Factor structure and internal consistency of the Clinical Assessment Interview for Negative Symptoms (CAINS) on a sample of persons with psychotic disorders in Bosnia and Herzegovina

The assessment of negative symptoms is crucial for development of adequate therapeutic interventions. This is a challenging task due to complex clinical presentation and lack of reliable and valid instruments. This study examined the psychometric characteristics of the Clinical Assessment Interview for Negative Symptoms (CAINS). The sample consisted of 81 persons with schizophrenia or schizoaffective disorder recruited from two health institutions in the Sarajevo Canton: the Clinical Center of the University of Sarajevo and the Psychiatric Hospital of the Sarajevo Canton. The 13 CAINS items grouped into four factors (expression, motivation and satisfaction in the recreational domain, motivation and satisfaction with social relationships, motivation and satisfaction with job and education). The four-factor solution accounted for 87.83% of the variance of manifest items. The reliabilities of extracted factors were as follows: for motivation and satisfaction with social relationships α = 0.897, for motivation and satisfaction with job and education α = 0.961, for Motivation and satisfaction in the recreation domain α = 0.981, and for expression α = 0.938. The highest correlation between factors was found between Motivation and satisfaction with recreation and Motivation and satisfaction with social relationships. On the other hand, the lowest correlation was found between motivation and satisfaction with social relations and motivation and satisfaction with job and education. In conclusion, the study showed that the latent structure of CAINS is adequate, clearly interpretable, and consisted of four factors. The measure can be used for assessment of the negative symptoms in outpatients with psychosis in Bosnia and Herzegovina.

Childhood loneliness as a specific risk factor for adult psychiatric disorders

Background Loneliness is a major risk factor for both psychological disturbance and poor health outcomes in adults. This study aimed to assess whether childhood loneliness is associated with a long-term disruption in mental health that extends into adulthood. Methods This study is based on the longitudinal, community-representative Great Smoky Mountains Study of 1420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9–16; 6674 observations; 1993–2000) for childhood loneliness, associated psychiatric comorbidities and childhood adversities. Participants were followed up four times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1334 participants; 1999–2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric anxiety, depression, and substance use outcomes. Results Both self and parent-reported childhood loneliness were associated with adult self-reported anxiety and depressive outcomes. The associations remained significant when childhood adversities and psychiatric comorbidities were accounted for. There was no evidence for an association of childhood loneliness with adult substance use disorders. More associations were found between childhood loneliness and adult psychiatric symptoms than with adult diagnostic status. Conclusion Childhood loneliness is associated with anxiety and depressive disorders in young adults, suggesting that loneliness – even in childhood – might have long-term costs in terms of mental health. This study underscores the importance of intervening early to prevent loneliness and its sequelae over time.

PSYCHOMETRIC CHARACTERISTICS OF THE MACEDONIAN VERSION OF CLINICAL ASSESSMENT INTERVIEW FOR NEGATIVE SYMPTOMS (CAINS)

Background: Despite the importance of effective assessment and treatment of negative symptoms among patients with psychosis, no validated instruments are available in the Republic of North Macedonia. The aim of this paper was to explore psychometric properties, namely factorial structure, internal consistency, convergent and discriminant validity of the Clinical Assessment Interview for Negative Symptoms (CAINS).Subjects and methods: In this cross-sectional study 82 outpatients diagnosed with psychosis (64 with schizophrenia and 18 with bipolar disorder; female=34, mean age=41.05±10.09) were assessed.Results: The exploratory factor analysis revealed two factorial structure of the negative symptoms as measured by the CAINS, i.e. ‘expression and motivation’ and ‘pleasure’. Two items aimed to measure motivation for family relations and motivation for work/school activities loaded on the expression factor instead on motivation and pleasure factor which differs from the original version of the CAINS. Convergent validity was proven by positive relationship to negative symptoms as measured by the BPRS. Positive, but weak correlation with BPRS positive symptoms demonstrated its discriminant validity. Internal consistency of overall CAINS scale and its two subscales was very high.Conclusion: The CAINS can be used to assess negative symptoms in individuals with psychosis in the Macedonian clinical context. Consequently, this work can provide a foundation for further clinical advancement and research of negative symptoms in Macedonian healthcare.

Risk assessment in deferred and recovered donors

Serologic testing and Donor Risk Assessment Interview (DRAI) combined have made tissue transplantation a frequent and safe modality for a variety of trauma and disease conditions. Donate Life America reports 30,000 tissue donors providing more than 1,750,000 tissue transplants annually. This study of 188 potential donor cases addresses issues of risk assessment in a medical examiner population in a metropolitan area, where serologic testing of deferred potential donors were compared with the DRAI screening, which determined the suitability or non-suitability for tissue procurement. Such serologic testing of deferred cases is not usually available in evaluating screening processes. This comparison gives insight into the effectiveness of the DRAI screening in deferring potential serology reactive donors. Results show in 65 cases how the DRAI screening eliminates most, but not all of the serologically reactive donors identified post recovery. The result emphasizes the need for the combined process of DRAI screening and testing to assure transplantation safety.

An Interview-Based Assessment of the Experience of Cognitive Impairment in Multiple Sclerosis: The Cognitive Assessment Interview (CAI)

Background: Cognitive impairment is a common feature of multiple sclerosis (MS). A semi-structured interview, including informant input, can characterize the experience of individuals living with MS and cognitive involvement.Objective: We administered the Cognitive Assessment Interview (CAI), a patient- and informant-based semi-structured interview, to characterize the experience of cognitive impairments in those living with MS.Methods: Trained raters administered the CAI to a sample of MS participants and their informants enrolled for a trial of cognitive remediation. Cognitive impairments on the CAI were characterized and compared to those captured by neuropsychological and self-report measures.Results: A total of n = 109 MS participants (mean age = 50.3 ± 12.2) and their available informants (n = 71) were interviewed. Participants reported experiencing processing speed (90/106, 85%), working memory (87/109, 80%), and learning and memory (79/109, 72%) problems most commonly. CAI-based ratings were moderately correlated with a self-report measure (Multiple Sclerosis Neuropsychological Screening Questionnaire, rs = 0.52, p < 0.001) and only mildly correlated with objective neuropsychological measures specific to executive functions (rs = 0.21, p = 0.029). For those with informant interviews, ratings were overall consistent, suggesting that the CAI is valid even in cases in which an informant is unavailable and the interview is conducted with the patient alone (as is often the case in clinical and research settings).Conclusions: The CAI provides a semi-structured interview to characterize the experience of cognitive impairment in MS, with findings representing real-world functioning, adding valuable information to both self-report measures and neuropsychological assessment.