DSM-5 Schizophrenia Spectrum Disorder Domains
The correct answer is A: delusions, hallucinations, disorganized thinking, disorganized or abnormal behavior, and negative symptoms—these are the five core symptom domains that define schizophrenia spectrum disorders according to DSM-5 and ICD-11 diagnostic frameworks. 1
Core Symptom Domains
The schizophrenia spectrum is characterized by abnormalities across five specific domains:
- Positive symptoms including delusions and hallucinations, which represent the most recognizable features but have the lowest expected influence on overall functioning 2
- Disorganized thinking (thought disorder) manifesting as loose associations, illogical thinking, and impaired discourse abilities 3
- Disorganized or abnormal behavior including bizarre behavior and catatonic symptoms 3, 4
- Negative symptoms encompassing five specific domains: avolition, anhedonia, asociality, blunted affect, and alogia 1
Dimensional Assessment Framework
ICD-11 and modern diagnostic approaches use dimensional symptom specifiers to describe current severity across six domains:
- Positive symptoms (delusions, hallucinations) 1
- Negative symptoms (avolition, anhedonia, asociality, blunted affect, alogia) 1
- Depressive symptoms 1
- Manic symptoms 1
- Psychomotor symptoms 1
- Cognitive symptoms 1
Each domain is rated on a 4-point scale from "not present" to "present and severe" 1
Why Other Options Are Incorrect
Option B is incorrect because eye movement disorders and "social relaxation problems" are not recognized DSM-5 diagnostic domains for schizophrenia spectrum disorders.
Option C is incorrect because it mentions "positive symptoms" as a separate category rather than recognizing that delusions and hallucinations ARE the positive symptoms, and it omits disorganized thinking as a distinct domain.
Option D is incorrect because sleep disturbances and speech disorders are not among the five core diagnostic domains, though disorganized speech is part of the disorganized thinking domain 3
Clinical Significance of Domains
- Negative symptoms affect approximately 40% of patients and show the strongest relationship to functional outcomes, with anhedonia demonstrating the highest centrality and connections to multiple functional domains 5, 2
- Positive symptoms (delusions, hallucinations) are common, occurring in 42-69% of patients, but typically occur alongside other symptom domains rather than in isolation 6
- Cognitive symptoms affect approximately 80% of patients and contribute substantially to illness burden, though they lack specific items in traditional rating scales like PANSS 1, 5