Diminished emotional expression in schizophrenia: an interdisciplinary approach based on behavioral interventions.

Abstract

Negative symptoms represent the main cause of disability in schizophrenia, having recently been grouped into two general dimensions: avolition and diminished emotional expression, which includes affective flattening and alogia. The aim of this study was to explore the response of these two symptoms to a set of behavioral interventions based on contingency management, performed in an interdisciplinary context. Behaviors of interest were monitored and evaluations before and after the treatment were performed on 9 schizophrenic inpatients with persistent negative symptoms. The program included 12 group double sessions aimed at developing facial expression and verbal communication, and a nursing care plan to generalize and strengthen these behaviors synergistically. there were appreciable differences in facial expression, which were less clear for alogia. The clinical evaluation using PANSS-N did not find notable differences at group level, but the nursing assessment using NOC indicators did. although difficult to modify, negative symptoms are not insensitive to the influence of behavioral interventions. Specific psychological interventions that address negative symptoms as a priority focus of attention and care need to be promoted and developed, particularly when considering the crucial role of context in their progression.