User:Ebdrake/Reduced affect display

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Flat and blunted affect is a defining characteristic in the presentation of schizophrenia. To reitorate, these individuals have a decrease in observed vocal and facial expression as well as the use of gestures (Marder) One study of flat affect in schizophrenia found that "flat affect was more common in men, and was associated with worse current quality of life" as well as having "an adverse effect on course of illness".

The study also reported a "dissociation between reported experience of emotion and its display" – supporting the suggestion made elsewhere that "blunted affect, including flattened facial expressiveness and lack of vocal inflection ... often disguises an individual's true feelings." Thus, feelings may merely be unexpressed, rather than totally lacking. On the other hand, "a lack of emotions which is due not to mere repression but to a real loss of contact with the objective world gives the observer a specific impression of 'queerness' ... the remainders of emotions or the substitutes for emotions usually refer to rage and aggressiveness". In the most extreme cases, there is a complete "dissociation from affective states". '''To further support this idea, a study examining emotion dysregulation found that individuals with schizophrenia could not exaggerate their emotional expression as healthy controls could. Participants were asked to express whatever emotions they had during a clip of a film, and the participants with schizophrenia showed deficits in behavioral expression of their emotions (Henry).'''

'''There is still some debate regarding the source of flat affect in schizophrenia. However, some literature indicates abnormalities in the dorsal executive and ventral affective systems; it is argued that dorsal hypoactivation and ventral hyperactivation may be the source of flat affect (Lee). Further, the authors found deficits in the mirror neuron system may also contribute to flat affect in that the deficits may cause disruptions in the control of facial expression.'''

Similarly blunted vocal expression is another characteristic of flat affect. Another study found that when speaking, individuals with schizophrenia with flat affect demonstrate less inflection than normal controls and appear to be less fluent. Normal subjects appear to express themselves using more complex syntax, whereas flat affect subjects speak with fewer words, and fewer words per sentence. Flat affect individuals' use of context-appropriate words in both sad and happy narratives are similar to that of controls. The authors suggest it is likely that flat affect is a result of deficits in motor expression as opposed to emotional processing. The moods of display are compromised, but subjective, autonomic, and contextual aspects of emotion are left intact

New information:

Deficits in verbal affect are another important facet of schizophrenia.