Systematic Review of Self-Assessment Scales for Specific Negative Symptom Domains in Psychotic Disorders

Negative symptoms (NS) impair outcomes in schizophrenia, affecting quality of life, and resisting pharmacological treatments. Scales targeting specific NS domains-eg, anhedonia, avolition, alogia, social withdrawal, and blunted affect-allow clinicians to assess how treatments affect individual symptoms, and deepen understanding of NS pathophysiology. While observer-rated scales are most widely used, self-assessment tools can provide insight into individuals' personal experiences. Here we evaluated the psychometric properties of NS self-assessment scales, focusing on tools for specific domains, to guide tailored treatments in clinical and research settings.

We conducted a comprehensive literature review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, searching MEDLINE, and Web of Science for self-assessment scales evaluating specific NS domains. Each tool's methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

We identified 15 self-assessment scales: 7 for anhedonia, 7 for avolition, 1 for social withdrawal, and none for alogia or blunted affect. The Temporal Experience of Pleasure Scale was the most valuable tool for anhedonia, with a grade B recommendation. All instruments assessing avolition were assigned a grade C recommendation, due to the limited numbers of validation studies. The University of California Los Angeles Loneliness Scale Version 3 (UCLALS-V3) was the only self-report measure targeting social withdrawal, but its emphasis on depressive symptomatology weakened its recommendation for NS assessment.

We identified 15 promising self-assessment scales on specific NS domains. Although they require further validation notably on their sensitivity to change, they provide detailed insights into symptomatology and facilitate precise monitoring.