Which of the following is a negative symptom?

• A. Auditory hallucinations
• B. Flat affect
• C. Delusions
• D. Disorganized speech

Answer: (B)

Negative symptoms reflect a reduction or absence of normal functioning. In schizophrenia, flat affect shows diminished emotional expression—facial expressions, voice tone, and eye contact may be reduced or blunted—which is a hallmark of negative symptoms. The other items listed are considered positive symptoms because they involve added or excess experiences: auditory hallucinations are perceiving sounds or voices without external stimuli, delusions are false beliefs held despite contrary evidence, and disorganized speech reflects disorganized thought. Because flat affect embodies a decrease in normal functioning rather than an added experience, it best fits the concept of a negative symptom.