KHA713 Lecture Notes - Lecture 2: Paranoid Schizophrenia, Clang, Thought Disorder
25 Jun 2018
School
Department
Course
Professor
Adult Psychopathology
Week 2
Schizophrenia
Schizophrenia:
- History of the disorder helps us understand where diagnostic systems come
from
Comparison videos:
- Completely non-overlapping symptoms, yet, attain the same diagnosis and
treatment
oThis is unique to schizophrenia
oDifferent symptom presentations
oWaste bucket of psychiatry
oMany people have many other diagnoses before receiving this one
- Core concept of the diagnostic group:
oOne or more of the following:
A significant distortion in the perception of reality
An impairment in the capacity to reason, speak, and behave
rationally or spontaneously
An impairment in the capacity to respond spontaneously with
appropriate affect and motivation
oIn the absence of an impairment of consciousness or memory
Not because of substances, or dementing disorder
oRange of symptoms:
Positive: something over and above the normal experience
Hallucinations:
oWithout it being externally present
oAuditory: most common
And are commonly very simple
Part of the auditory cortex light up as if
there was an external voice present
Miswiring
Qualitatively and quantitatively different
to
oVoices commenting:
Running commentary
oVoices conversing:
Rarely
Two or three voices having a
conversation
Typically about the person
oSomatic/tactile
Feeling themselves rotting away
oOlfactory
Smelling death or decay
oVisual:
Rare
find more resources at oneclass.com
find more resources at oneclass.com
Typically need to check for: temporal
lobe epilepsy or psychedelic substances
Delusions: don’t fit within the social norms or rules-
false beliefs- or don’t stand up to external validation
oPersecutory
Set out to hurt someone or self
Paranoid thinking in the general
population
oJealous
Significant other
oGuilt/sin
Feel like you need to be punished for
Can rule these out by asking ‘do you
think you’ve done something wrong and
that is why you would go to Hell’
oGrandiose
Feel you are special/talented
oReligious
Feel like you are God
Or given special powers by God
Corresponds with symptoms:
Having more
energy/ideas/experiences than
others
This is just a way of
understanding their difference
from others
This is an example whereby the
presentation actually makes
sense- there is a story behind
their experience, and this is what
you can build on/follow therapy
and treatment with
Rule: not a delusion if it is socially
sanctioned
Rule: can look at their changes over time
oSomatic
Similar to hallucinations
Rotting or in decay
oLoss of boundary delusional symptoms:
oReference
Ideas of reference- differ
Think that external events revolve/have
special meaning to you
Messages coded for them
oBeing controlled
External thing controlling you
Ties in with thought insertion
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find more resources at oneclass.com
oMind reading
Other people can read your
oThought broadcasting
Thoughts are being extracted
Or shared with everyone
oThought insertion
External source
“This week is blue”
oThought withdrawal
oWhen they say ‘paranoia’ need to unpack it
If it is a layman term
When you say your feel paranoia, what
does that feel like what do you mean
Bizarre behaviour:
oMisconception:
That they are violent
They are more likely to hurt themselves
than others
oClothing and appearance
oSocial and sexual behaviour
Social
oAggressive and agitated
Rarely aggressive to others
oRepetitive or stereotyped
Not movement disorders
Typical patterns
Positive formal thought disorder
oGroup of symptoms
oWe don’t know what is going on in someone’s
head- we must infer from their speech content
oAbility to communication a coherent message is
telling of your thinking
Thinking about
Thoughts and ideas, your audience, and
how you will convey these
oDerailment
Thinking slips off track over time
Tangential responses
Respond to people in a oblique
way
Incoherence
Illogically
Won’t connect in a logical
sequence
Circumstantiality
Hard to pick
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
History of the disorder helps us understand where diagnostic systems come from. Completely non-overlapping symptoms, yet, attain the same diagnosis and treatment: this is unique to schizophrenia, different symptom presentations, waste bucket of psychiatry, many people have many other diagnoses before receiving this one. Core concept of the diagnostic group: one or more of the following: A significant distortion in the perception of reality. An impairment in the capacity to reason, speak, and behave rationally or spontaneously. An impairment in the capacity to respond spontaneously with appropriate affect and motivation: in the absence of an impairment of consciousness or memory. Not because of substances, or dementing disorder: range of symptoms: Positive: something over and above the normal experience. Hallucinations: without it being externally present, auditory: most common. Part of the auditory cortex light up as if there was an external voice present. Qualitatively and quantitatively different to: voices commenting: Two or three voices having a conversation.
