PSYC 4430 Lecture Notes - Lecture 12: Dementia Praecox, Disorganized Schizophrenia, Single-Photon Emission Computed Tomography

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10 Jun 2018
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Chapter 12: Schizophrenia and Other Psychotic Disorders
1. Key terms
a. Psychosis: gross departure from reality
b. Hallucinations: sensing something in the absence of a sensory input (hearing
voices, smelling smoke/poison)
c. Delusions: beliefs that are strong and inaccurate that continue even when given
proof of them being false
2. History of Schizophrenia and Current Thinking
a. History
i. Schizophrenia is a pervasive type of psychosis characterized by disturbed
thought, emotion, and behavior
ii. Emil Kraepelindescribed schizophrenic syndrome using the term
deetia praeo
1. Subtypes of schizophrenia: catatonia, hebephrenia, paranoia
iii. Engen Bleuler—oied the ter shizophreia
1. Meas splittig of the id
b. Current thinking
i. Understanding onset and course are important
ii. Psychotic behavior
1. Can mean hallucinations, delusions, or the unusual behavior
associated with them
3. Symptoms
a. Positive cluster
i. Positive does not mean good
1. Active manifestations of abnormal behavior
2. Distortions or exaggerations of normal behavior
ii. Delusions: most common symptoms of schizophrenia
1. Delusions of grandeur
2. Delusions of persecution
iii. Hallucinations
1. Can involve all 5 senses, however auditory is the most common
(ex. Hearing voices)
2. Fidigs fro “PECT studies sho the Broa’s area is most active
during auditory hallucinations
a. This area is linked to speech production
b. Negative cluster
i. Does ot ea ad—means lack of or insufficiency of normal behavior
ii. Types
1. Avolition (or apathy)lack of initiation and persistence
2. Alogiarelative absence of speech
3. Anhedonialack of pleasure, or indifference
4. Affective flatteringlittle expressed emotion
c. Disorganized
i. Confused or abnormal speech, behavior, and emotion
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ii. Types
1. Cognitive spillageillogical and incoherent speech
2. Tangentialitygoing off on a tangent
3. Loose associationsbringing up things that are unrelated to
conversations
iii. Disorganized affect: inappropriate emotional responses
iv. Disorganized behavior
1. Catatoniacan be its own disorder or a symptom of
schizophrenia
4. Schizophrenia subtypes
a. Previously divided into subtypes
b. No longer divided in the DSM-5, but old terms are sometimes used
c. These include
i. Paranoia, catatonic, residual (minor symptoms after past episode),
disorganized and undifferentiated (two or more of the other types)
5. Schizophrenia Statistics
a. About .2-1.5% (about 1% of the population)
b. Often develops in early adulthood
c. Childhood cases are extremely rare
d. Generally chronic
i. Moderate-to-severe lifetime impairment
ii. Increased risk for suicide and accidents
e. Affects males and females about equally
i. Females have better long-term success
ii. Onset is slightly earlier for males
f. Similar rates across cultures
6. Schizophrenia Causes
a. Genetics
i. A tendency for schizophrenia can be inherited
ii. Risk increases with genetic relatedness (closer relation=greater chance)
iii. Twin studies
1. At greater risk if monozygotic twin his schizophrenia
iv. Adoption studies
1. Risk is high if biological parent has schizophrenia
2. Healthy environment can lower risk
v. Genetic markers
1. Likely involve multiple genes
2. Behavioral markers
a. Smooth-pursuit eye movement: reduced ability to track
moving objects with their eyes
b. Relatives of these patients also have trouble
b. Neurobiological influences
i. Dopamine hypothesis: overactive dopamine
1. Agonists (increase dopamine) result in schizophrenic-like behavior
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