PSYC 235 Chapter Notes - Chapter 13: Echopraxia, Eugen Bleuler, Catatonia

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7 Apr 2015
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Chapter 13- Schizophrenia and Other Psychotic Disorders
- Schizophrenia: broad spectrum of cognitive and emotional dysunctions including
delusions and hallucinations, disorganized speech and behaviour, and
inappropriate emotions
-Affects almost every aspect of daily functioning  perception, thought, movement,
speech
-Complete recovery is rare
Perspectives on the Concept of Schizophrenia
Early Figures in Diagnosing Schizophrenia
-Kraepelin  most accurate definition of schizophrenia
oCombined symptoms of multiple disorders to define schizophrenia as one
disorder:
Catatonia: alternating immobility and excited agitation
Hebephrenia: silly and immature emotionality
Paranoia: delusions of grandeur or persecution
All three combined into the term “dementia praecox”  later termed
schizophrenia
odifferentiated schizophrenia from bipolar disorder
oIdentified numerous symptoms of schizophrenia
-Bleuler
oChanged term from “dementia praecox” to “schizophrenia”
oRealized schizophrenia was an associative splitting of the basic functions
of personality (destruction of the forces that connect one function to the
next). Also discovered schizophrenics have difficulty keeping a consistent
train of thought
Identifying Symptoms
-not all schizophrenics share the same behaviours or symptoms
Clinical Description
- Psychotic: unusual behaviours (delusions, hallucinations)
-Diagnosis requires that 2 or more positive, negative, or disorganized symptoms be
present for at least one month
- Positive Symptoms: excess or distortion of normal behaviour (delusions and
hallucinations)
o50-70% of schizophrenic people display these symptoms
oDelusions: misinterpretations of reality.
delusions of grandeur, delusions of persecution
Cotard’s Syndrome: belief that part of body has changed in an
impossible way (ex. The brain)
Capgras Syndrome: belief that a known person has been replaced
by a double
People with schizophrenia produce smaller N400 brain waves to
target words that are inconsistent with the category being discussed
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(aka have more difficulty understanding what is
appropriate/making connections)
Those with strong delusions often have a strong sense of purpose
in life and little depression
oHallucinations
Auditory hallucinations are the most common
Hallucinations experienced more frequently when patient is
alone/not taking in any sensory input (ex. Not watching/listening to
anything)
- Negative Symptoms: deficits in normal behaviour such as speech and
motivation, social withdrawal, apathy
o25% of schizophrenic people display these symptoms
oAvolition/Apathy: inability to initiate and persist in activities
oAlogia: absence of speech. Short replies, delayed responses
oAnhedonia: lack of pleasure
oAffective Flattening: reacting externally in an unemotional manner
(vacant expression, toneless voice), though may be reacting emotionally
internally
oAsociality: little interest in socializing, poor social skills, few friendships
- Disorganized Symptoms: erratic behaviours, rambling speech, inappropriate
affect
oDisorganized speech: jump from topic to topic or talk illogically.
Tangentiality: going off on a tangent instead of answering a
specific question
Derailment/loose association: changing the topic to unrelated areas
schizophrenics rarely realize that they have a problem, so difficult
to get them to talk about their problems
oInappropriate Affect and Disorganized Behaviour
Disorganized behaviour: hoarding objects or acting in usual ways
in public.
May range ranges from wild agitation to immobility (catatonia).
Catatonic immobility = holding unusual posture for fear of
something terrible happening if they move
- Schizophrenia Subtypes:
o3 subtypes: paranoid, disorganized, catatonic. Note that a patient can come
from one subtype to another over the course of their illness
oParanoid Type: delusions and hallucinations. Usually around a central
theme.
oDisorganized Type: disruption in speech and behaviour, inappropriate
affect, vey self-absorbed. If delusions/hallucinations present, are not
around a central theme, but rather disorganized.
oCatatonic Type: remain fixed in positions, engage in excessive activity,
display odd mannerisms with bodies and faces, mimic words of others
(acholalia) or movement of others (echopraxia)
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