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Psychopathy 2

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Joe Kim

Psychopathy II Schizophrenia *No main symptom Different symptoms for different patients – combination Symptoms of schizophrenia – patient may experience only some of the symptoms and severity ranges i. Positive symptoms: increased presentation in schizophrenics 1) Disorders of thoughts = Train of thought has ideas loosely related to each other o Speech is vague and abstract 2) Delusions = irrational belief unsupported by external evidence o Popular delusions include: being persucuted by others, or just events or objects that only have significance to person - Thought broadcast: belief that others can hear one's thoughts - Thought withdrawal: belief that individual's thoughts are being removed from his head before he can think them. - Thought insertion: belief that thoughts are being placed in the individual's head by others. 3) Hallucinations = perceptions of things that aren't really o Auditory are more common than visual hallucinations o Hears voices in head saying negative things about individuals and commenting on person's behaviour or giving orders i. Negative symptoms = decreased presentation in schizophrenics. Decreased in an individual's engagement with the outside world o Loss of interest in the outside world – less interest in people and more concerned with internal ideas and fantasies. May lead to: Estrangement from family/coworkers and increased neglect of personal appearance o Emotional responses will change (ie. abnormal or absent affect) o Affect – emotional responsiveness. Flat/blunted affect - shows very little emotional response. Inappropriate affect - emotional reactions that are inapproproate to thecertain situation iii. Catatonic symptoms = movement behaviours not associated with environment (extreme rigidity) o Unrelated to stimuli from outside world Catatonic rigidity/stupor = dramatic reduction in movement, sometimes to the point of ceasing to move at all. (Like staring at the wall for hours...) Waxy flexibility – patient's arms and legs can be moved into a variety of positions (like a wax figure) and then very slowly move back to the original position. Repeated and stereotypes motor movements – no purpose and don't relate to what is occurring around person. Eg. Catatonic excitement = active or frantic movements Subtypes of schizophrenia: o Paranoid schizophrenia Auditory hallucinations/delusions within a single theme - Apart from the delusion person's thinking may be coherant with no disturbed affect [Thought, affect, and motor behaviour are normal] Individuals thinking may be relatively coherent with no disturbed affect - Shows anger/anxiety related to disturbing content of delusions o Catatonic schizophrenia Strong motor disruption (stupor/rigidity, excitement) May be stereotypied postures or mannerisms together with waxy flexibility o Disorganized schizophrenia Most severe type and disruptive type of schizophrenia. Incoherent thought and speech – loose associations Disorganized behaviour Demonstrates flat or inappropriate affect Delusions are incoherent and fragmentary Possible motor disturbance (brocka's/ werniki's area) Profound Social withdrawal o Undifferentiated schizophrenia Symptoms don't fall within other subtypes Causes of schizophrenia: Diathesis-stress hypothesis – Genetic predisposition for the disorder and some environmental stress that triggers the symptoms ** Strong genetic component of schizophrenia (more common in identical twins than fraternal) o Twin studies More in identical than fraternal o Adoption studies More common in biological relatives of adoptees than in nonmembers from their adoptive families. Some researchers believe that it is abnormalities in brain structure or changes in levels of neurotransmittors. o Environmental/family factors – external factors (stress, problems with family/relationships) may trigger genetic predisposition Higher levels of dysfunction in families with a schizophrenic But difficlt to tell if it was there before disorder or occured when family tried dealing with the symptoms Treatment of schizophrenia: o Chronic care: pre-1960s – debilitating long-term psychiatric care o Drug therapies: low adherence rates – effectiveness varies; side effects are common o Psychotherapy: low effectiveness – alone; helps with coping strategies o CBT: addresses how to identify and avoid environmental factors/triggers, helps patients cope – avoid triggers and learn positive ways to react to triggers Comply with medical instr
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