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Lecture 6

PSYC 465 Lecture 6: PSYC 361 Lecture 6
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Department
Psychology
Course Code
PSYC 465
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johnson

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PSYC 361 Lecture 6 Abnormal Psychology Chapter 10: Schizophrenia Spectrum and Other Psychotic Disorders • What is Psychosis? o From the Greek: psyche meaning “soul”, and osis for “abnormality” ▪ Abnormality of the soil o Definition : loss of contact with reality about world and self o Reality Testing ▪ Ability to distinguish between thoughts and perceptions originating from within our minds versus from the outside world - people with psychosis cannot do this or it is severely impaired o Different from “psychopathy” which occurs in antisocial personality disorder - refers to someone who is antisocial, has a complete disregard for others, etc. • Psychotic Symptoms o Hallucinations ▪ Sensory perceptions in the absence of external stimuli - can exist in all 6 (including balance) senses ▪ Auditory most common - 71% vs. 14% for visual hallucinations o Delusions ▪ Erroneous beliefs, misinterpretation of perceptions • Persecution (someone is out to get them) • Grandeur (believe they are god) • Influence (someone is forcing them to do things) • Reference (idea that one is receiving a special message just for them) ▪ Can be bizarre or non-bizarre o Disordered Thinking/Speech ▪ Derailment, loose associations, tangentiality, clanging, disorganization speaking (word salad) o Lack of insight that thoughts are unrealistic • Positive vs. Negative Symptoms o Positive - excess/distortion in normal functions ▪ Psychotic (hallucinations and delusions) ▪ Disorganization (speech, behaviors) • Catatonia - disorganized movement o Waxy flexibility o Negative - capacities patient has lost ▪ Reduced emotions (affective flattening, anhedonia) ▪ Reduced speech productivity (alogia) ▪ Reduced goal-directed behavior (avolition) o Cognitive Impairments ▪ Reduced scores on standard intelligence testing ▪ Impaired social cognition • Schizophrenia o History : Dementia Praecox ▪ Emil Kraepelin & Eugen Bleuler ▪ Young people developing dementia o Greek : schizo = “to split” , phrene = “mind” (e.g., split mind) ▪ Often misperceived as referring to Dissociative Identity Dx (DID) o 2 or more positive or negative sx’s, and lasts for 6 months or more ▪ Only need to be actively psychotic for 1 month or more ▪ Must include at least one positive sx : hallucinations, delusion, or disorganized speech o Not caused by drugs or organic factors, and result in markedly impaired function • Course of Schizophrenic Sx’s o Prodromal Phase ▪ Person begins deteriorating in interpersonal and work functioning • Also, poor grooming, odd thoughts, inappropriate emotionality, low energy, but no active sx’s o Active Phase ▪ Positive and/or negative sx’s for 1 month or more o Residual Phase ▪ Similar to prodromal phase, no more psychotic sx’s • Negative sx’s remain : impairment in work, relationship, self-care • Epidemiology o Prevalence / Demographics ▪ .72% (lifetime); “universal syndrome” ▪ Age of onset - varies by gender • Men - mid 20’s • Women - bimodal - late 20’s and 45 ▪ Gender • Men = women • Prognosis better for women - fewer negative sx’s ▪ Race • No difference in sx’s, but different rate of diagnoses o White people - more like to receive mood disorder diagnosis o Black people and Hispanics - more likely to receive schizophrenia diagnosis o Course ▪ Sx’s may stabilize or discontinue after acute phase ends, but complete remission is rare ▪ Typically, gets worse the longer it is left untreated • Etiology o Genetics
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