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Lecture 11

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Psychology 2030A/B
David Vollick

Abnormal  Psychology  Chapter  13:   Schizophrenia  and  Other  Psychotic  Disorders  (pp.467-­‐500)     Nature  of  Schizophrenia  and  Psychosis:  An  Overview  (pp.467-­‐470)   • Schizophrenia  vs.  Psychosis   o Psychosis  –  board  term  referring  to  hallucinations  and/or  delusions   o Schizophrenia  –  a  type  of  psychosis  with  disturbed  thought,  language,   emotion,  and  behaviour   • Early  Ideas  About  Scizophrenia   o Kraepelin    Combination  of  symptoms  (catatonia,  hebephrenia,  and   paranoia)  =  dementia  praecox      Distinction  from  bipolar    Focused  on  onset  and  outcomes   o Bleuler    Introduced  the  term  “schizophrenia”  or  “associative  splitting  of   the  mind  or  personality”    Cognitive  impairment   • Many  of  Kraepeling  and  Bleulers  ideas  are  still  with  us     Schizophrenia:  The  “Positive”  Symptom  Cluster  (pp.468-­‐471)   • The  Positive  Symptoms  –  Active  manifestations   • Delusions   o Gross  misrepresentations  of  reality  (delusions  of  grandeur,  paranoia,   persecution,  Capgras  syndrome,  or  Cotard’s  syndrome)   o Persist  because  new  information  not  properly  integrated   o Roberts  –  those  currently  delusional  have  a  stronger  sense  of  purpose,   less  depression   • Hallucinations:  Can  involve  all  five  senses   o Experience  of  sensory  events  without  environmental  input   o Auditory  hallucinations  (most  common)    Brain  scans  (Broca’s  area,  not  Wernicke’s)  =  misinterpretation   of  own  inner  speech  as  that  from  someone  else     Schizophrenia:  The  “Negative”  Symptom  Cluster  (pp.471-­‐472)   • The  Negative  Symptoms   o Absence  or  insufficiency  of  normal  behaviour   • Spectrum  of  Negative  Symptoms   o Avolition  (or  apathy)  –  refers  to  the  inability  to  initiate  and  persist  in   activities   o Alogia  –  lack  of  speech  content/slowed  speech  response   o Anhedonia  –  lack  of  pleasure,  or  indifference  to  pleasurable  activities   o Affective  flattening  –  sow  little  expressed  emotion  –  may  still  feel   emotion   o Asocialtiy  –  deficit  in  social  relationships     Schizophrenia:  The  “Disorganized”  Symptom  Cluster  (pp.472-­‐473)   • The  Disorganized  Symptoms   o Disorganized  speech    Cognitive  slippage  –  illogical  and  incoherent  speech    Tangentiality  –  “going  off  on  a  tangent”  and  not  answering  a   question  directly    Loose  associations  or  derailment  –  talking  conversation  in   unrelated  direction   o Disorganized  affect    Inappropriate  emotional  behaviour  (e.g.,  crying  when  one   should  be  laughing)   o Disorganixed  behaviour    A  variety  of  unusual  behaviours   • Catatonia  –  spectrum  from  wild  agitation,  waxy   flexibility,  to  complete  immobility     Subtypes  of  Schizophrenia  (pp.  473-­‐475)   • Paranoid  Type   o Intact  cognitive  skills  and  affect,  and  do  not  show  disorganized   behaviour   o Hallucinations  and  delusions  center  around  a  theme  (grandeur  or   persecution)   o Deficient  in  social  information  processing   o The  best  prognosis  of  all  subtypes   • Disorganized  Type   o Marked  disruptions  in  speech  and  behaviour,  flat  or  inappropriate   affect   o Hallucinations  and  delusions  have  a  theme,  but  tend  to  be  fragmented   o Develops  early,  tends  to  be  chronic,  lacks  periods  of  remissions   • Catatonic  Type   o Show  unusual  motor  responses  and  odd  mannerisms  (e.g.,  echolia,   echopraxia)   o This  subtype  tends  to  be  severe  and  quite  rare   • Undifferentiated  Type   o Wastebasket  category   o Major  symptoms  of  schizophrenia,  but  fail  to  meet  criteria  for  another   type   • Residual  Type   o One  past  episode  of  schizophrenia   o Continue  to  display  less  extreme  residual  symptoms  (e.g.,  odd  beliefs)   • Crow  –  Type  I  (paranoid)  and  Type  II  (nonparanoid)     Schizophrenia:  Some  Facts  and  Statistics  (pp.477-­‐479)   • Onset  and  Prevalence  of  Schizophrenia  Worldwide   o About  1%   o Usually  develops  in  early  adulthood  but  can  emerge  at  any  time   • Early  childhood  clinical  features  –  mild  physical  abnormalities,  poor  motor   coordination,  mild  cognitive  and  social  problems   • Schizophrenia  is  Generally  Chronic   o Most  fluctuate  between  moderate  and  severe  impairment  throughout   their  lives,  despite  treatment   • Schizophrenia  Affects  Males  and  females  About  Equally   o Females  tend  to  have  a  better  long-­‐term  prognosis   o Onset  of  schizophrenia  differs  between  males  and  females     Causes  of  Schizophrenia:  Findings  From  Genetic  Research  (pp.  478-­‐481)   • Appears  to  Have  a  Strong  Genetic  Component   • Family  Studies   o Inherit  a  tendency  for  schizophrenia,  not  a  specific  form   o More  severe  parent’s  disorders,  the  greater  the  risk  for  the  children   • Twin  Studies   o Risk  of  schizophrenia  in  MZ  twins  is  48%   o Risk  drops  to  17%  for  fraternal  (DZ)  twins   • Adoption  Studies   o Risk  of  schizophrenia  high  in  adopted  children  with  a  biological   parent  suffering  from  schizophrenia   • Summary  of  Genetic  Research   o Schizophrenia  has  a  strong  genetic  component,  but  genes  alones  are   not  enough     Search  for  Generic  and  Behavioural  Markers  of  Schizophrenia  (pp.481-­‐482)   • The  Search  for  Genetic  Markers:  Linkage  and  Association  Studies   o Find  blood-­‐type  “marker”  genes  (location  unknown)  inherited  along   with  the  disorder;  make  a  rough  guess  as  to  location  of  disorder  genes    Still  inconclusive   o Likely  to  involve  multiple  genes  (quantitative  trait  loci  model).   Explains  gradations  of  severity  seen  in  patients,  and  increase  in  risk   with  increase  in  number  of  affected  relatives   • The  Search  for  Behavioural  Markers:  Smooth-­‐Pursuit  Eye  Movement   o Tracking  a  moving  object  visually  with  the  head  kept  still  
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