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Positive and Negative Syndrome Scale (PANSS)

Instructions

The PANSS is a 30-item rating instrument evaluating the presence/absence and severity of positive, negative, and general psychopathology symptoms. Each item is accompanied by a specific definition as well as detailed anchoring criteria for all seven rating points: 1 = absent; 2 = minimal; 3 = mild; 4 = moderate; 5 = moderate-severe; 6 = severe; 7 = extreme Rate each item based on information relating to the past week.

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Delusions

Beliefs which are unfounded, unrealistic, and idiosyncratic.

Conceptual Disorganization

Disorganized process of thinking characterized by disruption of goal-directed sequencing.

Hallucinatory Behavior

Verbal report or behavior indicating perceptions which are not generated by external stimuli.

Excitement

Hyperactivity as reflected in accelerated motor behavior, heightened responsivity to stimuli, hypervigilance, or excessive mood lability.

Grandiosity

Exaggerated self-opinion and unrealistic convictions of superiority, including delusions of extraordinary abilities, wealth, knowledge, fame, power, and moral righteousness.

Suspiciousness/Persecution

Unrealistic or exaggerated ideas of persecution, as reflected in guardedness, a distrustful attitude, suspicious hypervigilance, or frank delusions that others mean harm.

Hostility

Verbal and nonverbal expressions of anger and resentment, including sarcasm, passive-aggressive behavior, verbal abuse, and assaultiveness.

Blunted Affect

Diminished emotional responsiveness as characterized by a reduction in facial expression, modulation of feelings, and communicative gestures.

Emotional Withdrawal

Lack of interest in, involvement with, and affective commitment to life's events.

Poor Rapport

Lack of interpersonal empathy, openness in conversation, and sense of closeness, interest, or involvement with the interviewer.

Passive/Apathetic Social Withdrawal

Diminished interest and initiative in social interactions due to passivity, apathy, anergy, or avolition.

Difficulty in Abstract Thinking

Impairment in the use of the abstract-symbolic mode of thinking, as evidenced by difficulty in classification, forming generalizations, and proceeding beyond concrete or egocentric thinking.

Lack of Spontaneity and Flow of Conversation

Reduction in the normal flow of communication associated with apathy, avolition, defensiveness, or cognitive deficit.

Stereotyped Thinking

Decreased fluidity, spontaneity, and flexibility of thinking, as evidenced in rigid, repetitious, or barren thought content.

Somatic Concern

Physical complaints or beliefs about bodily illness or malfunctions.

Anxiety

Subjective experience of nervousness, worry, apprehension, or restlessness.

Guilt Feelings

Sense of remorse or self-blame for real or imagined misdeeds in the past.

Tension

Overt physical manifestations of fear, anxiety, and agitation.

Mannerisms and Posturing

Unnatural movements or posture characterized by an awkward, stilted, disorganized, or bizarre appearance.

Depression

Feelings of sadness, discouragement, helplessness, and pessimism.

Motor Retardation

Reduction in motor activity as reflected in slowing or lessening of movements and speech, diminished responsiveness to stimuli, and reduced body tone.

Uncooperativeness

Active refusal to comply with the will of significant others, including the interviewer, hospital staff, or family.

Unusual Thought Content

Thinking characterized by strange, fantastic, or bizarre ideas, ranging from those which are remote or atypical to those which are distorted, illogical, and patently absurd.

Disorientation

Lack of awareness of one's relationship to the milieu, including persons, place, and time.

Poor Attention

Failure in focused alertness manifested by poor concentration, distractibility, and failure to complete tasks.

Lack of Judgment and Insight

Impaired awareness or understanding of one's own psychiatric condition and life situation.

Disturbance of Volition

Disturbance in the willful initiation, sustenance, and control of one's thoughts, behavior, movements, and speech.

Poor Impulse Control

Disordered regulation and control of action on inner urges, resulting in sudden, unmodulated, arbitrary, or misdirected discharge of tension and emotions.

Preoccupation

Absorption with internally generated thoughts and feelings and with autistic experiences to the detriment of reality orientation and adaptive behavior.

Active Social Avoidance

Diminished social involvement associated with unwarranted fear, hostility, or distrust.
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