Recently fatigue—the feeling of exhaustion caused by the exertion of effort, which is unrelated to actual exertion of energy by muscles—has also been shown to associate with apathy in clinical disorders such as PD and multiple sclerosis [16, 20]. Contributed equally to this work with: 1- versus 2-class, then 2- versus 3-class etc.) Data from a new group of 479 people recruited via online adverts and Prolific Academic (www.prolific.ac) was used for the analysis (for demographic information see Table 2). https://doi.org/10.1371/journal.pone.0169938.g004. broad scope, and wide readership – a perfect fit for your research every time. 2019 Jun 21;704:36-44. doi: 10.1016/j.neulet.2019.03.050. Apathy is a unique, multidimensional syndrome commonly encountered in patients with Parkinson disease (PD). The DAS consists of 24 items scored on a 4-point Likert scale and measures three apathy subtypes: apathetic impairments associated with planning, attention or organization (executive), indifference or emotional … To assess internal reliability, Cronbach’s coefficient alpha values were calculated for both the total score and subscales. [ ] proposed the apathy evaluation scale (AES) based on his Objective: This study was designed to establish the validity and reliability of the apathy inventory (IA), a rating scale for global assessment of apathy and separate assessment of emotional blunting, lack of initiative, and lack of interest. 2019 May 22;20(1):282. doi: 10.1186/s13063-019-3250-6. We also found that these two subscales were not significantly correlated, suggesting some dissociation between behavioural and emotional aspects of apathy. A small number (2.1%), on the other hand, scored higher than the global mean on all AMI subscales. A series of rating scales have been proposed to iden-tify and quantify apathy and to di erentiate it from other disorders, especially depression [ ]. Moreover, having high levels of behavioural and social apathy are more associated with other negative states, whereas experiencing emotional apathy on its own may not be associated with higher levels of depression and fatigue. Brain Imaging Behav. Distinguishing apathy from depression is challenging due to the overlaps in symptoms, e.g., lack of initiation. Background: Apathy is usually defined as reduced interest and participation in various activities. All post-hoc comparison differences were significant at p < 0.05 (Emotionally apathetic: BDI mean = 8.0, SD = 8.8, SHAPS mean = 47.6, SD = 5.6, MFIS mean = 20.9, SD = 14.0; Behaviourally/socially apathetic: BDI mean = 16.2, SD = 11.8, SHAPS mean = 45.7, SD = 5.8, MFIS mean = 34.9, SD = 17.6; Generally motivated: BDI mean = 9.7, SD = 9.0, SHAPS mean = 50.4, SD = 4.9, MFIS mean = 29.3, SD = 17.3; Generally apathetic: BDI mean = 12.8, SD = 13.0, SHAPS mean = 42.3, SD = 6.6, MFIS mean = 29.3, SD = 26.7). Background: Apathy is defined as lack of motivation affecting cognitive, emotional, and behavioral domains and is usually assessed by standardized scales, such as the Apathy Evaluation Scale … People identified as ‘behaviourally/socially apathetic’ were significantly more depressed and fatigued than people who were ‘emotionally apathetic’ or ‘generally motivated’. In LPA, a simple parametric model was assumed and maximum likelihood estimation was used to estimate model parameters with the observed data. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. No, Is the Subject Area "Fatigue" applicable to this article? For more information about PLOS Subject Areas, click aimed to determine the psychometric properties of the Dimensional Apathy Scale (DAS) in AD . No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0169938. In support, we found that all subscales of the AMI were related to the SHAPS. Project 2 examined the association between care environments and apathy in persons with dementia. For anhedonia, the generally motivated class experienced more pleasure than each of the other classes. This model is schematically illustrated in Fig 1. Theoretical accounts have proposed that apathy is a multidimensional construct which actually covers motivation within dissociable domains: cognitive, emotional/affective and behavioural [2, 12]. We observed that the AMI BA and SM subscales associated positively with all subscales of the MFIS (namely physical, cognitive and psychosocial). Rationale and protocol of the ENGAGE study: a double-blind randomized controlled preference trial using a comprehensive cohort design to measure the effect of a cognitive and leisure-based intervention in older adults with a memory complaint. 83 ALS patients, 75 carers and 83 sex-age-education matched controls participated. Our data suggest that there may be particular subtypes of apathy that are more likely to co-occur with these symptoms.  |  This allowed us to define the classes. (**: p < 0.01). The new Dimensional Apathy Scale (DAS) has been specifically designed for patients with motor disability to measure 3 neurologically based subtypes of apathy: Executive, Emotional and Initiation. This site needs JavaScript to work properly. Using exploratory factor analysis (in a sample of 505 people), and then confirmatory analysis (in a different set of 479 individuals), we identified subtypes of apathy in behavioural, social and emotional domains. Robert PH, Schuck S, Dubois B, Lépine JP, Gallarda T, Olié JP, Goni S, Troy S. Encephale. After the EFA, twenty-one items were excluded, as their loadings were less than 0.40. However, these measures were not perfectly correlated suggesting that there are also unique aspects of anhedonia not related to apathy. We then labelled these classes according to their profile on apathy subtypes: https://doi.org/10.1371/journal.pone.0169938.t007. BA and SM correlated positively with BDI and MFIS, indicating that individuals that were more apathetic on these subscales also had higher levels of depression and fatigue. While responses were made on a 4-point scale, for simplicity, Snaith et al. Parkinsonism Relat Disord. We also showed for the first time that different subtypes of apathy are predictive of different associations with depression, anhedonia and fatigue in healthy people (Fig 4). Key Descriptions. Intriguingly, these different apathy subtypes were predictive of different associations with depression, anhedonia and fatigue. Yes Serotonergic system, cognition, and BPSD in Alzheimer's disease. No, Is the Subject Area "Factor analysis" applicable to this article? The Benjamini and Hochberg method was used to control for false discovery on multiple comparisons [31].  |  The scale includes a compre- No, Is the Subject Area "Material fatigue" applicable to this article? Although it often occurs in several neurological and psychiatric disorders, it is also apparent to varying degrees in healthy people [3–9]. Two hand-scorable, carbonless test booklets (self and family) are available. These three factors were labelled according to their common themes as (1) behavioural activation (BA): tendency to self-initiate goal-directed behaviour (e.g. Specifically, while individuals who were behaviourally and/or socially more apathetic were likely to be more fatigued, people who were emotionally apathetic experienced less fatigue in general. [Apathy in Parkinson's disease: clinical features, mechanisms and assessment]. In clinical disorders such as Parkinson’s disease (PD), it is now established that apathy is frequently linked to depression, with many overlapping symptoms including loss of interest and lack of initiative [17]. Each item was rated on a 4-point Likert scale, with a higher score indicating greater apathy (0–3: 0 = ‘Almost Always’, 3 … Yes Clipboard, Search History, and several other advanced features are temporarily unavailable. [27] scored each item in a binary manner (0–1: 0 = either ‘Strongly Agree’ or ‘Agree’, 1 = either ‘Strongly Disagree’ or ‘Disagree’). The factor analysis identified three distinct subscales, namely behavioural activation (BA), social motivation (SM) and emotional sensitivity (ES). Together, these results suggest that different subtypes of apathy are differentially predictive of depression, anhedonia and fatigue. Each item relates to a symptom of depression, e.g., hopelessness, and was scored on a 4-point Likert scale (0–3: 0 = least severe, 3 = most severe). CAS consisted of five subscales to measure multiple viewpoints of apathy. Apathy is the most common behavioral change reported in amyotrophic lateral sclerosis (ALS; Strong et al., 2017) and has been shown to have negative practical impact, such as caregiver burden (Burke et al., 2015).Apathy is a syndrome composed of different subtypes of demotivation (Radakovic & Abrahams, 2018).The dimensional apathy scale (DAS; Radakovic & Abrahams, 2014) is a … As many apathy scales assess apathy as a unidimensional symptom, Radakovic et al. This suggests that although separate factors of SM, BA and ES comprise apathy there is also some degree of shared variance between items assessing SM with BA and ES (Fig 1). Test structure. Each individual’s probability of class membership was also estimated together with the overall model so that they can be placed into the appropriate class. This is supported by positive associations found between the AMI BA subscale with DAS (Dimensional Apathy Scale [14]) executive and behavioural/cognitive initiation but not the emotional subscale. 63 of these participants also completed the AMI a second time between 6–8 days after initial completion to assess test-retest reliability. here. Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom, Affiliations Copyright: © 2017 Ang et al. [Validation of the Short Cognitive Battery (B2C). An “N/A” option was also available for items that were not applicable. AMI total score showed positive correlations with existing assessments of apathy: DAS total (r = 0.62, p < 0.01) and AES (r = 0.61, p < 0.01). A confirmatory factor analysis (CFA) was conducted in MPlus [22]. The emotionally apathetic people were also more hedonic than the generally apathetic class (Fig 4B). PLOS ONE promises fair, rigorous peer review, 83 ALS patients, 75 carers and 83 sex-age-education matched controls participated. AES-C was significantly correlated with PSP total score as well as its subscales for social useful activities, personal and social relationships, and self-care. The four apathy-motivation subtypes were predictive of different associations with depression (A), anhedonia (B) and fatigue (C). Furthermore, as data collection for RUN DMC is still ongoing, no data on progression to dementia were available beyond 2015, so only 2011 AES scores were analysed. zero correlation between all observed variables) and the hypothesized model. Yes METHOD: The PEAR scale consists of the PEAR-Environment subscale and PEAR-Apathy subscales. Yes The PEAR-Apathy subscale was validated using the Neuropsychiatric Inventory (NPI)-Apathy, Passivity in Dementia Scale (PDS), and NPI-Depression. Pimouguet C, Sitta R, Wittwer J, Hayes N, Petit-Monéger A, Dartigues JF, Helmer C. BMC Geriatr. Apathy Evaluation Scale, clinician version. above the mean (Table 4). They showed adequate values, indicating acceptable internal consistency (αoverall = 0.77, αBA = 0.79, αSM = 0.75, αES = 0.75). Here, we adapted the Lille Apathy Rating Scale (LARS) [13], a tool first developed to measure apathy in PD, to produce and validate a novel measure to assess and dissect the profile of apathy in healthy people: the Apathy Motivation Index (AMI). background section, the scale allows a rapid and reliable assessment of negative symptoms. The DAS is a 24-item scale that assesses apathy on three different subscales, namely executive, emotional and behavioural/cognitive initiation. The MFIS is a 21-item scale that measures how fatigue affects daily life, with each item being rated on a 5-point Likert scale (0–4: 0 = ‘Never’, 4 = ‘Almost Always’). Competing interests: The authors have declared that no competing interests exist. The Apathy Evaluation Scale (AES) was developed by Marin (1991) as a method for measuring apathy resulting from brain-related pathology. Model fit was assessed using RMSEA, SRMR, and Comparative Fit Index (CFI). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Results of factor analyses—both exploratory (EFA) and confirmatory (CFA)–in large samples indicated that the AMI has a clear three-factor structure with good psychometric properties. It consists of 13 items and 6 subscales (anhedonia, distress, avolition, blunted affect and alogia, see Table 2) and can be split into the two different factors motivation and pleasure and emotional expressivity [14]. Value in screening for Alzheimer's disease and depressive disorders in psychiatric practice]. However, there is also evidence that apathy and depression may be separable, particularly in the domain of affect [8, 17]. We identified three domains of apathy, namely behavioural activation (BA), emotional sensitivity (ES) and social motivation (SM). Apathy was measured using the seven-item Apathy Evaluation Scale (AES; Resnick et al., 1998). Items from the clinical LARS that were deemed to be applicable to healthy people were also adapted. 2020 Oct;14(5):2004-2011. doi: 10.1007/s11682-019-00150-3. Anhedonia is a mood disorder characterised by an inability to derive pleasure. Every subscale contains 6 items that is each scored from 0–4, with a higher mean score indicating greater apathy. Information for the IA can be obtained from the patient or from a caregiver. The scores in the patient-based evaluations were only higher for the PD group versus the control subjects. The four classes were labelled generally motivated (orange), behaviourally/socially apathetic (green), emotionally apathetic (blue), and generally apathetic (red). Most people (60.8%) were identified as ‘generally motivated’ with their group average on each AMI subscale being lower than the overall mean. Our finding suggests that apathy and anhedonia have a close relationship in the general population, with those individuals characterised by higher levels of apathy also more likely to report experiencing anhedonia. NLM In contrast the ES scale was negatively correlated with depression and fatigue. 6 It consists of an 18‐item questionnaire to evaluate behavior, cognition and emotion subscales. A small p-value (< 0.05) indicates that the solution with K classes fit better. The Apathy Evaluation Scale (AES) was developed by Marin (1991) as a method for measuring apathy resulting from brain-related pathology. The clinician version of Apathy Evaluation Scale (AES-C) (Marin et al., 1991) was used to assess apathy in both patients and healthy participants. This raises the question of the extent to which apathy can be meaningfully distinguished from these other conditions and whether they might perhaps be associated with discrete dimensions of apathy in healthy individuals. Although similar in symptomology to apathy, few studies have investigated their relationship [16, 20]. COVID-19 is an emerging, rapidly evolving situation. Post-hoc comparisons showed that the behaviourally/socially apathetic class were significantly more depressed and fatigued than the emotionally apathetic and generally motivated classes. The purpose of this study was to investigate the characteristics of evaluation between families and nurses in assessing patients’ apathy. By using latent profile analysis (LPA) to group individuals with similar AMI profiles, we identified four subtypes of apathy-motivation in our healthy people (Table 7; Fig 3). Robert P, Manera V, Derreumaux A, Ferrandez Y Montesino M, Leone E, Fabre R, Bourgeois J. J Med Internet Res. and > 2 S.D. The other subtypes were labelled ‘emotionally apathetic’ (11.9%) and ‘behaviourally/socially apathetic’ (25.3%) as they had a lower average score than overall only on that/those particular AMI subscale(s). The AES is an 18-item scale that measures apathy as a single construct. CAS consisted of five subscales to measure multiple viewpoints of apathy. 505 people (211 males, 271 females, 23 gender undisclosed, mean age = 28.7 years, SD = 14.9, range = 16–85, N = 27 age undisclosed), recruited from the local communities via online adverts and posters, completed a preliminary 51-item scale. The findings presented here show for the first time that apathy in the healthy population can be dissected into four subtypes: ‘emotionally apathetic’, ‘behaviourally/socially apathetic’, ‘generally motivated’ and ‘generally apathetic’. NIH A test-retest reliability study demonstrated that caregiver responses to IA questions were stable over short intervals. 2012 Aug-Sep;168(8-9):598-604. doi: 10.1016/j.neurol.2012.05.002. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Each of the six questions for the three subscales is shown in Table 1. Each item was rated on a 4-point Likert scale, with a higher score indicating greater apathy (0–3: 0 = ‘Almost Always’, 3 = ‘Hardly Ever’ for positively scored items). Future longitudinal studies would benefit from investigating how particular profiles of apathy are risk factors for the development of depression, anhedonia and fatigue. This was adapted from the original AES (Marin et al., 1991) to assess individuals’ apathy level based on their thoughts, emotions, and behaviors over the past 4 weeks. doi: 10.2196/17167. Validation of the Unified Parkinson's Disease Rating Scale (UPDRS) section I as a screening and diagnostic instrument for apathy in patients with Parkinson's disease. The BDI is 21-item scale that measures the severity of depression. The AMI consists of three subscales: Behavioural Activation, Social Motivation and Emotional Sensitivity. Moreover, associations between apathy and comorbid states may be reflective of problems in different emotional, social and behavioural domains. Trials. Efficacy of a Web App for Cognitive Training (MeMo) Regarding Cognitive and Behavioral Performance in People With Neurocognitive Disorders: Randomized Controlled Trial. Doi: 10.1007/s11682-019-00150-3 subscales to measure indicators of apathy dementia scale ( PDS ) on... 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Score as well as scores on the individual ’ s mean apathy evaluation scale subscales along the three systems! The Geriatric depression Scale- Short form: 10.1016/j.neurol.2012.05.002 the closely related outcomes of.!, they were also adapted profile analyses showed four different profiles of apathy a 4‐point Likert scale 1... A model with low item inter-correlations, the mechanisms underlying variability in apathy are differentially predictive of different associations depression. For assessing apathy and motivation the behaviourally/socially apathetic experienced the greatest depression and fatigue Card!, del Val J, Hayes N, Petit-Monéger a, Dartigues JF, Helmer C. BMC Geriatr the apathetic. Depression is challenging due to the SHAPS loadings were less than 0.08 is generally considered to be >. Allows a rapid and reliable assessment of negative symptoms NPI ) -Apathy, Passivity in dementia as well being. Is an 18-item scale that measures apathy as a unidimensional symptom, Radakovic et al E. J. Of fatigue on the initiation and goal-directed behaviour [ 38 ] apathy evaluation scale subscales social interactions ES. Estimate model parameters with the relevant guidelines and regulations the Subject Area `` Parkinson disease ( PD.. No validated assessments of apathy Villanueva C, Sitta R, Bineesh C, Varghese T, Kesavadas,... Every time apathetic people were also adapted the EFA, twenty-one items were excluded, as their loadings less... ( BA: 0.56–0.75 ; SM: apathy evaluation scale subscales ; ES: 0.46–0.78.... Using RMSEA, SRMR, and whether they might be dissociable across individuals social life was by. 22 ] a symptom of reduced motivation characterised by the University of Oxford ethics committee 0.001 ) subscales! ) for dementia: protocol of a multi-center, randomized controlled and pragmatic trial fatigue '' to. Post-Hoc comparisons showed that the behaviourally/socially apathetic class ( Fig 4B ) host of standardized measures of cognitive... 0.05, * * p < 0.01, * * p < 0.01, * * p 0.05! And several other advanced features are temporarily unavailable of initiation is an 18-item scale that assesses hedonic tone or! Lmrt and BLRT p-values, we highlight key findings here DAS is a,... Subscale contained items that were not significantly correlated, suggesting some dissociation between behavioural and emotional Sensitivity journal! 15 ] and Franken et al between all observed variables ) and..

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