A new rating scale for negative symptoms:
The Motor-Affective-Social Scale
, Michelle Goggin
, Daniel Antonius
, Pàl Czobor
, Leslie Citrome
Clinical Research and Evaluation Facility, Nathan S. Kline Institute for Psychiatric Research and Rockland Psychiatric Center,
140 Old Orangeburg Road, Orangeburg, NY 10962, USA
Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA
Clinical Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA
Department of Psychology, The New School for Social Research, New York, NY 10011, USA
Received 25 July 2006; received in revised form 8 June 2007; accepted 24 June 2007
The commonly used rating scales for negative symptoms in schizophrenia have shown good reliability, but disagreement persists
regarding both the content definition and the validity of several items. Instead, authors have recommended rating the specific behaviors
that are defined as negative symptoms. To surmount these shortcomings, we developed a new rating scale for negative symptoms: the
Motor-Affective-Social Scale (MASS). During a 5-minute structured interview, hand coverbal gestures, spontaneous smiles, voluntary
smiling, and questions asked by the interviewer were counted and rated on 101 inpatients with a diagnosis of schizophrenia or
schizoaffective disorder. Information on social behavior was obtained from nursing staff. The scale consisted of a total of eight items. The
MASS showed high internal consistency (Cronbach alpha coefficient=0.81), inter-rater reliability, and test–retest reliability (intra-class
correlation coefficient=0.81). Convergent validity analyses showed high correlations between MASS scores and scores on the Scale for
the Assessment of Negative Symptom (SANS), and the negative symptoms subscale of the Positive and Negative Syndrome Scale
(PANSS). The MASS showed excellent psychometric properties, practicality, and subject tolerability. Future research that includes the
use of the MASS with other patient populations and that investigates the scale's sensitivity during clinical trials should be performed.
© 2007 Elsevier Ireland Ltd. All rights reserved.
Keywords: Schizophrenia; Schizoaffective disorder; Blunted affect
Negative symptoms in schizophrenia refer to the
absence of certain normal functions, including emotion-
al expression, speech and social motivation. The
pathophysiology of negative symptoms is poorly
understood, and they remain a significant treatment
challenge for the psychopharmacologist. When taken
into consideration with cognitive deficits, negative
Available online at www.sciencedirect.com
Psychiatry Research 160 (2008) 346 – 355
This work was presented in part as a poster at the XX International
Congress on Schizophrenia Research, Savannah, Georgia, April 2–6,
2005, and at the 46th annual meeting of the New Clinical Drug
Evaluation Unit, Boca Raton, Florida, June 12–15, 2006.
Corresponding author. Nathan S. Kline Institute, 140 Orangeburg
Road, Orangeburg, NY 10962, USA. Tel.: +1 845 398 5599; fax: +1
845 398 5483.
E-mail address: Ftremeau@NKI.RFMH.ORG (F. Trémeau).
0165-1781/$ - see front matter © 2007 Elsevier Ireland Ltd. All rights reserved.