Blunted Affect - Affective Flattening

Affective flattening is a general category which includes diminishment of, or absence of, emotional expressiveness. It is sometimes inappropriately equated with blunted or restricted affect. "Blunted" is an affect that is present but only with minimal degrees of emotions evident. "Restriction" is a holding back as in alexithymia. "Restricted" is not as severe as in flattened or blunted affect.

Constricted affect is an affect type that represents mild reduction in the range and intensity of emotional expression. If the client is consistently euphoric and all intensity is congruent but is unaffected by content, this would be still considered constricted to a euphoric affect.

Labile affect refers to the pathological expression of laughter, crying, or smiling. It is also known as "pseudobulbar affect", "emotional lability", "pathological laughter and crying", or, historically, "emotional incontinence". An individual may find themselves laughing uncontrollably at something that is only moderately funny, being unable to stop themselves for several minutes.

Qualities describing the affective response include:

• concordance (expressed emotion seems to fit what patient is saying, doing), appropriateness, responsiveness (expressed emotion sensibly follows from the precipitating stimuli)
• full range/stable (normal variation of emotions during exam)
• restricted, constricted range (limited variability of emotion during exam)
• labile (type or intensity shifts suddenly, rapidly)
• blunted (few emotions expressed, low intensity)
• flat (affect is even less intense than blunted; patient may appear inanimate)
• exaggerated intensity