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Lecture 9

Abnormal Psychology Lecture 9.docx

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Konstantine Zakzanis

Abnormal Psychology: Lecture 8 Guest Speaker: Neil  Illness is schizophrenia, invisible disability  Exhilarating feeling  Always on the need for a mission  Need to be part of a movement  Medication has helped with delusions and keeping him safe Schizophrenia video  Affects 1% of the population in the earth  Affects women and men equally (inaccurate) but onset conditions appear earlier for men than in women  After every episode it becomes more difficult to return to a regular state  Often socially impaired th  Half of all schizophrenic’s attempt suicide and about 1/10 succeed Schizophrenia  Psychotic disorder characterized by major disturbances in thought, emotion and behavior  Disordered thinking in which ideas are not logically related, faulty perception and attention, flat or inappropriate affect and bizarre disturbances in motor activity  Most severe- because it’s more difficult to cope with. It puts both self and others at risk.  Schizophrenia most common in men *, typically found in adults sometimes teen.  Earlier onset conditions in men earlier than in women  There is also late onset schizophrenia.  Acute episodes- are characterized by positive symptoms also known as psychotic symptoms. These symptoms bring the attention to a specialist. o Between these episodes they will have negative episodes o As each acute episode occurs they get further and further away from normality  Illness is extremely heterogeneous- lots of variety from someone who’s homeless to someone who has a university of degree  50% of patients have a comorbid disorder o Typically a personality disorder  Dependent personality disorder- they can’t meet the demands of their daily activities so they depend on others  Paranoid personality disorder  Avoidance personality disorder- stems from the fact that they miss a lot of social aspects.  Substance abuse is also common- cigarettes, cannabis  Predictors of outcome o Predictor of positive outcome- early remission of acute episode. That is within the first three months of the onset of disorder, the symptoms go away, they probably have a good outcome. o Predictor of negative outcome- cognitive impairments making it difficult to maintain a job, a family and school  Schizophrenia is not a one person disorder, it affects the people around the individual and requires more attention. Clinical Symptoms of Schizophrenia  Positive symptoms of schizophrenia- too much of a behavior that is not apparent in most people (added to personality thus positive) o Excesses or distortions o Disorganized speech (thought disorder)  Incoherence  Loose associations- problems in organizing ideas and in speaking so that a listener understands  Make up fake words  Repetitive speaking because they get stuck in set  Echolalia- is when they echo what is said to them o Delusions- you have beliefs that are held contrary to reality  Persecutory Delusions- someone is after them or something bad will happen  Thought broadcasting- If a patient in watching TV they may think the caster is stealing their thoughts and repeating them on television.  They may believe their behavior is controlled by others o Hallucinations – sensory (any senses) in the absence of any stimulation from the environment  Most common is auditory hallucinations - hearing voices  Negative symptoms – residual stages of schizophrenia (which are just as bad). We should have these, but we don’t.  Strong predictors of quality of life o Behavioral deficits o Avolition- lack of energy and absence of interest or inability to persist routine tasks such as dressing or cleaning o Alogia-poverty of speech where the patient is either lacking in amount of speech or content of speech o Anhedonia- describe inability to experience pleasure o Flat Affect- inability to experience pleasure, shown externally, by not showing emotion. However, internally they can experience pleasure o Asociality – lose social skills, few friends, shy. Stem from paranoia quality  Other symptoms o Catatonia- illustrate motor abnormalities  Catatonic immobility- hysterical posturing and hands and legs moving all over the place having no purpose to the observer but may have a purpose to the person. For example neil felt that moving left or right dictated his political views.  Waxy flexibility- putting these individual in a strange position and they will stay that way for long. Rare these days due to medication  Inappropriate affect- reacting strangely to situations such as laughing when parents die or crying when winning the lottery. Inappropriate affect is highly specific to this illness.  Schizophrenia: It’s Diagnosis o DSM requires at least six months of disturbance  Must include one month of the active (acute)phase- that is those positive symptoms  Remaining time must be negative phases during prodromal (before active phase) or residual (after active phase).  Examples include social withdrawl impaired role functioning, lack of initia
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