PSY353 Chapter Notes - Chapter 13-15: Dementia Praecox, Eugen Bleuler, Psychosis
CH 13 – SCHIZOPHRENIA SPECTRUM AND PSYCHOTIC DISORDERS
PERSPECTIVES ON SCHIZOPHRENIA
Schizophrenia – disorder characterised by a broad spectrum of cognitive and emotional dysfunctions
• Delusions
• Hallucinations
• Disorganised speech and behaviour
• Inappropriate emotions
Society often devalues people with schizophrenia
• More likely to be stigmatised and discriminated against
Emotional and financial toll
• Annual cost of schizophrenia in US → exceeds 60 billion
Approximately 1 in every 100 people at some point in their lives are effected by schizophrenia
Questio hat is schizophrenia has ot ee aseed
EARLY FIGURES IN DIAGNOSING SCHIOZPHRENIA
John Haslam 1809 → Wrote Observations on madness and melancholy
• Described a form of insanity that informs current conception of schizophrenia
Philippe Pine 1801/1809 → writing about people we now would describe as having schizophrenia
Benedict Morel 1852→ Demence (French word for loss of mind) and precoce (early/premature because onset of
schizophrenia is often during adolescence)
Emil Kraepelin 1898/1899→ 2 of his accomplishments are important:
1. Combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct
disorders: catatonia (alternating immobility and excited agitation), hebephrenia (silly and immature
emotionality) and paranoia (delusions of grandeur or persecution)
Kraepelin thought these symptoms shared similar underling features and included them under Latin term Dementia
Praecox
Early onset at the heart of eah disode deelops ito etal eakess
2. Distinguished dementia praecox from manic-depressive illness (bipolar)
In dementia praecox → eal age of oset ad poo outoe ee haateisti its ot eessa fo ipola
Eugen Bleuler 1908 → introduced term schizophrenia
• Means split mind in Greek
• Underlying all unusual behaviours shown by people with this disorder was an associative splitting of basic
functions of personality
• Highlighted universal underlying problem whereas Kraepelin focused on early onset and poor outcomes
• Split mind → inspired common but incorrect use of schizophrenia to mean split/multiple personality
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IDENTIFYING SYMTOMS
• “hizopheia is a age of ehaious/sptos that aet eessail shaed all people ho are
schizophrenic
• Cluster of symptoms that make up disorder
CLINICAL DESCRIPTION, SYMPTOMS AND SUBTYPES
Psychotic behaviour – characterises many unusual behaviours
• Delusions (irrational beliefs)
• Hallucinations (sensory experiences in the absence of external events)
Evidence of violence among people with schizophrenia suggests that although they may be more likely to commit
violent acts than general population, traits such as anger and antisocial personality are better predictors of violence
than psychosis
Diagnosis of schizophrenia requires that 2 or more positive, negative and/or disorganised symptoms be present for
at least 1 month
• At least one symptom including delusions, hallucinations or disorganised speech
Positive symptoms – refer to symptoms around distorted reality
Negative symptoms – involve deficits in normal behaviour (e.g. lack of emotion reactivity)
Disorganised symptoms – rambling speech, erratic behaviour and inappropriate affect
POSITIVE SYMPTOM
• More obvious signs of psychosis
• Involves disturbing experiences of delusions and hallucinations
• 50-70% of people with schizophrenia experience hallucinations, delusions or both
Delusions (disorder of thought content) – belief that would be seen by most members of society as a
misrepresentation of reality
• Basic characteristic of madness
• Delusion of grandeur – mistaken belief that the person is famous or powerful
• Common delusion → people are out to get them → delusions of persecution
• Capgras syndrome – person believes someone they know has been replaced by a double
• Cotads sdoe – person believes they are dead
2 theories explain why people believe delusions:
1. Motivation (motivational view of delusions) – beliefs as attempts to deal with and relieve anxiety and stress
2. Deficit (deficit view of delusions) – beliefs as resulting from brain dysfunction that creates these disordered
cognitions or perceptions
Hallucination – experience of sensory events without any input from the surrounding environment
• Common hallucination (70%) → auditory hallucination – heaig thigs that aet thee
• Hallucinations related to metacognition → people who experience hallucinations appear to have intrusive
thoughts but they believe they are coming from somewhere or someone else
• Meta-worry – worrying about worrying
• Meta-worry linked to increased anxiety and depression symptoms
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• Bai ost atie duig halluiatios as Boas aea ioled i speeh podutio → people with
auditory hallucinations are listening to their own thoughts/voices and cannot recognise it → poor emotional
prosody comphrension
• Emotional prosody is deficient in people with auditory verbal hallucinations (prosody – aspect of language
that communicates meaning and emotion through pitch, amplitude, pauses etc (e.g. hungry?))
• Weikles area (language comprehension)
NEGATIVE SYMPTOMS
• Usually indicate absence or insufficiency of normal behaviour
• Apathy
• Poverty (limited) of thought or speech
• Emotional and social withdrawal
• 25% of people with schizophrenia display these symptoms
Avolition – inability to initiate and persist in activities
• Also known as apathy
• Little interest in performing most basic everyday functions
Alogia – refers to relative absence of speech
• Respond with brief replies or may seem uninterested in taking
• Reflects a negative thought disorder rather than inadequate communication skills
• People with alogia might have trouble finding the right words to formulate their thoughts
• Alogia can take form of delayed comments or slow responses
Anhedonia – presumed lack of pleasure in activities (e.g. eating, social interaction, sex)
Asociality – lack of interest in social interactions
• Can worsen by limited opportunities to interact with others
Affective flattening – lack of emotional reactivity (like a person wearing a mask)
• Howard Berenbaum and Thomas Oltmanns → people with flat affect showed little change in facial
expression but reported experiencing the appropriate emotions when watching comedy film
• Flat affect may reflect difficulty expressing emotion, not a lack of feeling
• Children who later went on to develop schizophrenia typically displayed less positive and more negative
affect than those children who did not develop disorder → emotional expression may be one way to identify
potential schizophrenia in children
DISORGANISED SYMPTOMS
• Least studied and understood
• Variety of erratic behaviour that affect speech, motor behaviour and emotional reactions
• Prevalence is unclear in schizophrenia
Disorganised speech – communication problems such as:
• People with schizophrenia lack insight (awareness that they have problem) → makes conversations tricky
• Experience associative splitting and cognitive slippage → speech problems, such as jumping from topic to
topic or talking illogically
Inappropriate affect – laughing or crying at inappropriate times
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find more resources at oneclass.com
Document Summary
Ch 13 schizophrenia spectrum and psychotic disorders. Schizophrenia disorder characterised by a broad spectrum of cognitive and emotional dysfunctions: delusions, hallucinations, disorganised speech and behaviour. Society often devalues people with schizophrenia: more likely to be stigmatised and discriminated against. Emotional and financial toll: annual cost of schizophrenia in us exceeds 60 billion. Approximately 1 in every 100 people at some point in their lives are effected by schizophrenia. Questio(cid:374) (cid:858)(cid:449)hat is schizophrenia(cid:859) has (cid:374)ot (cid:271)ee(cid:374) a(cid:374)s(cid:449)e(cid:396)ed. John haslam 1809 wrote observations on madness and melancholy: described a form of insanity that informs current conception of schizophrenia. Philippe pine 1801/1809 writing about people we now would describe as having schizophrenia. Benedict morel 1852 demence (french word for loss of mind) and precoce (early/premature because onset of schizophrenia is often during adolescence) Kraepelin thought these symptoms shared similar underling features and included them under latin term dementia.
