GMCH Chandigarh - 2019
Mental Health Nursing
Hard
Which of the following pairs is not the negative symptom of schizophrenia?
Appeared in: GMCH Chandigarh - 2019
Explanation
- Hallucinations (perceiving things that are not there) and bizarre behavior are considered 'positive' symptoms because they represent an addition of psychotic experiences to a person's mental state.
- Positive symptoms are excesses or distortions of normal functions, such as thought, perception, and behavior.
- In contrast, negative symptoms, like those in the other options, represent a loss or deficit of normal functions (e.g., loss of emotional expression, motivation, or speech).
Why Other Options Were Wrong
- Option A: This option is incorrect because both emotional flattening (blunted affect) and asociality (social withdrawal) are core negative symptoms of schizophrenia, representing a loss of emotional expression and social drive.
- Option B: This option is incorrect because anhedonia (inability to feel pleasure) and amotivation (lack of motivation, also known as avolition) are defining negative symptoms, indicating a deficit in goal-directed behavior and emotional reward.
- Option C: This option is incorrect because poverty of speech (alogia) and apathy (lack of concern or interest) are well-established negative symptoms, reflecting diminished speech output and emotional/cognitive engagement.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Distinguishing between positive and negative symptoms of schizophrenia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Differentiating between positive and negative symptoms is crucial for treatment planning. Antipsychotic medications are generally more effective for positive symptoms, while negative symptoms often require psychosocial interventions, such as social skills training and cognitive-behavioral therapy.
- Negative symptoms are often more persistent and are strongly associated with poor long-term functional outcomes, such as difficulties with employment, independent living, and social relationships.
- A nurse's assessment must carefully document both types of symptoms to provide a complete clinical picture and to monitor the effectiveness of treatment. For example, an improvement in hallucinations (positive) but worsening social withdrawal (negative) requires a different care approach.
How to Approach the Question
- First, identify the core task of the question. The word 'not' is a key lead-in, meaning you are looking for the option that does not fit the category of 'negative symptom'.
- Next, recall the definitions of positive and negative symptoms in schizophrenia. Think: 'Positive' means adding an abnormal behavior, while 'Negative' means a loss of a normal function.
- A helpful mnemonic for negative symptoms is the '5 A's': Affective flattening, Alogia (poverty of speech), Avolition (apathy/amotivation), Anhedonia (loss of pleasure), and Asociality (social withdrawal).
- Evaluate each option against this framework. Options A, B, and C all contain pairs of symptoms that fall under the '5 A's'.
- Option D, 'Hallucinations and bizarre behavior,' describes experiences that are 'added' to reality, which clearly fits the definition of positive symptoms.
- Therefore, the pair that is NOT a set of negative symptoms is hallucinations and bizarre behavior.
Concept Tested & Keywords
- Concept Tested: Distinguishing between positive and negative symptoms of schizophrenia.
- Stem keywords: schizophrenia, negative symptom
- Lead-in keywords: not
- Negative lead-in flag: The question asks to identify the option that is NOT a negative symptom.
Question ID
QwvPs0rZcLB_Gf6N8x0zeh
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. 4731-4733, 4730-4732
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1091-1093
Practise the full GMCH Chandigarh - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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