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Schizophrenia

Positive Symptoms Continued and Negative Symptoms

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.

Positive Symptoms: The Disorganized Dimension

person walking outside Disorganized thinking becomes noticeable in speech patterns as schizophrenia progresses. This may show up as:

  • people losing their train of thought during conversations
  • making loose associations of topics. This might be either jumping from one topic to another apparently at random, or from minor associations of one topic to another
  • giving answers to unrelated questions
  • talking continuously, giving lots of irrelevant information or never getting to the point

Occasionally, speech is so disorganized that it becomes completely jumbled without any obvious meaning even though it is full of words.

Disorganized behavior may range from simple problems with self-care behaviors such as personal hygiene to unpredictable and bizarre socially inappropriate outbursts. For example, people may not dress according to the weather. They may wear a heavy coat in the middle of summer., They may wear odd or inappropriate makeup. They may shout at people for no obvious reason. They may mutter to themselves continuously. Most anything is possible.

Catatonic motor behaviors are a type of disturbed behavior that sometimes happens when schizophrenia goes untreated. Catatonia is a negative symptom of schizophrenia. In catatonia, peoples' reaction to their surroundings becomes very decreased. They may take a rigid, uncomfortable looking position and then not move for hours or days, resisting efforts by others to move them. They may allow themselves to be moved into new positions, but do not move on their own. Most of the time, this is not an act or a show but rather a genuine symptom of the illness that the person cannot help. Catatonia is observed less today than in past years because of advances in treating schizophrenia.

Negative Symptoms

Negative symptoms of schizophrenia involve missing behaviors compared to normal functioning.

Affect refers to the expression of emotions. People with schizophrenia often show what is referred to as affective flattening. This means that the person doesn't have the full range of emotional expression that others do. They may show relatively immobile and unresponsive facial expressions, have poor eye contact and little body language or movement.

Alogia refers to difficulty with speaking. In some people with schizophrenia this shows as less speech overall and less ease with choosing words (known as verbal fluency). For example, they may struggle to give brief answers to questions.

Avolition describes a loss of motivation, which is the will or desire to participate in activities or to do things. This might be displayed by sitting still for long periods of time without showing much interest in their surroundings. It might also involve not displaying any interest in work or social activities with others. In extreme cases, this behavior becomes catatonia. In catatonia, peoples' reaction to their surroundings becomes very decreased. They may take a rigid, uncomfortable looking position and then not move for hours or days, resisting efforts by others to move them. They may allow themselves to be moved into new positions, but do not move on their own. Most of the time, this is not an act or a show but rather a genuine symptom of the illness that the person cannot help. Catatonia is observed less today than in past years because of advances in treating schizophrenia.

 

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