Part 2- L7
Schizophrenic spectrum disorders (DIMENTIONAL PERSPECTIVE)
- More stable personality types
- Contain symptoms for schizophrenia
- Less problematic or significant level
- A dimensional view of schizophrenia rather than it being an all or nothing dichotomous
condition as exemplified by DSM.
o Schizoid personality
Does not enjoy close relationships
Frequently chooses solitary activities
Little interest in having sexual experiences with another person
Appears indifferent to the praise or criticism of others
Shows emotional coldness, detachment or flattened mood.
o Schizotypal personality
Frequently experiences ideas of reference
Has odd beliefs that influence behaviour and are inconsistent with sub-
Unusual perceptual experiences, including bodily illusions.
Odd thinking and speech
Show suspiciousness or paranoid ideation
Lack close friends
Experience excessive social anxiety.
Nature of schizophrenia
- Clinical impression
o Ambivalence (uncertainty, inconsistency)
o Associative disturbances
o Affective disturbances
o Preference for fantasy over reality
o Disturbances in thought processes
- Classification for schizophrenia (DSM5)
o In DSM4 you had to have two of the five symptoms to be diagnosed with
Lack motivation, expression, affect etc.
o Need to have one of the three symptoms
o Characteristic symptoms
× Of control
Being able to control others
Being controlled by others
× Grandeur (grand)
Believing they are rich, famous, talented
× Of reference
× Believing the behaviour of others is directly related to them
× glances, looks, laughter
Hallucinations × Something that has no stimulus in the environment
× Taste, small, sight, hearing, touch
× Auditory is most frequent
× Conversations may lack coherence
× Jumping from topic to topic in an incoherent manner
× a quarter are likely to maintain good social and vocational
× Neologisms (coinages, buzzwords)
× Repletion’s in speech/language
o Grossly disorganised or
catatonic (unconscious) behaviour
o Social or occupational dysfunction
o Continuous sign persist for at least 6 months
o Only one of these symptoms is required
if the delusions are bizarre
the hallucinations comprise a voice keeping up a running commentary on
the person’s behaviour or thoughts
involve two or more voices conversing with each other
- Classification of schizophrenia
o Multiple classification symptoms
× Disorganized speech and behaviour
× Flat or inappropriate mood
× Most common type of schizophrenia
× Characterized by stable, paranoid delusions.
× Auditory hallucinations may support these delusional beliefs.
× Disturbances of mood and speech, and catatonic symptoms, are not
× Psychomotor disturbances.
× The condition varies from extreme excitement to stupor
× ‘Waxy flexibility’ in which the individual can be placed in a position
which they maintain for several hours.
× Automatic obedience or a dreamlike state accompanied by vivid
× Rarely seen in industrial countries, remains common elsewhere.
× characterized by an absence of prominent delusions, hallucinations,
disorganized speech, or grossly disorganized or catatonic behaviour × Disturbance, indicated by the presence of negative symptoms or
two or more of the key symptoms in an attenuated form.
o Multiple presentation of the same general classification
o Unreliability of diagnostic classification
o Non-specific symptoms
o 1% of adults have some form of schizophrenia
o Prevalence rates appear stable across countries, cultures and over time
o Onset typically occurring between 20 and 35 years
o women develop the condition three to four years later than men
second peak of onset around the menopause
- Family perspective
o Abrupt or imperceptible change
o Significance of family for achieving favourable outcomes
o The dopamine hypothesis