Spanish Validation of the MAP-SRTwo Heads Better Than One for the Assessment of Negative Symptoms of Schizophrenia

  1. María Paz García-Portilla 1
  2. Leticia García-Álvarez 1
  3. Lorena de la Fuente-Tomás 1
  4. Francesco Dal Santo 2
  5. Ángela Velasco 1
  6. Leticia González-Blanco 1
  7. Paula Zurrón-Madera 1
  8. Eduardo Fonseca-Pedrero 3
  9. María Teresa Bobes-Bascarán 1
  10. Pilar A Sáiz 1
  11. Julio Bobes 1
  1. 1 Universidad de Oviedo

    Universidad de Oviedo

    Oviedo, España


  2. 2 Servicio de Salud del Principado de Asturias (SESPA)

    Servicio de Salud del Principado de Asturias (SESPA)

    Oviedo, España

  3. 3 Universidad de La Rioja

    Universidad de La Rioja

    Logroño, España



ISSN: 0214-9915 1886-144X

Year of publication: 2021

Issue Title: Monográfico Mariano Yela

Volume: 33

Issue: 3

Pages: 473-480

Type: Article

DOI: 10.7334/PSICOTHEMA2020.457 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Psicothema


Background: There is little research on self-reported negative symptomatology measures in schizophrenia. The aims of this study were to validate the Spanish version of the Motivation and Pleasure Scale-Self-Report (MAP-SR) and determine the concordance between patient-reported outcome measures for reflecting the severity of negative symptoms of schizophrenia and clinician-rated outcome measures. Method: A sample of 174 subjects who completed the MAP-SR and 104 who completed the Self-Evaluation of Negative Symptoms (SNS) were analyzed. The clinician-reported outcome measures (CROMs) were the Spanish versions of the Clinical Assessment Interview for Negative Symptoms (CAINS) and the Positive and Negative Syndrome Scale (PANSS), while the patient-reported outcome measures (PROMs) were MAP-SR and SNS. Cronbach’s a, bivariate analyses and Lin’s concordance correlation coefficient (CCC) were calculated. Results: The Spanish version of the MAP-SR demonstrated excellent reliability (Cronbach’s α=.923). Its correlation coefficients were higher with CAINS [CAINS-Total: r=.608, p<.005; CAINS-Motivation and Pleasure subscale(CAINS-MAP): r=.662, p<.005] than with PANSS negative scales [PANSS-Negative scale(PANSS-N): r=.393, p<.005; PANSS-Marder Negative Factor(PANSS-MNF): r=.478, p<.005]. Finally, concordance between clinician and patient ratings was low in all cases, varying from a CCC of 0.661 to .392. Conclusions: We found poor concordance between patient and clinician ratings, hence we believe that the two evaluations are not mutually exclusive but complementary

Funding information

This work was partly supported by the Government of the Principality of Asturias PCTI-2018-2022 IDI/2018/235, Fundación para la Investigación e Innovación Biosanitaria del Principado de Asturias (FINBA), the CIBERSAM, the Instituto de Salud Carlos III (grants PI13/02263 and PI16/01761 to Dr. Julio Bobes), and Fondos Europeos de Desarrollo Regional (FEDER).

Bibliographic References

  • Alonso, J., Prieto, L., & Antó, J. M. (1995). The Spanish version of the SF36 Health Survey (the SF-36 health questionnaire): An instrument for measuring clinical results. Medicina Clínica (Barc), 104, 771-776.
  • Arango, C., Kirkpatrick, B., Buchanan, R. W., & Carpenter, WT.Jr. (1998). El síndrome deficitario: un dominio dentro de la esquizofrenia [The deficit syndrome: A domain of schizophrenia]. Actas Luso Españolas de Neurología, Psiquiatría y Ciencias Afi nes, 26, 180-186.
  • Bobes, J., Arango, C., García-García, M., Rejas, J., & Group, C. S. C. (2010). Prevalence of negative symptoms in outpatients with schizophrenia spectrum disorders treated with antipsychotics in routine clinical practice: Findings from the CLAMORS study. Journal of Clinical Psychiatry, 71(3), 280-286.
  • Bobes, J., García-Portilla, M. P., Bascarán, M. T., Sáiz, P. A., & Bousono, M. (2007). Quality of life in schizophrenic patients. Dialogues in Clinical Neuroscience, 9(2), 215-226. DCNS.2007.9.2/jbobes
  • Brady, R. O., Jr., Gonsalvez, I., Lee, I., Ongur, D., Seidman, L. J., Schmahmann, J. D., Eack, S.M., Keshavan, M.S., Pascual-Leone, A., & Halko, M. A. (2019). Cerebellar-Prefrontal Network Connectivity and Negative Symptoms in Schizophrenia. The American Journal of Psychiatry, 176(7), 512-520.
  • Browne, S., Roe, M., Lane, A., Gervin, M., Morris, M., Kinsella, A., Larkin, C., & Callaghan, E. O. (1996). Quality of life in schizophrenia: Relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiatrica Scandinavica, 94(2), 118-124. https://
  • Carpenter, W. T., Jr., Heinrichs, D. W., & Wagman, A. M. (1988). Deficit and nondeficit forms of schizophrenia: The concept. The American Journal of Psychiatry, 145(5), 578-583.
  • Dollfus, S., Mach, C., & Morello, R. (2016). Self-Evaluation of Negative Symptoms: A Novel Tool to Assess Negative Symptoms. Schizophrenia Bulletin, 42(3), 571-578.
  • Engel, M., & Lincoln, T. M. (2016). Motivation and Pleasure ScaleSelf-Report (MAP-SR): Validation of the German version of a selfreport measure for screening negative symptoms in schizophrenia. Comprehensive Psychiatry, 65, 110-115. comppsych.2015.11.001
  • Engel, M., & Lincoln, T. M. (2017). Concordance of selfand observerrated motivation and pleasure in patients with negative symptoms and healthy controls. Psychiatry Research, 247, 1-5. https://doi. org/10.1016/j.psychres.2016.11.013
  • Fervaha, G., Takeuchi, H., Agid, O., Lee, J., Foussias, G., & Remington, G. (2015). Determinants of patient-rated and clinician-rated illness severity in schizophrenia. Journal of Clinical Psychiatry, 76(7), 924- 930.
  • García-Alvarez, L., García-Portilla, M. P., Sáiz, P. A., Fonseca-Pedrero, E., Bobes-Bascarán, M. T., Gomar, J., Muñiz, J., & Bobes, J. (2018). Spanish validation of the Negative Symptom Assessment-16 (NSA-16) in patients with schizophrenia. Revista de Psiquiatría y Salud Mental, 11(3), 169-175.
  • García-Álvarez, L., Martínez-Cao, C., Bobes-Bascarán, T., Portilla, A., Courtet, P., de la Fuente-Tomás, L., Velasco, Á., González-Blanco, L., Zurrón-Madera, P., Fonseca-Pedrero, E., Sáiz, P. A., García-Portilla, M. P., & Bobes, J. (2020). Validation of a European Spanish-version of the Self-Evaluation of Negative Symptoms (SNS) in patients with schizophrenia. Revista de Psiquiatría y Salud Mental, S1888- 9891(20)30036-7.
  • García-Portilla, M. P., & Bobes, J. (2013). Ante el nuevo reto de identificar el síndrome negativo de la esquizofrenia [The new challenge in identifying the negative syndrome of schizophrenia]. Revista de Psiquiatría y Salud Mental, 6(4), 141-143. rpsm.2013.09.002
  • García-Portilla, M. P., García-Alvarez, L., Sáiz, P. A., Al-Halabi, S., Bobes-Bascarán, M. T., Bascarán, M. T., Muñiz, J., & Bobes, J. (2015). Psychometric evaluation of the negative syndrome of schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 265(7), 559-566.
  • Hervochon, C., Bourgeois, V., Rotharmel, M., Duboc, J. B., Le Goff, B., Quesada, P., Campion, D., Dollfus, S., & Guillin, O. (2018). [Validation of the French version of the self-evaluation of negative symptoms (SNS)]. Encephale, 44(6), 512-516. 10.1016/j.encep. 2017.10.002
  • IBM Corp. (2016). IBM SPSS Statistics for Windows (Version 24.0) [Computer software]. IBM Corp.
  • Kirkpatrick, B., Strauss, G. P., Nguyen, L., Fischer, B. A., Daniel, D. G., Cienfuegos, A., & Marder, S. R. (2011). The brief negative symptom scale: Psychometric properties. Schizophrenia Bulletin, 37(2), 300-305.
  • Kring, A. M., Gur, R. E., Blanchard, J. J., Horan, W. P., & Reise, S. P. (2013). The Clinical Assessment Interview for Negative Symptoms (CAINS): Final development and validation. The American Journal of Psychiatry, 170(2), 165-172.
  • Lehman, A. F. (1983). The effects of psychiatric symptoms on quality of life assessments among the chronic mentally ill. Evaluation and Program Planning, 6(2), 143-151. 7189(83)90028-9
  • Li, Y., Li, W. X., Zou, Y. M., Yang, Z. Y., Xie, D. J., Yang, Y., Lui, S. S. Y., Strauss, G.P., Cheung, E.F.C., & Chan, R. C. K. (2018). Revisiting the persistent negative symptoms proxy score using the Clinical Assessment Interview for Negative Symptoms. Schizophrenia Research, 202, 248- 253.
  • Lin, L. I. (1989). A concordance correlation coefficient to evaluate reproducibility. Biometrics, 45(1), 255-268. 2532051
  • Llerena, K., Park, S. G., McCarthy, J. M., Couture, S. M., Bennett, M. E., & Blanchard, J. J. (2013). The Motivation and Pleasure Scale-Self-Report (MAP-SR): Reliability and validity of a self-report measure of negative symptoms. Comprehensive Psychiatry, 54(5), 568-574. https://doi. org/10.1016/j.comppsych.2012.12.001
  • McBride, G.B. (2005). A proposal for strength-of-agreement criteria for Lin’s Concordance Correlation Coeffi cient. National Institute of Water & Atmospheric Reseach Ltd. McBride2005.pdf
  • MedCalc Software (2016). MedCalc Statistical Software (Version 16.4.3) [Computer software]. MedCalc Software bvba.
  • Marder, S.R., Davis, J.M., & Chouinard, G. (1997). The effects of risperidone on the fi ve dimensions of schizophrenia derived by factor analysis: Combined results of the North American trials. The Journal of Clinical Psychiatry, 58, 538-546.
  • Menéndez-Miranda, I., García-Portilla, M. P., García-Alvarez, L., Arrojo, M., Sánchez, P., Sarramea, F., Gomar, J., Bobes-Bascarán, M.T. Sierra, P., Sáiz, P.A., & Bobes, J. (2015). Predictive factors of functional capacity and real-world functioning in patients with schizophrenia. European Psychiatry, 30(5), 622-627. eurpsy.2014.12.011
  • Peralta, V., & Cuesta, M. J. (1994). Validación de la Escala de los Síndromes Positivo y Negativo (PANSS) en una muestra de esquizofrénicos españoles [Validation of the Positive and Negative Syndrome Scale (PANSS) in a sample of Spanish patients with schizophrenia]. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afi nes, 22, 171- 177.
  • Richter, J., Hesse, K., Eberle, M. C., Eckstein, K. N., Zimmermann, L., Schreiber, L., Burmeister, C.P., Wildgruber, D., & Klingberg, S. (2019). Self-assessment of negative symptoms Critical appraisal of the motivation and pleasure-Self-report’s (MAP-SR) validity and reliability. Comprehensive Psychiatry, 88, 22-28. 10.1016/j.comppsych.2018.10.007
  • Salagre, E., Arango, C., Artigas, F., Ayuso-Mateos, J. L., Bernardo, M., Castro-Fornieles, J., Bobes, J., Desco, M., Fañanás, L., GonzálezPinto, A., Haro, J.M., Leza, J.C., Mckenna, P.J., Meana, J.J., Menchón, J.M., Micó, J.A., Palomo, T., Pazos, A., Pérez, V., . . . Vieta, E. (2019). CIBERSAM: Ten years of collaborative translational research in mental disorders. Revista de Psiquiatría y Salud Mental, 12(1), 1-8. https://doi. org/10.1016/j.rpsm.2018.10.001
  • Sarro, S., Dueñas, R. M., Ramírez, N., Arranz, B., Martínez, R., Sánchez, J. M., González, J.M., Salo, L., Miralles, L., & San, L. (2004). Crosscultural adaptation and validation of the Spanish version of the Calgary Depression Scale for Schizophrenia. Schizophrenia Research, 68(2-3), 349-356.
  • Song, J., Borlido, C., De Luca, V., Burton, L., & Remington, G. (2019). Patient versus rater evaluation of symptom severity in treatment resistant schizophrenia receiving clozapine. Psychiatry Research, 274, 409-413.
  • The WHOQOL Group (1995). The World Health Organization Quality of Life Assessment (the WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41, 1403-1409. https://doi. org/10.1016/0277-9536(95)00112-K
  • Valiente-Gómez, A., Mezquida, G., Romaguera, A., Vilardebo, I., Andrés, H., Granados, B., Larrubia, J., Pomarol-Clotet, E., McKenna, P.J., Sarró, S., & Bernardo, M. (2015). Validation of the Spanish version of the Clinical Assessment for Negative Symptoms (CAINS). Schizophrenia Research, 166(1-3), 104-109. schres.2015.06.006
  • Weldring, T., & Smith, S. M. S. (2013). Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs). Health Services Insight, 6, 61-68.