title: The Positive and Negative Syndrome Scale (PANSS): A Three-Factor Model of Psychopathology in Marginally Housed Persons with Substance Dependence and Psychiatric Illness.
abstract: Rates of psychopathology are elevated in marginalized and unstably housed persons, underscoring the need for applicable clinical measures for these populations. The Positive and Negative Syndrome Scale (PANSS) is a clinical instrument principally developed for use in schizophrenia to identify the presence and severity of psychopathology symptoms. The current study investigates whether a reliable and valid PANSS factor structure emerges in a marginally housed, heterogeneous sample recruited from the Downtown Eastside of Vancouver where substance use disorders and psychiatric illness are pervasive. Participants (n = 270) underwent structured clinical assessments including the PANSS and then were randomly assigned to either exploratory (EFA) or confirmatory factor analytic (CFA) subsamples. EFA pointed to a novel three factor PANSS. This solution was supported by CFA. All retained items (28 out of 30) load significantly upon hypothesized factors and model goodness of fit analyses are in the acceptable to good range. Each of the three first-order factor constructs, labeled Psychosis/Disorganized, Negative Symptoms/Hostility, and Insight/Awareness, contributed significantly to measurement of a higher-order psychopathology construct. Further, the latent structure of this 3-factor solution appears temporally consistent over one-year. This PANSS factor structure appears valid and reliable for use in persons with multimorbidity, including substance use disorders. The structure is somewhat distinct from existing solutions likely due to the unique characteristics of this marginally housed sample.
authors.affiliation: Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: Chantelle J
authors.initials: CJ
authors.lastname: Giesbrecht
authors.affiliation: Department of Public Health and Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Norm
authors.initials: N
authors.lastname: O'Rourke
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Olga
authors.initials: O
authors.lastname: Leonova
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Verena
authors.initials: V
authors.lastname: Strehlau
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Paquet
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Fidel
authors.initials: F
authors.lastname: Vila-Rodriguez
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: William J
authors.initials: WJ
authors.lastname: Panenka
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: G William
authors.initials: GW
authors.lastname: MacEwan
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Geoffrey N
authors.initials: GN
authors.lastname: Smith
authors.affiliation: Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: Allen E
authors.initials: AE
authors.lastname: Thornton
authors.affiliation: Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: William G
authors.initials: WG
authors.lastname: Honer
mesh_terms: D000328:Adult; D000368:Aged; D004651:Employment; D005163:Factor Analysis, Statistical; D005260:Female; D006798:Housing; D006801:Humans; D007182:Income; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D008960:Models, Psychological; D011599:Psychopathology; D062487:Social Marginalization / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D013577:Syndrome; D013997:Time Factors