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Chapter 14

PSYC 1200 Chapter 14: Chapter 14 - Symptoms

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PSYC 1200
Dawson Clary

General Symptoms: Delusions and irrational thought  Thinking can be bizarre    Disturbed, irrational thought processes are the central feature  Delusions are false beliefs that are maintained even though they clearly are out of  touch with reality  Delusions of grandeur: people maintain that they are famous or important    Persons train of thought deteriorates  Thinking becomes chaotic, rather than logical and linear   Loosing of associations as people shift topics in disjointed ways Deterioration of adaptive behaviour  Deterioration of the quality of the persons routine functioning in work, social relationships, and personal care Hallucinations  Perceptual distortions    Most common being auditory hallucinations  Hallucinations are sensory perceptions that occur in the absence of a real,  external stimulus or are gross distortions of perceptual input  They hear voices of nonexistent or absent people talking to them Disturbed emotions  Normal emotional tone can be disrupted    Little emotional responsiveness – blunted or flat affect  Inappropriate emotional responses that don’t fit the situation or with what they are saying Subtypes, Course, and Outcome: 4 subtypes: Paranoid type:  Paranoid schizophrenia is dominated by delusions of persecution, along with delusions of grandeur oSDP  People come to believe that they have many enemies who want to harass and oppress them   Convinced they are being watched and manipulated in malicious ways Catatonic type:   Catatonic schizophrenia is marked by striking motor disturbances, ranging from muscular rigidity to random motor activity   Extreme form of withdrawal known as catatonic stupor o Virtually motionless and seem oblivious to the environment around them for long periods of time   Others go into catatonic excitement o Hyperactive and incoherent   Alternate between then extremes  Catatonic type is not common and seems to be declining Disorganized type:  In disorganized schizophrenia, a particularly severe deterioration of adaptive behaviour is seen    Symptoms: emotional indifference, incoherence, social withdrawal  Aimless babbling and giggling are common   Delusions often center on bodily functions (brain melting for example) ndifferentiated type:  People who cannot be placed into any of the three previous categories   Undifferentiated schizophrenia is marked by idiosyncratic mixtures of schizophrenic symptoms   Fairly common Positive versus negative symptoms:  There aren’t meaningful difference between the subtypes in etiology, prognosis, or  response to treatment  Andreasen: alternative approach to sub-typing   Two categories based on predominance of negative versus positive symptoms   Negative symptoms involve behavioural deficits, such as flattened emotions, social withdrawal, apathy, impaired attention, and poverty of speech   Positive symptoms involve behavioural excesses or peculiarities, such as hallucinations, delusions, bizarre behaviour, and wild flights of ideas   Most patients exhibit both types of symptoms are vary only in the degree to which positive or negative symptoms dominate Course and outcome: OcSD   Emerge during adolescence or early adulthood  Long history of particular behaviour, along with cognitive and social deficits,  although most do not manifest full psychological disorder during childhood  Usually gradual   People with schizophrenia tend to fall into 3 groups: o Milder disorders treated successfully and enjoy a full recovery o Partial recovery so that they can return to independent living for a time – regular relapses over the remainder of their lives o Chronic illness marked by relentless deterioration and extensive hospitalization Etiology of Schizophrenia: Genetic vulnerability:   Hereditary factors play a role in the development   Twin studies prove this  Child born with two schizophrenic parents has 46% chance at developing   Some people inherit a poly-genically transmitted vulnerability to schizophrenia Neuro-chemical factors:   Accompanied by changes in the activity of one or more neurotransmitters in the  brain  Excess dopamine activity has been implicated as a possible cause   Most of the drugs that are useful in the treatment are known to dampen dopamine activity   Dysfunction in neural circuits using glutamate play a role in schizophrenia   Marijuana use during adolescence may help to precipitate schizophrenia in young people who have genetic vulnerability to the disorder   Key chemical ingredient in marijuana (THC) may increase neurotransmitter activity in dopamine circuits in certain areas of the brain Structural abnormalities in the brain:  Schizophrenia exhibit a variety of deficits in attention, perception and information processing    Impairments in working (short term) memory are prominent  Disorder may be caused by neurological defects   CT scans and MRI scans suggest an association between enlarged brain  ventricles and this disorder  Enlarged ventricles are assumed to reflect the degeneration of nearby brain tissue   Could be the consequence or the cause of schizophrenia oSDP   Reductions in both grey matter and white matter in specific brain regions  Reflect losses of synaptic density and myelinization   Schizophrenia is caused by disruptions in the brains neural connectivity, which impairs the normal communication among neural circuits The neurodevelopmental hypothesis:  Caused in part of various disruptions in the normal maturational processes of the brain before or at birth   Insults to the brain at sensitive phases of prenatal development or during birth can cause subtle neurological damage that elevates individuals vulnerability to schizophrenia years later in adolescence and early adulthood   Severe maternal stress   Minor physical abnormalities consistent with prenatal neurological damage are more common among people with schizophrenia than others Expressed emotion:   Family dynamics influences the course of illness after the onset of the disorder  Expressed emotion (EE) is the degree to which a relative of a schizophrenic patient displays highly critical or emotionally over involved attitudes toward the patient   Family high in expressed emotion show relapse rates about three times that of patients who return to a family low in expressed emotion   Families re probably more sources of stress than of social support Precipitating stress:   Stress plays a key role in triggering schizophrenic disorders  Stress can also trigger relapses in patients who have made progress toward recovery     Personality Disorders:  Personality disorders are a class of disorders marked by extreme, inflexible personality traits that cause subjective distress or impaired social and occupational  functioning  Emerge during late childhood or adolescence and often continue  throughout adulthood  Some personality disorders are mild versions of more severe axis I disorders   3 clusters of personality disorders: o Anxious/fearful – maladaptive efforts to control anxiety and fear about social rejection    Avoidant personality disorder   Dependent personality disorder oSDP   Obsessive-compulsive personality disorder o Odd/eccentric – distrustful, socially aloof, and unable to connect with othe
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