Dysfunctional Beliefs: Causal Role in Negative Symptoms and Neurocognitive Impairments

  1. A cluster of related beliefs forms a direct path to the negative symptoms.
    • Defeatist beliefs lead to loss of purpose and goals.
    • An expectation of lack of satisfaction leads to anhedonia.
    • The belief in social alienation leads to asociality.
    • The general defeatist beliefs, lead to amotivation, leading to inactivity.
  2. The probable sequence is that people prone to negative symptoms probably had strong avoidant tendencies prior to the onset of their psychosis.  The avoidant tendency, thus, becomes exacerbated by the psychosis. 
  3. The avoidant tendencies are promulgated by defeatist and asocial beliefs.
  4. The negative symptoms actually represent a cluster of interrelated normal functions that are deactivated or in abeyance in the negative state.
  5. Under normal conditions, these functions are involved in individuals engaging in immediately rewarding activities, such as singing and dancing, participating in a party, or playing games.  The other activities are generally related to some goal or purpose.  Thus, these activities are meaningful, so far as, they represent steps towards fulfilling a purpose (such as helping others), or reaching a goal (making more money, getting a job, establishing a relationship).
  6. The loss of motivation may be expressed in general immobility and immobile faces, diminished gesturing, and aphonia.
  7. In the negative syndrome, we get a combination of avoidance and loss of constructive drive.
  8. Personnel who work with these patients may read the immobility as a rejection of social intrusion and lack of basic interest in the outside world.  The personnel reacts to the negative symptoms with detachment or rejection, thus, aggravating the symptoms.  In actuality, these individuals are just as interested, or even more interested in social interactions, but this interest is covered up by a layer of avoidance, etc.
  9. Defeatist beliefs may lead to neurocognitive impairment, as measured by computer tasks, but this finding is not constant. 

~ATB