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5 Domains of Negative Symptoms of Schizophrenia Cheat Sheet by

5 Domains of Negative Symptoms of Schizophrenia
symptoms     behaviors     domains     healthcare     mental     negative     schizophrenia


Lack of awareness of negative symptoms, often confused with anhedonia, is common in indivi­duals with schizo­phr­enia. Patients and relatives are often unaware of the extent of these symptoms and seldom commun­icate them to the clinician.

What follows are the 5 domains of negative symptoms identified from the Negative Symptom Assessment (NSA).

The NSA describes the behaviors that might be observed in each domain. Assessment starts with one question “Starting from the time you get up, could you tell me how you have spent a typical day in the past week?” From this one question, many different levels of clinical inform­ation can be gathered

1. Commun­ication

Patient may produce very little speech even with prodding or, limit responses to 1 or 2 words; may exhibit long pauses before responding to questions; may produce speech that is vague and have trouble clarifying further; may mumble as if it is too difficult to articu­late. Is the patient non-co­mmu­nic­ative? Do you have to pull out every detail?

2. Emotio­n/a­ffect

Patient may have a limited range of emotional experi­ences such as anger, happiness, sadness, surprise, fear or pride; reduced affective expres­siv­eness as evidenced by monotone speech and blunting; reduced ability to display common affective states on request. Does the patient generate a multif­aceted answer without prompt­ing?

3. Social Activity

Patient may have few friends; limited desire for or intera­ctions with others; poor rapport with the interv­iewer; limited desire for contact. Is the patient actively engaged with hobbies and productive activity during the day?

Domains of Negative Symptoms & Observed Behaviors

4. Motivation

Patient may engage in little productive activity; spend much of the day sitting or lying around; may not take care of basic grooming and hygiene; has little interest in world events or hobbies; may have limited life goals or sense of purpose. Is the individual enthus­iastic about any specific activities

5. Psycho­motor activity

Patient exhibits slowed movements; may appear that moving requires consid­erable effort; expressive gestures such as using hands and shaking head that normally facilitate commun­ication may be reduced or absent. How does this individual compare with a person without schizo­phr­enia?

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