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rhesus macaques early in life can permanently alter affective processing. Lesioning the amygdala causes blunted affect responses to both positive and negative stimuli. This effect is irreversible in the rhesus macaques; neonatal damage produces the same effect as damage that occurs later in life. The macaques' brain cannot compensate for early amygdala damage, even though significant neuronal growth may occur. There is some evidence that blunted affect symptoms in schizophrenia patients are not a result of just amygdala responsiveness, but a result of the amygdala not being integrated with other areas of the brain associated with emotional processing, particularly in amygdala-prefrontal cortex coupling. Damage in the limbic region prevents the amygdala from correctly interpreting emotional stimuli in individuals with schizophrenia by compromising the link between the amygdala and other brain regions associated with emotion.
179:, hyporeactivity), similar to what is seen in blunted affect. Individuals with schizophrenia with blunted affect show activation of the brainstem during fMRI scans, particularly the right medulla and the left pons, when shown "sad" film excerpts. The bilateral midbrain is also activated in individuals with schizophrenia diagnosed with blunted affect. Activation of the midbrain is thought to be related to autonomic responses associated with the perceptual processing of emotional stimuli. This region usually becomes activated in diverse emotional states. When the connectivity between the midbrain and the medial prefrontal cortex is compromised in individuals with schizophrenia with blunted affect an absence of emotional reaction to external stimuli results.
195:(PFC). Failure to activate the PFC is possibly involved in impaired emotional processing in individuals with schizophrenia with blunted affect. The medial PFC is activated in average individuals in response to external emotional stimuli. This structure possibly receives information from the limbic structures to regulate emotional experiences and behavior. Individuals being reconditioned with quetiapine, who show reduced symptoms, show activation in other areas of the PFC as well, including the right medial prefrontal gyrus and the left orbitofrontal gyrus.
267:) and produces feelings of detachment from others, restricted emotional expression and a reduced tendency to express emotions behaviorally. Blunted affect is often seen in veterans as a consequence of the psychological stressful experiences that caused PTSD. Blunted affect is a response to PTSD, it is considered one of the central symptoms in post-traumatic stress disorders and it is often seen in veterans who served in combat zones. In PTSD, blunted affect can be considered a psychological response to PTSD as a way to combat overwhelming
146:
following brain areas when shown emotionally negative pictures: midbrain, pons, anterior cingulate cortex, insula, ventrolateral orbitofrontal cortex, anterior temporal pole, amygdala, medial prefrontal cortex and extrastriate visual cortex. Whereas, individuals with schizophrenia with blunted affect show activation in the following brain regions when shown emotionally negative pictures: midbrain, pons, anterior temporal pole and extrastriate visual cortex.
247:
fewer words per sentence. Flat affect individuals' use of context-appropriate words in both sad and happy narratives are similar to that of controls. It is very likely that flat affect is a result of deficits in motor expression as opposed to emotional processing. The moods of display are compromised, but subjective, autonomic, and contextual aspects of emotion are left intact.
368:
314:, which is the decrease or cessation of all feelings of pleasure (which thus affects enjoyment, happiness, fun, interest, and satisfaction). In the case of anhedonia, emotions relating to pleasure will not be expressed as much or at all because they are literally not experienced or are decreased. Both blunted affect and anhedonia are considered negative symptoms of
263:. However, recently, psychologists have started to focus their attention on the blunted affects and also the decrease in feeling and expressing positive emotions in PTSD patients. Blunted affect, or emotional numbness, is considered one of the consequences of PTSD because it causes a diminished interest in activities that produce pleasure (
238:
from affective states". To further support this idea, a study examining emotion dysregulation found that individuals with schizophrenia could not exaggerate their emotional expression as healthy controls could. Participants were asked to express whatever emotions they had during a clip of a film, and
221:
Flat and blunted affect is a defining characteristic in the presentation of schizophrenia. To reiterate, these individuals have a decrease in observed vocal and facial expressions as well as the use of gestures. One study of flat affect in schizophrenia found that "flat affect was more common in men
242:
There is still some debate regarding the source of flat affect in schizophrenia. However, some literature indicates abnormalities in the dorsal executive and ventral affective systems; it is argued that dorsal hypoactivation and ventral hyperactivation may be the source of flat affect. Further, the
145:
Individuals with schizophrenia with blunted affect show different regional brain activity in fMRI scans when presented with emotional stimuli compared to individuals with schizophrenia without blunted affect. For instance, individuals with schizophrenia without blunted affect show activation in the
225:
The study also reported a "dissociation between reported experience of emotion and its display" – supporting the suggestion made elsewhere that "blunted affect, including flattened facial expressiveness and lack of vocal inflection ... often disguises an individual's true feelings." Thus, feelings
158:
when viewing emotional stimuli. In individuals with schizophrenia with blunted affect neural processes begin in the occipitotemporal region of the brain and go through the ventral visual pathway and the limbic structures until they reach the inferior frontal areas. Damage to the amygdala of adult
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Muenzenmaler, Kristina; Castille, Dorothy M.; Shelley, Anne-Marie; Jamison, Andrea; Battaglia, Joseph; Opler, Lewis A.; Alexander, Mary Jane (2005). "Comorbid
Posttraumatic Stress Disorder and Schizophrenia-PTSD is particularly difficult to diagnose with schizophrenia, and the issues surrounding
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Another study found that when speaking, individuals with schizophrenia with flat affect demonstrate less inflection than normal controls and appear to be less fluent. Normal subjects appear to express themselves using more complex syntax, whereas flat affect subjects speak with fewer words, and
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In making assessments of mood and affect the clinician is cautioned that "it is important to keep in mind that demonstrative expression can be influenced by cultural differences, medication, or situational factors"; while the layperson is warned to beware of applying the criterion lightly to
120:
Blunted affect is a lack of affect more severe than restricted or constricted affect, but less severe than flat or flattened affect. "The difference between flat and blunted affect is in degree. A person with flat affect has no or nearly no emotional expression. They may not react at all to
744:
Fahim, Cherine; Stip, Emmanuel; Mancini-Marïe, Adham; Mensour, Boualem; Boulay, Luc J.; Leroux, Jean-Maxime; Beaudoin, Gilles; Bourgouin, Pierre; Beauregard, Mario (2005). "Brain activity during emotionally negative pictures in schizophrenia with and without flat affect: An fMRI study".
889:
Stip, Emmanuel; Fahim, Cherine; Mancini-Marïe, Adham; Bentaleb, Lahcen Ait; Mensour, Boualem; Mendrek, Adrianna; Beauregard, Mario (2005). "Restoration of frontal activation during a treatment with quetiapine: An fMRI study of blunted affect in schizophrenia".
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and the reported magnitude of sad feelings evoked by viewing sad film excerpts. The rostral subdivision of this region is possibly involved in detecting emotional signals. This region is different in individuals with schizophrenia, with blunted affect.
1519:
Troisi, Alfonso; Belsanti, Sergio; Bucci, Anna
Rosaria; Mosco, Cristina; Sinti, Fabiola; Verucci, Monica (2000). "Affect Regulation in Alexithymia: An Ethological Study of Displacement Behavior during Psychiatric Interviews".
302:, 'impoverished' affect ... all presuppose that there are reliable, valid impersonal criteria for making attributions about the other person's relation to actions. There are no such reliable or valid criteria".
51:
either verbally or nonverbally, especially when talking about issues that would normally be expected to engage emotions. In this condition, expressive gestures are rare and there is little animation in
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but to a real loss of contact with the objective world gives the observer a specific impression of 'queerness' ... the remainders of emotions or the substitutes for emotions usually refer to rage and
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is severed from the rest of the brain, the result is a striking inability to gauge the emotional significance of events; this condition is sometimes called 'affective blindness
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circumstances that usually evoke strong emotions in others. A person with blunted affect, on the other hand, has a significantly reduced intensity in emotional expression".
337:– a condition describing people who "lack words for their feelings. They seem to lack feelings altogether, although this may actually be because of their inability to
176:
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authors found deficits in the mirror neuron system may also contribute to flat affect in that the deficits may cause disruptions in the control of facial expression.
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emotion rather than from an absence of emotion altogether". Alexithymic patients however can provide clues via assessment presentation which may be indicative of
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Harpur, T. J., Hare, R. D., & Hakstian, A. R. (1989). "Two-factor conceptualization of psychopathy: Construct validity and assessment implications".
342:
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Alpert, Murray; Rosenberg, Stanley D.; Pouget, Enrique R.; Shaw, Richard J. (2000). "Prosody and lexical accuracy in flat affect schizophrenia".
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are responsible for passive emotional coping strategies characterized by disengagement or withdrawal from the external environment (
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Amdur, Richard L.; Larsen, Randy; Liberzon, Israel (2000). "Emotional
Processing in Combat-Related Posttraumatic Stress Disorder".
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Henry, Julie D.; Green, Melissa J.; de Lucia, Amber; Restuccia, Corinne; McDonald, Skye; O'Donnell, Maryanne (1 September 2007).
318:, meaning that they are indicative of a lack of something. There are some other negative symptoms of schizophrenia which include
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A restricted or constricted affect is a reduction in an individual's expressive range and the intensity of emotional responses.
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1112:"Emotion dysregulation in schizophrenia: Reduced amplification of emotional expression is associated with emotional blunting"
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Sierra, M.; Berrios, G.E. (2001). "The
Phenomenological Stability of Depersonalization: Comparing the Old with the New".
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that the patients feel. In blunted affect, there are abnormalities in circuits that also include the prefrontal cortex.
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Shin, L. M.; Rauch, SL; Pitman, RK (2006). "Amygdala, Medial
Prefrontal Cortex, and Hippocampal Function in PTSD".
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and was associated with worse current quality of life" as well as having "an adverse effect on course of illness".
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may merely be unexpressed, rather than lacking. On the other hand, "a lack of emotions which is due not to mere
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356:". In some cases, blunted affect can fade, but there is no conclusive evidence of why this can occur.
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the participants with schizophrenia showed deficits in the behavioral expression of their emotions.
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Gur, R. E; Kohler, C. G; Ragland, J D.; Siegel, S. J; Lesko, K.; Bilker, W. B; Gur, R. C (2006).
839:"Emotion Effects on Attention, Amygdala Activation, and Functional Connectivity in Schizophrenia"
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Lee, Jung Suk; Chun, Ji Won; Yoon, Sang Young; Park, Hae-Jeong; Kim, Jae-Jin (1 January 2014).
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Post-traumatic stress disorder (PTSD) was previously known to cause negative feelings, such as
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Foundations of
Counseling and Psychotherapy: Evidence-Based Practices for a Diverse Society
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987:"Flat Affect in Schizophrenia: Relation to Emotion Processing and Neurocognitive Measures"
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Individuals with schizophrenia, as well as patients being successfully reconditioned with
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790:"Neonatal amygdala lesions result in globally blunted affect in adult rhesus macaques"
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Individuals with schizophrenia with flat affect show decreased activation in the
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84:. It may also be a side effect of certain medications (e.g., antipsychotics and
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personalities in our 'normal' population, and our tendency to psychological
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1167:"Involvement of the mirror neuron system in blunted affect in schizophrenia"
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Ackner, B. (1954). "Depersonalisation: I. Aetiology and phenomenology".
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or vocal inflection. Additionally, reduced affect can be symptomatic of
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in particular stressed that "such 'clinical' categories as schizoid,
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Shallow affect has an equivalent meaning to blunted affect. In the
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Bliss-Moreau, Eliza; Bauman, Melissa D.; Amaral, David G. (2011).
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Price, Jonathan; Cole, Victoria; Goodwin, Guy M. (August 2009).
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A positive correlation has been found between activation of the
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Kashdan, Todd B.; Elhai, Jon D.; Christopher Frueh, B. (2007).
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Progress in Neuro-Psychopharmacology and
Biological Psychiatry
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133:, Factor 1 identifies shallow affect as a common attribute of
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Saperstein, J.L. (1949). "Phenomena of depersonalization".
433:. London: Royal College of Psychiatrists. pp. 167–86.
99:, which explicitly refer to a lack of emotional sensation.
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reactivity in an individual. It manifests as a failure to
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Condition of reduced emotional reactivity in an individual
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Marder, Stephen R.; Galderisi, Silvana (February 2017).
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However, reduced affect should be distinguished from
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Basic
Concepts of Psychiatric-mental Health Nursing
234:". In the most extreme cases, there is a complete "
660:. Lippincott Williams & Wilkins. p. 110.
1482:A Layman's Guide to Psychiatry and Pscyhoanalysis
1359:treatment of this comorbidity are addressed in".
578:. Hoboken: John Wiley & Sons. pp. 64–6.
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429:. In Stein, George; Wilkinson, Greg (eds.).
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1398:. New Jersey: John Wiley & Sons.
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1051:The Psychoanalytic Theory of Neurosis
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427:"Schizophrenia: the clinical picture"
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431:Seminars in General Adult Psychiatry
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2311:Psychopathic Personality Inventory
570:Sue, David; Sue, Diane M. (2012).
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310:Blunted affect is very similar to
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2071:Transcranial magnetic stimulation
1836:Bipolar Spectrum Diagnostic Scale
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1396:Textbook of Biological Psychiatry
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747:Psychiatry Research: Neuroimaging
619:The British Journal of Psychiatry
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538:10.1097/00005053-200109000-00010
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2046:Dialectical behavior therapy
2041:Cognitive behavioral therapy
1861:Rating scales for depression
1394:Panksepp, Jaak, ed. (2004).
1317:Journal of Anxiety Disorders
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1128:10.1016/j.schres.2007.06.002
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43:, is a condition of reduced
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35:, sometimes referred to as
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1846:General Behavior Inventory
1284:10.1016/j.paid.2007.01.013
1036:Treating Difficult Couples
682:Fundamentals of Psychiatry
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1053:. London. pp. 445–6.
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456:Journal of Mental Science
425:Liddle, Peter F. (2007).
205:anterior cingulate cortex
199:Anterior cingulate cortex
1866:Young Mania Rating Scale
1841:Child Mania Rating Scale
1720:Schizoaffective disorder
1699:Major depressive episode
1083:Narcissism: A New Theory
696:Psychological Assessment
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1993:Atypical antipsychotics
1752:Emotional dysregulation
1499:. Penguin. p. 128.
1484:. Penguin. p. 207.
1451:10.1196/annals.1364.007
1049:Fenichel, Otto (1946).
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392:Emotional dysregulation
116:Blunted and flat affect
2326:Sexual sadism disorder
2286:History of psychopathy
2255:Superficially charming
2056:Involuntary commitment
1818:Reduced affect display
1694:Melancholic depression
1171:Schizophrenia Research
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1085:. London. p. 122.
991:Schizophrenia Bulletin
843:Schizophrenia Bulletin
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1495:Laing, R. D. (1969).
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684:(2011) Section 25.2.3
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2098:Frederick K. Goodwin
1918:Valproate semisodium
1808:Psychotic depression
1480:Berne, Eric (1976).
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1222:Psychiatry Research
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1497:Self and Others
1493:
1489:
1478:
1474:
1442:10.1.1.523.5686
1417:
1413:
1406:
1392:
1388:
1356:
1352:
1313:
1309:
1264:
1257:
1228:(2–3): 107–18.
1218:
1214:
1163:
1159:
1108:
1104:
1088:
1087:
1076:
1072:
1056:
1055:
1047:
1043:
1032:
1028:
983:
976:
931:
927:
887:
880:
835:
831:
786:
782:
742:
729:
713:
712:
692:
688:
679:
675:
668:
652:
648:
611:
607:
598:
597:
593:
586:
568:
561:
522:
518:
487:
483:
452:
448:
441:
423:
419:
415:
382:Antonio Damasio
372:
367:
365:
362:
353:
308:
290:hypochondriasis
277:
253:
219:
214:
201:
185:
165:
152:
143:
127:
118:
110:
105:
86:antidepressants
28:
23:
22:
15:
12:
11:
5:
2401:
2391:
2390:
2385:
2380:
2378:Mood disorders
2363:
2362:
2360:
2359:
2357:Robert D. Hare
2354:
2349:
2343:
2341:
2337:
2336:
2334:
2333:
2328:
2323:
2318:
2313:
2308:
2303:
2298:
2293:
2288:
2283:
2278:
2273:
2267:
2265:
2264:Related topics
2261:
2260:
2258:
2257:
2252:
2250:Shallow affect
2247:
2242:
2237:
2232:
2227:
2222:
2217:
2212:
2207:
2202:
2197:
2191:
2189:
2185:
2184:
2182:
2181:
2176:
2170:
2168:
2164:
2163:
2156:
2155:
2148:
2141:
2133:
2124:
2123:
2121:
2120:
2115:
2110:
2105:
2100:
2095:
2093:Emil Kraepelin
2089:
2087:
2081:
2080:
2077:
2076:
2074:
2073:
2068:
2063:
2058:
2053:
2048:
2043:
2038:
2032:
2030:
2026:
2025:
2023:
2022:
2021:
2020:
2015:
2010:
2005:
1995:
1990:
1988:Antipsychotics
1984:
1982:
1975:
1974:
1972:
1971:
1966:
1961:
1956:
1951:
1946:
1940:
1938:
1926:
1925:
1923:
1922:
1921:
1920:
1915:
1905:
1900:
1895:
1889:
1887:
1878:
1872:
1871:
1869:
1868:
1863:
1858:
1853:
1848:
1843:
1838:
1832:
1830:
1824:
1823:
1821:
1820:
1815:
1810:
1805:
1800:
1799:
1798:
1793:
1785:Sleep disorder
1781:
1776:
1771:
1770:
1769:
1764:
1759:
1749:
1744:
1738:
1736:
1730:
1729:
1726:
1725:
1723:
1722:
1716:
1714:
1710:
1709:
1707:
1706:
1701:
1696:
1691:
1686:
1681:
1676:
1670:
1668:
1662:
1661:
1659:
1658:
1653:
1648:
1643:
1638:
1633:
1628:
1623:
1618:
1612:
1610:
1601:
1595:
1594:
1587:
1586:
1579:
1572:
1564:
1557:
1556:
1547:
1511:
1509:Goleman, p. 50
1502:
1487:
1472:
1411:
1404:
1386:
1350:
1307:
1278:(4): 725–735.
1255:
1212:
1177:(1): 268–274.
1157:
1122:(1): 197–204.
1102:
1070:
1041:
1038:. p. 154.
1026:
974:
925:
878:
829:
780:
727:
686:
673:
666:
646:
625:(3): 211–217.
605:
591:
584:
559:
532:(9): 629–636.
516:
497:(3): 236–251.
481:
446:
439:
416:
414:
411:
410:
409:
404:
399:
394:
389:
384:
378:
377:
361:
358:
307:
304:
276:
273:
257:depressed mood
252:
249:
232:aggressiveness
218:
215:
213:
210:
200:
197:
184:
181:
164:
161:
151:
148:
142:
139:
126:
125:Shallow affect
123:
117:
114:
109:
106:
104:
101:
26:
18:Blunted affect
9:
6:
4:
3:
2:
2400:
2389:
2386:
2384:
2381:
2379:
2376:
2375:
2373:
2358:
2355:
2353:
2350:
2348:
2345:
2344:
2342:
2338:
2332:
2329:
2327:
2324:
2322:
2319:
2317:
2314:
2312:
2309:
2307:
2304:
2302:
2299:
2297:
2294:
2292:
2289:
2287:
2284:
2282:
2279:
2277:
2274:
2272:
2269:
2268:
2266:
2262:
2256:
2253:
2251:
2248:
2246:
2243:
2241:
2238:
2236:
2233:
2231:
2230:Lack of guilt
2228:
2226:
2223:
2221:
2218:
2216:
2213:
2211:
2208:
2206:
2203:
2201:
2198:
2196:
2193:
2192:
2190:
2186:
2180:
2177:
2175:
2172:
2171:
2169:
2165:
2161:
2154:
2149:
2147:
2142:
2140:
2135:
2134:
2131:
2119:
2116:
2114:
2111:
2109:
2108:Karl Leonhard
2106:
2104:
2101:
2099:
2096:
2094:
2091:
2090:
2088:
2086:
2082:
2072:
2069:
2067:
2066:Psychotherapy
2064:
2062:
2061:Light therapy
2059:
2057:
2054:
2052:
2049:
2047:
2044:
2042:
2039:
2037:
2034:
2033:
2031:
2027:
2019:
2016:
2014:
2011:
2009:
2006:
2004:
2001:
2000:
1999:
1996:
1994:
1991:
1989:
1986:
1985:
1983:
1981:
1976:
1970:
1967:
1965:
1962:
1960:
1957:
1955:
1952:
1950:
1947:
1945:
1942:
1941:
1939:
1936:
1931:
1927:
1919:
1916:
1914:
1911:
1910:
1909:
1906:
1904:
1903:Oxcarbazepine
1901:
1899:
1896:
1894:
1893:Carbamazepine
1891:
1890:
1888:
1886:
1882:
1879:
1877:
1873:
1867:
1864:
1862:
1859:
1857:
1854:
1852:
1849:
1847:
1844:
1842:
1839:
1837:
1834:
1833:
1831:
1829:
1825:
1819:
1816:
1814:
1811:
1809:
1806:
1804:
1801:
1797:
1794:
1792:
1789:
1788:
1787:
1786:
1782:
1780:
1777:
1775:
1774:Hallucination
1772:
1768:
1765:
1763:
1760:
1758:
1755:
1754:
1753:
1750:
1748:
1745:
1743:
1740:
1739:
1737:
1735:
1731:
1721:
1718:
1717:
1715:
1713:Comorbidities
1711:
1705:
1702:
1700:
1697:
1695:
1692:
1690:
1687:
1685:
1682:
1680:
1677:
1675:
1672:
1671:
1669:
1667:
1663:
1657:
1656:Rapid cycling
1654:
1652:
1649:
1647:
1644:
1642:
1639:
1637:
1634:
1632:
1629:
1627:
1624:
1622:
1619:
1617:
1614:
1613:
1611:
1609:
1605:
1602:
1600:
1596:
1592:
1591:Mood disorder
1585:
1580:
1578:
1573:
1571:
1566:
1565:
1562:
1551:
1543:
1539:
1535:
1531:
1527:
1523:
1515:
1506:
1498:
1491:
1483:
1476:
1468:
1464:
1460:
1456:
1452:
1448:
1443:
1438:
1434:
1430:
1426:
1422:
1415:
1407:
1401:
1397:
1390:
1382:
1378:
1374:
1370:
1366:
1362:
1354:
1346:
1342:
1338:
1334:
1330:
1326:
1323:(3): 219–38.
1322:
1318:
1311:
1303:
1299:
1294:
1289:
1285:
1281:
1277:
1273:
1269:
1262:
1260:
1251:
1247:
1243:
1239:
1235:
1231:
1227:
1223:
1216:
1208:
1204:
1200:
1196:
1192:
1188:
1184:
1180:
1176:
1172:
1168:
1161:
1153:
1149:
1145:
1141:
1137:
1133:
1129:
1125:
1121:
1117:
1113:
1106:
1098:
1092:
1084:
1080:
1074:
1066:
1060:
1052:
1045:
1037:
1030:
1022:
1018:
1013:
1008:
1004:
1000:
997:(2): 279–87.
996:
992:
988:
981:
979:
970:
966:
961:
956:
952:
948:
944:
940:
936:
929:
921:
917:
913:
909:
905:
901:
897:
893:
885:
883:
874:
870:
865:
860:
856:
852:
849:(5): 967–80.
848:
844:
840:
833:
825:
821:
816:
811:
807:
803:
800:(6): 848–58.
799:
795:
791:
784:
776:
772:
768:
764:
760:
756:
752:
748:
740:
738:
736:
734:
732:
723:
717:
709:
705:
701:
697:
690:
683:
677:
669:
667:9780781797078
663:
659:
658:
650:
642:
638:
633:
628:
624:
620:
616:
609:
601:
595:
587:
581:
577:
573:
566:
564:
555:
551:
547:
543:
539:
535:
531:
527:
520:
512:
508:
504:
500:
496:
492:
485:
477:
473:
469:
465:
461:
457:
450:
442:
436:
432:
428:
421:
417:
408:
405:
403:
400:
398:
395:
393:
390:
388:
385:
383:
380:
379:
375:
364:
357:
351:
346:
344:
340:
336:
331:
329:
325:
321:
317:
316:schizophrenia
313:
303:
301:
297:
293:
291:
287:
283:
272:
270:
266:
262:
258:
248:
244:
240:
237:
233:
229:
223:
217:Schizophrenia
209:
206:
196:
194:
190:
180:
178:
174:
170:
167:Parts of the
160:
157:
156:limbic system
147:
138:
136:
132:
122:
113:
100:
98:
94:
89:
87:
83:
79:
75:
71:
67:
63:
62:schizophrenia
59:
55:
50:
46:
42:
38:
34:
30:
19:
2235:Manipulative
2215:Disinhibited
2118:Mogens Schou
1954:Escitalopram
1817:
1783:
1550:
1525:
1521:
1514:
1505:
1496:
1490:
1481:
1475:
1427:(1): 67–79.
1424:
1420:
1414:
1395:
1389:
1364:
1360:
1353:
1320:
1316:
1310:
1275:
1271:
1225:
1221:
1215:
1174:
1170:
1160:
1119:
1115:
1105:
1082:
1073:
1050:
1044:
1035:
1029:
994:
990:
945:(1): 14–24.
942:
938:
928:
895:
891:
846:
842:
832:
797:
793:
783:
750:
746:
716:cite journal
699:
695:
689:
681:
676:
656:
649:
622:
618:
608:
594:
575:
529:
525:
519:
494:
490:
484:
459:
455:
449:
430:
420:
347:
338:
332:
309:
294:
278:
261:hyperarousal
254:
245:
241:
236:dissociation
224:
220:
202:
186:
166:
153:
144:
128:
119:
111:
90:
82:brain damage
40:
36:
32:
31:
29:
2245:Remorseless
2160:Psychopathy
1937:and similar
1898:Lamotrigine
1791:Hypersomnia
1631:Bipolar NOS
1626:Cyclothymia
1528:(1): 13–8.
1367:(1): 50–6.
898:(1): 21–6.
753:(1): 1–15.
702:(1): 6–17.
335:alexithymia
330:behaviour.
296:R. D. Laing
286:cyclothymic
135:psychopathy
2372:Categories
2331:Sociopathy
2306:Narcissism
2281:Dark triad
2174:In fiction
1969:Sertraline
1959:Fluoxetine
1779:Mood swing
1666:Depression
1621:Bipolar II
413:References
275:Assessment
228:repression
189:quetiapine
177:immobility
173:quiescence
66:depression
2225:Impulsive
2220:Grandiose
2103:John Cade
1944:Bupropion
1908:Valproate
1876:Treatment
1828:Diagnosis
1803:Psychosis
1762:Dysphoria
1757:Anhedonia
1679:Dysthymia
1641:Hypomania
1636:Childhood
1616:Bipolar I
1437:CiteSeerX
1373:1938-2456
1191:0920-9964
1136:0920-9964
1091:cite book
1059:cite book
600:"Inkling"
328:catatonic
320:avolition
312:anhedonia
265:anhedonia
212:Diagnoses
169:brainstem
163:Brainstem
97:anhedonia
45:emotional
2167:Contexts
1796:Insomnia
1742:Delusion
1734:Symptoms
1599:Spectrum
1542:10665455
1467:14972288
1459:16891563
1381:27724748
1337:10868981
1302:18769508
1250:22446103
1242:11166083
1207:34377252
1199:24268934
1152:44415559
1144:17630254
1081:(2003).
1021:16452608
969:28127915
920:26614932
912:15610941
873:21415225
824:21988521
775:23542860
767:16143498
641:19721109
554:22920376
546:11580008
511:18147948
476:13222014
360:See also
350:amygdala
348:"If the
300:autistic
282:schizoid
2205:Callous
2085:History
1998:Lithium
1429:Bibcode
1345:5824208
1293:2084052
1012:2632232
960:5269507
864:3446234
815:3313682
339:express
269:anxiety
1978:Other
1540:
1465:
1457:
1439:
1402:
1379:
1371:
1343:
1335:
1300:
1290:
1248:
1240:
1205:
1197:
1189:
1150:
1142:
1134:
1019:
1009:
967:
957:
918:
910:
871:
861:
822:
812:
773:
765:
664:
639:
582:
552:
544:
509:
474:
437:
324:alogia
93:apathy
58:autism
1935:SSRIs
1646:Mania
1463:S2CID
1341:S2CID
1246:S2CID
1203:S2CID
1148:S2CID
916:S2CID
771:S2CID
550:S2CID
103:Types
2200:Bold
1538:PMID
1455:PMID
1425:1071
1400:ISBN
1377:OCLC
1369:ISSN
1333:PMID
1298:PMID
1238:PMID
1195:PMID
1187:ISSN
1140:PMID
1132:ISSN
1097:link
1065:link
1017:PMID
965:PMID
908:PMID
869:PMID
820:PMID
763:PMID
722:link
662:ISBN
637:PMID
580:ISBN
542:PMID
507:PMID
472:PMID
435:ISBN
326:and
284:and
95:and
1530:doi
1526:188
1447:doi
1325:doi
1288:PMC
1280:doi
1230:doi
1179:doi
1175:152
1124:doi
1007:PMC
999:doi
955:PMC
947:doi
900:doi
859:PMC
851:doi
810:PMC
802:doi
798:125
755:doi
751:140
704:doi
627:doi
623:195
534:doi
530:189
499:doi
495:110
464:doi
460:100
292:".
88:).
80:or
60:,
39:or
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