"Negative Symptoms": Conceptual and Methodological Problems

Sommers, Alison A.

doi:10.1093/schbul/11.3.364

Cited by 188 publications

(62 citation statements)

References 67 publications

(70 reference statements)

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“…In addition, the stimuli may have differed along dimensions other than cognitive demand, such as a social-nonsocial dimension. Despite these caveats, our results suggest that if a causal relation between cognitive deficits and affective flattening does exist, it is probably more complex than we had originally anticipated.Although it has been suggested that affective flattening may be caused by neuroleptic agents (e.g., Sommers, 1985), a simple relation between medication and emotional expression was not found in this study. The blunted and nonblunted schizophrenics were receiving equivalent types and amounts of medication, which indicates that the administration of neuroleptic agents is not sufficient to cause affective flatness.…”

contrasting

confidence: 88%

Emotional Experience and Expression in Schizophrenia and Depression

Berenbaum¹,

Oltmanns²

2005

What the Face RevealsBasic and Applied Studies of Spontaneous Expression Using the Facial Action Coding System (FACS)

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The emotional responses of schizophrenic, depressed, and normal subjects and whether differences in the emotional responding of these groups depended on how emotional responses were elicited or measured were examined. Twenty-three blunted and 20 nonblunted schizophrenics, 17 unipolar depressed subjects, and 20 normal subjects were exposed to a series of affect-eliciting stimuli. The stimuli varied in valence (positive vs. negative) and in level of cognitive demand. Subjects reported their subjective experiences, and their facial expressions were videotaped. Blunted schizophrenics were the least facially expressive, although their reported subjective experiences did not differ from those of the other groups. The nonblunted schizophrenics were more responsive than the depressed subjects to the positive stimuli, although the two groups did not differ in their clinical ratings of affective flatness.Historically, psychopathologists have placed a great deal of emphasis on the role of emotional disturbance in schizophrenia. Whereas both Bleuler (1911Bleuler ( /1950 and Kraepelin (1919Kraepelin ( /1971 considered affective flatness to be a universal symptom of schizophrenia, the International Pilot Study of Schizophrenia (World Health Organization, 1973) revealed that only 66% of the schizophrenic patients studied exhibited flat affect. People with major depression have also been found to have flat affect (e.g., Andreasen, 1979;Pogue-Geile & Harrow, 1984). Although blunted affect may not be a universal symptom of schizophrenia and is not specific to the disorder, it does appear to have prognostic importance (Carpenter, Bartko, Strauss, & Hawk, 1978; Knight, Roff, Barmen, & Moss, 1979).Most of what is known about affective flatness has come from studies in which psychiatric patients were observed during clinical interviews and received unidimensional ratings of emotional expressiveness. Unfortunately, in such studies there is a risk of overlooking several important factors. For example, it is essential to specify which facets of the emotional response are blunted. Neurological evidence indicates that the systems controlling HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript facial expressions and subjective experience can act independently (e.g., Ross & Mesulam, 1979). This suggests the need to systematically examine both the subjective experience and the outward expression of emotion. Another important factor that has generally been overlooked is the distinction between positive and negative emotions. Knowledge concerning how groups of psychiatric patients differ from each other and from normal persons, such as whether the differences are restricted to a particular facet of emotional responding or are limited to positive or negative emotions, has implications beyond its potential diagnostic utility. The answers to these questions can provide clues to the origins of affective disturbances in psychopathologic disorder.The mechanism that mediates schizophrenics' affective dis...

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contrasting

confidence: 88%

Emotional Experience and Expression in Schizophrenia and Depression

Berenbaum¹,

Oltmanns²

2005

What the Face RevealsBasic and Applied Studies of Spontaneous Expression Using the Facial Action Coding System (FACS)

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“…Typically it involves a loss of contact with reality through hallucinations (a sensory perception experienced in the absence of an external stimulus, Silbersweig et al, 1995) and/or delusions (strongly held beliefs, maintained despite a lack of evidence, Bentall, Corcoran, Howard, Blackwood, & Kinderman, 2001) and is often concomitant with negative symptoms (e.g., withdrawal or lack of thoughts, feelings, and behaviors that are usually present, Sommers, 1985). These experiences are among the clinical hallmarks of many psychiatric diagnoses including schizophrenia, schizoaffective disorder, and bipolar disorder.…”

Section: P R E P U B L I C a T I O N C O P Ymentioning

confidence: 99%

Self-help interventions for psychosis: A meta-analysis

Webb

Rowse

2015

Clinical Psychology Review

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Self-help has been shown to be an effective intervention for a wide range of mental health problems. However, there is less evidence on the efficacy of self-help for psychosis and, to date, there has been no systematic review. A search of bibliographic databases identified 24 relevant studies with a total sample size of N = 1816. Ten studies adopted a repeated measures design and 14 an independent group design (including RCTs and quasiexperimental studies). Self-help interventions had, on average, a small-to-medium-sized effect on overall symptoms (d + = 0.33, 95% CI: 0.17 to 0.48). Sub-analyses revealed that selfhelp interventions had a small-to-medium-sized effect on positive symptoms (d + = 0.42, 95% CI: 0.13 to 0.72), a small-to-medium-sized effect on negative symptoms (d + = 0.37, 95% CI: 0.07 to 0.66), and a small-sized effect on outcomes associated with the symptoms of psychosis such as quality of life (d + = 0.13, 95% CI: 0.02 to 0.24). Moderation analysis identified a number of factors that influenced treatment effects including the complexity of the intervention and amount of contact time. Self-help interventions for psychosis have a lot of potential and recommendations for further research are discussed. Word count: 190Key words: Self-help, psychosis, meta-analysis P r e P u b l i c a t i o n C o p y Self-help interventions for psychosis 3 Self-help interventions for psychosis: A meta-analysis "A massive, systematic, and yet largely silent revolution is occurring in mental health today and is gathering steam for tomorrow" (Norcross, 2000, p. 370) In the quote above, Norcross (2000) refers to the proliferation of self-help approaches for mental health conditions, an approach that has gathered momentum with practitioners, researchers, and policy makers placing an increasing emphasis on self-help for treating mental health problems (Lewis et al., 2003). Self-help interventions are defined as those that are "designed to be conducted predominantly independently of professional contact" (Bower, Richards, & Lovell, 2001, p. 839). Self-help interventions can be administered through a variety of mediums such as face-to-face or group meetings, through computers, mobile, and online platforms. Self-help typically involves working independently through a guide that describes the steps to be taken in order to apply a psychological treatment. A slight variation is guided self-help, which is distinguished "by the support that is given by a professional therapist or coach to the patient when working through the standardized treatment" (Cuijpers, Donker, van Straten, & Andersson, 2010, p. 1934. The support offered can range from assisting the person to work through the self-help program to emotional support and can be provided in a range of ways (e.g., face-to-face, telephone, or email). Most self-help interventions are based on standardized psychological treatments, with the most common interventions being those based on cognitive behavioral therapy (CBT: Cuijpers & Schuurmans, 2007). Self-help inter...

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“…103 Its construct validity and neurobiological correlates remain ambiguous. [104][105][106] As no theorybased rule exists for classifying the symptoms of schizophrenia as negative or positive, the distinction is supported by their differential loadings on separate factors. The argument is somewhat circular, since cross-sectional symptomatology is typically assessed by rating scales designed a priori to reflect such distinction.…”

Section: Molecular Psychiatrymentioning

confidence: 99%

Subtyping schizophrenia: implications for genetic research

2006

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Phenotypic variability and likely extensive genetic heterogeneity have been confounding the search for the causes of schizophrenia since the inception of the diagnostic category. The inconsistent results of genetic linkage and association studies using the diagnostic category as the sole schizophrenia phenotype suggest that the current broad concept of schizophrenia does not demarcate a homogeneous disease entity. Approaches involving subtyping and stratification by covariates to reduce heterogeneity have been successful in the genetic study of other complex disorders, but rarely applied in schizophrenia research. This article reviews past and present attempts at delineating schizophrenia subtypes based on clinical features, statistically derived measures, putative genetic indicators, and intermediate phenotypes, highlighting the potential utility of multidomain neurocognitive endophenotypes.

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"Negative Symptoms": Conceptual and Methodological Problems

Cited by 188 publications

References 67 publications

Emotional Experience and Expression in Schizophrenia and Depression

Emotional Experience and Expression in Schizophrenia and Depression

Self-help interventions for psychosis: A meta-analysis

Subtyping schizophrenia: implications for genetic research

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