Blunting of affect is manifest as decreased responsiveness to emotional issues, loss of vocal inflection, and diminished facial expression. These objective signs of affective blunting are sometimes accompanied by awareness of loss of emotional tone that, paradoxically, patients find to be distressing. More commonly, there is a lack of concern and even a lack of awareness of the problem. Affective blunting is one of the hallmarks of chronic schizophrenia. Bleuler (1) remarked that when the affects disappear, the illness becomes chronic. While blunted affect is usually chronic, it can also be a feature of acute episodes of the illness that resolves as the acute episode resolves.
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