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PSYC203 (40)

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Gareth Treharne

Part 2- L7 Schizophrenia 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- cultural norms  Unusual perceptual experiences, including bodily illusions.  Odd thinking and speech  Show suspiciousness or paranoid ideation  Appear eccentric,  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 schizophrenia  Lack motivation, expression, affect etc. o Need to have one of the three symptoms o Characteristic symptoms  Delusions × 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  Disorganised speech × Conversations may lack coherence × Jumping from topic to topic in an incoherent manner × a quarter are likely to maintain good social and vocational functioning × Neologisms (coinages, buzzwords) × Repletion’s in speech/language o Grossly disorganised or  catatonic (unconscious) behaviour  Negative symptoms 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 × Disorganized speech and behaviour × Flat or inappropriate mood  Paranoid × 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 prominent.  Catatonic × 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 hallucinations. × Rarely seen in industrial countries, remains common elsewhere.  Residual (Lasting) × 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 Guilt o Grief o Significance of family for achieving favourable outcomes - Cause o The dopamine hypothesis
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