AFFECTIVE BOTTOM: what is it, symptoms, causes and treatment

Emotions are so important to the human being that without them he would not and would not have been able to survive. However, we may know people whose emotional reactions are minimal. For example, they do not rejoice when good news is given and remain impassive, at least on the surface.

Although there are people more expressionless than others, it is true that this fact could be a pathological phenomenon in some cases. There are disorders in which emotional reactions are pathologically altered. Do you want to know why this happens and in what circumstances we can find it? Continue reading this Psychology-Online article in which we talk about this phenomenon called Affective blunting: what is it, symptoms, causes and treatment.

Index

1. What is affective blunting
2. Symptoms or characteristics of affective blunting
3. Disorders in which affective blunting appears
4. Causes of affective blunting
5. Treatment of affective blunting.

According to the American Psychiatric Association, affectivity constitutes the degree of response of a person to emotional stimuli such as pleasure or pain. Affective dullness, according to the definition of the same organism, constitutes a disturbance in emotional responses to different situations.

We are not talking about the person being unable to express, describe or distinguish their emotions (this alteration is called alexithymia) but their emotional responses are altered.

Affective blunting is not a diagnostic category with associated symptoms, is a symptom that appears in different disorders. Therefore, in this section, it would be more appropriate to refer to the characteristics of the symptom. In general, we will witness impassivity in people with affective dullness. The person is going to show himself in such a way that it will give us the feeling that emotional stimuli do not affect him (or at least not in the way expected). Following Godoy, J.F., Godoy-Izquierdo, D. and Vázquez, M.L. (2014)^[2], affective blunting would be characterized by:

• Immobility and lack of response in facial expression.
• Poor eye contact
• Body language reduction.
• Lack of tonality in words.

As a symptom, affective blunting appears in various mental disorders that we discuss below.

• Depersonalization / Derealization Disorder. This disorder is framed within the dissociative disorders. Specifically, affective dullness would appear in depersonalization, which is an experience of unreality in which the person sees himself as an external observer, with a distance.
• Stimulant poisoning. In this case, affective blunting may appear as a consequence of the consumption of a stimulant substance such as amphetamine or cocaine. Know here the effects of drugs on the nervous system.
• Continued use of cannabis. According to the DeAngelis study, B.N. and al´Absi, M. (2020)^[1], chronic cannabis use would be associated with affective blunting in response to acute stress.
• Post-traumatic stress disorder. The DSM-5 diagnostic classification of the American Psychiatric Association can specify whether this disorder appears with dissociative symptoms. Within these, depersonalization may appear in which, we recall, affective dullness may be present. The appearance of affective blunting and very intense acute post-traumatic reactions increase the risk of this disorder becoming chronic.
• Psychotic disorders. In this case, the DSM-5 includes affective blunting as a negative symptom. However, he does not label it as such but as "diminished emotional expression." This symptom appears in the schizophrenia and schizophreniform disorder.
• Depression. Some studies, such as Goodwin, G.M., Price, J., De Bodinat, C. and Laredo, J., (2017)^[3] relate the appearance of affective blunting and the consumption of antidepressant drugs. Although they find affective blunting in nearly half of surveyed patients taking antidepressants, indicate the possibility that affective blunting may be a residual symptom of the depression itself.

As we have seen, affective blunting is a symptom that is framed within different disorders. The cause of said symptom, therefore, must take into account the context and causes of the appearance of said disorders, that is, their etiology.

• Substance use. This would be the case of stimulant substances, the continued use of cannabis or the administration of antidepressant psychotropic drugs.
• A traumatic event. This may be the cause of affective blunting framed in post-traumatic stress disorder or depersonalization / derealization disorder.
• Brain dysfunctions. This cause would be associated with the appearance of affective blunting as a negative symptom of schizophrenia or schizophreniform disorder. In this sense, more intense cognitive deficits have been identified in patients who show these negative symptoms, pointing out some structures involved such as the prefrontal dorsal lateral circuit in association with subcortical circuits (Pantelis C.A. et al., 2004. Seen in Servat, M., Lehmann, Y., Harari, K., Gajardo, L. and Eva, P. 2005)^[6] or dysfunction of the right frontal lobe (Suzuki, M., Kurachi, M., Kawasaki, Y., Kiba, K. and Yamaguchi, N., 1992)^[7].
• Age. There are also studies in which an increase in affective blunting has been observed with age, such as that of Partiot, A., Pierson, A., Le Houezec, J., Dodin, V., Renault, B. and Jouvent, R. (1993)^[4].

Again, the treatment will be framed in the context of the psychological disorder in which the affective numbness appears.

Substance use cessation

We have seen that there are substances that can cause affective dullness, therefore in these cases consumption should be terminated to eliminate said symptom.

Affective dullness as a dissociative symptom

Following (Robles García, R., Páez Agraz, F. and Marín Tejada, M., 2014) many dissociative symptoms will disappear when treating the underlying disorder or the change of vital circumstances before which the problem occurs.

However, let us remember that DSM-5 frames affective blunting in depersonalization. In this sense, at the Harvard Medical School (Havard Medical School, 2005; seen in Robles García et al., 2014)^[5] Techniques and resources have been proposed such as:

• Establishment of physical contact of the patient with someone in her immediate context.
• Concentration on some task like reading, talking, or exercising.
• Memory of positive events or visualize a safe place.

Other interventions that have been carried out to treat this problem are: cognitive restructuring and the EMDR therapy.

Schizophrenia

In this case, the treatment of psychotic disorders includes several strategies to respond to all the symptoms that appear.

In this article we are interested in the response to negative symptoms, including affective blunting. For this type of symptoms and following Godoy, J.F. et al (2014), the rehabilitation of functions basic, especially cognitive ones like attention or memory, it would be the most interesting option.

It is important to note that schizophrenia will be treated (although directed more at positive symptoms such as hallucinations) by antipsychotic drugs.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Affective dullness: what it is, symptoms, causes and treatment., we recommend that you enter our category of Clinical psychology.

1. DeAngelis, B.N. and al´Absi, M. (2020) Regular cannabis use is associated with blunted affective, but not cardiovascular, stress responses. Addictive behaviors, 107. Recovered from https://doi.org/10.1016/j.addbeh.2020.106411
2. Godoy, J.F., Godoy-Izquierdo, D. and Vázquez, M.L. (2014). Spectrum of schizophrenia and other psychotic disorders. In Caballo, V.E., Salazar, I.C. And Carrobles, J.A. Manual of Psychopathology and Psychological Disorders. Madrid. Pyramid.
3. Goodwin, G.M., Price, J., De Bodinat, C. and Laredo, J., (2017). Emotional blunting with antidepressant treatments: A survey among depressed patients. Journal of Affective Disorders. 221, 31-35. https://doi.org/10.1016/j.jad.2017.05.048
4. Partiot, A., Pierson, A., Le Houezec, J., Dodin, V., Renault, B. and Jouvent, R. (1993). Loss of automatic processes and blunted-affect in depression: a P3 study. European Psychiatry. 8, 309-318.
5. Robles García, R., Páez Agraz, F. and Marín Tejada, M. (2014). Dissociative disorders. In Caballo, V.E., Salazar, I.C. And Carrobles, J.A. Manual of Psychopathology and Psychological Disorders. Madrid. Pyramid.
6. Servat, M., Lehmann, Y., Harari, K., Gajardo, L. and Eva, P. (2005). Neuropsychological evaluation in schizophrenia. Chilean Journal of Neuro-Psychiatry, 43 (3), 210-216.
7. Suzuki, M., Kurachi, M., Kawasaki, Y., Kiba, K. and Yamaguchi, N. (1992). Left hypofrontality correlates with blunted affect in schizophrenia. The Japanese Journal of Psychiatry and Neurology. 46 (3), 653-657 DOI: 10.1111 / j.1440-1819.1992.tb00539.x

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