Implications for Social, Linguistic, and Cultural Consistency
by ANZALEE KHAN, PhD; LORA LIHARSKA, MS; PHILIP D. HARVEY, PhD; ALEXANDRA ATKINS, PhD; DANIEL ULSHEN, BA; and RICHARD S.E. KEEFE, PhD
Emerging consensus in recent literature posits a two-factor structure of negative symptoms in schizophrenia: experiential deficits and expressive deficits.1 This presents a departure from the previous one-factor model by differentiating negative symptoms into two potentially correlated but distinct dimensions.2 Experiential deficits comprise avolition (decreased motivation and lack of interest in daily activities), asociality (social withdrawal and reduced value and interest in social contact), and anhedonia (decreased anticipation and experience of pleasure); expressive deficits comprise blunted affect (decreased emotional expressivity and diminished facial expression) and alogia (poverty of speech).3–6 The implications of this two-dimensional model are far-reaching: recent research suggests that each dimension might have its own distinct underlying causes and clinical and functional correlates.6-8
The expressive-experiential distinction has been shown to have vast importance in relation to functional outcomes in schizophrenia. Specifically, experiential deficits have been shown to be more robust predictors of…