title: Cognition and the five-factor model of the positive and negative syndrome scale in schizophrenia.
abstract: Different exploratory and confirmatory factorial analyses of the Positive and Negative Syndrome Scale (PANSS) have found a number of factors other than the original positive, negative, and general psychopathology. Based on a review of previous studies and using confirmatory factor analyses (CFA), Wallwork et al. (Schizophr Res 2012; 137: 246-250) have recently proposed a consensus five-factor structure of the PANSS. This solution includes a cognitive factor which could be a useful measure of cognition in schizophrenia. Our objectives were 1) to study the psychometric properties (factorial structure and reliability) of this consensus five-factor model of the PANSS, and 2) to study the relationship between executive performance assessed using the Wisconsin Card Sorting Test (WCST) and the proposed PANSS consensus cognitive factor (composed by items P2-N5-G11). This cross-sectional study included a final sample of 201 Spanish outpatients diagnosed with schizophrenia. For our first objective, CFA was performed and Cronbach's alphas of the five factors were calculated; for the second objective, sequential linear regression analyses were used. The results of the CFA showed acceptable fit indices (NNFI=0.94, CFI=0.95, RMSEA=0.08). Cronbach's alphas of the five factors were adequate. Regression analyses showed that this five-factor model of the PANSS explained more of the WCST variance than the classical three-factor model. Moreover, higher cognitive factor scores were associated with worse WCST performance. These results supporting its factorial structure and reliability provide robustness to this consensus PANSS five-factor model, and indicate some usefulness of the cognitive factor in the clinical assessment of schizophrenic patients.
authors.affiliation: Department of Psychiatry, Instituto de Investigación Hospital 12 de Octubre (i+12), Avda. de Córdoba s/n, 28041, Madrid, Spain. roberto.rodriguez.jimenez@gmail.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez-Jimenez
authors.forename: Alexandra
authors.initials: A
authors.lastname: Bagney
authors.forename: Laura
authors.initials: L
authors.lastname: Mezquita
authors.forename: Isabel
authors.initials: I
authors.lastname: Martinez-Gras
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Sanchez-Morla
authors.forename: Natalia
authors.initials: N
authors.lastname: Mesa
authors.forename: Manuel-Ignacio
authors.initials: MI
authors.lastname: Ibañez
authors.forename: Justo
authors.initials: J
authors.lastname: Diez-Martin
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Jimenez-Arriero
authors.forename: Antonio
authors.initials: A
authors.lastname: Lobo
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: Santos
authors.forename: Tomas
authors.initials: T
authors.lastname: Palomo
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D025341:Principal Component Analysis; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D055815:Young Adult