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Cited by 537Schizophrenia research and treatmentMental Health and PsychiatryMental Health Research Topics

The current conceptualization of negative symptoms in schizophrenia

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Marder, Stephen R., Galderisi, Silvana·2017·World Psychiatry
DOI 10.1002/wps.20385PMC PMC5269507
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Abstract

Negative symptoms have long been conceptualized as a core aspect of schizophrenia. They play a key role in the functional outcome of the disorder, and their management represents a significant unmet need. Improvements in definition, characterization, assessment instruments and experimental models are needed in order to foster research aimed at developing effective interventions. A consensus has recently been reached on the following aspects: a) five constructs should be considered as negative symptoms, i.e. blunted affect, alogia, anhedonia, asociality and avolition; b) for each construct, symptoms due to identifiable factors, such as medication effects, psychotic symptoms or depression, should be distinguished from those regarded as primary; c) the five constructs cluster in two factors, one including blunted affect and alogia and the other consisting of anhedonia, avolition and asociality. In this paper, for each construct, we report the current definition; highlight differences among the main assessment instruments; illustrate quantitative measures, if available, and their relationship with the evaluations based on rating scales; and describe correlates as well as experimental models. We conclude that: a) the assessment of the negative symptom dimension has recently improved, but even current expert consensus‐based instruments diverge on several aspects; b) the use of objective measures might contribute to overcome uncertainties about the reliability of rating scales, but these measures require further investigation and validation; c) the boundaries with other illness components, in particular neurocognition and social cognition, are not well defined; and d) without further reducing the heterogeneity within the negative symptom dimension, attempts to develop successful interventions are likely to lead to great efforts paid back by small rewards.

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  • Long-term social functioning deficits have been associated with increased severity of negative symptoms such as social withdrawal, avolition and apathy.

    “Long‐term social functioning deficits have also been associated with an increased severity of negative symptoms such as social withdrawal, avolition and apathy (Kirkpatrick et al. 2006; Marder and Galderisi 2017).”

    From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Marder and Galderisi 2017

    The FACTORS WITHIN NEGATIVE SYMPTOMS section reports a strong, consistent relationship between avolition and poor social outcome; the AVOLITION section also says avolition predicts poor functional outcome and notes that it is sometimes termed apathy. The ASOCIALITY section identifies apathetic social withdrawal as a negative-symptom measure. These passages support the general association, but do not specifically establish that greater severity of each named symptom is associated with long-term social functioning deficits (page numbers unavailable). (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Social withdrawal is a prominent negative symptom of SCZ.

    “With regard to human psychopathology, social withdrawal is a prominent negative symptom of SCZ (Marder and Galderisi 2017).”

    From Neurexin1α knockout in rats causes aberrant social behaviour: relevance for autism and schizophrenia (2025) · cites this paper as Marder and Galderisi 2017

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Authors
Marder, S. R., & Galderisi, S.
Affiliations
  • University of California, Los Angeles (US)
  • University of Naples Federico II (IT)
ORCID
Venue
World Psychiatry
Publisher
Wiley
Published
2017-01-26
Volume
16
Issue
1
Pages
14-24
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
DOI
10.1002/wps.20385
PMC
PMC5269507
OpenAlex
W2580975499
Cited by
537
References
12
Citations by year
2026: 56 · 2025: 56 · 2024: 72 · 2023: 61 · 2022: 100 · 2021: 59 · 2020: 50 · 2019: 33 · 2018: 32 · 2017: 18
FWCI
29.60
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • World Psychiatry (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
negative symptoms, schizophrenia, blunted affect, alogia, anhedonia, asociality, avolition, rating scales, objective measures, neurocognitive function, social cognition, functional outcome

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