Elsevier

Comprehensive Psychiatry

Volume 44, Issue 3, May–June 2003, Pages 220-226
Comprehensive Psychiatry

The brief symptom inventory and the positive and negative syndrome scale: discriminate validity between a self-reported and observational measure of psychopathology

https://doi.org/10.1016/S0010-440X(03)00010-5Get rights and content

Abstract

Concern within the literature has emerged from time to time arguing the poor validity of self-reported measures in psychopathology, namely, the reporting of psychotic experience. Although it is commonly believed that patients who have had a psychotic episode cannot accurately self-report their experience, very few studies have been conducted to measure the concordance between self-reported and observational measures of psychopathology using multivariate statistical techniques. Sixty-nine patients presenting their first psychotic episode were interviewed and assessed on the Positive and Negative Syndrome Scale (PANSS) and were asked to complete the Brief Symptom Inventory (BSI). By clustering symptom dimensions from the BSI into discriminate functions, the research demonstrated that these symptom dimensions could adequately classify high versus low scores on the PANSS subscales and total score. When the same clusters were entered into multivariate analysis of variance (MANOVA) models, they also demonstrated significant differences between high versus low observed symptomatology on the PANSS Positive and General Subscale Groups and Total Score Groups. The current findings shed some doubt on the supposition that those who experience psychosis are unable to report symptom dimensions that concord with those who observe the psychosis. It appears that models, operational definitions, and the language used in measuring psychopathology may differ significantly from those who experience the psychotic experience and those who observe it. Techniques such as multitrait multimethod are discussed as ways of overcoming these concerns.

Section snippets

Patients

Patients were recruited from two early psychosis intervention programs in the southern metropolitan region of Perth Western Australia. DSM-IIIR diagnosis was generated by a psychiatrist using OPCRIT.23 Data for the diagnosis were obtained by a combination of clinical interview and review of case notes.

The BSI and PANSS scores consisted of the initial assessment interviews conducted within 4 to 6 weeks of patients entering treatment in the early psychosis programs. In order for psychopathology

Results

Of the 69 interviews conducted 61% of the PANSS interviews and BSI forms were completed on the same day while the remainder were completed within 7 days of each other.

Discussion

Symptom dimensions from the BSI where entered into multivariate symptom clusters to explain high versus low scores on subscales from the PANSS. As individual variables they only described moderate discriminate power; however, when analyzed in combination with each other the symptom dimensions were able to demonstrate considerable power to classify high versus low scores on their respective PANSS subscale groups. This is noted particularly for symptom dimensions that describe the positive

Acknowledgements

The authors wish to acknowledge the valuable contribution of clinicians from the First Psychosis Liaison Unit, Bentley Mental Health Service, and the Rockingham/Kwinana Early Psychosis System of Care Service to this research project. Acknowledgment is also given to Dr. Peter Sevastos, Curtin University of Technology, Western Australia, for his advice on the statistical analysis.

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