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In the context of schizophrenia and other psychotic disorders, "positive" and "negative" do not refer to the emotional valence of the voices (i.e., whether they are pleasant or unpleasant). Instead, they are clinical terms used to categorize different types of symptoms experienced by individuals with schizophrenia. These terms are part of a broader classification system called the "positive and negative symptom model."

  1. Positive symptoms: These symptoms involve an excess or distortion of normal functions. They are called "positive" because they represent an addition to the person's typical experiences. Positive symptoms can include:

    • Hallucinations: This is when a person perceives sensory experiences that are not based in reality. Auditory hallucinations, such as hearing voices, are one of the most common positive symptoms in schizophrenia.

    • Delusions: These are false beliefs that are firmly held, despite evidence to the contrary. Delusions can be paranoid, grandiose, or persecutory, among others.

    • Disorganized thinking: Individuals may have difficulty organizing their thoughts, making their speech incoherent and hard to follow.

    • Disorganized or abnormal motor behavior: This can manifest as unpredictable or unusual movements and gestures.

  2. Negative symptoms: These symptoms involve a reduction or loss of normal functions. They are called "negative" because they represent a reduction in typical experiences. Negative symptoms can include:

    • Affective flattening: Reduced emotional expression and facial expressions.

    • Alogia: Decreased speech output, often resulting in reduced verbal communication.

    • Avolition: Reduced motivation to initiate and sustain purposeful activities.

    • Anhedonia: Diminished ability to experience pleasure or interest in previously enjoyable activities.

    • Social withdrawal: Decreased interest in social interactions and a preference for being alone.

It's essential to note that not all individuals with schizophrenia will experience both positive and negative symptoms. The symptom profile can vary from person to person, and some individuals may experience a mixture of both types.

Schizophrenia is a complex mental disorder, and individuals experiencing any of these symptoms should seek professional help for a proper evaluation, diagnosis, and appropriate treatment. Early intervention and support are crucial for managing the condition effectively.

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