also include purposeless and excessive motor activity without obvious cause ( catatonic
excitement ). Other features are repeated stereo typed movements, staring, grimacing,
mutism, and the echoing of speech. Although catatonia has historically been associated
with schizophrenia, catatonic symptoms are nonspecific and may occur in other mental
disorders (e.g., bipolar or depressive disorder s with catatonia) and in medical conditions
(catatonic disorder due to another medical condition).
Negative Symptoms
Negative symptoms  account for a substantial portion of the morbidity associated with
schizophrenia but are less prominent in other psychotic disorders. Two negative symp-
toms are particularly prominent in schizophrenia: diminished emotional expression and
avolition. Diminished emotional expression includes reductions in the expression of emo-
tions in the face, eye contact, intonation of speech (prosody), and movements of the hand,
head, and face that normally give an emotional emphasis to speech. Avolition  is a decrease
in motivated self-initiated purposeful activities. The individual may sit for long periods of
time and show little interest in  participating in work or so cial activities. Other negative
symptoms include alogia, anhedonia, and asociality. Alogia  is manifested by diminished
speech output. Anhedonia  is the decreased ability to ex perience pleasure from positive
stimuli or a degradation in the recollection of pleasure previously experienced. Asociality
refers to the apparent lack of interest in so cial interactions and may be associated with avo-
lition, but it can also be a ma nifestation of limited opportunities for social interactions. 
Disorders in This Chapter
This chapter is organized along a gradient of psychopathology. Clinicians should first con-
sider conditions that do not re ach full criteria for a psychotic disorder or are limited to one