Blunted Emotions / People with schizophrenia often seem emotionally flat and unresponsive to things happening around them. They may be unable to show emotion by varying their facial expressions, gestures, or tone of voice. The person may not show much response to happy or sad events, or may respond in an inappropriate way. In some types of schizophrenia, especially the hebephrenic or disorganised type (see below), grossly inappropriate and incongruous emotions and actions are among the main symptoms. The person may appear to be misdirected, goalless, playfully intrusive, and often impulsive. The whole personality of the person with schizophrenia often appears to be changed from its previous pattern.

Loss of Drive / Schizophrenia may reduce people's motivation so that they are less able to work or participate in leisure activities. They may seem uninterested in everyday activities such as washing and cooking or, in extreme cases, may be unable to care for their personal hygiene or feed themselves. Indecision, negativism, and passivity may appear, mixed with sudden impulses. In extreme cases, the person may become withdrawn, agitated, or stuporous for no apparent reason.

Social Withdrawal / People with schizophrenia may have difficulty making and keeping friends or acquaintances; they may have few, if any, intimate relationships. Their interactions with others may be brief and superficial. In extreme cases, the person may actively avoid all social interactions.

Poverty of Thought / Some people with schizophrenia reveal a marked reduction in the amount and content of their thinking. They may only rarely speak spontaneously and may answer questions with short answers that provide no detail. In extreme cases, the person's speech is limited to short phrases such as "yes," "no," or "I don't know." Other people with schizophrenia may talk freely, but their speech, while comprehensible, does not really convey any content. They may answer questions in a roundabout way that never gets to the point. Their speech may reflect loose or unrelated associations between ideas and incomprehensible breaks and jumps in the train of thought.
     The negative symptoms of schizophrenia are often misinterpreted by others as a sign that the person is lazy or purposely misbehaving to annoy others rather than being seen as part of the illness. Such a misinterpretation contributes in a large way to the negative image and stigma associated with schizophrenia.
     In assessing negative symptoms that are not accompanied by positive symptoms, the clinician should evaluate for a change from previous behaviour. Although negative symptoms that occur in the absence of positive symptoms are often missed, the person with negative symptoms only still needs help.
     In cultures in which frequent and intense social interaction is the norm (e.g., many Western cultures), the presence of negative symptoms may be particularly stigmatising. It is extremely important to take culture into consideration in evaluating negative symptoms and their impact.
     Unlike positive symptoms, negative symptoms are more subtle deficits in functioning that are often not recognised as symptoms of the illness. Sometimes family members or others misinterpret the negative symptoms of schizophrenia as a sign of "laziness." For example, if the person is unmotivated and unconcerned about personal appearance, they may think that he or she is just too lazy to bother or is neglecting his or her appearance to annoy the family.
     Negative symptoms may also be the result of depression (which can occur at the same time as schizophrenia) or an understimulating environment (such as a prolonged hospital stay), or may actually represent side effects of some antipsychotic medications. It is often hard to tell if negative symptoms are a part of the schizophrenic illness itself or the result of these other problems.
     The person's ability to work, to interact with others, and to care for himself or herself during remission depends to a large extent on the severity of the person's residual negative symptoms.
Most people with schizophrenia only have a few positive and negative symptoms at any given time. Typically, the type and severity of symptoms vary considerably over the course of the illness and from one person to another. Some individuals never have hallucinations; others never have delusions; some never have negative symptoms while others suffer from them persistently.
     Negative symptoms are associated with the stigma of psychological weakness, lack of will or drive to lead a more active and participatory life, and an inability to take care of oneself. The results of negative symptoms may be perceived as a voluntarily chosen life-style characterised by social withdrawal and a lack of responsibility toward others. Negative symptoms are often associated with the stigma of being lazy.
     The person's ability to work, to interact with others, and to care for himself or herself during remission depends to a large extent on the severity of the person's residual negative symptoms.

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