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Chapter 6 (2) - Psychological Disorders 2 Video Lecture Psych 1X03

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McMaster University
Joe Kim

Video Lecture Psych 1X03 Chapter 6: Psychological Disorders Psychopathology 2 Schizophrenia  Symptoms o Positive Symptoms o Negative Symptoms o Catatonic Symptoms  Positive Symptoms – increased presentation in schizophrenics; paranoid o Disorders of Thought  Schizophrenic thinking is characterized by loose associations; the individuals train of thought may consist of ideas that are often only loosely related to each other; speech may be vague and abstract  Eg/ “I wish you a happy, joyful and fruitful year, and many good apple years are cabbage and squash years” o Delusions – a belief that is irrational or unsupported by external evidence  Common delusions; the idea that the individual is being persecuted by others, or that events or objects have special significance for the individual  Thought Broadcast –the belief that others can hear ones thoughts  Thought Withdrawal – the belief that the individuals thoughts are being removed from his head before he can think them  Thought Insertion – the belief that thoughts are being placed in the individuals head by others o Hallucinations – perception of things that are not really there  Auditory hallucinations – individual may hear voices in head, or speaking from parts of the body; voices usually saying negative things, commenting on individuals behaviours or giving orders  Most common  Visual hallucinations  Negative Symptoms – decreased presentation in schizophrenics; disorganized o Individual decreases engagement with the outside world; may become less interested in people and events in the outside world and more concerned with internal ideas or fantasies o May lead to a growing estrangement from family and coworkers and an increasing neglect of ones personal appearance o Affect – emotional responsiveness  Flat (blunted) affect – individual shows very little emotional response  Inappropriate affect – individual may laugh when speaking about the loss of a family member  Catatonic Behaviours– movement behaviours not associated with environment (extreme rigidity) o Unrelated to stimuli from the outside world o Catatonic Rigidity (or catatonic stupor) – involves dramatic reduction in movement, sometimes to the point of ceasing to move at all  Individual may maintain a single posture for very long periods of time and resist being moved o “Waxy Flexibility” – patients arms and legs can be moved into a variety of positions and then slowly move back to original position o Repeated or stereotyped motor movements that seem to have no purpose at all, and are unrelated to what is going on around the person o Catatonic Excitement – very active or even frantic movements Video Lecture Psych 1X03  Subtypes of Schizophrenia o Paranoid  Dominant Symptoms  Delusions or auditory hallucinations with a single theme  Anger or anxiety related to the disturbing content of the delusions  Thinking relatively coherent, no disturbed affect or psychomotor disturbances o Catatonic  Dominant Symptoms  Psychomotor disturbances; strong motor disturbances  Catatonic stupor (rigidity), catatonic excitement or alteration between the two  Stereotyped postures or mannerisms, and waxy flexibility o Disorganized  Dominant Symptoms:  Incoherent thought and speech with very loosely associations  Disorganized behaviours  Possible motor disturbance  Social withdrawal  Flat or inappropriate affect  Delusions (if present) are incoherent and fragmentary  Most severe and disruptive of all types of schizophrenia o Undifferentiated  Cases that do not fit into any of the other three categories  Categories of Schizophrenia o Strong genetic predisposition (diathesis) of schizophrenia  Epidemiological evidence for genetic predisposition is very consistent  Eg/ The probability that an individual will develop the symptoms of schizophrenia increases the more closely he or she is related to someone who has the disorder  Eg/ Identical twins are more likely than fraternal twins to both have schizophrenia  Adoption studies report that schizophrenia is more common in biological relatives of adoptees than in non-related members from their adoptive families  Not clear what the inherited disposition is; some researchers believe that it is abnormalities in brain structure or changes in levels of neurotransmitters o External factors (environmental stress) may trigger genetic predisposition  Leading candidate is stress and problems with relationships with others, especially immediate family  Evidence of higher levels of dysfunction in the families of schizophrenics; difficult to tell whether it was there before the disorder appeared or occurred as the family tried to deal with the individuals symptoms  Treatment of Schizophrenia o For many years, the only treatment for schizophrenia was chronic care o Schizophrenia left untreated is among the most debilitating of all disorders o Pharmacological treatment  Most common therapy  Drugs are not equally effective for all patients or with all types of symptoms  Most drugs that are effective against the symptoms of schizophrenia have severely unpleasant side effects of their own Video Lecture Psych 1X03  Some patients would rather experience the symptoms of schizophrenia than the side effects of the drug which can affect compliance rates o Psychotherapy  Alone does not help very much in treating the major symptoms of schizophrenia  May help patient developing new coping strategies once drugs have relieved their symptoms  Cognitive Behavioural Therapy (CBT)  Patient is taught how to think about the psychosis in ways that allow him to better cope  Patients learn to identify and avoid triggers or learn positive ways to react to these triggers  Often used to encourage patients to comply with medicinal instructions through rewarding adherence
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