FACTORS CONTRIBUTING TO THE CONSISTENCY OF SELF AND INTERVIEWER REPORT OF NEGATIVE SYMPTOMS

Abstract

Negative symptoms emerge early in the course of psychosis and are one of the best indicators of clinical outcomes; thus, the accurate, identification of these symptoms is paramount to early intervention efforts. Negative symptoms are typically assessed via self-report questionnaire or interviewer rated semi-structured interviews. However, the degree of concordance between self and interviewer report has been demonstrated to be low, approximately 50%. Therefore, it is important to identify the degree of discordance within each negative symptom domain (anhedonia, alogia, blunted affect, asociality, and amotivation) as well as to identify potential contributors to this lack of concordance. The present study examined each of the five negative symptom domains in regard to self and interviewer rating concordance in a sample (N = 70) that consists of a full range of negative symptoms and psychotic-like experiences (PLEs). Results indicated that self and interviewer report of negative symptom domains were inconsistently correlated. Dimensionally, asociality and avolition were the most concordant domains and alogia and anhedonia were more discordant. Although self and interviewer report scores of blunted affect did not significantly differ, each score may be capturing separate aspects of this experience. Participant drug use frequency was found to significantly impact rater responding on blunted affect, participant emotional clarity significantly impacted rater responding on alogia, participant clinical high risk (CHR) status impacted rater responding on consummatory anhedonia, and participant anxiety impacted rater responding on anticipatory anhedonia. This study identifies factors that underlie negative symptom rating discordance, which may help improve treatment intervention for those experiencing this critical phase of the disorder, and improve our ability to accurately monitor these symptoms in individuals with psychosis spectrum disorders.