Method: Transcripts of in-depth interviews with participants (n = 24) recruited from Early Intervention in Psychosis services were analysed thematically with a focus on participants’ experiences and personal understandings of features corresponding to the negative symptoms construct.
Results: Descriptions of reductions in expression, motivation and sociability were common features of participants’ accounts. Several participants described the experience of having difficulty interacting as like being a ‘zombie’. Some participants experienced diminished capacity for emotion, thought or drive as underlying these experiences. However, participants typically attributed reductions in expression, motivation and sociability to medication side-effects, lack of confidence or active avoidance intended to protect them from rejection or ridicule, sometimes linked to internalised stigma.
Conclusions: Personal accounts of experiences of reduced expression, motivation and sociability during first-episode psychosis highlight the personal meaningfulness and role of agency is these features, challenging the framing of negative symptoms as passive manifestations of diminished capacity.