By A. Marneros, M. T. Tsuang (auth.), Professor Dr. med. Andreas Marneros, Nancy C. Andreasen MD., Ph. D., Ming T. Tsuang MD., Ph. D., D. Sc. (eds.)
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Extra resources for Negative Versus Positive Schizophrenia
C. Andreasen et al. 36 conceptual structure of the SANS and SAPS, since inappropriate affect is an exaggeration or distortion of a normal function rather than a loss of function. It was initially grouped with the negative symptoms because it was assumed to be associated with the defect state. Effects of Treatment Another perspective on the assessment of positive and negative symptoms can be obtained by examining the effects of treatment. One persistent concern about the evaluation of negative symptoms is that they may be affected by neuroleptic medication, specifically worsened by the extrapyramidal side effects.
Such techniques have been used to explore what is perhaps the most widely held theory about the underlying mechanism producing negative symptoms, the hypofrontality hypothesis. As applied to negative symptoms, it suggests that they represent the loss of functions generally thought to reside in the frontal lobes (Andreasen 1988). The frontal lobes generate, for example, fluency of thought and speech, emotional expression, volition and drive, and the ability to form emotional attachments (Fuster 1989), and attention, alogia, affective blunting, avolition, anhedonia, and attentional impairment represent a loss of these various functions.
Figures 2 and 3 show the result of our findings for the first 27 patients whom we studied. All these patients were able to successfully complete the 3-week drug wash-out period. These figures show the regression lines or the changes in positive and negative symptoms at time 1 (admission,on medication) and time 2 (the end of the 3-week drug wash-out period). A significant worsening in both positive and negative symptoms was seen when the patients were withdrawn from medication. The values on these figures are based on the sum of the global ratings.