Eugene Bleuler's four As

Hist Psychol. 2009 May;12(2):43-59. doi: 10.1037/a0015934.

Abstract

One hundred years have passed since Eugene Bleuler first coined the term schizophrenia. In that time, a simple mnemonic, the Four As, has come to distort his complex descriptive pathology. However, at no stage did Bleuler give precedence to the Four As or describe them in such a fashion. The Four As are a caricatured representation of Bleuler's schizophrenia that distorts the later conceptualization of schizophrenia. Despite historical attempts to signal this error, it remains virulent in the schizophrenia literature, masquerading as historical fact. This article corrects this distortion and clarifies the precise relationship of the Four As to Bleuler's thinking. It discusses their emergence and persistence, and draws attention to Bleuler's emphasis of other important symptoms--most notably splitting.

Publication types

  • Biography
  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Association
  • Autistic Disorder
  • Decision Making
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Mental Disorders / history
  • Mood Disorders
  • Psychiatric Status Rating Scales
  • Schizophrenia / diagnosis
  • Schizophrenia / history*
  • Schizophrenic Psychology*
  • Terminology as Topic*

Personal name as subject

  • Eugene Bleuler