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Negative Symptoms and Cognitive Deficits
Published in Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman, Understanding and Caring for People with Schizophrenia, 2020
Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman
What Nellie was experiencing was negative symptoms and cognitive deficits. Negative symptoms generally involve the lack of some normal function. Typical negative symptoms experienced by individuals with schizophrenia are poverty of speech and thought (alogia), decreased interest in things (anhedonia), decreased energy and motivation (anergia, amotivation), decreased affect, a general state of indifference (apathy), and decreased interest in socialization. Cognitive deficits in schizophrenia include impaired attention, worse short-term memory, and decreased higher order “executive” functions such as retaining, planning, and manipulating information. Most individuals with schizophrenia experience at least some negative symptoms and cognitive deficits, though there are a few who do not. Negative symptoms and cognitive deficits are thought to account for greater functional impairment than the positive symptoms of schizophrenia, though they are not responsive to traditional treatments, such as antipsychotic medications.
The Distortion of Consciousness
Published in Max R. Bennett, The Idea of Consciousness, 2020
The definition of schizophrenia, as already noted, is that a patient possesses two or more of the following symptoms: delusions, hallucinations, incoherent speech, disorganized or catatonic behavior, and negative symptoms (which include affective flattening, avolition and alogia). Planning and volition involve neural activity in the frontal cortex; if such activity fails, alogia and avolition can result. Because the cingulate cortex connects the areas of the associational cortex involved in the higher processes of verbal and visual experiences in consciousness, failure of this pathway can give rise to auditory and visual hallucinations. The hippocampus and amygdala are responsible for the laying down of declarative or specific memories and emotional memories, respectively. Thus failure of normal activity in, say, the amygdala can give rise to the flattening of the emotions. Is there a common agent that could be malfunctioning in each of these brain areas, so giving rise to the schizophrenic condition? The answer is ‘yes’, for (as discussed in relation to Figure 5.6) each of them receives an extensive projection of axons from the ventral tegmentum of the midbrain; these release the transmitter dopamine. There is a very dense projection of these dopaminergic axons to the frontal cortex, to the cingulate cortex, and through the cingulate cortex to the hippocampus and the amygdala. Thus a malfunction in this ventral tegmentum projection can have severe repercussions for the workings of a range of activities associated with consciousness. These repercussions can give rise to the schizophrenic mind.
Questions and Answers
Published in David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly, MRCPsych Paper I One-Best-Item MCQs, 2017
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly
Answer: D. Logoclonia is the term. Logorrhoea describes voluble garrulous speech. Echolalia is the automatic imitation and repetition of another person’s speech or words. Echologia is repetition of another individual’s speech using one’s own words or phrases. Alogia is poverty of speech, with responses being often limited to single words. [F. pp. 80–1]
Validation of the Turkish version of the self-evaluation of negative symptoms scale (SNS)
Published in International Journal of Psychiatry in Clinical Practice, 2022
Irmak Polat, Ezgi Ince Guliyev, Sibel Elmas, Sufiya Karakaş, Ömer Aydemir, Alp Üçok
SNS is a 20-item self-assessment survey consisting of five subscales that are as follows: social withdrawal, diminished emotional range, alogia, avolition, and anhedonia (Dollfus et al., 2016). Social withdrawal assessed the patient’s attitude towards social relationships; diminished emotional range covers the feelings of the patient; alogia is assessed by the patient’s interpretation of her/his verbal interaction with other people; avolition subscale includes questions about her/his goals and motivation for activities; anhedonia evaluates the consummatory and anticipatory pleasure expressed by the patient. All five subscales contain four items. The patient puts a cross in the box next to the response that best corresponds to their current opinion based on the previous week, scoring as strongly agree (2), somewhat agree (1), or strongly disagree (0). The total score is the sum of the 20 items, ranging from 0 (no negative symptoms) to 40 (severe negative symptoms).
Atypical antipsychotics in the treatment of patients with a dual diagnosis of schizophrenia spectrum disorders and substance use disorders: the results of a randomized comparative study
Published in Journal of Addictive Diseases, 2021
V. Yu. Skryabin, M. A. Vinnikova, E. V. Ezhkova, M. S. Titkov, R. A. Bulatova
Out of 90 patients included in the study, 22 patients were diagnosed with paranoid schizophrenia (F20.014 – Episodic course with the progressive development of negative symptoms in the intervals between psychotic episodes, and F20.03 – Episodic remittent course with complete or virtually complete remissions between psychotic episodes, according to ICD-10); 68 patients were diagnosed with the schizotypal disorder (F21.1 – Latent schizophrenia; F21.3 – Pseudoneurotic schizophrenia; F21.4 – Pseudopsychopathic schizophrenia; F21.5 – «Symptom-depleted» schizophrenia; F21.8 – Schizotypal personality disorder). Despite different ICD-10 diagnostic codes, the group was considered in total volume, since the number of observations with each variant of the schizophrenic process was limited and the clinical picture of all patients was very similar. In all patients, the mental disorder was characterized by a relatively favorable, slow-progressive course, the clinical picture was dominated by different variants of depressive and subthreshold depressive disorders, and the productive symptoms included overvalued and paranoid ideas that did not reach the level of delusion. Deficit symptoms were manifested in the form of autism, isolation, emotional exhaustion, tangentiality, distractible speech, and alogia.
Beyond descriptive neurology: Broca, cerebral hemodynamics, and cortical function
Published in Journal of the History of the Neurosciences, 2018
Broca could not have been pleased with the reporting from Norwich, where the localization of language was referred to as “bastard phrenology” (Anonymous, 1868c), and his address, published in French a year after the meeting, dealt only in passing with the localization of language (Broca, 1869). Instead, Broca proposed a new semiology of aphasia. This consisted of four clinical entities: alogia to describe the condition of those intellectually incapable of learning a language; verbal amnesia or the inability to understand the meaning of words; Broca’s own aphemia; and mechanical alalia, which results from damage to the muscles and nerves of the organs of articulation. Semiology is useful, Broca stated, but it has its limitations: Le trouble du langage peut bien servir à deviner le siège de la lésion, mais non à en diagnostiquer l’espèce … S’agit-il d’une apoplexie ou d’une embolie, ou d’un ramollissement aigu ou chronique, ou d’une atrophie circonscrite ou progressive, ou d’une tumeur de la pie-mère, ou de toute autre lésion ?[The language deficiency might well help to determine the site of the lesion, but not its cause …. Are we dealing with apoplexy or embolism, with an acute or chronic softening, with a limited or progressive atrophy, with a tumor of the pia mater, or with any other lesion?] (Broca, 1869, p. 269)