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PSYC 3082 Exam 4

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PSYC 3082
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PSYC 3082EXAM 4Chapter 12 Schizophrenia and Other Psychotic Disorderspg 450480I Perspectives on Schizophrenia Three types of symptoms 1 Positive delusions hallucinations 2 Negative the 4 As3 Disorganized disorganized speech and behavior schizophrenia devastating psychotic disorder that may involve characteristic disturbances in thinking delusions perception hallucinations speech emotions and behavior DSMIV Criteria 2 of following during a 1 month period with signs of disturbances for 6 months 1 symptom necessary if delusions are bizarre or hallucinations keep a running commentary 2 conversing voicesDelusionsHallucinationsDisorganized speechDisorganized behaviorNegative symptoms blunt affect Alogia or avolitionSocial or Occupational DysfunctionCant be due to another psychotic disorder another Axis I disorder general medical condition or substance A Early Figures in Diagnosing Schizophreniacatatonia disorder of movement involving immobility or excited agitation hebephrenia silly and immature emotionality a characteristic of some types of SZparanoiapeoples irrational beliefs that they are especially important delusions of grandeur or that other people are seeking to do them harm dementia praecox premature loss of mind an early label for what is now called SZ emphasizing the disorders frequent appearance during adolescence associative splitting separation among basic functions of human personality Ex cognition emotion and perception seen by some as the defining characteristic of SZB Identifying Symptoms II Clinical Description Symptoms and Subtypes psychotic behavior severe psychological disorder category characterized by hallucinations and loss of contact with reality A Positive Symptoms Positive symptoms move overt symptom such as delusion or hallucination displayed by some people with SZAKA Psychotic symptoms Positive vs negative symptoms of schizophrenia Presence of aberrant response 1 Delusionsdelusion psychotic symptom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality Idiosyncratic beliefs help despite preposterous nature disconfirming evidence Examples Delusions of grandeur think they are God chosen by God thought insertion mind reading Typically personal ie not shared by other members of the persons family or cultural groupMotivational views vs Deficit view2 Hallucinations Hallucination psychotic symptom of perceptual disturbance in which something is seen heard or otherwise sensed although not actually present Experience of sensory events without environmental input Usually auditoryPersistent usually distressing B Negative Symptoms negative symptoms less outgoing symptom such as flat affect or poverty of speech displayed by some people with SZIndicate absence of particular response Tend to be more stable than positive symptomsSpectrum of Negative Symptoms 1 Avolition apathy lack of initiation and persistence inability to initiate or persist in important activities2 Alogia relative absence of speech3 Anhedonia lack of interest or pleasure 4 Affective Flattening little expressed emotion when a reaction is expectedC Disorganized Symptoms 1 Disorganized Speech1PSYC 3082EXAM 4disorganized speech style of talking often seen in people with SZ involving coherence and lack of typical logic patterns Thinking disturbances bizarre behavior Thought DisturbancesDisorganized SpeechCognitive Slippage illogical and incoherent speech where person jumps from one topic to nextTangentially going off on tangent reply with irrelevant response rather than answering a question directly Loose Associations Derailment shifting topics abruptly Perseveration persistently repeating same thing over and overBizarreDisorganized Behavior Inappropriate affectCatatonia spectrum from wild agitation to immobility 2 Inappropriate Affect and Disorganized Behavior inappropriate affect emotional display that is improper for situation catatonic immobility disturbance of motor behavior in which the person remains motionless sometimes in an awkward posture for extended periods D Schizophrenia SubtypesSchizophrenia vs Schizoaffective disorder Types of Schizophrenia residual disorganized etc Like most disorders schizophrenia defined by a variety of symptomsFew disorders show the breadth of symptoms seen in schizophrenia Attempts to reduce heterogeneity Subtypes as follows 1 Paranoid Type intact cognitive skills and affect do not show disorganized behavior hallucinations and delusions grandeur persecution the best prognosis of all types of schizophrenia 2 Disorganized Type disorganized speech behavior and flat or inappropriate affect all 3 must be present Hallucinations and delusions if present tend to be fragmented 3 Catatonic Type motor immobility or excessive purposeless activity tends to be severe and quite rare 4 Undifferentiated Type symptomatic but do not fit into other categoriescategory for individuals who meet criteria for SZ but not one of defined subtypes 5 Residual Type partial remission no longer have active psychotic symptoms but show subclinical or negative symptoms E Other Psychotic Disorders1 Schizophreniform Disordersschizophreniform disorder psychotic disorder involving the symptoms of SZ but lasting less than 6 months 2 Schizoaffective DisorderSchizoaffective disorder psychotic disorder featuring symptoms of both SZ and major mood disorder Uninterrupted period of illness during which at some point there is either a MDE Mania or Mixed Episode concurrent with Schizophrenia symptoms During which there have been delusions or hallucinations for 2weeks in absence of mood symptoms Mood symptoms present for substantial portion of total duration of active and residual periods Based on observation of high comorbidity between mood disorders and schizophrenia How to distinguish schizoaffective from comorbid depression mania and schizophreniaSchizophrenia symptoms occur outside of mood episode 3 Delusional Disorderdelusional disorder psychotic disorder featuring a persistent belief contrary to reality delusion but no other symptoms of SZNonbizarre delusions ie beliefs about situations that could occur in real life for 1months Lack other positive or negative symptoms Common delusions subtypesErotomanic person higher status in love with patient Grandiose inflated worth power etcJealous patients partner unfaithfulPersecutory patient being malevolently treatedSomatic physical defect medical condition 4 Brief Psychotic DisorderBrief psychotic disorder psychotic disturbance involving delusions hallucinations or disorganized speech or behavior but lasting less than 1 month often occurs in reaction to a stressor One or more positive symptoms of schizophrenia that last at least 1 day and1 monthUsually precipitated by extreme stress or traumaLong term outcome good rare and under researched 5 Shared Psychotic Disorder shared psychotic disorder psychotic disturbance in which individuals develop a delusion similar to that of a person with whom they share a close relationship schizotypal personality disorder cluster A odd or eccentric personality disorder involving a pervasive pattern of interpersonal deficits featuring acute discomfort with and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior Schizotypal personality disorder vs schizophrenia III Prevalence and Causes of Schizophrenia 2
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