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Positive and Negative Symptoms of Schizophrenia

The symptoms of Schizophrenia are divided into two main categories, called positive and negative symptoms.  

Positive Symptoms of Schizophrenia

The positive symptoms are those where the person behaves in certain ways, or has certain experiences, that are clearly different from normal behavior and experience.  These symptoms are very quickly noticed by others as being strange and problematic.   The word 'positive' is based on the idea that these symptoms seem to be something extra that is produced or added onto a persons otherwise usual behavior.   Psychosis, including delusions and hallucinations, are classified as positive symptoms, and sometimes disorganized thoughts and behaviors are counted as well.

Negative Symptoms of Schizophrenia

The negative symptoms refer to an absence or deficit of certain normal abilities.  These include:

Affective flattening or blunting:  The person shows few emotions, whether through facial expressions, body movements or tone of voice.  Often people with affective flattening will report that they do not feel much emotion at all. 

Alogia: The person seems to be very slow in thinking or to be empty of thoughts.  They may take a long time to respond to questions, or will use very few words to express ideas, which is called poverty of speech (ie. answering questions with only yes,no or I don't know.).  They may also stop speaking in mid-sentence and then forget what they were saying, which is called thought blocking.

Poor social judgment:  The person seems oblivious to normal social norms or cues.  For example, they may dress in very odd ways or not put any effort into grooming themselves, and it can be hard to relate to them in conversation because they may seem emotionally odd or distant, lack the usual social graces, and have trouble picking-up on other people's social cues and body language.

Avolition/ apathy:  The person seems generally apathetic, without motivation for any activities, sometimes to the point of not even bothering to maintain basic hygiene.

Anhedonia and social withdrawal:  The person does not have interest in any activities or in maintaining relationships, and may live a reclusive life. 

The categories of positive and negative symptoms were established in the early 1980's.  Since then, it has become increasingly recognized that there are important cognitive deficits associated with Schizophrenia that likely account for the negative symptoms [ref]. 


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Core Symptoms

Cognitive Deficits