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Chapter 10

Management and Organizational Studies 4410A/B Chapter Notes - Chapter 10: Synaptic Pruning, Neural Development, Etiology


Department
Management and Organizational Studies
Course Code
MOS 4410A/B
Professor
David Vollick
Chapter
10

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Chapter 10 – Schizophrenia spectrum and other psychotic disorders
Psychotic Disorders
Psychotic disorders – unusual thinking, distorted perceptions, and odd behaviour
oOut of touch with reality
oUnable to think in a logical or coherent manner
oTalking or mumbling to their self
Psychosis – severe mental condition characterized by a loss of contact with reality
Delusion – false belief (ex. Being spied on)
Hallucination – false sensory perception (ex. Seeing cartoon characters when they aren’t there)
oHaving delusions or hallucination alone doesn’t mean the person has a psychotic disorder
oThese symptoms can occur in other psychological disorders – bipolar, depression, PTSD,
substance- abuse, autism, OCD ect.
oThese symptoms can also occur in people with physical illnesses – brain tumors, neurocognitive
disorder from Alzheimer’s, Parkinsons, after any physical damage to brain, or exposure to toxins
oThese symptoms can occur with no psychological disorder – brief or limited (2-12% of adults)
oDifference is that people with a psychotic disorder hear voices as negative and are not in control
What is Schizophrenia?
Schizophrenia – disorganization in thought, perceptions, and behaviour
oDo not think logically, perceive the world inaccurately, and behave in a way that permits normal
everyday life and work
oSchizophrenia is a severe mental disorder because the condition creates severe impairment and is
often chronic
Emil Kreapelin and Eugen Bleuler – first defined Schizophrenia over 100 years ago
oKreapelin – “dementia praecox”
Dementia – pervasive disturbances of perceptual and cognitive facilities
Praecox – early life onset
oBleuler – 4 symptoms of the disorder
Ambivalence
Disturbances of affect
Disturbances of association
Preference for fantasy over reality
He renamed it to Schizophrenia – split (schizo) and mind (phrene)  to highlight
splitting of thought, affect, and behaviour
Misconceptions
oLack of understanding has led to many inaccurate media and literary portrayals of Schizophrenia
oThe strange case of Dr. Jekyll and Mr. Hyde (Robert Louis Stevenson) – 2 contradictory
personalities
Jekyll – sensitive and kind
Hyde – violent murderer
People with Schizophrenia DO NOT have split personality, the split is between an
individual’s thoughts and feelings – 2/3 of people believe that split personality is a part of
Schizophrenia
oThe Three Faces of Eve and Sybil – one personality may be unaware of the other’s behaviour.
Each personality perceives, deals with, and interacts with the environment successfully

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People with Schizophrenia DO NOT have multiple personalities, dissociative identity
disorder (DID) does
Schizophrenia in Depth
Positive symptoms – presence of abnormal behaviour within the individual
oUnusual thoughts, feelings, and behaviour
oPresence of delusions – fixed beliefs that are not changeable when presented with conflicting
evidence
oTypes of delusions:
Persecutory delusions – most common
Belief that someone is harming or attempting to harm the person
Delusions of influence – beliefs that other control ones behaviour or thoughts
Thought withdrawal
Thought broadcasting – believes that their private thoughts are being revealed
Thought insertion – believes that the government or evil forces are inserting
thoughts into their head
Self-significance – thoughts of grandeur
Reference (random events, objects, and behaviours of others have a particular and
unusual significance to oneself)
Religion (believing that one is a supreme being)
Guilt or sin
Somatic - belief that one’s body is rotting away
oPresence of Hallucinations – perception-like experience without an external stimulus (ex.
Hearing voices, seeing visions that no one else sees)
oTypes of hallucinations:
Auditory – most common
Range from simple noises to one or more voices
Most commonly negative but sometimes comforting or kind
Exclusive – voices that keep a running commentary on the individual’s behaviour
or several voices that have a conversation
Visual – less common, often in those who are severe
Seeing the devil or a dead relative or a friend
Tactile – touch
Olfactory – smells
Gustatory – Taste
Somatic – feelings of pain or deterioration of parts of ones body or feeling that thins are
crawling on, or in, the skin or the body
oDisorganized thinking – usually assessed by abnormality of speech that indicate deterioration in
their cognitive functioning
oTypes of cognitive deterioration:
Loose associations – thoughts that have little or no logical connection to the next
Thought blocking – unusually long pauses in their speech
Clang association – speech is governed by words that sound alike, rather than meaning
oCatatonia – a person is awake but nonresponsive to external stimulation
The person may not move or make eye contact with others
They may be mute or muscularly rigid (statue)
Waxy flexibility – parts of the body remain frozen when positioned that way by another
person

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Negative symptoms – absence of behaviours that exist in the general population
oBehaviours, emotions, or thought processes that exist in people without Schizophrenia
oDiminished emotional expression – Reduced or immobile facial expressions and monotonic
vocal tone that does not change
This is what leads people to believe they have split personalities
oAnhedonia – lack of capacity for pleasure, person feels no joy or happiness
oAvolition – or apathy – Inability to initiate or follow through on plans
oAlogia – decreased quality or quantity of speech
oPsychomotor retardation – slow mental or physical activities
oNegative symptoms are treatment-resistant, they persist and restrict a persons ability for
everyday functions
Cognitive Impairments – impairments in visual and verbal learning, memory, inability to pay attention,
decreased speed of information processing, and impaired abstract reasoning and executive functioning
oLike negative symptoms, cognitive deficits are long-lasting and strongly correlated with
functional impairment
oSocial Cognition – ability of perceive, interpret, and understand social information including
other people’s beliefs, attitudes, and emotions
They normally have deficits in basic skills necessary for positive social interaction
Comorbidity
Additional psychological disorders
oDepression affects as many as 45% of people with Schizophrenia
oApprox. 5% commit suicide
oFactors that increase the likelihood of self-harm: depressed mood, drug abuse, agitation or
restlessness, fear of mental deterioration, or delusions or hallucinations
o47% of people with Schizophrenia also have anxiety disorders
o43% of people with Schizophrenia have PTSD
o50% have substance-related disorders
89% alcohol
27% marijuana
13% Benzodiazepines
Self-Medication hypothesis: the use of a substance by people with Schizophrenia is a strategy to cope
with or escape from negative symptoms such as the inability to feel pleasure
Functional Impairment
Positive correlation between severity of symptoms of Schizophrenia and the degree the symptoms
impair the person’s ability to function.
Delay in treatment increases severity of functional impairment – treatment should begin as soon as
possible to limit the chronic nature
Schizophrenia is considered 1 out of 10 most debilitating conditions in terms of disability-adjusted life
years
Over 100 years ago, Kreapelin and Bleuler considered Schizophrenia to have a progressively
deteriorating course with little or no change of recovery
1960’s effective treatment for positive symptoms (hallucinations and delusions) may have periods of
remission and relapse
25% of all psychiatric hospital beds were occupied by patients with Schizophrenia
oEstimated cost was $62.7 billion
20% adults had a good outcome – released after 2-12 years
o78% had a relapse
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