Brief Negative Symptoms Scale (BNSS)

The Brief Negative Symptom Scale (BNSS) was designed to assess negative symptoms of schizophrenia in a way that can be easily implemented into clinical research.1,2
Description: The Brief Negative Symptom Scale (BNSS) was designed to assess negative symptoms of schizophrenia in a way that can be easily implemented into clinical research.1,2
Disease States: Schizophrenia
Validated Uses: Symptom Severity
Administration Method: Clinician-report
Time to administer: 15 minutes
Commonly used in: Clinical Trials & Research
Detailed Description: The BNSS was developed based on recommendations from the 2005 National Institute of Mental Health Consensus Development Conference on Negative Symptoms, which found that negative symptoms of schizophrenia require further study. A working group developed the BNSS to assess the fundamental components of negative symptoms in a simple and concise way to be implemented in clinical research. Although the primary intended use of the BNSS was for clinical research, it can also be used in clinical practice for evaluation and tracking of change.2 

The BNSS is comprised of 13 questions organized into 6 subscales that assess anhedonia, distress, asociality, avolition, blunted affect, and alogia. Items are scored on a 0 to 6 scale, with 0 indicating the symptom is absent and 6 indicating the symptom is severe. Items are summed for a total score that ranges between 0 and 78. The BNSS is administered as a semi-structured interview.2
Scale Validity: Inter-rater reliability, test-retest reliability, discriminant validity, and convergent validity of the BNSS have been rated as excellent.1,2 Its internal consistency is rated as strong.2
Alternative Versions: Alternate versions of the BNSS are available in several different languages, including Spanish, Italian, Turkish, Chinese, German, Russian, Dutch, Danish, Polish, Norwegian, Japanese, Portuguese, and Korean.1
Cited Limitations: The BNSS cannot be used to define a negative symptom subtype.2 BNSS ratings may also be vulnerable to “the halo effect,” which is a form of bias.3,5 In assessments, the halo effect refers to instances when a clinician rates test items positively based on an overall positive impression of the patient rather than considering each individual test item on its own merit.5,6 Alternately, a clinician might rate a test item positively (or negatively) and then feel inclined to rate subsequent items similarly even though they are separate, unrelated test items.7
 
Some items of the BNSS may not translate consistently across languages and cultures. Researchers examining the use of the BNSS in cross-cultural studies have indicated the need for improved standardization across different cultures.3
 
No research has yet established the minimal clinically important difference for the BNSS.3 Additionally, more research is needed to assess neurobiological, cognitive, and social correlates of the BNSS domains, which would help further validate its psychometric properties.4

Footnotes:

Supporting references for the filers are as follows: Disease States: Schizophrenia;1 Validated Uses: Symptom Severity; Clinical Research; Treatment Monitoring and Evaluation;2 Administration Method: Clinician-rated;2 Time to Administer: About 15 minutes;2 Commonly Used In: Clinical practice and research2
 

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References:

  1. Kirkpatrick B, et al. Schizophr Res. 2017;197:269-273.
  2. Kirkpatrick B, et al. Schizophr Bull. 2011;37(2):300-305.
  3. Tatsumi K, et al. Euro Neuropsychopharm. 2020;33:36-44.
  4. Ang MS, et al. Schizophr Res. 2019; 208:97-104.
  5. Benini A. ACAPS Subjective Measures in Humanitarian Analysis. Geneva, Assessment Capacities Project – ACAPS: 2018.
  6. Strauss GP & Gold JM. Schizophr Bull. 2016;42(6):1384-94.
  7. Allen M, eds. The SAGE Encyclopedia of Communication Research Methods. Vol. 4. Thousand Oaks, CA: SAGE Publications, Inc; 2017.

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