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Living a Full Life with Schizophrenia

Negative Symptoms of Schizophrenia: The 5 Most Common Ones

Negative Symptoms of Schizophrenia: The 5 Most Common Ones

For millions of Americans, the negative symptoms of schizophrenia can be disabling; in fact, the disease is one of the top 10 causes of disability in the world, particularly for young adults. These symptoms affect a person's ability to live independently, to obtain and keep a job, and to function in a variety of social settings. As a result, most adults who have schizophrenia need some type of support, whether through government funding or caregivers. Only 10 to 20 percent of those with schizophrenia are able to work full or part-time. 


An Overview of Schizophrenia

An Overview of Schizophrenia

Schizophrenia is a serious mental illness, and its severity varies widely, particularly in relation to the negative symptoms of schizophrenia. The way these symptoms manifest themselves is different in each patient, and it profoundly affects how well they function.

The symptoms are divided into different categories: positive and negative. Each set has distinct signs and causes. In addition, each set of symptoms responds differently to various treatments.

What Are the Positive Symptoms of Schizophrenia?

What Are the Positive Symptoms of Schizophrenia

In this context, a positive symptom means a symptom which is present but is not considered a sign of normal functioning. These are the most dramatic and noticeable symptoms of schizophrenia and are frequently the main ones for which individuals seek help. These symptoms include:

  • Delusions
  • Hallucinations
  • Disorganized thinking
  • Paranoia

It’s not unusual for someone with schizophrenia to hear imaginary voices in his or her head and believe that these voices are real.

What Are the Negative Symptoms of Schizophrenia?

What Are the Negative Symptoms of Schizophrenia

In this context, negative symptoms of schizophrenia refer to the loss of a normal function. While the positive symptoms may be more dramatic and gain clinical attention, it is often the negative symptoms that create extreme difficulty in day-to-day functionality. These symptoms include the inability to feel pleasure and the inability to interact socially with others.

Treatment with modern antipsychotic medication can relieve most positive symptoms, but it can still be challenging to treat the negative symptoms of schizophrenia. As many as 25percent of those with schizophrenia also have deficit syndrome. Deficit syndrome means they have persistent, severe negative symptoms.

Negative symptoms are related to deficiencies in thought. Schizophrenic patients do not perform well on tests that measure flexibility and mental fluency. They have particular difficulty with word fluency, which involves producing words that are related to a specific category. These studies indicate the far-reaching effects these limitations have on everyday life.

While the positive symptoms often have a devastating impact on quality of life, the negative symptoms of schizophrenia remain the main reasons that those with the disorder find it difficult to live independently, manage personal relationships, or function well in everyday social situations. Studies have indicated that patients who experience the best outcomes are the same ones who had the fewest severe negative symptoms of schizophrenia.

In fact, it is these negative symptoms of schizophrenia that create such a heavy burden on caregivers. Not only that, but these symptoms are more difficult to treat and tend to last much longer than the positive symptoms. Initially, it was the negative symptoms that the original clinicians saw as the primary problem presented by schizophrenia. However, the positive symptoms gained more prominent attention, not only because they are so dramatic, but because it is more difficult to notice and document the negative symptoms of schizophrenia.

5 Negative Symptoms of Schizophrenia

5 Negative Symptoms of Schizophrenia

A consensus panel of The National Institute of Mental Health Measurement and Treatment Research to Improve Cognition in Schizophrenia clearly outlined the five main negative symptoms associated with this disease. They are:

  • Blunted affect
  • Alogia
  • Asociality
  • Avolition
  • Anhedonia

What Does it Mean to Have a Blunted Affect?

What Does it Mean to Have a Blunted Affect

If someone has a flat or blunted affect, it means they do not exhibit any emotional expression, and they do not respond to people in an expected manner. Many believe that because those with schizophrenia do not express themselves, they don't feel anything.  That’s not true. When asked, patients clearly state that they may be depressed or anxious. This loss of expressiveness may be isolating for them, particularly when considering the fear of social stigma. Blunt or flat affect may also be a neurological side effect of certain types of antipsychotic drugs.

What Is Alogia?

What Is Alogia

Alogia is also referred to as poverty of speech. Those who have schizophrenia may respond with monosyllabic answers, talk very little, or not be as verbally expressive as those without the disease.

What Is Asociality?

What Is Asociality

Those with asociality are uninvolved in various social or intrapersonal relationships. Those with this negative symptom are less likely to start personalized interactions with others or respond when invited to join a conversation or activity.

What Is Avolition?

What Is Avolition

Someone who exhibits abolition has lost any interests or desire in certain goals. Individuals with this symptom frequently show a lack of motivation and will not initiate activities.

What Is Anhedonia?

What Is Anhedonia

Anhedonia is the loss of or the inability to experience pleasure. Many who have schizophrenia may also have depression, and anhedonia is one of the main symptoms of depression. Sometimes, by treating the depression, the negative symptom of anhedonia is also relieved

Treatment for the Negative Symptoms of Schizophrenia

Treatment for the Negative Symptoms of Schizophrenia

Typically, physicians and clinicians have focused primarily on treating the positive symptoms of schizophrenia. However, studies have shown that it is equally important to address the negative symptoms. Patients who have the best outcomes are often those whose negative symptoms are under control. However, the situation is complicated because often, the side effects of certain antipsychotic medications can exacerbate the problem.


As a result, doctors have several different options. They can prescribe a medication that is less likely to produce side effects, or they can prescribe medication at a lower dose. Many of those with schizophrenia also have depression, and some of the negative symptoms of schizophrenia are also similar to the symptoms of depression. Therefore, the clinician should consider treating the patient for depression.

Psychosocial Therapy Treatment

Other Therapeutic Treatments

Family Education Is Essential 


Schizophrenia is typically thought of as a series of positive symptoms, meaning symptoms that are outside of the normal range. These symptoms include delusions, hallucinations, and irrational behaviors. However, the negative symptoms of schizophrenia can have an equally destructive effect on the lives of those with this disease.

In many cases, it is these negative symptoms of schizophrenia that make it more difficult to hold a job, participate in social activities, and live independently. While research is ongoing for the best way to treat the negative symptoms of schizophrenia, many believe a combination of carefully monitored atypical antipsychotics and psychosocial training may be the most successful treatment.

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