Which is a negative symptom of schizophrenia?

NIMHANS Nursing Officer - 2021

Mental Health Nursing

Easy

Appeared in: NIMHANS Nursing Officer - 2021

Explanation

Ambivalence, the coexistence of contradictory feelings or ideas about something, is a negative symptom of schizophrenia.
Negative symptoms are characterized by a diminution or loss of normal functions, such as the ability to make decisions, express emotion, or feel motivated.
In this context, ambivalence reflects a deficit in will and goal-directed thinking, making it difficult for the individual to act decisively.

Option A: Motor hyperactivity is a form of disorganized or catatonic behavior, which is classified as a positive symptom of schizophrenia. It represents an excess of motor activity.
Option B: A delusion is a false, fixed belief that is firmly held despite evidence to the contrary. It is a classic positive symptom, representing a distortion of thought content.
Option D: A hallucination is a false sensory perception without an external stimulus (e.g., hearing voices). It is a classic positive symptom, representing a distortion of perception.

Clinical Relevance

Nursing practice connection: Knowing Classification of Schizophrenia Symptoms (Positive vs. Negative) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must accurately identify both positive and negative symptoms as they require different treatment approaches. While antipsychotic medications are more effective for positive symptoms, negative symptoms often require psychosocial interventions.
Negative symptoms like ambivalence, avolition, and anhedonia are often more persistent and debilitating than positive symptoms, leading to poor social and occupational functioning.
What if? - If a patient expresses a desire to get a job but makes no effort to apply for one, this could be an example of ambivalence or avolition. The nursing intervention would focus on breaking down tasks into small, manageable steps and providing encouragement, rather than just medication adjustment.

How to Approach the Question

First, identify the core concept of the question, which is 'negative symptom' of 'schizophrenia'.
Recall the basic classification of schizophrenia symptoms: positive (added experiences like hallucinations) and negative (loss of function like flat affect).
Analyze each option. Ask yourself, 'Is this an added, abnormal experience, or is it a loss of a normal function?'
Motor hyperactivity, delusions, and hallucinations are all additions to normal experience, so they are positive symptoms.
Ambivalence, the inability to make a decision due to conflicting feelings, represents a loss of the normal function of decisiveness and will. Therefore, it is a negative symptom.

Concept Tested & Keywords

Concept Tested: Classification of Schizophrenia Symptoms (Positive vs. Negative)
Stem keywords: schizophrenia, negative symptom
Lead-in keywords: Which is
Negative lead-in flag: false

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1097-1099, 1091-1093

E6 Psychology Baron Misra 5e Part 2 p. 187-189