Which of the following has the lowest risk for sexual dysfunction and weight gain?

A. Lack of motivation. Avolition, not alogia, refers to a severe lack of motivation to initiate and sustain goal-directed activities. It is a common negative symptom of schizophrenia, leading to difficulties in completing tasks such as hygiene, work, or social activities.

B. No empathy. Lack of empathy is more commonly associated with antisocial personality disorder (ASPD) or narcissistic personality disorder (NPD) rather than schizophrenia. Individuals with schizophrenia may struggle with social interactions, but this is due to cognitive deficits rather than a lack of concern for others.

C. Reduction in quantity of words spoken. Alogia refers to poverty of speech, characterized by diminished verbal output and difficulty generating spontaneous speech. It is a negative symptom of schizophrenia, often presenting as brief, empty responses or difficulty engaging in conversation.

D. Inability to experience pleasure. Anhedonia refers to the inability to feel pleasure in activities that were once enjoyable. It is another negative symptom of schizophrenia and is also seen in major depressive disorder and other mood disorders.

A. Worry about health despite no symptoms. This describes illness anxiety disorder (formerly hypochondriasis), where individuals have an excessive fear of having a serious illness despite minimal or no physical symptoms. Unlike factitious disorder, these individuals are not fabricating symptoms but are genuinely convinced they are sick.

B. Normal voluntary and sensory dysfunction. This does not describe any recognized psychiatric disorder. However, conversion disorder (functional neurological symptom disorder) involves involuntary neurological symptoms (e.g., paralysis, blindness) without a medical cause, whereas factitious disorder involves intentional symptom fabrication.

C. Worry is out of proportion to the symptoms. This is characteristic of somatic symptom disorder (SSD), where individuals have excessive concern and distress over real but often minor physical symptoms. Unlike factitious disorder, their symptoms are not deliberately produced or exaggerated for attention.

D. Deliberate exaggeration and fabricated symptoms. Factitious disorder (formerly Munchausen syndrome) involves intentionally faking, exaggerating, or inducing medical symptoms to assume the "sick role". Unlike malingering (which is done for external rewards like financial gain), factitious disorder is driven by an internal psychological need for medical attention.