Affective Dullness: What It Is, Causes And Associated Pathologies

emotional dullness

Emotions are a fundamental part of ourselves and therefore something inherent to being human. But we don’t always experience them the same.

In fact, there are conditions that can radically vary our processing of emotions. This time we will focus on emotional dullness. We will review this term to understand its meaning and what causes it in some people.

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What is emotional dullness?

Affective blunting, also called affective flattening or blunted affectivity, refers to the inability of a subject to experience emotions in situations that, by their nature, should generate an emotional response in the person. That is, the subject would feel indifferent to a stimulus that in other circumstances should generate a very specific emotion.

Affective dullness is precisely that indifference, that lack of emotional response to scenarios that should directly provoke a reaction translated, for example, into intense joy or great sadness, depending on the case. On the contrary, the person simply does not react on an emotional level, so he remains impassive in that sense.

Emotions accompany us in our daily lives, we feel them constantly. They are a psychophysiological manifestation of a specific mental state, and generally anyone is able to recognize them, with some exceptions, such as some pathologies. Likewise, all individuals experience them naturally.

But this is where affective dullness comes in, as a psychological phenomenon that can paralyze this capacity temporarily and make the person not have that emotional correspondence that is expected in certain eventswhich have a meaning for the subject, in one sense or another.

What emotions does emotional dullness affect? To all of them, because there is no distinction between those of a positive nature, such as joy, and those of a negative nature, such as anger or sadness.

It must be taken into account that this phenomenon does not always occur completely, but instead of completely eliminating the emotional response, what it can do is soften it to a certain degree, which can range from a small reduction in the response to the almost emotional inexpression, or a total lack of reaction on an emotional level to the stimulus in question.

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Psychopathologies associated with this alteration

The emotional dullness It does not necessarily have to be part of a psychopathology, but sometimes it can appear as a symptom of some disorders of a different nature. Let’s get to know some of the most important ones.

1. Schizophrenia

The first mental disorder that we encounter in which we can find emotional flattening is schizophrenia. One of the characteristics of this disease, among many others, is that Patients who suffer from it generally have non-existent or inadequate emotional responses to the events experienced..

Affective blunting is an unfavorable indicator in schizophrenia. Furthermore, this condition tends to occur more likely in men than in women. These patients have a worse prognosis than the others, although it is a purely statistical indicator, so each case must be considered individually, as is logical.

A study suggests the possibility that affective blunting in schizophrenia patients affects only the expressiveness of the emotion itself, but not the underlying feeling. That is, researchers wonder if what is being limited is the physical reaction, such as facial gestures or changes in tone of voice, or if the feeling inherent to the emotion is also suppressed.

It has also been observed that in some patients there is a limitation at the motor level that could be the cause of the apparent emotional dullness, by making it difficult or preventing the person from performing gesticulation or physical movements associated with the expression of emotion.

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2. Depression

Another of the main psychopathological disorders in which emotional dullness can appear is depression. In this case, it is important to keep in mind that It is not a symptom of the disease itself, but a side effect of some pharmacological treatments that can be prescribed to patients.

We would be talking about antidepressants and antipsychotics. Specifically, the compounds most used to treat these disorders would be SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors).

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The main difficulty in delving into this issue is that The majority of existing works on the side effects of these psychotropic drugs are focused on those of a physical nature.being less frequent those that place the focus on the emotional issue, which would be those that would encompass issues such as emotional dullness.

Speaking of depression and the disorders associated with it, it is worth making a small clarification regarding anhedonia, which is one of the symptoms of this disease and is sometimes confused with emotional dullness. Anhedonia refers to the difficulty or even inability of the subject to experience pleasure in any situation.

Then, Anhedonia means that a stimulus that previously caused a certain satisfaction or pleasure in the affected person, now does not cause it.. On the other hand, affective dullness implies the lack (or decrease) of an emotional response to any stimulus, whether positive or negative.

And, as we have seen, this phenomenon, when we talk about depression, is associated with the medication prescribed to treat said disease.

3. Post-traumatic stress disorder

Continuing with the different psychological pathologies in which examples of emotional dullness can be observed for one reason or another, we must now consider post-traumatic stress disorder, or PTSD. This condition generates different symptoms in patients, and one of them is precisely the difficulty in expressing emotions..

This emotional flattening is more evident when it comes to positive situations, since the subject usually loses interest in them, which would also imply a certain anhedonia, as we saw when we talked about depression. In any case, PTSD patients will tend to suppress any emotional response, positive or negative.

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Biological bases of emotional dullness

After discovering the psychological disorders where we can encounter cases of emotional dullness, we are now going to explore the biological bases that underlie this phenomenon. For it, we must focus on various parts of the brain that are somehow related to the suppression of emotional expressiveness.

1. Limbic system

The first structure that we must mention is none other than the limbic system, one of the most primitive regions of the brain and which is especially important for emotional regulation. It is mainly made up of the hippocampus and the amygdala. Precisely, damage to the amygdala can have direct repercussions on the management of emotions, and can cause, among other effects, emotional dullness.

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This is the case of patients with schizophrenia, as they have difficulties correctly connecting stimuli between the amygdala and other regions of the cerebral cortex, necessary to control emotions. The consequence, in some cases, is a flattening of affect, as we have seen before.

2. Brainstem

The brain stem may also be involved in the subject’s lack of emotional reaction. In MRI tests, Patients with schizophrenia show activation in this brain area when they observe negative stimulisuch as cinematographic scenes with sad content.

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3. Prefrontal cortex

Now reaching the cortical area, and more specifically that which corresponds to the prefrontal area, we find other parts of the brain that are important in the process of emotions. Continuing with schizophrenia patients who have been affected by affective dulling, it has been discovered that they have less activation in this brain region.

To try to correct this problem, a drug called quetiapine is used, which helps to recover the activation of these circuits and therefore better emotional processing, which can reduce emotional dullness.

Within the prefrontal cortex, they would specifically the orbitofrontal gyrus of the left hemisphere and the medial prefrontal gyrus of the right hemisphere the most relevant parts for the issue at hand.

4. Anterior cingulate cortex

Another part of the cerebral cortex that is relevant to the processing of emotions is the anterior cingulate. Likewise, An anomaly is observed in the activation of this sector when the brain of people with schizophrenia is studied when viewing negative stimuli..

In these people, those who suffer from emotional dullness, less activation would be observed compared to that shown by people in the control group.

Bibliographic references:

  • Arancibia, M., Behar, R. (2015). Alexithymia and depression: evidence, controversies and implications. Chilean journal of neuro-psychiatry.
  • Crespo, M., G√≥mez, M. (2012). The evaluation of post-traumatic stress: Presentation of the global evaluation scale of post-traumatic stress (EGEP). Clinic and Health. SciELO Spain.
  • Donnoli, VF, Santos, LG, Almeida, TS, Ferreyra, P. (2007). Affective flattening in schizophrenia: qualitative study. Argentine Journal of Neuropsychiatric Clinic.