148:
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.
168:, 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.
184:(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.
256:) 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
135:
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.
236:
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.
357:
303:, 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
252:. 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 (
227:
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
210:
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
231:
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
134:
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
214:
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
147:
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
1347:
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
235:
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
268:
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
109:
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
733:
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".
878:
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".
196:
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.
1508:
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".
291:, '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".
40:
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
110:
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".
326:– 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
165:
232:
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
683:
Harpur, T. J., Hare, R. D., & Hakstian, A. R. (1989). "Two-factor conceptualization of psychopathy: Construct validity and assessment implications".
331:
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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".
62:
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Henry, Julie D.; Green, Melissa J.; de Lucia, Amber; Restuccia, Corinne; McDonald, Skye; O'Donnell, Maryanne (1 September 2007).
307:, 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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1101:"Emotion dysregulation in schizophrenia: Reduced amplification of emotional expression is associated with emotional blunting"
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427:
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513:
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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345:". 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).
828:"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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976:"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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779:"Neonatal amygdala lesions result in globally blunted affect in adult rhesus macaques"
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604:"Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study"
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Individuals with schizophrenia with flat affect show decreased activation in the
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73:. 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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1156:"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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924:"The current conceptualization of negative symptoms in schizophrenia"
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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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33:
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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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81:
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Progress in Neuro-Psychopharmacology and
Biological Psychiatry
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122:, Factor 1 identifies shallow affect as a common attribute of
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732:
1098:
478:
Saperstein, J.L. (1949). "Phenomena of depersonalization".
422:. London: Royal College of Psychiatrists. pp. 167–86.
88:, 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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1507:
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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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646:
Basic
Concepts of Psychiatric-mental Health Nursing
223:". In the most extreme cases, there is a complete "
649:. Lippincott Williams & Wilkins. p. 110.
1471:A Layman's Guide to Psychiatry and Pscyhoanalysis
1348:treatment of this comorbidity are addressed in".
567:. Hoboken: John Wiley & Sons. pp. 64–6.
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826:Anticevic, A.; Repovs, G.; Barch, D. M. (2011).
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1543:Daniel Goleman, Emotional Intelligence, p. 15
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709:: CS1 maint: multiple names: authors list (
418:. In Stein, George; Wilkinson, Greg (eds.).
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1511:The Journal of Nervous & Mental Disease
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180:for blunted affect, show activation of the
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643:Shives, Louise Rebraca (1 January 2008).
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480:The Journal of Nervous and Mental Disease
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63:depersonalization derealization disorder
1693:Depression in childhood and adolescence
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1023:Snyder, D. K.; Whisman, M. A. (2003).
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1387:. New Jersey: John Wiley & Sons.
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1040:The Psychoanalytic Theory of Neurosis
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416:"Schizophrenia: the clinical picture"
96:
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420:Seminars in General Adult Psychiatry
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1736:Depression (differential diagnoses)
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2300:Psychopathic Personality Inventory
559:Sue, David; Sue, Diane M. (2012).
549:
299:Blunted affect is very similar to
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2060:Transcranial magnetic stimulation
1825:Bipolar Spectrum Diagnostic Scale
1578:
1385:Textbook of Biological Psychiatry
748:10.1016/j.pscychresns.2005.06.003
736:Psychiatry Research: Neuroimaging
608:The British Journal of Psychiatry
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1523:10.1097/00005053-200001000-00003
527:10.1097/00005053-200109000-00010
492:10.1097/00005053-194911030-00005
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2260:Antisocial personality disorder
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59:post-traumatic stress disorder
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2310:Sadistic personality disorder
1318:10.1016/S0887-6185(99)00035-3
1223:10.1016/S0165-1781(00)00231-6
401:
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67:schizoid personality disorder
2035:Dialectical behavior therapy
2030:Cognitive behavioral therapy
1850:Rating scales for depression
1383:Panksepp, Jaak, ed. (2004).
1306:Journal of Anxiety Disorders
1172:10.1016/j.schres.2013.10.043
1117:10.1016/j.schres.2007.06.002
200:
151:
32:, is a condition of reduced
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1845:Mood Disorder Questionnaire
1673:Seasonal affective disorder
893:10.1016/j.pnpbp.2004.08.015
348:
24:, sometimes referred to as
10:
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1835:General Behavior Inventory
1273:10.1016/j.paid.2007.01.013
1025:Treating Difficult Couples
671:Fundamentals of Psychiatry
2372:Symptoms of schizophrenia
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1042:. London. pp. 445–6.
621:10.1192/bjp.bp.108.051110
445:Journal of Mental Science
414:Liddle, Peter F. (2007).
194:anterior cingulate cortex
188:Anterior cingulate cortex
1855:Young Mania Rating Scale
1830:Child Mania Rating Scale
1709:Schizoaffective disorder
1688:Major depressive episode
1072:Narcissism: A New Theory
685:Psychological Assessment
91:
1982:Atypical antipsychotics
1741:Emotional dysregulation
1488:. Penguin. p. 128.
1473:. Penguin. p. 207.
1440:10.1196/annals.1364.007
1038:Fenichel, Otto (1946).
783:Behavioral Neuroscience
697:10.1037/1040-3590.1.1.6
457:10.1192/bjp.100.421.838
381:Emotional dysregulation
105:Blunted and flat affect
2315:Sexual sadism disorder
2275:History of psychopathy
2244:Superficially charming
2045:Involuntary commitment
1807:Reduced affect display
1683:Melancholic depression
1160:Schizophrenia Research
1105:Schizophrenia Research
1074:. London. p. 122.
980:Schizophrenia Bulletin
832:Schizophrenia Bulletin
669:A. Tasman/W. K. Mohn,
391:Expressive suppression
386:Experiential avoidance
295:Differential diagnosis
248:, re-experiencing and
22:Reduced affect display
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2184:Anti-social behaviour
1640:Mixed affective state
1484:Laing, R. D. (1969).
992:10.1093/schbul/sbj041
844:10.1093/schbul/sbq168
673:(2011) Section 25.2.3
396:Narcissistic defences
120:Psychopathy Checklist
2280:Juvenile delinquency
2102:Kay Redfield Jamison
2087:Frederick K. Goodwin
1907:Valproate semisodium
1797:Psychotic depression
1469:Berne, Eric (1976).
561:"Mental Status Exam"
376:Emotional detachment
2341:George E. Partridge
2025:Clinical psychology
1840:Hypomania Checklist
1678:Atypical depression
1422:2006NYASA1071...67S
1211:Psychiatry Research
322:Closely related is
2336:Hervey M. Cleckley
2229:Pathological lying
2199:Diminished empathy
2018:Non-pharmaceutical
1350:Psychiatric Annals
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1463:
1431:10.1.1.523.5686
1406:
1402:
1395:
1381:
1377:
1345:
1341:
1302:
1298:
1253:
1246:
1217:(2–3): 107–18.
1207:
1203:
1152:
1148:
1097:
1093:
1077:
1076:
1065:
1061:
1045:
1044:
1036:
1032:
1021:
1017:
972:
965:
920:
916:
876:
869:
824:
820:
775:
771:
731:
718:
702:
701:
681:
677:
668:
664:
657:
641:
637:
600:
596:
587:
586:
582:
575:
557:
550:
511:
507:
476:
472:
441:
437:
430:
412:
408:
404:
371:Antonio Damasio
361:
356:
354:
351:
342:
297:
279:hypochondriasis
266:
242:
208:
203:
190:
174:
154:
141:
132:
116:
107:
99:
94:
75:antidepressants
17:
12:
11:
5:
2390:
2380:
2379:
2374:
2369:
2367:Mood disorders
2352:
2351:
2349:
2348:
2346:Robert D. Hare
2343:
2338:
2332:
2330:
2326:
2325:
2323:
2322:
2317:
2312:
2307:
2302:
2297:
2292:
2287:
2282:
2277:
2272:
2267:
2262:
2256:
2254:
2253:Related topics
2250:
2249:
2247:
2246:
2241:
2239:Shallow affect
2236:
2231:
2226:
2221:
2216:
2211:
2206:
2201:
2196:
2191:
2186:
2180:
2178:
2174:
2173:
2171:
2170:
2165:
2159:
2157:
2153:
2152:
2145:
2144:
2137:
2130:
2122:
2113:
2112:
2110:
2109:
2104:
2099:
2094:
2089:
2084:
2082:Emil Kraepelin
2078:
2076:
2070:
2069:
2066:
2065:
2063:
2062:
2057:
2052:
2047:
2042:
2037:
2032:
2027:
2021:
2019:
2015:
2014:
2012:
2011:
2010:
2009:
2004:
1999:
1994:
1984:
1979:
1977:Antipsychotics
1973:
1971:
1964:
1963:
1961:
1960:
1955:
1950:
1945:
1940:
1935:
1929:
1927:
1915:
1914:
1912:
1911:
1910:
1909:
1904:
1894:
1889:
1884:
1878:
1876:
1867:
1861:
1860:
1858:
1857:
1852:
1847:
1842:
1837:
1832:
1827:
1821:
1819:
1813:
1812:
1810:
1809:
1804:
1799:
1794:
1789:
1788:
1787:
1782:
1774:Sleep disorder
1770:
1765:
1760:
1759:
1758:
1753:
1748:
1738:
1733:
1727:
1725:
1719:
1718:
1715:
1714:
1712:
1711:
1705:
1703:
1699:
1698:
1696:
1695:
1690:
1685:
1680:
1675:
1670:
1665:
1659:
1657:
1651:
1650:
1648:
1647:
1642:
1637:
1632:
1627:
1622:
1617:
1612:
1607:
1601:
1599:
1590:
1584:
1583:
1576:
1575:
1568:
1561:
1553:
1546:
1545:
1536:
1500:
1498:Goleman, p. 50
1491:
1476:
1461:
1400:
1393:
1375:
1339:
1296:
1267:(4): 725–735.
1244:
1201:
1166:(1): 268–274.
1146:
1111:(1): 197–204.
1091:
1059:
1030:
1027:. p. 154.
1015:
963:
914:
867:
818:
769:
716:
675:
662:
655:
635:
614:(3): 211–217.
594:
580:
573:
548:
521:(9): 629–636.
505:
486:(3): 236–251.
470:
435:
428:
405:
403:
400:
399:
398:
393:
388:
383:
378:
373:
367:
366:
350:
347:
296:
293:
265:
262:
246:depressed mood
241:
238:
221:aggressiveness
207:
204:
202:
199:
189:
186:
173:
170:
153:
150:
140:
137:
131:
128:
115:
114:Shallow affect
112:
106:
103:
98:
95:
93:
90:
15:
9:
6:
4:
3:
2:
2389:
2378:
2375:
2373:
2370:
2368:
2365:
2364:
2362:
2347:
2344:
2342:
2339:
2337:
2334:
2333:
2331:
2327:
2321:
2318:
2316:
2313:
2311:
2308:
2306:
2303:
2301:
2298:
2296:
2293:
2291:
2288:
2286:
2283:
2281:
2278:
2276:
2273:
2271:
2268:
2266:
2263:
2261:
2258:
2257:
2255:
2251:
2245:
2242:
2240:
2237:
2235:
2232:
2230:
2227:
2225:
2222:
2220:
2219:Lack of guilt
2217:
2215:
2212:
2210:
2207:
2205:
2202:
2200:
2197:
2195:
2192:
2190:
2187:
2185:
2182:
2181:
2179:
2175:
2169:
2166:
2164:
2161:
2160:
2158:
2154:
2150:
2143:
2138:
2136:
2131:
2129:
2124:
2123:
2120:
2108:
2105:
2103:
2100:
2098:
2097:Karl Leonhard
2095:
2093:
2090:
2088:
2085:
2083:
2080:
2079:
2077:
2075:
2071:
2061:
2058:
2056:
2055:Psychotherapy
2053:
2051:
2050:Light therapy
2048:
2046:
2043:
2041:
2038:
2036:
2033:
2031:
2028:
2026:
2023:
2022:
2020:
2016:
2008:
2005:
2003:
2000:
1998:
1995:
1993:
1990:
1989:
1988:
1985:
1983:
1980:
1978:
1975:
1974:
1972:
1970:
1965:
1959:
1956:
1954:
1951:
1949:
1946:
1944:
1941:
1939:
1936:
1934:
1931:
1930:
1928:
1925:
1920:
1916:
1908:
1905:
1903:
1900:
1899:
1898:
1895:
1893:
1892:Oxcarbazepine
1890:
1888:
1885:
1883:
1882:Carbamazepine
1880:
1879:
1877:
1875:
1871:
1868:
1866:
1862:
1856:
1853:
1851:
1848:
1846:
1843:
1841:
1838:
1836:
1833:
1831:
1828:
1826:
1823:
1822:
1820:
1818:
1814:
1808:
1805:
1803:
1800:
1798:
1795:
1793:
1790:
1786:
1783:
1781:
1778:
1777:
1776:
1775:
1771:
1769:
1766:
1764:
1763:Hallucination
1761:
1757:
1754:
1752:
1749:
1747:
1744:
1743:
1742:
1739:
1737:
1734:
1732:
1729:
1728:
1726:
1724:
1720:
1710:
1707:
1706:
1704:
1702:Comorbidities
1700:
1694:
1691:
1689:
1686:
1684:
1681:
1679:
1676:
1674:
1671:
1669:
1666:
1664:
1661:
1660:
1658:
1656:
1652:
1646:
1645:Rapid cycling
1643:
1641:
1638:
1636:
1633:
1631:
1628:
1626:
1623:
1621:
1618:
1616:
1613:
1611:
1608:
1606:
1603:
1602:
1600:
1598:
1594:
1591:
1589:
1585:
1581:
1580:Mood disorder
1574:
1569:
1567:
1562:
1560:
1555:
1554:
1551:
1540:
1532:
1528:
1524:
1520:
1516:
1512:
1504:
1495:
1487:
1480:
1472:
1465:
1457:
1453:
1449:
1445:
1441:
1437:
1432:
1427:
1423:
1419:
1415:
1411:
1404:
1396:
1390:
1386:
1379:
1371:
1367:
1363:
1359:
1355:
1351:
1343:
1335:
1331:
1327:
1323:
1319:
1315:
1312:(3): 219–38.
1311:
1307:
1300:
1292:
1288:
1283:
1278:
1274:
1270:
1266:
1262:
1258:
1251:
1249:
1240:
1236:
1232:
1228:
1224:
1220:
1216:
1212:
1205:
1197:
1193:
1189:
1185:
1181:
1177:
1173:
1169:
1165:
1161:
1157:
1150:
1142:
1138:
1134:
1130:
1126:
1122:
1118:
1114:
1110:
1106:
1102:
1095:
1087:
1081:
1073:
1069:
1063:
1055:
1049:
1041:
1034:
1026:
1019:
1011:
1007:
1002:
997:
993:
989:
986:(2): 279–87.
985:
981:
977:
970:
968:
959:
955:
950:
945:
941:
937:
933:
929:
925:
918:
910:
906:
902:
898:
894:
890:
886:
882:
874:
872:
863:
859:
854:
849:
845:
841:
838:(5): 967–80.
837:
833:
829:
822:
814:
810:
805:
800:
796:
792:
789:(6): 848–58.
788:
784:
780:
773:
765:
761:
757:
753:
749:
745:
741:
737:
729:
727:
725:
723:
721:
712:
706:
698:
694:
690:
686:
679:
672:
666:
658:
656:9780781797078
652:
648:
647:
639:
631:
627:
622:
617:
613:
609:
605:
598:
590:
584:
576:
570:
566:
562:
555:
553:
544:
540:
536:
532:
528:
524:
520:
516:
509:
501:
497:
493:
489:
485:
481:
474:
466:
462:
458:
454:
450:
446:
439:
431:
425:
421:
417:
410:
406:
397:
394:
392:
389:
387:
384:
382:
379:
377:
374:
372:
369:
368:
364:
353:
346:
340:
335:
333:
329:
325:
320:
318:
314:
310:
306:
305:schizophrenia
302:
292:
290:
286:
282:
280:
276:
272:
261:
259:
255:
251:
247:
237:
233:
229:
226:
222:
218:
212:
206:Schizophrenia
198:
195:
185:
183:
179:
169:
167:
163:
159:
156:Parts of the
149:
146:
145:limbic system
136:
127:
125:
121:
111:
102:
89:
87:
83:
78:
76:
72:
68:
64:
60:
56:
52:
51:schizophrenia
48:
44:
39:
35:
31:
27:
23:
19:
2224:Manipulative
2204:Disinhibited
2107:Mogens Schou
1943:Escitalopram
1806:
1772:
1539:
1514:
1510:
1503:
1494:
1485:
1479:
1470:
1464:
1416:(1): 67–79.
1413:
1409:
1403:
1384:
1378:
1353:
1349:
1342:
1309:
1305:
1299:
1264:
1260:
1214:
1210:
1204:
1163:
1159:
1149:
1108:
1104:
1094:
1071:
1062:
1039:
1033:
1024:
1018:
983:
979:
934:(1): 14–24.
931:
927:
917:
884:
880:
835:
831:
821:
786:
782:
772:
739:
735:
705:cite journal
688:
684:
678:
670:
665:
645:
638:
611:
607:
597:
583:
564:
518:
514:
508:
483:
479:
473:
448:
444:
438:
419:
409:
336:
327:
321:
298:
283:
267:
250:hyperarousal
243:
234:
230:
225:dissociation
213:
209:
191:
175:
155:
142:
133:
117:
108:
100:
79:
71:brain damage
29:
25:
21:
20:
18:
2234:Remorseless
2149:Psychopathy
1926:and similar
1887:Lamotrigine
1780:Hypersomnia
1620:Bipolar NOS
1615:Cyclothymia
1517:(1): 13–8.
1356:(1): 50–6.
887:(1): 21–6.
742:(1): 1–15.
691:(1): 6–17.
324:alexithymia
319:behaviour.
285:R. D. Laing
275:cyclothymic
124:psychopathy
2361:Categories
2320:Sociopathy
2295:Narcissism
2270:Dark triad
2163:In fiction
1958:Sertraline
1948:Fluoxetine
1768:Mood swing
1655:Depression
1610:Bipolar II
402:References
264:Assessment
217:repression
178:quetiapine
166:immobility
162:quiescence
55:depression
2214:Impulsive
2209:Grandiose
2092:John Cade
1933:Bupropion
1897:Valproate
1865:Treatment
1817:Diagnosis
1792:Psychosis
1751:Dysphoria
1746:Anhedonia
1668:Dysthymia
1630:Hypomania
1625:Childhood
1605:Bipolar I
1426:CiteSeerX
1362:1938-2456
1180:0920-9964
1125:0920-9964
1080:cite book
1048:cite book
589:"Inkling"
317:catatonic
309:avolition
301:anhedonia
254:anhedonia
201:Diagnoses
158:brainstem
152:Brainstem
86:anhedonia
34:emotional
2156:Contexts
1785:Insomnia
1731:Delusion
1723:Symptoms
1588:Spectrum
1531:10665455
1456:14972288
1448:16891563
1370:27724748
1326:10868981
1291:18769508
1239:22446103
1231:11166083
1196:34377252
1188:24268934
1141:44415559
1133:17630254
1070:(2003).
1010:16452608
958:28127915
909:26614932
901:15610941
862:21415225
813:21988521
764:23542860
756:16143498
630:19721109
543:22920376
535:11580008
500:18147948
465:13222014
349:See also
339:amygdala
337:"If the
289:autistic
271:schizoid
2194:Callous
2074:History
1987:Lithium
1418:Bibcode
1334:5824208
1282:2084052
1001:2632232
949:5269507
853:3446234
804:3313682
328:express
258:anxiety
1967:Other
1529:
1454:
1446:
1428:
1391:
1368:
1360:
1332:
1324:
1289:
1279:
1237:
1229:
1194:
1186:
1178:
1139:
1131:
1123:
1008:
998:
956:
946:
907:
899:
860:
850:
811:
801:
762:
754:
653:
628:
571:
541:
533:
498:
463:
426:
313:alogia
82:apathy
47:autism
1924:SSRIs
1635:Mania
1452:S2CID
1330:S2CID
1235:S2CID
1192:S2CID
1137:S2CID
905:S2CID
760:S2CID
539:S2CID
92:Types
2189:Bold
1527:PMID
1444:PMID
1414:1071
1389:ISBN
1366:OCLC
1358:ISSN
1322:PMID
1287:PMID
1227:PMID
1184:PMID
1176:ISSN
1129:PMID
1121:ISSN
1086:link
1054:link
1006:PMID
954:PMID
897:PMID
858:PMID
809:PMID
752:PMID
711:link
651:ISBN
626:PMID
569:ISBN
531:PMID
496:PMID
461:PMID
424:ISBN
315:and
273:and
84:and
1519:doi
1515:188
1436:doi
1314:doi
1277:PMC
1269:doi
1219:doi
1168:doi
1164:152
1113:doi
996:PMC
988:doi
944:PMC
936:doi
889:doi
848:PMC
840:doi
799:PMC
791:doi
787:125
744:doi
740:140
693:doi
616:doi
612:195
523:doi
519:189
488:doi
484:110
453:doi
449:100
281:".
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69:or
49:,
28:or
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