Affective dullness: what it is, causes and associated pathologies

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

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

• Related article: "The 16 most common mental disorders"

What is affective blunting?

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 on 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 day to day, we constantly feel them. They are a psychophysiological manifestation of a specific mental state, and generally anyone is capable of recognizing them, with some exceptions, such as some pathologies. Likewise, all individuals experience them naturally.

But that 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 before certain events, that have a meaning for the subject, in one sense or another.

What emotions does affective blunting affect? To all of them, as 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 to soften it in a a certain degree, which can range from a small reduction in response to almost emotional expressionlessness, or a total lack of emotional reaction to the stimulus in question.

Psychopathologies associated with this alteration

Affective dullness does not necessarily have to be part of a psychopathology, but sometimes it can appear as a symptom of some disorders of different kinds. We are going 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 that of 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 they have experienced.

Affective blunting is an unfavorable indicator in schizophrenia. Also, this condition tends to be 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 should 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, the researchers wonder if what is being limited is the physical reaction, such as the facial gestures or changes in tone of voice or if the feeling inherent in the emotion.

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 dullness affective, by hindering or preventing the person from making the gestures or physical movements associated with the expression of the emotion.

• You may be interested in: "What is schizophrenia? Symptoms and Treatments "

2. The Depression

Another of the main psychopathological disorders in which affective blunting can appear is depression. In this case, it is important to note that it is not a symptom of the disease itself, but a side effect of some drug 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 (inhibitors selective serotonin reuptake) and SNRIs (serotonin reuptake inhibitors and noradrenaline).

The main difficulty in delving into this question is that Most of the existing studies 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 encompass issues such as affective numbness.

Speaking of depression and the disorders associated with it, it is convenient to make a little clarification about anhedonia, which is one of the symptoms of this disease and is sometimes confused with dullness affective. Anhedonia refers to the difficulty or even inability of the subject to experience pleasure in any situation.

Then, anhedonia supposes that a stimulus that previously caused a certain satisfaction or pleasure to the affected person, now does not cause it. On the other hand, affective blunting implies the lack (or decrease) of an emotional response to any stimulus, be it 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 it can be observed for one reason or another, examples of affective blunting, we must now turn to post-traumatic stress disorder, or PTSD. This condition generates different symptoms in patients, and one of them is precisely the difficulty to express emotions.

This emotional flattening becomes more evident when it comes to positive situations, since the subject usually lose interest in them, which would also imply a certain anhedonia, as we saw when we spoke of the depression. In either case, PTSD patients will tend to suppress any positive or negative emotional responses.

• You may be interested in: "Post Traumatic Stress Disorder: Causes and Symptoms"

Biological bases of affective blunting

After discovering which are the psychological disorders where we can come across cases of affective blunting, now we are going to explore what are 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, that of affective dullness.

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

2. Brainstem

The brainstem or brainstem may also be involved in the subject's lack of emotional reaction. In MRI tests, patients with schizophrenia show an activation in this brain area when they observe negative stimuli, such as movie scenes with sad content.

• You may be interested in: "Brainstem: functions and structures"

3. Prefrontal cortex

Already reaching the cortical zone, and more specifically the one that 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 blunting, it has been found that they have less activation in this brain region.

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

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

4. Anterior cingulate cortex

Another part of the cerebral cortex that has relevance in the processing of emotions is the anterior cingulate. Equally, An abnormality in the activation of this sector is observed when studying the brain of people with schizophrenia when visualizing negative stimuli.

In these people, those who suffer from affective blunting, a lower 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., Gómez, M. (2012). The assessment of post-traumatic stress: Presentation of the global assessment scale of post-traumatic stress (EGEP). Clinic and Health. SciELO Spain.
• Donnoli, V.F., Santos, L.G., Almeida, T.S., Ferreyra, P. (2007). Affective flattening in schizophrenia: qualitative study. Argentine Journal of Neuropsychiatric Clinic.