A nurse is caring for a client who is diagnosed with schizophrenia. Which of the following manifestations should the nurse identify as a negative symptom?

Choice A rationale Negative symptoms in schizophrenia represent a diminution or absence of normal mental functions, contrasting with positive symptoms which are an excess or distortion of normal functions. A lack of emotions, specifically blunted or flat affect, where there is a reduction in the range and intensity of emotional expression, is a classic negative symptom. Choice B rationale Confusion is a general cognitive symptom that can be present in various psychiatric or neurological conditions and is not specifically categorized as a negative symptom of schizophrenia. While cognitive deficits are part of the disorder, confusion is a broader term. Choice C rationale Distorted beliefs, specifically delusions, are hallmark positive symptoms of schizophrenia. Delusions are fixed, false beliefs that are not amenable to change in light of conflicting evidence. They represent an addition or exaggeration of normal thought processes. Choice D rationale Paranoia, which involves suspiciousness and a belief that others are trying to harm oneself, is a type of delusion, and thus a positive symptom of schizophrenia. Positive symptoms involve the presence of abnormal thoughts or behaviors, unlike negative symptoms.