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Pharmacopsychiatry 2012; 45(04): 156-161
DOI: 10.1055/s-0031-1298022
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Are Ratings on the Positive and Negative Syndrome Scale for Schizophrenia Biased by Personality Traits?

C. G. Huber
1   Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre ­Hamburg-Eppendorf, Hamburg, Germany
,
A. Hoppe
1   Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre ­Hamburg-Eppendorf, Hamburg, Germany
,
A. Agorastos
1   Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre ­Hamburg-Eppendorf, Hamburg, Germany
,
B. Andresen
1   Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre ­Hamburg-Eppendorf, Hamburg, Germany
,
D. Naber
1   Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre ­Hamburg-Eppendorf, Hamburg, Germany
,
K. Schroeder
1   Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre ­Hamburg-Eppendorf, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

received 27 June 2011
revised 28 November 2011

accepted 29 November 2011

Publication Date:
30 January 2012 (online)

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Abstract

Objective:

The aim of this study was to estimate the potential bias by personality traits for ratings on the Positive and Negative Syndrome Scale (PANSS).

Method:

Personality dimensions (five factor model), personality traits (SCID-II) and PANSS scores were assessed prospectively in 45 patients with schizophrenia spectrum disorders (SSD).

Results:

Borderline (r=0.34; p=0.021), avoidant (r=0.66; p<0.001) and depressive (r=0.51; p<0.001) personality traits were significantly correlated with the PANSS total score. There were significant correlations for all PANSS subscores with the exemption of PANSS positive. In multivariate analyses, the final models for PANSS total score and PANSS depressive explained a total of 45.3% and 54.3% of the variance. Avoidant traits could lead to a difference of 13.1 (95% CI: 5.6–20.7) points regarding PANSS total score, depressive traits could cause differences of 4.8 points (95% CI: 2.2–7.3) for PANSS depressive subscore.

Conclusion:

Although PANSS positive subscore and PANSS excited component are relatively robust against bias by personality traits, PANSS total score and the remaining subscores are affected to a clinically relevant degree. Outcome studies in SSD patients should control for personality traits.

Key words

five factor model - PANSS - personality traits - psychopathology - schizophrenia spectrum disorder - SCID-II
 

  • References

  • 1 Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261-276
    Google Scholar
  • 2 Bell M, Milstein R, Beam-Goulet J et al. The positive and negative syndrome scale and the brief psychiatric rating scale. Reliability, comparability, and predictive validity. J Nerv Ment Dis 1992; 180: 723-728
    CrossrefPubMedGoogle Scholar
  • 3 Leucht S, Kane JM, Kissling W et al. What does the PANSS mean?. Schizophrenia Res 2005; 79: 231-238
    CrossrefPubMedGoogle Scholar
  • 4 Andreasen NC, Carpenter Jr WT, Kane JM et al. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005; 162: 441-449
    CrossrefPubMedGoogle Scholar
  • 5 Mortimer AM. Symptom rating scales and outcome in schizophrenia. Br J Psychiatry Suppl 2007; 50: s7-s14
    PubMedGoogle Scholar
  • 6 McGlashan TH, Grilo CM, Skodol AE et al. The collaborative longitudinal personality disorders study: baseline axis I/II and II/II diagnostic co-occurrence. Acta Psychiatr Scand 2000; 102: 256-264
    CrossrefPubMedGoogle Scholar
  • 7 Widiger TA, Shea T. Differentiation of axis I and axis II disorders. J Abnorm Psychol 1991; 100: 399-406
    CrossrefPubMedGoogle Scholar
  • 8 Tyrer P, Gunderson J, Lyons M et al. Extent of comorbidity between mental state and personality disorders. J Pers Disord 1997; 11: 242-259
    CrossrefPubMedGoogle Scholar
  • 9 Newton-Howes G, Tyrer P, North B et al. The prevalence of personality disorder in schizophrenia and psychotic disorders: systematic review of rates and explanatory modelling. Psychol Med 2008; 38: 1075-1082
    PubMedGoogle Scholar
  • 10 Moran P, Hodgins S. The correlates of comorbid antisocial personality disorder in schizophrenia. Schizophr Bull 2004; 30: 791-802
    CrossrefPubMedGoogle Scholar
  • 11 Keshavan MS, Duggal HS, Veeragandham G et al. Personality dimensions in first-episode psychoses. Am J Psychiatry 2005; 162: 102-109
    CrossrefPubMedGoogle Scholar
  • 12 Costa Jr PT, McCrae RR. Stability and change in personality assessment: the revised NEO Personality Inventory in the year 2000. J Pers Assess 1997; 68: 86-94
    CrossrefPubMedGoogle Scholar
  • 13 Lysaker PH, Bell MD, Kaplan E et al. Personality and psychopathology in schizophrenia: the association between personality traits and symptoms. Psychiatry 1999; 62: 36-48
    PubMedGoogle Scholar
  • 14 Kentros M, Smith TE, Hull J et al. Stability of personality traits in schizophrenia and schizoaffective disorder: a pilot project. J Nerv Ment Dis 1997; 185: 549-555
    CrossrefPubMedGoogle Scholar
  • 15 Herran A, Sierra-Biddle D, Cuesta MJ et al. Can personality traits help us explain disability in chronic schizophrenia?. Psychiatry Clin Neurosci 2006; 60: 538-545
    CrossrefPubMedGoogle Scholar
  • 16 Schroeder K, Hoppe A, Andresen B et al. Considering DSM-5: Personality diagnostics in patients with schizophrenia spectrum disorders. Psychiatry in press
    PubMedGoogle Scholar
  • 17 APA . Diagnostic & Statistical Manual of Mental Disorders. Fourth Edition. Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Publishing; 2000
    Google Scholar
  • 18 Opler MG, Yang LH, Caleo S et al. Statistical validation of the criteria for symptom remission in schizophrenia: preliminary findings. BMC Psychiatry 2007; 7: 35
    CrossrefPubMedGoogle Scholar
  • 19 Levine SZ, Rabinowitz J. Revisiting the 5 dimensions of the positive and negative syndrome scale. J Clin Psychopharmacol 2007; 27: 431-436
    CrossrefPubMedGoogle Scholar
  • 20 Davis JM, Chen N. The effects of olanzapine on the 5 dimensions of schizophrenia derived by factor analysis: combined results of the North American and international trials. J Clin Psychiatry 2001; 62: 757-771
    CrossrefPubMedGoogle Scholar
  • 21 Andresen B. Six basic dimensions of personality and a seventh factor of generalized dysfunctional personality: a diathesis system covering all personality disorders. Neuropsychobiology 2000; 41: 5-23
    CrossrefPubMedGoogle Scholar
  • 22 Andresen B. Hamburger Persönlichkeitsinventar. Das NEOCAR Basisfaktor-System. Göttingen: Hogrefe; 2002;
    PubMedGoogle Scholar
  • 23 Wittchen HU, Zaudig M, Fydrich T. Strukturiertes Klinisches Interview für DSM-IV: Handanweisung. Göttingen: Hogrefe-Verlag; 1997
    Google Scholar
  • 24 Farmer RF, Chapman AL. Evaluation of DSM-IV personality disorder criteria as assessed by the structured clinical interview for DSM-IV personality disorders. Compr Psychiatry 2002; 43: 285-300
    CrossrefPubMedGoogle Scholar
  • 25 Cohen J. A power primer. Psychol Bull 1992; 112: 155-159
    CrossrefPubMedGoogle Scholar
  • 26 Fava M, Farabaugh AH, Sickinger AH et al. Personality disorders and depression. Psychol Med 2002; 32: 1049-1057
    CrossrefPubMedGoogle Scholar
  • 27 Case BG, Biel MG, Peselow ED et al. Reliability of personality disorder diagnosis during depression: the contribution of collateral informant reports. Acta Psychiatr Scand 2007; 115: 487-491
    CrossrefPubMedGoogle Scholar
  • 28 Hori H, Noguchi H, Hashimoto R et al. Personality in schizophrenia assessed with the temperament and character inventory (TCI). Psychiatry Res 2008; 160: 175-183
    CrossrefPubMedGoogle Scholar
  • 29 Cortes MJ, Valero J, Gutierrez-Zotes JA et al. Psychopathology and personality traits in psychotic patients and their first-degree relatives. Eur Psychiatry 2009; 24: 476-482
    CrossrefPubMedGoogle Scholar
  • 30 Poustka L, Murray GK, Jaaskelainen E et al. The influence of temperament on symptoms and functional outcome in people with psychosis in the Northern Finland 1966 Birth Cohort. Eur Psychiatry 2010; 25: 26-32
    PubMedGoogle Scholar
  • 31 Miles J, Shevlin M. Applying regression and correlation: a guide for students and researchers. London: Sage; 2001
    Google Scholar