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Chapter 11

Chapter 11: Schizophrenia.docx

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Konstantine Zakzanis

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Chapter 11 Schizophrenia - Psychotic disorder characterized by major disturbances in thought, emotion, & behavior: disordered thinking in which ideas aer not logically related, faulty perception & attention, flat or inappropriate affect, & bizarre disturbances in motor activity Positive Symptoms Disorganized Speech  Loose Associations or Derailment Person may be successful in communication but has difficulty stick to one topic May drift off train on train of associations evoked by an idea from the past Delusions Beliefs held contrary to reality - May be unwilling recipient of bodily sensation or thoughts imposed by an external agency - People may believe that their thoughts are broadcasted/transmitted, so others know what they are thinking - People may think their thoughts are being stolen from them by an external force - Some people believe their feelings are controlled by an external force - Some people believe that their Chapter 11 behavior is controlled by an external force - Some people believe that impulses to behave in certain ways are imposed by some external force Hallucinations Sensory experiences in the absence of any stimulation from the environment, may be important diagnostically - May report hearing their own thoughts spoken by another voice - May claim that they hear voices arguing - May hear voices commenting on behavior Negative Symptoms Avolition Apathy Lack of energy & seeming absence of interest in or an inability to persist in usually routine activities - May become inattentive to grooming & personal hygiene - Difficulty persisting in occupation or education Alogia Poverty of speech: amount is greatly reduced Poverty of content of speech: amount is adequate but conveys little info, Chapter 11 tends to be vague & repetitive Anhedonia Inability to experience pleasure Flat Affect Virtually no stimulus can elicit an emotional response - Flat, toneless voice - Not referring to inner experience (which may not be impoverished at all) Asociality Severely impaired social relationships - Few friends - Poor social skills - Little interest in being with others Other Symptoms Catatona Defined by several motor abnormalities - Gesturing repeatedly, using peculiar (maybe complex) sequence of extremities that often seem purposeful - May manifest in unusual increase in overall level of activity (wild flailing limb Catatonic Immobility Adopting unusual postures & maintain them for very long periods of time  Waxy flexibility Another person can move person’s limbs into strange positions that they maintain for extended periods Chapter 11 Inappropriate Affect Emotional responses of individuals are out of context Likely to shift rapidly from one emotional state to another for no discernible reason DSM-IV-TR Diagnosis 1. 6 months of disturbance a. One month active period: defined by 2 of following i. Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior b. Remaining time of prodromal (before active phase) or residual (after active phase) i. Negative symptoms (only one required if delusions are bizarre or hallucinations consist of voices arguing or commenting) ii. Includes: social withdrawal, impaired role functioning,
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