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PSYB32H3 Study Guide - Final Guide: Aversion Therapy, Etiology, Schizotypal Personality Disorder

Course Code
Konstantine Zakzanis
Study Guide

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Chapter 11: Schizophrenia
Schizophrenia: psychotic disorder characterized by major disturbances in
through, emotion, and behaviour disordered thinking in which ideas are
not logically related, faulty perceptions and attention, flat or inappropriate
affect, and bizarre disturbances in motor activity
They withdraw from people and reality, often into a fantasy life of delusions
and hallucinations
Its one of the most severe psychopathologies
Prevalence of 1%
Clinical Symptoms of Schizophrenia
Disturbances in several major areas –thought, perceptions and attention,
motor behaviour; affect or emotions and life functioning
There is a lot of heterogeneity
Positive Symptoms
Positive symptoms: comprise excesses or distortions, such as
disorganized speech, hallucinations and delusions, an acute episode of
It involve the presence of a behaviour that is not apparent in most people
Disorganized speech
Aka formal thought disorder
Disorganized speech: problems in organizing ideas and in speaking so
that a listener can understand
There is incoherence in conversations (not connected and hard to
Speech may also be disordered as loose associations/derailment
(difficulty sticking to one topic)
oThey may drift off in what they are saying
But disorganized speech is not a discriminator between schizophrenia and
other psychoses (like some mood disorders)
Thinking that others are plotting against you
Delusions: beliefs held contrary to reality, are common positive symptoms
Persecutory delusions are found in 65% of them
They may think their thoughts are beings stolen from them or are being
Hallucinations and Other disorders of Perception
They may feel depersonalized
Hallucinations: sensory experiences in the absence of any stimulation
from the environment (more auditory than visual)
oThey hear their own thoughts spoken by another voice
oThey hear voices arguing
oHere voices commenting on their behaviour

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Negative Symptoms
Negative symptoms: behavioural deficits, such as avolition, alogia,
anhedonia, flat affect and ascoiality
They tend to endure beyond an acute episode and have profound effects on
the lives of patients
Flat affect can be a side effect of antipsychotic medication
Apathy/avolition: lack of energy and seeming absence of interest or
inability to persist in what are usually routine activities
Inattentive to grooming and personal hygiene
Difficulty persistent at work, school or household chores
A negative thought disorder
Poverty of speech, sheer amount of speech is greatly reduced
Poverty in content of speech
Vague and repetitive speech
An inability to experience pleasure
They are aware of it
Flat Affect
No stimulus can elicit an emotional response
Stare vacantly, muscles of face flaccid, and eyes lifeless
Flat and toneless voice
impaired social relationships
few friends, poor social skills and little interest being with people
Schizophrenia onset is beginning in childhood
It is also said that they might not be able to recognize the emotions on top
of not being able to express it
Other Symptoms
Catatonia: several motor abnormalities
oGesture repeatedly, using peculiar and complex finger sequences of
finger, hand and arm movements
oSometimes excitement, wild flailing of the limbs
oCatatonic Immobility: patients adopt unusual postures and
maintain hem for a very long period of time (stand on one leg)
oWaxy flexibility: another person can move the patient’s limb into
strange positions that the patient will then maintain for extended
Inappropriate affect: emotional response are out of context (laugh at
someone’s death)
othey shift rapidly from one state to another for no discernible

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History of the Concept of Schizophrenia
Early Descriptions
formulated by Kraepelin and Bleuler
dementia praecox: early term for schizophrenia
he divided it into 2 major groups of endogenous or internally caused
omanic-depressive illness
odementia praecox
included dementia paranoids, catatonia, and hebephrenia
The DSM-IV-TR Diagnosis
Schizoaffective disorder: comprises a mixture of symptoms of
schizophrenia and mood disorders
Requires at least 6 months; at least 1 month of the active phase (the
presence of at least 2 of the following: delusions, hallucinations,
disorganized speech, grossly disorganized or catatonic behaviour and
negative symptoms)
oOnly 1 is required if delusions are bizarre or hallucinations consists
of commenting or arguing voices
Prodromal: before the active phase
Residual: after the active phase
Problems during prodormal and residual
oSocial withdrawal, impaired role functioning, blunted or
inappropriate affect, lack of initiative, vague and circumstantial
speech, impaired hygiene, grooming
oOdd beliefs or magical thinking and unusual perceptual
Schizophreniform disorder: acute schizophrenia DSMII
oSame as those of schizophrenia symptoms but lasts only from 1-6
Brief psychotic disorder: lasts from 1day to 1 months and usually
brought on by extreme stress
Delusional disorder: troubled persistent persecutory delusions or by
delusional jealousy, the unfounded conviction that a spouse or lover is
oSomatic delusions: believing some internal organ is
oDelusions of erotomania: believed that one is loved by some
other person (usually a complete stranger in higher status)
oA person with delusions disorder does not have disorganized speech
or hallucinations, and delusions are less bizarre
oIt is quite rare and begins later in life than schizophrenia
Categories of Schizophrenia is DSM-IV-TR
3 types of schizophrenic disorders in the DSM IV TR
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