PSY240H1 Lecture Notes - Lecture 6: Psychomotor Retardation, Personality Disorder, Echopraxia
Week 6 – Wednesday March 2nd, 2016
Key Features
• Type I / Positive symptoms
• Adding something to normal functioning
• The "addition" of something - positive in this case does not mean good, just
means addition of a function
o Delusions
• Fixed beliefs that are not amendable to change despite conflicting evidence
• Types
▪ Persecutory
• Other people are out to get you
• Conspiring against you
▪ Referential
• When you believe that events or objects have some personal
meaning for you
• e.g. watching TV and then newscaster says "that’s tough luck for the
Blue Jays"
• Makes you think newscaster is saying "tough luck" about what a
loser you are
• Might think that the newscaster is speaking directly to them
▪ Somatic
• Perception of a change in the appearance of function of a part or
parts of your body
• e.g. thinking your head is too small
▪ Religious
• Having unusual religious beliefs
• Outside of their background area
• e.g. someone who grew up as a Christian believes he is Jesus
• This doesn't fit with Christianity
▪ Grandiose
• Thinking that you have a special power or ability to do things that
other people can't do
▪ Erotomanic
• The idea that somebody else is in love with you
• e.g. guy who thought Madonna was in love with him and threatened
to slice her throat open if she didn't marry him
▪ Nihilistic
• The belief that you or part of your body or the world doesn't exist or
it's been destroyed
• e.g. Mademoiselle X denied the existence of her body and refused to
eat
• Ended up dying of starvation
• Psychomotor retardation
• Hopelessness
• Cotard syndrome
• "Walking corpse" syndrome - you believe that you've been
destroyed or that you're dead
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• Bizarre
▪ e.g. believing that an outside source (like aliens) have removed your
organs without leaving marks
• Non-bizarre
▪ e.g. believing that they're under police surveillance
• Common delusions
▪ Thought broadcasting
• Thinking that other people can hear your thoughts
▪ Thought withdrawal
▪ Thought insertion
• Having thoughts that aren't their own (other people putting thoughts
in their head)
▪ Delusions of control
• Things you do are completely outside your control
o Hallucinations
• Perception-like experiences
▪ Touch, taste, hearing, seeing, etc.
• Can occur in any sensory modality
▪ Auditory more common
• Hearing voices
• Maybe telling you what to do
• Must occur while awake
▪ Might have hypnogogic hallucinations when they come out of a deep
sleep
• This wouldn't count
• Can be normal part of religious experience
▪ Need to make sure this is a case outside of the normal subgroup
o Disorganized thinking
• Typically inferred from speech
▪ Can get an idea of what someone is thinking by what they're saying
• Examples
▪ Derailment / loose associations
• Jumping from topic to topic without a clear flow
▪ Tangentiality
• Somebody asking you questions and you're asking in a completely
unrelated manner
▪ Incoherence
• Nearly incomprehensible, seems like you have some form of
receptive aphasia
o Grossly disorganized behaviour
• Silliness
• Unpredictable agitation
• Difficulties goal-directed behaviour
• Difficulties in performing daily activities
• Catatonic behaviour / movements
▪ Catatonia
• Katatoniato: "tension insanity" (Kahlbaum, 1869)
• A syndrome of motor abnormalities
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• WIRED 'N MIRED (if you have 3 or more of these, they would do
additional testing)
• Waxy flexibility
• Patient maintains a posture that they're placed in
• Immobility
• Refusal to eat / drink
• Excitement
• Deadpan staring
• Negativism
• Mutism
• Impulsivity
• Rigidity
• Echolalia / echopraxia
• Echopraxia is mimicking movements of somebody else
• Direct observation of catatonic features in past week
• Stereotyped movement
▪ Repetitive movements like hand flapping
• Echolalia
▪ Repeating things that you're hearing
• Someone asking you a question and you respond by repeating the
question several times
• Type II Symptoms
o Negative symptoms (reduction of usual level of functioning)
• Diminished emotional expression
▪ Being flat
▪ Reduced expression in the face, no eye contact, etc.
• Avolition
▪ Decreased motivation
▪ Not a lot of self-initiated activities going on
• Alogia
▪ Decreased speech output
• Anhedonia
▪ Lack of pleasure or excitement from things that used to be enjoyable
• Asociality
▪ Lack of interest in social interactions
▪ Can be related to other things like avolition but can also be due to
lacking opportunities for social interaction
Schizophrenia
• Violence
o Most people with schizophrenia are non-violent
o More likely to harm themselves than others
o Typically keep to themselves
o Why does misperception exist?
• They've found that some violent people tend to have schizophrenia
• Prevalence (for schizophrenia and psychotic disorders in general)
o ~0.5 - 2% Canadians
o Immigrants seem to be at increased risk
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find more resources at oneclass.com
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