A two-factor structure of first rank symptoms in patients with a psychotic disorder

SCHIZOPHRENIA RESEARCH

卷:147

Article

Heering, Henriette D.¹  van Haren, Neeltje E. M.²  Derks, Eske M.¹ 

[1] Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands

[2] Univ Med Ctr Utrecht, Dept Psychiat, Rudolf Magnus Inst Neurosci, Utrecht, Netherlands

关键词: Psychosis;    First rank symptoms;    Factor analysis;    Self-disturbance;   

DOI  :  10.1016/j.schres.2013.04.032

来源: Elsevier

【 摘 要 】

Kurt Schneider defined 'first rank symptoms' (FRS) of psychosis. Previous research found two clusters of FRS: 'loss of ego bound' symptoms (e. g., delusions of external control) and auditory hallucinations (e. g, commenting voices). In patients with a psychosis we investigated whether FRS are a separate cluster within the group of positive symptoms, consisting of two underlying factors that are stable over time. We conducted a principal axis factor analysis (PAF) at baseline (n = 857) and a confirmative factor analysis (CFA) at three-year follow-up (n = 414) on (FRS) symptom score. Also, we investigated the stability of the two-factor structure of FRS over the interval. PAF on 16 items representing positive symptoms at baseline revealed two factors with eigenvalues > 1. FRS-delusional self experience (thought withdrawal, thought broadcasting, thought insertion, and beliefs that impulses and/or actions are controlled by an outside force) clustered in one factor and FRS-auditory hallucinations (auditory hallucinations, conversational voices, and voices commenting on one's actions) in the second factor. Furthermore, CFA on the FRS-items at follow-up confirmed the two-factor structure of FRS. FRS delusional self experience and FRS-auditory hallucinations at baseline were significantly associated with the same factors at three-year follow-up (FRS-delusional self experience: r = 0.38; FRS-auditory hallucinations r = 0.47). Hence, our findings confirm a two-factor structure of first rank symptoms, i.e. FRS-delusional self experience and FRS-auditory hallucinations, with a moderate to large internal coherence within each factor and relative stability over time. Future studies on self-processes may contribute to our understanding of the pathophysiology of first rank symptoms. (C) 2013 Elsevier B. V. All rights reserved.

【 授权许可】

Free