Emotional blunting

Reduced affect should be distinguished from apathy and anhedonia, which explicitly refer to a lack of emotion, whereas reduced affect is a lack of emotional expression regardless of whether emotion is actually reduced or not. A restricted or constricted affect is a reduction in an individual's expressive range and the intensity of emotional responses. 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. He or she may not react at all to 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'. Shallow affect has equivalent meaning to blunted affect. Factor 1 of the Psychopathy Checklist identifies shallow affect as a common attribute of psychopathy. 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 'friends, otherwise is likely to make false judgments, in view of the prevalence of schizoid and cyclothymic personalities in our 'normal' population, and our tendency to psychological hypochondriasis'. R. D. Laing in particular stressed that 'such 'clinical' categories as schizoid, autistic, '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'. Patients with schizophrenia have long been recognized as showing 'flat or inappropriate affect, with splitting of feelings from events ... feelings seem flat instead of being in contact with what is going on'. One study of flat affect in schizophrenia found that 'flat affect was more common in men, and was associated with worse current quality of life' as well as having 'an adverse effect on course of illness'. 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 may merely be unexpressed, rather than totally lacking. On the other hand, 'a lack of emotions which is due not to mere repression 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 aggressiveness'. In the most extreme cases, there is a complete 'dissociation from affective states'.