Passive/Apathetic Social Withdrawal and Active Social Avoidance in Schizophrenia: Difference in Underlying Psychological Processes

Abstract

Objective Social withdrawal, a core feature of negative symptoms, is differentiated into passive social withdrawal (PSW) and active social avoidance (ASA). We examined whether this differentiation was related to differences in underlying psychological processes of object relations and reality testing. Method Two hundred seventy-two outpatients with schizophrenia and schizoaffective disorders from VA Connecticut Healthcare System/Connecticut Mental Health Center were evaluated using the Bell Object Relations and Reality Testing Inventory (BORRTI) and the Positive And Negative Symptoms Scale. Results Distinct patterns were found; PSW was associated with object relation subscales explaining 5% of the variance, ASA was associated with object relations and all reality testing subscales explaining 12% of the variance. Conclusions Findings suggest differences in the underlying mechanisms behind PSW and ASA, confirming that PSW is a primary negative symptom, while ASA is related more to positive symptoms.