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DSSSB - 28 August 2019 (Shift-1)
Psychiatric Nursing
Easy

The client is no longer interested in going out and meeting friends. This is an example of which behaviour?

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

  • Avolition is a core negative symptom of schizophrenia, defined as a severe lack of motivation or initiative to accomplish purposeful tasks.
  • The client's behavior of losing interest in socializing and meeting friends is a classic manifestation of avolition, reflecting a withdrawal from previously enjoyable activities.
  • According to DSM-5, avolition is an inability to initiate and persist in goal-directed activities, which can lead to deficits in work, social interaction, and self-care.

Why Other Options Were Wrong

  • Option A: Perseveration is the persistent and inappropriate repetition of a response or behavior. The client is not repeating an action but has instead stopped engaging in a social activity.
  • Option C: Affective flattening refers to a reduced intensity of emotional expression, such as a blank facial expression or monotonous voice. The stem describes a lack of interest and motivation, not a lack of emotional expression.
  • Option D: Alogia, or poverty of speech, involves reduced fluency and production of speech, such as giving brief, empty replies to questions. The question does not provide any information about the client's speech patterns.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Negative Symptoms of Schizophrenia as background academic context rather than a clinical decision trigger.
  • Recognizing negative symptoms like avolition is crucial for nurses, as they are often more debilitating and less responsive to medication than positive symptoms.
  • Nursing interventions for avolition focus on setting small, achievable goals, providing prompts and encouragement, and structuring daily activities to promote engagement and a sense of accomplishment.
  • What if? If the client stated, 'I want to go out, but I'm too scared people are plotting against me,' the primary issue would shift from avolition (a negative symptom) to paranoid ideation (a positive symptom), requiring different interventions focused on safety and reality testing.
How to Approach the Question
  • First, identify the core behavior described in the question stem: the client is 'no longer interested in going out and meeting friends.'
  • Analyze this behavior. It represents a loss of motivation and social drive.
  • Next, evaluate the given options, which are all psychiatric terms, many of which are negative symptoms of schizophrenia.
  • Define each term based on your knowledge: Perseveration (repetition), Avolition (lack of motivation), Affective flattening (lack of emotional expression), and Alogia (poverty of speech).
  • Match the client's behavior (loss of interest/motivation) to the correct definition. The loss of interest in social activities is a hallmark of avolition.
  • Confirm the choice by ensuring the other options do not fit the scenario.
Concept Tested & Keywords
  • Concept Tested: Negative Symptoms of Schizophrenia
  • Stem keywords: no longer interested, going out, meeting friends
  • Lead-in keywords: example of which behaviour
  • Negative lead-in flag: false

Question ID

QoEsQXEdTPvrT6tZB0BXjd

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 4730-4732, 4731-4733

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