The negative symptoms of schizophrenia: A cognitive perspective
Open accessAbstract
Recent reports of improvement in the negative symptoms of schizophrenia following targeted cognitive interventions have prompted interest in the cognitive underpinnings of these symptoms. This review integrates current experimental research with the phenomenological accounts of patients participating in cognitive therapy for these specific symptoms. We propose that, in addition to the well-established role of neurobiological factors in their development and maintenance, specific cognitive appraisals and beliefs play a role in the expression and persistence of negative symptoms. This cognitive model of negative symptoms is based on a diathesis–stress formulation: a continuum of predispositional traits from the premorbid personality to the full-blown negative symptomatology, the incorporation of negative social and performance attitudes within these traits, and low expectancies for pleasure or success in goal-oriented activities. We suggest that negative symptoms represent, in part, a compensatory pattern of disengagement in response to threatening delusional beliefs, perceived social threat, and anticipated failure in tasks and social activities. A psychological aspect of this motivational and behavioural inertia appears to be the patient's perception of limited psychological resources—a perception that motivates patients to conserve energy by minimizing investment in activities requiring effort.
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Cognitive feedback loops may become self-reinforcing.
“Cognitive feedback loops may then become self-reinforcing (Rector et al., 2005).”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Rector et al., 2005
Relevant contributing psychological processes in development of negative symptoms seem to be demoralization due to low expectancies for pleasure or success, internalized stigma, lack of participation and activities, and maladaptive coping responses such as social anhedonia and substance abuse.
“Relevant contributing psychological processes in the development of negative symptoms thereby seem to be a demoralization due to patients’ low expectancies for pleasure or success (64, 86), internalized stigma (87), a lack of participation and activities (88), and maladaptive coping responses such as social anhedonia and substance abuse to deal with aversive internal and external experiences (89).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [86]
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References 82 · Cited by 268
Research works printed but not linked: 4
- Bleuler E. Dementia praecox or the group of schizophrenics. Kinkin J, translator. New York: International Universities Press Inc; 1950.
- Meehl PE. Schizotaxia, schizotypy and schizophrenia. Am Psychol 1962;17:827-38.
- Chapman LJ, Chapman JP, Miller EN. Reliabilities and intercorrelations of 8 measure of proneness to psychosis. J Consult Clin Psychol 1982;50:187-95.
- Kring AM, Neale JM. So schizophrenic patients show a disjunction amount expressive, experiential, and psychophysiological components of emotion? J Abnorm Psychol 1996;105:249-57.
- Authors
- Rector, N. A., Beck, A. T., & Stolar, N.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Pittsburgh (US)
- University of Pennsylvania (US)
- Corresponding author
- Rector, Neil A
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2005-04
- Volume
- 50
- Issue
- 5
- Pages
- 247-257
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W2102632633
- Cited by
- 268
- References
- 82
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 7 · 2023: 14 · 2022: 7 · 2021: 13 · 2020: 14 · 2019: 19 · 2018: 15 · 2017: 10 · 2016: 21 · 2015: 14 · 2014: 22 · 2013: 20 · 2012: 21
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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 › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- schizophrenia, negative symptoms, cognitive models, cognitive therapy, cognitive appraisal, diathesis-stress model, premorbid personality, delusions, social danger, psychological resources, goal-directed behavior
- MeSH terms
- Affect, Culture, Delusions, Humans, Motivation, Psychomotor Disorders, Schizophrenia, Schizophrenic Psychology, Social Behavior, Cognitive Behavioral Therapy
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