Table 1.

Conceptual Limitations of Currently Existing UHR Interviews with Regard to Negative Symptom Assessment

Conceptual Limitations
Negative Symptom Domains
Avolition	Asocialitv	Anhedonia	Blunted Affect	Alogia
SIPS
Separate experiential and objective components not measured. Occupational functioning item is not part of the negative symptom construct	Does not contain an asociality item specifically. Asociality conflated with anhedonia. Does not measure social interactions that take place via social media and texting.	Anhedonia item evaluates social domain only and neglects physical, role, or recreational domains. Conflates asociality, social anxiety, and social skill. Probes do not evaluate pleasure for social situations. Does not differentiate between anticipation and consumption of pleasure or frequency vs. intensity of pleasure.	Expression of Emotion item does not separate channels of communication (face, body, voice). Conflates alogia and blunted affect. Incorporates poor rapport and lack of eye contact into rating, which are not part of the construct	Expression of Emotion item conflates blunted affect and alogia. Conflates poor rapport
CAARMS
Items do not incorporate persistence, only initiation. The impetus for the activity is also not considered (i.e., whether the subject had to be pushed to initiate the activity)	Does not contain a formal asociality item contained within the subheading of negative symptoms. The social isolation item is the closest to asociality, but it conflated with social anxiety. Does not evaluate social media, texting etc.	Assesses interest, which is typically linked to depression rather than schizophrenia-spectrum disorders. The subjective emotional experience item includes elements of inappropriate affect, which is more conceptually relevant to disorganization and incorporates information on experience of both positive and negative emotion reductions	Factors in rater rapport, rather than pure behavioral observation. Not a comprehensive evaluation of face, voice, and body gestures	Conflated with disorganization including content related to thought blocking and vagueness. Incorporates both participant self report and observed speech behavior, despite issues with insight affecting self-report
SPI
Items focus solely on internal experience of avolition (including motivation, initiation, and persistence), but neglect behavioral engagement in goal-oriented tasks.	Contains 1 item inquiring into desire for social contact. Does not evaluate nature, quality, and frequency of social engagement. Neglects interactions on social media, texting etc.	Minor reference to decreased positive emotional response toward others. Does not assess for hedonic behavioral experience of any sort. Does not contain items assessing physical, role, or recreational hedonic experience, nor any reference to anticipatory or past frequency of enjoyment in activities.	Items prioritize self-report over behavior.	Items prioritize self-report over behavior.