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Canada (511,431)
Psychology (3,528)
PSY240H1 (234)
Lecture 5


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Martha Mc Kay

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PSY240 Review Notes LECTURE 5 1 Schizophrenia Diagnostic Presence of severe symptoms for at least one month and the presence Criteria of some symptoms for at least six months A Core symptoms two or more of the following present for at least a one month period 1 Delusions 2 Hallucinations 3 Disorganized speech 4 Grossly disorganized or catatonic behavior 5 Negative symptomsB Social occupational functioning signifi cant impairment in work academic performance interpersonal relationships and or self care C Duration continuous signs of the disturbance for at least six months at least one month of this period must include symptoms that meet Criterion A above Positive Symptoms excess or distortion in normal repertoire of behaviourDelusions persecutory reference grandiose being controlled thought broadcasting thought insertion thought withdrawal guiltsin somatic Hallucinations auditory visual tactile or somatic Tactile feel things outside body Somatic feel things inside body Disorganized Thought and Speech eg word salad Formal thought disorder Loose associationsderailmentmove from one topic to an unrelated one with little coherent transition Word Saladspeech so disorganized incoherent to listener Neologismsmade up words Clangsassociations between words made up based on soundEg Dog is Spog Perseverationrepeating same word or saying over and over again Disorganized or Catatonic Behaviour eg disheveled appearance inappropriate clothing agitated repetitive behaviours Behaviour that is highly unpredictable bizarre or shows complete lack of responsiveness for long periods of time Catatoniacomplete lack of responsiveness to outside world Disorganzed Examples untriggered agitation shouting swearing pacing Dishevelled and dirtyinappropriately dressed for weather Catatonic Examples holding strange poses for hours catatonic excitementwild agitation no response difficult to subdue may be infused with angry outbursts may reveal nature of hallucintionsdelusions Negative Symptoms Affective Flattening or Blunted Affect Severe reduction or complete absence of affective responses to the environment Alogia Severe reduction or absence of speech Avolition Inability to persist at common goaloriented tasks Inappropriate Affect Laughing at sad things crying at happy things Anhedonia Loss of interest in and across all realms of life Impaired Social Skills More often caused by negative symptoms Prodromal Symptomspresent before acute phase Residual Symptoms present after pt come out of acute phase May express unusual beliefs but are not delusional Have strange perceptual experiences not fullblown hallucinations May speak in tangential and disorganized manner yet remain coherent Negative symptoms are especially prominentwithdrawal from others work or school gradually slipping awayTypes of Schizophrenia Paranoid Prominent delusions and hallucinations involving persecution and grandiosity best known better prognosis onset later in life Disorganized thoughts and behaviours are severely disorganized word salads cant bathe disturbed emotional expression early onset most disabled by disorder Catatonic rare subtype very distinctive features eg catatonic stupor or excitement Show variety of motor behaviours and ways of speakingcomplete lack of responsiveness to their environment Two of the following symptoms Catatonic Stupor motionless Catatonic Excitement Maintenance of rigid posture or complete mutism Odd mannerisms grimacing or hand flapping Echolalia word repetition or echopraxia repeated movements Undifferentiated some symptoms but not enough to meet complete diagnosis of any subtype early onset chronic difficult to treat Residual at least one acute episode in the past with lingering Type II and mild Type I symptoms may have symptoms chronically for many years Prevalence In Canada 052 of the population has been diagnosed with a schizophreniaspectrum disorder Immigrants to Canada and to other countries seem to be at increased risk Schizophrenia may be relatively culture free however in that worldwide prevalence appears to be uniformly around 1 with varying estimates likely reflecting diagnostic discrepancies rather than real differencesAge and Gender Factors Lifespan development and stabilization Women who develop schizophrenia have a more favorable course of the disorder than do men who develop schizophrenia
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