Primary and secondary negative schizotypal traits in a large non-clinical sample

The negative symptoms of schizophrenia reflect behavioral and affective deficits and are etiologically heterogeneous, reflecting either “primary” (i.e., apathy) or “secondary” sources (e.g., depression, anxiety, medication side effects). This distinction is critical for understanding treatment response, illness course and a host of neurocognitive, neurobiological and functioning variables in schizophrenia. Negative schizotypy, defined in terms of subclinical negative traits, occurs in a sizeable portion of the adult population and is associated with increased risk for developing schizophrenia-spectrum disorders as well as a host of neurocognitive and functional anomalies. It is, as yet, unclear whether primary and secondary sources characterize negative schizotypy in a similar manner as schizophrenia. The present study contrasted putative “primary” (i.e., apathy) and “secondary” (i.e., depression and anxiety) causes in their relationships to negative schizotypy and quality of life in a sample of 1356 non-clinical adults. Our data suggests that negative schizotypy reflects two distinct “mechanisms”, one involving a putatively primary source (i.e., social anhedonia) and the other reflecting a putatively secondary one (i.e., depression). These primary and secondary mechanisms were separately important for understanding quality of life impoverishments. Implications of a “two-process” model of negative schizotypy are discussed.