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Ch11 Textbook Notes

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University of Toronto St. George

CHAPTER 11 SCHIZOPHRENIA psychosis inability to differentiate between what is real and what is unrealone of the most common psychotic disorder is schizophreniaover 90 of people with schizophrenia seek treatment in a mentalhealth facility or general medical facility in any given yearin Canada annual direct health care and nonhealthcare 202 billion 2004with productivity loss factored in 685 billionmost develop in late teenage or early adult yearstends to be a lifelong disorderlifetime prevalence of 052 of schizophreniaspectrum disorder th one of the most stigmatized disorders lepers of the 20 centuryhigher incidence among immigrants than nativeborn populationsmay be more common in men varies among studiesonset in women tends to be later in life late 20s or early 30sshow fewer cognitive deficits particularly in verbal processingSymptoms Diagnosis and Prognosis of SchizophreniaSymptomspositive symptoms type I symptoms are characterized by the presence of unusual perceptions thoughts or behavioursnegative symptoms type II symptoms represent losses or deficits in certain domainsPositive Symptoms Delusionsideas that an individual believes are true but are highly unlikely and often impossibledifferences from selfdeceptions eg winning the lotteryselfdeceptions are not completely implausiblepeople harbouring delusions tend to be preoccupied with themlook for evidence in support of beliefs attempt to convince others take actions based on beliefspeople holding delusions are highly resistant to argument or facts contradicting their delusionscommon types of delusionspersecutory delusion belief that they are being watched or tormenteddelusion of reference belief that random events or comments are directed at themgrandiose delusions beliefs that one is a special person or being or possesses special powersdelusions of being controlledthought broadcasting belief that ones thoughts are being broadcast from ones mind for others to hearthought insertion belief that another personobject is inserting thoughtsthought withdrawal belief that personobject is removing thoughtsdelusions of guilt or sin belief that one has committed or is responsible for a terrible actsomatic delusions belief that ones appearance or part of ones body is diseasedalteredcontent of delusions differ across cultureseg whites fear their government is altering themdelusions of being slandered by others are relatively common in Japanreligious delusions are relatively common in Germany and Austriasome theorists argue that oddimpossible beliefs that are part of a cultures shared belief system cant be considered delusions when they are held by individuals in that cultureHallucinationsunreal perceptual experiencesauditory hallucination is the most common more common in womenvisual hallucination is the second most common often accompanied by auditory hallucinationstactile hallucinations involve the perception that something is happening to the outside of ones body eg bugs crawling up ones backsomatic hallucinations involve the perception that something is happening inside ones bodycontent may be culture specificDisorganized Thought and Speechformal thought disorder refers to the disorganized thinking of people with schizophrenialoosening of associations tendency to slip from one topic to a seemingly unrelated topicmay answer questions with comments barely related to questionsspeech may be totally incoherent to listener word saladneologisms making up words that mean something only to himherclangs making associations between words based on sounds of the wordsperseverate saying the same wordstatement over and over againmay be tied to fundamental deficits in cognition and attentionshow deficits in smooth pursuit eye movement eye trackingshow deficits in working memory capacity to hold and manipulate information in memorymake it difficult to suppress unwantedirrelevant information or pay attention to relevant informationmen tend to show more severe deficits in languagepossible because language is controlled more bilaterally in womenDisorganized or Catatonic Behaviourmay display unpredictable and seemingly untriggered agitationmay engage in socially unacceptable behaviourmay appear dishevelled and dirtycatatonia disorganized behaviours that reflect lack of responsiveness to outside worldcatatonic excitement person becomes wildly agitated for no apparent reason and is difficult to subdueNegative Symptomscan be difficult to diagnose
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