Cognitive characterization and therapy of negative symptoms and formal thought disorder
Cognitive therapy has emerged as an innovative and effective treatment for individuals diagnosed with schizophrenia and schizo-affective disorder. However, this therapeutic effort has been, like pharmacotherapy, primarily focused upon the psychotic symptoms. This chapter proposes that specific active psychological processes contribute to what on the surface might seem to be more behavioral, linguistic and emotional deficiencies. Explanatory models of negative symptoms have, since the seminal writings of Hughlings Jackson, appealed to degenerative neurobiology. One proposal is that loss of brain tissue causes the loss of capacity characteristic of negative symptomatology, as indicated by studies that find enlarged cerebral ventricles associated with prominent negative symptoms in schizophrenia. Formal thought disorder, along with inappropriate affect and bizarre behavior, comprise the disorganization dimension in schizophrenia. Cognitive deficits combined with limited availability of processing resources will likely provoke those with vulnerability for negative symptoms, producing adverse developmental stressors, such as social and academic failures.