A framework for understanding experiential deficits in schizophrenia

The link between disruptions in emotional/motivational systems and chronic functional impairments in individuals with schizophrenia has been well substantiated. However, attempts to delineate the exact nature of these disruptions have been complicated by the reality that schizophrenia is a markedly heterogeneous disorder. In this article, we integrate findings from schizophrenia, neuroscience, and basic psychology literatures to advance the hypothesis that emotional deficits occur via two separate, mutually exclusive pathways: "ambivalence" - characterized by intact hedonic and abnormally co-activated negative emotion systems, and "apathy" - characterized by anhedonia and relatively sparse negative emotion. Further examination of how negative affect manifests differently across patients will be an important focus of future research, particularly given that the "downstream" social and occupational consequences of these abnormalities may appear similar but reflect dramatically divergent etiologies. (C) 2009 Elsevier Ireland Ltd. All rights reserved.