Lived Experiences of Negative Symptoms in First-Episode Psychosis: A Qualitative Secondary Analysis

Research output: Contribution to journalArticlepeer-review


  • Brioney Gee
  • Jo Hodgekins
  • Caitlin Notley
  • Maximillian Birchwood
  • Linda Everard
  • Nick Freemantle
  • Peter B Jones
  • Swaran P Singh
  • Tim Amos
  • Max Marshall
  • Vimal Sharma
  • Jo Smith
  • David Fowler

Colleges, School and Institutes

External organisations

  • Norwich Medical School
  • University of East Anglia
  • University of Warwick
  • Birmingham and Solihull Mental Health NHS Foundation Trust
  • University of Cambridge
  • University of Bristol
  • University of Manchester
  • Cheshire and Wirral Partnership NHS Foundation Trust
  • University of Worcester
  • University of Sussex
  • University College London Hospitals NHS Foundation Trust
  • Research Department of Primary Care and Population Health
  • PRIMENT Clinical Trials Unit
  • University College London
  • University of Chester


Aim: Exploring how negative symptoms are experienced and understood by individuals with lived experience of psychosis has the potential to offer insights into the complex psychosocial processes underlying negative symptom presentations. The aim of the current study was to investigate lived experiences of negative symptoms through secondary analysis of interviews conducted with individuals recovering from first-episode psychosis.
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.


Original languageEnglish
JournalEarly Intervention in Psychiatry
Early online date24 Mar 2018
Publication statusE-pub ahead of print - 24 Mar 2018