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Chapters 5ii and 6.doc

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McMaster University
Christopher Teeter

Schizophrenia! - Literally means split mind, split mental processes (attention, perception, emotion, motivation, thought) NOT split personality! - Entirely different from dissociative identity disorder! Prevalence and Emergence of Schizophrenia! - Around 11% on average in the homeless population! - Places a financial burden on the patient, their family, health care system! - Usually emerges in late adolescence or early adulthood ! - Appears 4 years earlier and is more severe in males than females! - Can tell usually if children will develop schizophrenia! - Socially, they are less responsive than children with healthy outcomes, and show more negative facial expressions than their siblings who do not develop schizophrenia, tends to show more delays and abnormalities in motor development like walking later in life! Clinical Symptoms of Schizophrenia! i. Positive Symptoms! - Include behavioural excesses or peculiarities, such as hallucinations, delusions, bizarre behaviour, and wild flights or ideas! - Actions that are most prominent! - Presence of behaviours that are not apparent in most people! - Delusions is a false belief that tis irrational or maintained despite being unsupported by external evidence! - Considered psychotic symptoms (ex. George thinking his mother fed him glass)! - Often about thinking or thoughts! - Delusions of Grandeur: Regarded as beliefs of one’s own self-importance, for instance, thinking that you are the president! - Delusions of Persecution: Beliefs that people are plotting against you! - Delusions of Being Controlled: Believing that one’s thoughts are being controlled by radio waves! - Hallucinations are sensory perceptions that occur in the absence of a real, external stimulus, - Can exist in visual, tactile, olfactory! - Most common is hearing voices of people that do not exist! - Auditory hallucinations include insults directed at the afflicted individual in the form of a running commentary of their behaviour, convey commands, may be argumentative ! - Neuroimaging research reveals that both speech generation and perception areas are activated during auditory verbal hallucination! ii. Negative Symptoms! - Absence of behaviours that are typically present in most people! - The lack or reduction in expected behaviours, thoughts, feelings, and drives! - Flattened emotions, social withdrawal, apathy, and poverty of speech! - General slowing down of bodily movements, and loss of basic drives such as hunger and loss of pleasure (like eating your favorite meal)! - Have the most detrimental effect on the quality of life and deterioration of adaptive behaviours Affect! - People with schiz have disturbed emotions and display deviant emotional repsonses! Flat Affect: Problems with the range of emotions are frequently evident, person’s face appearing immobile and unresponsive, poor eye contact and reduced body language ! Inappropriate Affect: Tend to have emotional responses that are out of context, specific in schizophrenia (ex. Laughing when someone telling you a person died)! Alogia! - Diagnostic term for poverty of speech! - Manifested by brief, empty replies to questions! - Appear to have a reduction of thoughts that is subsequently reflected in a decreased production of the speech ! Avolition and Anhedeonia! - Apathy is avolition, the lack of energy and a seeming disinterest in continuing to engage in regular activities, may appear to have the inability to initiate and persist in goal-directed behaviours ! - May sit for an inordinately long period of time or show little interest in participating in social! - Anhedeonia — inability to experience pleasurable emotions from normally pleasurable life events such as eating, social interaction, sexual activity! Cognitive Deficits in Shcizophrenia! - Primary cognitive impairments in schizophrenia have been found across a wide assortment of tasks including: attention, memory, and executive functioning! Executive Functions: High-level processes such as the ability to problem solve, employ abstract thinking skills, and plan ahead! - May have the inability to regulate attention (cannot filter out anything)! Genetic Vulnerability! - Heredity plays a big role, but does not necessarily predict whether you have it or not! - Some form of stressor is usually required for the onset of schizophrenia! - Twins studies demonstrate: 48% of identical, 17% for fraternal! Neurochemistry! - 2 main neurotransmitters have been implicated in schizophrenia: dopamine and glutamate! Dopamine Hypothe
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