Affective Dullness: What It Is, Symptoms, Causes And Treatment.

According to the American Psychiatric Association, affectivity constitutes the degree of a person’s response to emotional stimuli such as pleasure or pain. Emotional dullness, according to the definition of the same organism, constitutes a alteration 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 that their emotional responses are altered.

Affective blunting does not constitute a diagnostic category with associated symptoms, It 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 emotional dullness. The person is going to show himself in such a way that he is going to give us the feeling that the emotional stimuli do not affect him (or at least not in the way we expect). Following Godoy, JF, Godoy-Izquierdo, D. and Vázquez, ML (2014)⁽²⁾affective dullness would be characterized by:

• Immobility and lack of response in facial expression.
• Poor eye contact
• Reduction of body language.
• Lack of tonality in the words.

As a symptom, emotional dullness appears in various mental disorders that we discuss below.

• Depersonalization/derealization disorder. This disorder is part of 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, emotional dullness may appear as a consequence of the consumption of a stimulant substance such as amphetamine or cocaine. Learn about the effects of drugs on the nervous system here.
• Continued cannabis use. According to the study by DeAngelis, BN and al’Absi, M. (2020)⁽¹⁾chronic cannabis use would be associated with emotional blunting in response to acute stress.
• Post-traumatic stress disorder. In the DSM-5 diagnostic classification of the American Psychiatric Association, it can be specified whether this disorder appears with dissociative symptoms. Within these, depersonalization may appear in which, we remember, emotional dullness may be present. The appearance of emotional dullness and very intense acute post-traumatic reactions increase the risk of this disorder becoming chronic.
• Psychotic disorders. In this case, the DSM-5 includes emotional blunting as a negative symptom. However, it does not label it as such but as “diminished emotional expression.” This symptom appears in schizophrenia and schizophreniform disorder.
• Depression. Some studies, such as that of Goodwin, GM, Price, J., De Bodinat, C. and Laredo, J., (2017)⁽³⁾ relate the appearance of emotional dullness and the consumption of antidepressant drugs. Although they found affective blunting in almost half of the patients surveyed taking antidepressants, they indicate the possibility that affective dulling may be a residual symptom of depression itself.

As we have seen, emotional dullness is a symptom that falls 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 consumption of cannabis or the administration of antidepressant psychotropic drugs.
• a traumatic event. This may be the cause of the emotional blunting framed in post-traumatic stress disorder or depersonalization/derealization disorder.
• Brain dysfunctions. This cause would be associated with the appearance of affective dullness 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 dorsumolateral prefrontal circuit in association with subcortical circuits (Pantelis CA 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 emotional blunting with age has been observed, 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 emotional dullness appears.

Substance use cessation

We have seen that there are substances that can cause emotional dullness, therefore in these cases consumption must be ended to eliminate said symptom.

Affective blunting 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 changing the life circumstances in which the problem arises.

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

• Establishing physical contact of the patient with someone from his immediate context.
• Concentration on a 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, which include emotional blunting. For this type of symptoms and following Godoy, JF et al (2014), the rehabilitation of functions basics, especially cognitive ones such as attention or memory 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) using antipsychotic drugs.

This article is merely informative, at PsychologyFor 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.

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