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Chapter 11

PSYB32 Chapter 11 Notes.docx

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Konstantine Zakzanis

Abnormal Psychology Textbook Notes Chapter 11 SchizophreniaIntroDiagnosis ofhas existed for over a century More research than any other psych problemLifetime prevalence of all psychotic disorders3Prevalence for schizophrenia is 1Real variation across geographic areas Asian popns have lowest prevalenceSignificantly more likely in malesSometimes begins in childhood but usually appears in late teensearly adulthoodAbout 13 of those with a schizophreniaspectrum disorder schizophrenia related disorders related PDs etc are early onsetBegins a bit earlier for men than for women10 of those withcommit suicide50 withhave a comorbid disorder including many having depression anxietyMany also have substance abuse mainly in male schizophrenicsComorbidity with OCD is related to a previous history of suicide ideationattemptsPTSD is also highly prevalent and underdiagnosed among military veteran schizophrenics Clinical Symptoms of SchizophreniaThere are no essential symptoms out of the huge list so schizophrenics are heterogeneous Positive SymptomsExcessesdistortions such as disorganized speech hallucinations delusionsThese define acute episodesDisorganized speech formally known as thought disorder o Incoherence person may make repeated refs to a central theme fragments are too disconnected to understando Loose associationsderailment difficulty sticking to one topic drifting off on a train of associations This is similar to loose associations of manic people o Disturbances in speech were once regarded as principal symptom of Delusions o Beliefs held contrary to reality o persecutory delusions are common o over half of those with have delusions o delusions are also found in mania delusional depression and other disorders o however delusions in schizophrenics are often more bizarre and impossibleHallucinations and other disorders of perception o World feels different or unreal depersonalization o Difficulty paying attention to goings on around you o Common auditory hallucinations that happen more often inthan other diagnosesHearing voices arguingHearing own thoughts spoken by another voiceHearing a voice commenting on own behv Negative SymptomsBehavioural deficits that tend to endure beyond acute deficitsStrong predictor of poor quality of lifeAssociated with earlier onset brain damage enlarged ventricles and progressive loss of cog skills IQ declineImportant to distinguish negative symptoms that are really offrom those due to other factors like side effect of meds or from depressionAvolition lack of energy or interest or inability to persist in what are usually routine activitiesAlogia a negative thought disorder that can take several forms o Poverty of speech little info vague repetitive poverty of content Notof wordsAnhedonia inability to experience pleasureFlat Affect virtually no stimulus can elicit an emotional response o Found in majority of people witho Vacant stare muscles of face flaccid eyes lifeless o Only the outward expression inwardly they may not be impoverished at allReport same amount of emotion just less facially expressiveAsociality severly impaired social relationshipso Few friends poor social skills little interest in being with people shy o More childhood social troubles are an early indicator o Deficits in recognizing emotional cues displayed by others Other Symptoms that are neither Positive or NegativeCatatonia motor abnormalities like gesturing repeatedly flailing limbs or catatonic immobility maintaining an unusual posture for extended amounts of time These people may also have waxy flexibility where they can be moved into different positionsInappropriate affect emotional responses that are out of context shifting rapidly in emotions for no discernible reason Both of these symptoms are very rare but also fairly unique toHistory and Concept of SchizophreniaFirst discovered by Emil Kraplin and Eugen Bleuler
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