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Stephanie Cassin

PSY240H1: Lecture #8 08/04/2011 00:39:00 Psychotic disorders -Symptoms Alterations in perceptions, thoughts, or consciousness o i.e. presence of delusions -DSM Categories Schizophrenia Delusional disorder Shared Brief Etc Substance-induced (induced by meds aka amphetamines) History of Schizophrenia -Kraeplin-dementia praecox (early onset intellectual decline that starts early in life; doesnt remit)talked about in 1898; focused on talking about descriptions but not subtypes/variations -Bleuler-schizophrenia1908: meant fragmented mind or split head Thought of it as multiple personality disorder Thought thinking problems were primary problem: people would have ideas but it would split off---couldnt keep a clear focus on thoughts Different prognosis for schizophrenia depending on people His son was the first person who did outcome study of shizophrenia 1200 ppl and tracked their prognosi25% people improved entirely and remained recovered; 50% fluctuations (lots of heterogeneity for people who have schizophrenia) o This is where group of schizophrenias came out: hard to characterize one thing as schizophrenia, different prognosis for ppl;; different subtypes etc -Best researched mental illness Schizophrenia Diagnosis -Two or more fo the following, significant portion of time during 1 month Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behaviour Negative symptoms: affective/flattening/lack of motivation/ not talking too much -1 symptom required in certain circumstances : bizarre delusions (realistically cannot happeni.e. all of their organs have been replaced but no scars in body), multiple voices conversing, running commentary (of their behaviour2 voices talking to one another: also only 1 symptom required) -Must cause significant dysfunction -Must last more than 6 months (acute symptoms and residual symptoms (left over symptoms that are not as severe that it was there during the active phase (i.e. not quite as fixed in their delusions) -Prevalence: 1% more prevalent of low SESSOCIAL selection/causation theory: LOWER SES w/ schizophrenia b/c used to be of high SES and lost $ etc OR low SES causes schizophrenia -EQUALLY in males and females happens earlier in males (15-24 yrs) vs. females (25-34 yrs) -Estrogen might bbe a protective factor in the development of schizophrenia -Has a high suicide rate10% of ppl commit suicide -Costly disorder---8% of hospital beds are devoted to ppl with schizophrenia Positive symptoms (type 1 symptoms) (type 2 symptoms=negative symptoms) -excess or distortion of normal functions and are usually present in the early stages of schizophrenias a person is first developing schizophrenia -2 dimensions: (neural mechanism differences and psychological differences) Psychotic: delusions, hallucinations Disorganized: thought/speech, behaviour Delusions -distortions in thought content: in beliefs and what their actual thoughts are -firmly held beliefs that a person has -usually involves some type of misperception (misinterpretation of experience) -bizarre (no way its possible) vs. non-bizarre (in theory can be true but no evidence to support that belief of the person persecutory: some1 is being tormented, spied on, tricked, ridiculed, etc (in reference to themselves) o most of the time non-bizarre o delusional disorder: fixed non-bizarre delusionotherwise life looks fairly normal (no disruption to life) referential: person believes that things like gestures, comments, passages from books, news reports are directed at them specifically (i.e. does it ever feel like people are sending messages to you? schizophrenic would feel like newscaster talking to them) grandiose: belief that you have special, magical powers, special relationships to people who are really high up somatic: beliefs that stranger removed organs but there are no scars; i.e. electricity going through veins being controlled : thoughts are being withdrawn from external force, people implanting thoughts in their head that are not hteir own, their thoughts are being broadcast (projected out onto a screen) Hallucinations (postive symptom) -Distortion in perception and can occur in any sensory modality: Auditory: most common; experienced as voices that are distinct from ones own thought; sometimes voices tell you to behave or feel certain ways (really minor or severe) Visual: seeing things that arent there
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