Schizophrenia - Abnormal Psychology - Lecture Slides, Slides of Abnormal Psychology

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Schizophrenia

Schizophrenia

• Schizophrenia: A group of disorders characterized by severely impaired cognitive processes, personality disintegration, affective disturbances, and social withdrawal. - Literal translation “split mind”, a split from reality (not the same as a split in personality as seen in dissociative disorders).

History of the Diagnostic Category and DSM-IV-TR

• Emil Kraepelin: Dementia praecox (insanity at an early age)
• Eugen Bleuler: Observed that age of onset and course of schizophrenia were more variable than theorized by Kraepelin.
• DSM-I and II: Broader definition allowed more disorders to be incorporated into the category of schizophrenia.

History of the Diagnostic Category and DSM-IV-TR

• DSM-III-R: New categories:
  • Brief Psychotic Disorder: Lasts no longer than one month.
  • Schizophreniform Disorder: Duration of at least 1 month, but less than 6 months.
• DSM-IV-TR: Uses the more restrictive duration requirements of DSM-III-R

The Symptoms of Schizophrenia Positive Symptoms

• Positive Symptoms: Psychoticism and disordered thought are present during active phase, then disappear with treatment: - Psychoticism includes hallucinations and delusions, disorganized speech and behavior, inappropriate affect, and motoric disturbances. - May indicate a reversible condition (due to chemical imbalance)

The Symptoms of Schizophrenia Positive Symptoms Delusions

• Delusions: False beliefs firmly and consistently held despite disconfirming evidence or logic. - Delusions of Grandeur: Belief that a person is famous or powerful. - Delusions of Control: Belief that other people, animals, or objects are trying to influence or take control. - Delusions of Thought Broadcasting: Belief that others can “hear” your thoughts.

The Symptoms of Schizophrenia Positive Symptoms Hallucinations

• Perceptual Distortion (hallucinations): Sensory perceptions not directly attributable to environmental stimuli (appear real to the schizophrenic): - Auditory (hearing) - Visual (seeing), - Olfactory (smelling) - Tactile (feelings) - Gustatory (tasting)

The Symptoms of Schizophrenia Positive Symptoms Hallucinations

• Greatest distress: When voices are dominant and insulting, and patient lacks communication with the voices.
• Coping strategies:
  • Distraction-Do something else
  • Ignoring-Would you injure yourself if the neighbor told you to?
  • Selective listening-Only listen to positive
  • Setting limits-Only listen between 9 and 10!

The Symptoms of Schizophrenia Positive Symptoms Hallucinations

Before Treatment After Treatment

Courtesy Dr. Alvaro Pascual-Leone, Lab for Magnetic Brain Stimulation, Beth Israel Deaconess Medial Center

The Symptoms of Schizophrenia Positive Symptoms Disorganized Thought

• Loosening of Associations (Cognitive Slippage): Continual shifting from topic to topic without any apparent logical or meaningful connection between thoughts.

“This morning, when I was at Hillside Hospital, I was making a movie. I was surrounded by movie stars. The X-ray technician was Peter Lawford. The security guard was Don Knotts. That Indian doctor in Building 40 was Lou Costello. I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”

The Symptoms of Schizophrenia Positive Symptoms Disorganized Thought

The Symptoms of Schizophrenia Positive Symptoms Disorganized Motor Disturbances

• Disorganized motoric disturbances:
  • Extreme activity levels, peculiar body movements or postures (Catatonia), strange gestures or grimaces, or a combination.

The Symptoms of Schizophrenia

• Primary Symptoms: Arise from the disease itself.
• Secondary Symptoms: Response to medication and institutionalization.
• Anhedonia: Inability to feel pleasure
• Lack of insight concerning symptoms