Question
A man diagnosed with schizophrenia shows all of the following: he hears a voice commenting on his actions; he believes a broadcaster is transmitting instructions to him; his sentences drift from one unrelated topic to the next; he has stopped bathing and rarely initiates any activity; and, after eight months on an antipsychotic, he has developed involuntary lip-smacking movements. Which feature is a negative symptom?
- a.The voice commenting on his actions
- b.The belief that a broadcaster is transmitting instructions to him
- c.The speech that drifts between unrelated topics
- d.The absence of self-care and failure to initiate activity
- e.The involuntary lip-smacking movements
Correct answer
D. The absence of self-care and failure to initiate activity
Full reasoning
- 1Translate the labels before sorting anything: positive means added to normal functioning and negative means subtracted from it, with no evaluative meaning attached to either word.
- 2Hallucinations and delusions are additions to experience, so both are positive symptoms regardless of how distressing they are.
- 3Disorganized speech is the trap in this item. Because it presents as lost coherence it reads as a subtraction, but it is a disturbance added to thought and language and is grouped with the positive symptoms.
- 4Neglected hygiene and failure to initiate activity are the absence of goal-directed behavior — avolition — which is a textbook negative symptom, alongside flat affect and reduced speech output.
- 5Check the timeline on any feature that appears after treatment begins: involuntary oral movements emerging months into antipsychotic use are a side effect, not a symptom of schizophrenia.
Why each choice is right or wrong
Choice A
An auditory hallucination is an experience added to ordinary functioning, which makes it a positive symptom. Reading positive as favorable is the error this option is built on.
Choice B
A fixed false belief held despite contrary evidence is a delusion, another addition to normal experience and therefore a positive symptom.
Choice C
Disorganized speech reflects disorganized thinking. It feels like a loss of coherence, but it is a disturbance added to normal thought and language and is classified as a positive symptom.
Choice D
Correct. Avolition — the loss of motivation for goal-directed behavior, here appearing as neglected hygiene and inactivity — is a subtraction from normal functioning and therefore a negative symptom.
Choice E
These began only after eight months of antipsychotic treatment, which points to tardive dyskinesia, a medication side effect. It belongs to neither symptom category of the disorder.
Related formula
Positive versus negative symptom test
experience added to normal functioning = positive (hallucination, delusion, disorganized speech); capacity subtracted from normal functioning = negative (flat affect, alogia, avolition)
Assumptions: Medication side effects such as tardive dyskinesia belong to neither category.
Related topic and practice
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Sources
Authored for this public explainer registry. It has no database question ID and is not copied from a protected or official exam bank.
- Psychology 2e, Section 15.8: Schizophrenia — OpenStax. Accessed 2026-08-15. OpenStax textbook content is CC BY-NC-SA 4.0; attribute and avoid verbatim reuse beyond short cited references.
- Psychology 2e, Section 16.2: Types of Treatment — OpenStax. Accessed 2026-08-15. OpenStax textbook content is CC BY-NC-SA 4.0; attribute and avoid verbatim reuse beyond short cited references.
Sources and corrections
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