In her Ted Talk, "My Journey Through Schizophrenia and Homelessness" (2006), Bethany Yeiser describes her experience of schizophrenia. She courageously details how her thinking changed and became clouded by beliefs that she would be a prophet and menacing voices. After a battle involving hospitalizations and times of being unhoused, she made a remarkable recovery and now advocates for others while sharing her own story.

Early in her talk, she says, "My heart was like ice." This experience of emotional flatness or blunted affect is common in schizophrenia. On the outside, it can look like a still face, on the inside it can feel like a disconnection. This is one of several schizophrenia symptoms known as negative symptoms, things like loss of motivation, social withdrawal, and flatness.

While not as well-known as the hallmark symptoms of hallucinations and delusions in schizophrenia, research shows that this set of symptoms might better predict a person's functioning (Milev et al., 2005). These symptoms can affect a person's relationships and joy in life. Yet perhaps because these symptoms are sometimes less apparent than others, they often go untreated.

That said, psychotherapy techniques involving focus on the body and the use of art in therapy are effective in treating negative symptoms including emotional blunting in schizophrenia (Isabelina et al., 2023). Research on the use of time and negative symptoms has also uncovered that less productive use of time is often linked with increased negative symptoms (D’Anna et al., 2023). While it is difficult to draw the arrow of causation here, behavior activation might also be a target in treating negative symptoms.

A study of Recovery-Oriented Cognitive Therapy (CT-R) for individuals living with a schizophrenia spectrum disorder with a high level of negative symptoms found a decrease in negative symptoms after the six-month treatment (Grant et al., 2017). This is particularly interesting as CT-R has taken a non-traditional focus in treating serious mental illness. By focusing on cultivating what is called the 'adaptive mode,' or a mindset bent toward how the person is at their best while also invigorating aspirations, the treatment takes a recovery-oriented approach.

While the majority of medications currently in use to treat schizophrenia, with the possible exception of clozapine, have not been found effective in treating negative symptoms, newer and investigational medications are showing more positive results. These newer medications appear to have somewhat different mechanisms of action than most antipsychotics.

The medication lumateperone, for example, appears to target glutamate, a neurotransmitter that has been considered in its role of negative symptoms (Gruber et al., 2014) in addition to dopamine and serotonin. This medication has shown some positive effects on negative symptoms of schizophrenia (Tarzian et al., 2023).

Other investigational medications with entirely novel mechanisms of action including KarTX, which is expected to be released later this year are also showing promising effects on negative symptoms like emotion blunting (Horan et al, 2023).

The recent research focus on the long-neglected challenge of negative symptoms in schizophrenia is encouraging. With innovative interventions, more individuals facing this blunting may have an opportunity for an increased quality of life and a sense of connection.

References

D’Anna, G., Zarbo, C., Cardamone, G., Zamparini, M., Calza, S., Rota, M., ... & de Girolamo, G. (2023). Interplay between negative symptoms, time spent doing nothing, and negative emotions in patients with schizophrenia spectrum disorders: results from a 37-site study. Schizophrenia, 9(1), 63.

Grant, P. M., Bredemeier, K., & Beck, A. T. (2017). Six-month follow-up of recovery-oriented cognitive therapy for low-functioning individuals with schizophrenia. Psychiatric Services, 68(10), 997-1002.

Gruber, O., Chadha Santuccione, A., & Aach, H. (2014). Magnetic resonance imaging in studying schizophrenia, negative symptoms, and the glutamate system. Frontiers in psychiatry, 5, 32.

Horan, William P., et al. "Potential impact of KarXT on negative symptoms in acute schizophrenia: An analysis of pooled data from 3 trials." CNS Summit (2023).

Milev, P., Ho, B. C., Arndt, S., & Andreasen, N. C. (2005). Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. American Journal of Psychiatry, 162(3), 495-506.

Tarzian, M., Ndrio, M., Chique, B., Serai, J., Thalackal, B., Lau, J., ... & Serai, J. K. (2023). Illuminating Hope for Mental Health: A Drug Review on Lumateperone. Cureus, 15(9).

Yeiser, B. (2016). My Journey Through Schizophrenia and Homelessness. Ted Talk. My journey through schizophrenia and homelessness | Bethany Yeiser | TEDxCincinnati (youtube.com)

QOSHE - A Sometimes Overlooked Schizophrenia and Psychosis Symptom - Jennifer Gerlach Lcsw
menu_open
Columnists Actual . Favourites . Archive
We use cookies to provide some features and experiences in QOSHE

More information  .  Close
Aa Aa Aa
- A +

A Sometimes Overlooked Schizophrenia and Psychosis Symptom

35 0
05.05.2024

In her Ted Talk, "My Journey Through Schizophrenia and Homelessness" (2006), Bethany Yeiser describes her experience of schizophrenia. She courageously details how her thinking changed and became clouded by beliefs that she would be a prophet and menacing voices. After a battle involving hospitalizations and times of being unhoused, she made a remarkable recovery and now advocates for others while sharing her own story.

Early in her talk, she says, "My heart was like ice." This experience of emotional flatness or blunted affect is common in schizophrenia. On the outside, it can look like a still face, on the inside it can feel like a disconnection. This is one of several schizophrenia symptoms known as negative symptoms, things like loss of motivation, social withdrawal, and flatness.

While not as well-known as the hallmark symptoms of hallucinations and delusions in schizophrenia, research shows that this set of symptoms might better predict a person's functioning (Milev et al., 2005). These symptoms can affect a person's relationships and joy in life. Yet perhaps because these symptoms are sometimes less apparent than others, they often go untreated.

That said, psychotherapy techniques involving focus on the body and the........

© Psychology Today


Get it on Google Play