Negative symptoms and emotional blunting in schizophrenic patients

Background: Emotional blunting and negative symptoms were explored as interchangeable concepts in evaluating schizophrenic patients. Method: We evaluated 115 consecutively admitted patients who had DSM-III R schizophrenia. We performed a principal component analysis of Abrams and Taylor's Scale for Emotional Blunting (SEB) and Andreasen's Scale for the Assessment of Negative Symptoms (SANS) and correlated the subscales derived by factor analyses with demographic and clinical variables. Results: Both scales contained subscales corresponding to poverty of affect and speech and inappropriate affect. The SEB also included an indifference subscale, whereas the SANS included avolition-anhedonia, asociality, and blocking subscales. Poor premorbid functioning was most strongly associated with poverty of affect and speech. Inappropriate affect and anhedonia avolition asociality were moderately correlated with poor response to treatment. Conclusion: Negative symptoms and emotional blunting are similar concepts, but they are not interchangeable. Flatness and inappropriateness appear to be different affective dimensions with different clinical correlations. Inappropriate affect, inattention, and blocking should not be considered negative symptoms.