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1Chapter 13 Textbook Notes - Schizophrenia

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PSYC 235
Christopher Bowie

Chapter 13 Schizophrenia and Other Psychotic Disorders Positive Delusions (Grandeur / Persecutory) Symptoms Hallucinations (Auditory) Negative Avolition (inability to initiate and persist in activities) Symptoms Alogia (absence of speech) Anhedonia (lack of pleasure) Affective Flattening (do not show emotions) Asociality (poor social or interpersonal functioning) Disorganized Disorganized Speech (Tangentiality/Loose association) Symptoms Inappropriate Affect and Disorganized Behaviour (laughing at inappropriate times / Catatonic immobil)ty To receive a diagnosis of schizophrenia, a person must display two or more positive, negative, or disorganized symptoms for a major portion of at least one month. Schizophrenia Paranoid Type Subtypes (delusions or hallucinatio)s Disorganized Type (disruption in their speech and behaviour and show flat or inappropriate a)fect Catatonic Type (waxy flexibility / grimacing / mimic the words of others or the movements of o)hers Undifferentiated Type (have major symptoms of schizophrenia but who do not meet the criteria typ)s Residual Type (at least one episode of schizophrenia but who no longer manifest major symptoms) Other Psychotic Schizophreniform Disorder Disorders (experience the symptoms for a few months only, then disappears) Schizoaffective Disorder (symptoms of schizophrenia and exhibit the characteristics of mood disorders) Delusional Disorder (the imagined events could actually happen but arent, compared to imagined events that arent possible) Brief Psychotic Disorder (positive symptoms or disorganized speech or behaviour lasting 1 month or less) Shared Psychotic Disorder (an individual develops delusions simply as a result of a close relationship with a delusional individual) Schizotypal Personality Disorder (similar to those experienced by people with schizophrenia, but less severe) Schizophrenia the startling disorder characterized by a broad spectrum of cognitive and emotional dysfunctions including delusions and hallucinations, disorganized speech and behaviour, and inappropriate emotions. It is a complex syndrome and is a disorder that can disrupt a persons perception, thought, speech, and movement almost every aspect of daily functioning. Emil Kraeplin combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders: catatonia (alternating immobility and excited agitation), hebephrenia (silly and immature emotionality), and paranoia (delusions of grandeur or persecution). dementia praecox Chapter 13 Schizophrenia and Other Psychotic Disorders Eugen Bleuler introduced the term schizophrenia, which comes from the combination of the Greek words for split (skhizein) and mind (phren), and reflected Bleulers belief that underlying all the unusual behaviours shown by people with this disorder was an associative splitting of the basic functions of personality. This concept emphasized the breaking of associative threads, or the destruction of the forces that connect one function to the next. Identifying Symptoms Schizophrenia is a number of behaviours or symptoms that arent necessarily shared by all the people who are given this diagnosis. There are clusters of symptoms with schizophrenia. CLINICAL DESCRIPTION - Psychotic has been used to characterize many unusual behaviours, although in its strictest sense it usually involves delusions (irrational beliefs) and hallucinations (sensory experiences in the absence of external events). Schizophrenia is one of the disorders that involve psychotic behaviour. - Mental health workers typically distinguish between positive & negative symptoms of schizophrenia. A third dimension, disorganized symptoms, also appears to be an important aspect of the disorder. - Positive symptoms generally include the more active manifestations of abnormal behaviour, or an excess or distortion of normal behavior, such as delusions and hallucinations. Negative symptoms involve deficits in normal behaviour in such areas as speech and motivation. Disorganized symptoms include rambling speech, erratic behaviour, and inappropriate affect. - A diagnosis of schizophrenia requires that two or more positive, negative, or disorganized symptoms are present for at least one month. POSITIVE SYMPTOMS DELUSIONS A belief that would be seen by most members of a society as a misrepresentation of reality Delusion, or a disorder of thought content, has been called the basic characteristic of madness - Delusion of Grandeur (ending world starvation or believing they are Jesus or Napoleon) - Delusion of Persecution (others are out to get them) Other more unusual delusions include Cotards syndrome, in which the person believes a part of their body (ex. the brain) has changed in some impossible way, and Capgras syndrome, in which the person believes someone they know has been replaced by a double. HALLUCINATIONS Experiences of sensory events without any input from the surrounding environment Hallucinations can involve any of the senses, although hearing things that arent there, or auditory hallucination, is the most common form experienced by people with schizophrenia. - One theory of auditory verbal hallucinations states that people who are hallucinating are in fact not hearing the voices of others, but are listening to their own thoughts or their own voices and cannot recognize the difference. An alternative theory is that auditory verbal hallucinations arise from abnormal activation of the primary auditory cortex. This theory is consistent with both views regarding the origins of hallucinations (i.e. misinterpretation of inner speech and abnormal activation of the primary auditory cortex) and suggest that the two mechanisms are not necessarily mutually exclusive.Chapter 13 Schizophrenia and Other Psychotic Disorders NEGATIVE SYMPTOMS Indicate the absence or insufficiency of normal behaviour. They include emotional and social withdrawal, apathy, and poverty of thought or speech. AVOLITION - Avolition is the inability to initiate and persist in activities. People with this symptom (also refered to as apathy) show little interest in performing even the most basic daily functions, including those associated with personal hygiene. ALOGIA - Refers to the relative absence of speech. - A person with alogia may respond to questions with very brief replies that have little content and may appear uninterested in the conversation. - Sometimes alogia takes the form of delayed comments or slow responses to questions. ANHEDONIA - the presumed lack of pleasure experienced by some people with schizophrenia - signals an indifference to activities that would typically be considered pleasurable, including eating, social interactions, and sexual relations. AFFECTIVE FLATTENING - 2/3 people with schizophrenia exhibit what is called flat (or blunted) affect. They are similar to people wearing masks because they do not show emotions when you would normally expect them to. They may stare at you vacantly, speak in a flat & toneless manner, and seem unaffected by things going on around them. -Although they do not react openly t
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