Negative symptoms of schizophrenia comprise a group of severe symptoms contributing to high disease burden and poor long-term prognosis. Conceptual work has shown that these symptoms can be mapped onto, at least, two distinct dimensions: apathy including the domains avolition, asociality and anhedonia, and diminished expression including the domains blunted affect and alogia. Growing evidence suggest that these dimensions have partly distinct behavioral, cognitive and neural correlates. Nonetheless, modulation and treatment of specific processes and brain correlates related to these negative symptom dimensions through behavioral, pharmacological, and brain stimulation interventions remains poorly understood. Here, we address this question by employing an integrative approach and comprehensively synthesizing the current literature on neuroimaging, behavior and clinical studies of both negative symptom dimensions. While considerable progress has been made, it remains an open challenge to develop integrative mechanistic pathophysiological models for apathy and diminished expression. We conclude that such multi-level frameworks are key for the development of new biological and psychosocial treatments and may advance progress towards an individualized treatment of negative symptoms.

精神分裂症的阴性症状包括一组严重的症状，这些症状导致较高的疾病负担和较差的长期预后。概念研究表明，这些症状至少可以映射到两个不同的维度上：包括领域意志消沉，社会性和快感缺乏的冷漠，以及包括使情感和失语减退的领域的表达减少。越来越多的证据表明，这些维度具有部分不同的行为，认知和神经相关性。尽管如此，通过行为，药理和脑刺激干预对与这些负面症状范围相关的特定过程和大脑相关的调节和治疗仍知之甚少。在这里，我们通过采用整合方法并全面综合有关神经影像学的现有文献来解决这个问题，行为和阴性症状维度的临床研究。尽管已经取得了相当大的进步，但是开发用于冷漠和表达减少的综合机械病理生理学模型仍然是一个公开的挑战。我们得出的结论是，这样的多层次框架对于开发新的生物学和社会心理治疗方法至关重要，并且可能会推动对阴性症状的个体化治疗取得进展。