian, G., Focseneanu, B. E., Sima, C. T., Ciobanu, C. A., Riga, S., et al. (2022) · Biomedicines · doi:10.3390/biomedicines10112939 · Cited by 7
“With the emergence of new scales for the analysis of negative symptoms, such as The Clinical Assessment Interview for Negative Symptoms (CAINS) and The Brief Negative Symptom Scale (BNSS) [95,96], we consider it appropriate to use them in future studies that exclusively target negative symptoms in schizophrenia.”
Method
Understanding and treating amotivation in people with psychosis: An experimental study of the role of guided imagery
Cox, C. I. A., Jolley, S., & Johns, L. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.09.047 · Cited by 8
“Negative symptoms were assessed using the SANS, which has attracted some criticism, and replicating findings using scales specifically designed to overcome the shortcomings of the SANS (e.g. the Brief Negative Symptom Scale (Kirkpatrick et al., 2011; or the Clinical Assessment Interview for Negative Symptoms (Kring et…”
ResultInfluential
Validation of the Chinese Version of the 16-Item Negative Symptom Assessment
Huang, B., Wang, Y., Miao, Q., Yu, X., Pu, C., & Shi, C. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s251182 · Cited by 6
Increasing motivation in effort-based decision-making tasks: effects of salience and reward expectancy manipulations
Renz, K. E., Pillny, M., & Lincoln, T. M. (2022) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2021.2007068 · Cited by 7
“The MAP-SR includes 15 items in self-report format derived from the Clinical Assessment Interview for Negative Symptoms motivation and pleasure scale (Kring et al., 2013).”
Method
Validating a Behavioral Health Instrument for Adults: Exploratory Factor Analysis
Walton, B. A., & Kim, H. (2018) · Journal of Social Service Research · doi:10.1080/01488376.2018.1442897 · Cited by 6
Grant Report on Social Reward Learning in Schizophrenia
Butler, P. D., Hoptman, M. J., Smith, D. V., Ermel, J. A., Calderone, D., Lee, S. H., & Barch, D. M. (2020) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20200004 · Cited by 6
“The Clinical Assessment Interview for Negative Symptoms (CAINS): final development and validation.”
MethodInfluential
Pupillary responses as a biomarker of cognitive effort and the impact of task difficulty on reward processing in schizophrenia
Bismark, A. W., Mikhael, T., Mitchell, K. R., Holden, J. L., & Granholm, E. L. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.03.025 · Cited by 5
Effectiveness, Engagement, and Safety of a Digital Therapeutic (CT-155/BI 3972080) for Treating Negative Symptoms in People With Schizophrenia: Protocol for the Phase 3 CONVOKE Randomized Controlled Trial
Lakhan, S. E., Dorner‐Ciossek, C., Besedina, O., Dickerson, F., Hastedt, C., Isla, R., Kahn, R. S., Lindenmayer, J., Mehta, R., Snipes, C., et al. (2025) · JMIR Research Protocols · doi:10.2196/81293 · Cited by 6
“CAINS is a second-generation negative symptoms scale that was developed to reflect updated conceptualizations of negative symptoms, as recommended by the National Institute of Mental Health and the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative [99,100].”
Influential
Cognitive effort in Schizophrenia: Dissimilar effects on cardiovascular activity and subjective effort
Décombe, A., Brinkmann, K., Merenciano, M., Capdevielle, D., Gendolla, G. H. E., & Raffard, S. (2022) · Current Psychology · doi:10.1007/s12144-022-03145-4 · Cited by 5
Are effort‐based decision‐making tasks worth the effort?—A study on the associations between effort‐based decision‐making tasks and self‐report measures
Renz, K. E., Schlier, B., & Lincoln, T. M. (2022) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1943 · Cited by 5
“The MAP‐SR consists of 15 items adapted from the Clinical Assessment Interview for Negative Symptoms (Kring et al., 2013).”
Method
A transdiagnostic approach of negative symptoms in psychiatric disorders: replication of a two-factor structure in major depressive disorder and bipolar disorder
Li, S., Zhang, J., Liu, C., Wang, L.-L., Hu, H., Chu, M., Wang, Y., Lv, Q., Lui, S. S. Y., Yi, Z., et al. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01934-5 · Cited by 5
“…structure of negative symptoms of SCZ has inconsistent results, such as two-factor, three-factor and five-factor structures [ 28, 38, 39, 67], it seems more evidence favors the two-factor model comprising the MAP and the EXP dimensions, and this model is relatively stable [ 6, 32, 33, 37, 44, 46 ].”
Influential
Combining cognitive behavioral therapy and group training for social skills and cognition to improve negative symptoms in patients with psychotic disorders: a randomized controlled pilot trial
Wildgruber, D., Hesse, K., Eckstein, K. N., Richter, J., Eberle, M.-C., Kreifelts, B., Hawlik, L., Martus, P., Erb, M., & Klingberg, S. (2025) · Schizophrenia Research · doi:10.1016/j.schres.2025.05.030 · Cited by 6
“…(T0) and after the 8-month intervention (T1) comprised measures of psychopathology (PANSS (Kay et al., 1987; Shafer and Dazzi, 2019), CAINS (Kring et al., 2023; Richter et al., 2019b), TEPS (Gard et al., 2006), CDSS (Müller et al., 1999)), social skills (SSPA (Patterson et al., 2001)),…”
Influential

Authors: Kring, A. M., Gur, R. E., Blanchard, J. J., Horan, W. P., & Reise, S. P.
Affiliations: University of California, Los Angeles (US)
ORCID: Kring, Ann M.
Gur, Raquel E.
Blanchard, Jack J.
Horan, William P.
Reise, Steven P.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2013-02
Volume: 170
Issue: 2
Pages: 165-172
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2012.12010109
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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The Clinical Assessment Interview for Negative Symptoms (CAINS): Final Development and Validation

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