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Psych 257 Chap 13 Psych 257 Psychopathology Barlow et Al: Abnormal Psychology 2nd CDN edition Chapter 13

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Uzma Rehman

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Schizophrenia and Other Psychotic Disorders
-broad spectrum of cognitive/emotional dysfunctions; affects 1% of pop. With different subtypes
-ex. Delusions, hallucinations, disorganized speech and behavior, and inappropriate emotions
Perspectives on the concept of Schizophrenia
Early Figures in Diagnosing Schizophrenia
-Kraepeliin: combined (originally separate) insanity symptoms into ‘dementia praecox’
-catatonia: alternate immobility & excited agitation, hebephrenic: immature emotionality, & paranoia
-distinguished DP from bipolar disorder, diff due to DP has early age of onset and poor outcome
-Bleuler: intro’d term ‘schizophrenia’: underlying issue was the associative splitting of basic personality functions
Identifying Symptoms
-schizophrenia has a number of behaviours/symptoms that aren’t necc. shared by all people given the disorder
-instead: clusters of symptoms make up schizophrenia: eg. hallucinations, unrealistic beliefs, delusions
Clinical Description
-psychotic: used for many unusual behaviours but usu.: delusions (irrational belief) and hallucinations
-schizo: affects all function: not actually violent/split personality;
-diff. b/w positive, negative, and disorganized symptoms; usu. need 2+ symptoms of either to be diagnosed
-positive: active manifestations of abnormal behavior/excess or distortion of normal behavior ex. Delusions
-negative: deficits in normal behavior ex. In speech/motivation
-disorganized: ex. Rambling speech, erratic behavior, inappropriate affect;
-active phase symptoms: experienced at the time
Positive Symptoms
-delusions: disorder of thought content, ex. Grandeur, persecution; misrepresentations of reality
-ex. Cotard’s syndrome: body part changed in impossible way; capgras: someone known switched with a double
-poss.: due to unable to integrate new info, or maybe an adaptive function, help someone deal with changes
-hallucinations: any sense (ex. Auditory) may be due to hearing own thoughts and don’t recognize it’s their own
-positive symptoms are multi-dimensional; not just one
Negative Symptoms
-25% of schizo’s; absence/insufficiency of normal behavior; ex. Emotional/social withdrawal, apathy, etc.
-avolition: can’t start/persist in activities; highly assoc’d with poor outcome,
-alogia: absence of speech, have trouble finding right words to formulate thought, answer with only few words
-anhedonia: lack of pleasure; -> delayed treatment seeking, strong corr. b/w depression & anhedonia/avolition,
-affective flattening: 2/3rds of schizo’s: don’t show emotions, speak flat, toneless etc.
-not due to lack of feeling but difficulty in expressing emotion;
-deficit in social relationship; -> few friends, poor social skills; assoc’d with ^ neg symptoms
-if poor social functioning before development of psychosis; -> ^ neg symptoms & social impairment
Disorganized Symptoms
-disorganized speech: jump from topics, tangentiality, jump to unrelated topic, -> don’t answer question asked
-inappropriate affect: laughing/crying at improper times;
-disorganized behavior: ex. Hoarding, acting weird in public, some motor dysfunction,
-possible fear of something terrible if they move -> catatonic immobility
Schizophrenia Subtypes
-3 divisions: paranoid, disorganized, catatonic; w/ differences in prognosis, course, treatment response
-paranoid: delusions/hallucinations but intact cognitive skills/affect; don’t usu. have disorganized speech/affect
-better prognosis; DSM diagnosis= preoccupied w/ 1+ delusions w/o disorganized speech, catatonic behavior
-disorganized: disruption in speech/behavior, ex. Flat affect; usu. seem self absorbed
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