Negative Symptoms Assessment for Schizophrenia: Theoretical Models and Clinical Implications

Schizophrenia is complex psychiatric disorder characterized by psychotic symptoms, negative symptoms and cognitive impairments. Negative symptoms in schizophrenia constitute a heterogeneous syndrome that comprises anhedonia, avolition, asociality, alogia and blunted affect. Recently, there is reviving interest in studying negative symptoms due to these symptoms are less responsive to conventional and atypical antipsychotic medications. With the guidance of the advanced theoretical framework of anhedonia, I shall first address the issue of anhedonia paradox observed in schizophrenia and the recent reconceptualization of negative symptoms in schizophrenia research. I then adopt the two-factor model of negative symptoms, i.e., the Motivation and Pleasure (MAP) factor and the Expression (EXP) factor, and further illustrate with a series of studies to highlight the important role of MAP factor but not EXP factor contributing to social functioning in these patients. These findings help to validate and establish a set of measures to characterize the evaluation of anhedonia and highlight potential development of intervention platform for anhedonia across clinical and subclinical populations.

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