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Background Negative symptoms of schizophrenia are suggested to map onto two distinct factors – amotivation and diminished expression, which relate to different aspects of behaviour and neural activity. Most research in patients with schizophrenia is conducted with broad symptom assessment scales, such as the PANSS, for which factor solutions allowing the distinction between amotivation and diminished expression have only recently been reported. We aimed to establish whether the PANSS factor structure corresponds to the well-established two-factor structure of the Brief Negative Symptom Scale (BNSS) and whether it allows distinguishing specific behavioural and neuronal correlates of amotivation. Methods In study 1 (N=120) we examined the correlations between the PANSS factors and the BNSS factors. In study 2 (N=31) we examined whether PANSS amotivation is specifically associated with reduced willingness to work for reward in an effort-based decision making task. In study 3 (N=43) we investigated whether PANSS amotivation is specifically correlated with reduced ventral striatal activation during reward anticipation using functional magnetic resonance imaging. Results On the clinical level, the PANSS amotivation and diminished expression were highly correlated with their BNSS counterparts. On the behavioural level, PANSS amotivation factor but not the diminished expression factor was specifically associated with reduced willingness to invest effort to obtain a reward. On the neural level, PANSS amotivation was specifically associated with ventral striatal activation during reward anticipation. Discussion Our data confirm that the two domains of negative symptoms can be measured with the PANSS and are linked to specific aspects of behaviour and brain function. To our knowledge, this is the first study employing behavioural and neural measures to validate a new approach to clinical measurement of negative symptoms. Our results warrant a re-analysis of previous work that used the PANSS to further substantiate the distinction between the two factors in behavioural and neuroimaging studies.

S71. CLINICAL, BEHAVIOURAL AND NEURAL VALIDATION OF THE POSITIVE AND NEGATIVE SYMPTOM SCALE (PANSS) AMOTIVATION FACTOR