Am J Psychiatry 1994; 151:249-253
Copyright © 1994 by American Psychiatric Association
Assessing positive and negative symptoms in children and adolescents
JH Fields, S Grochowski, JP Lindenmayer, SR Kay, D Grosz, RB Hyman and G Alexander
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center-Bronx Children's Psychiatric Center, NY 10461.
OBJECTIVE: The purpose of this study was to test the reliability and
validity of a new assessment instrument for positive and negative symptoms
in severely disturbed children and adolescents (Kiddie-PANSS). METHOD: The
Positive and Negative Syndrome Scale for adult schizophrenia was modified
through successive field trials on the basis of developmental
characteristics of children and adolescents. The scale was then given to 34
inpatients (19 children, mean age = 9.35 years, and 15 adolescents, mean
age = 14.33 years) with DSM-III-R diagnoses of schizophrenia, psychosis not
otherwise specified, schizoaffective, affective, conduct, personality, and
developmental disorders determined independently by child psychiatrists.
All patients with schizophrenia were placed in the schizophrenic group, and
all others were placed in a general inpatient group. The Kiddie-PANSS
ratings were given by three trained child psychiatrists after a
30-35-minute structured interview. The Achenbach Child Behavior Checklist,
the Scale for the Assessment of Positive Symptoms, and the Scale for the
Assessment of Negative Symptoms were also administered in order to
determine criterion-related association. RESULTS: Intraclass correlation
coefficients revealed that all subscales and total psychopathology were
reliably assessed among raters. The Kiddie-PANSS and Scale for the
Assessment of Positive Symptoms/Scale for the Assessment of Negative
Symptoms correlated with one another, indicating criterion-related
association. Differences on measures of positive, negative, and general
psychopathology, as measured by the Kiddie-PANSS, between the patients with
schizophrenia and the general inpatient group were highly significant.
CONCLUSIONS: The Kiddie-PANSS shows good interrater reliability and
criterion- related validity. In a cohort of inpatient children and
adolescents the scale successfully differentiated schizophrenic patients
from nonschizophrenic patients.
