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Chapter 13

Chapter 13

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Department
Psychology
Course
Psychology 2030A/B
Professor
Doug Hazlewood
Semester
Fall

Description
LECTURE 11 3/28/11 6:56 PM CHAPTER 13 Schizophrenia and Other Psychotic Disorders (464-499) SCHIZOPHRENIA the disorder characterized by a broad spectrum of cognitive and emotional dysfunctions including delusions and hallucinations, disorganized speech and behaviour, and inappropriate emotions Many live in poverty and unemployed 1 out of every 100 people experience it at some point in their lives NATURE OF SCHIZOPHRENIA AND PSYCHOSIS: AN OVERVIEW Schizophrenia vs. Psychosis oPsychosis broad term referring to hallucinations and/or delusion H sensory experiences in the absence of external events; can be either visual/auditory/sensation in the skin D irrational beliefs; beliefs that dont make sense Ex. If I stopped thinking about a certain thing world will collapse and everyone will die They are pervasive encompass their whole life Unstoppable doesnt matter how much you talk about them or how realistic they are still believe in them oSchizophrenia a type of psychosis with disturbed thought, language, emotion, and behavior DT thought process is not the same as ours When they are talking theyll be talking about something that doesnt make sense May never show emotion or may show inappropriate emotion Behaviour kind of bizarre; may not ever move Early ideas about Schizophrenia o Kraeplin He combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders Combinations of symptoms (catatonia, hebephrenia, & paranoia) = dementia praecox Catatonia alternating immobility and excited agitation Hebeprenia silly and immature emotionality Paranoia delusions of grandeur or persecution Schizophrenia believes this is going to happen to them Distinct from bipolar (dont have the ups and downs dont have manic nor do they have the depressive stage) as well - dementia praecox = an early age of onset and a poor outcome were characteristics Focused on the onset and outcomes What happens once it starts Is this person going to get better? Worse? Stay the same? oBleuler Introduced the term schizophrenia or associative splitting of the mind or personality Not associated with anything The label was significant b/c it signaled Bleulers departure from K on what he thought was the core problem Believe that underlying all the unusual behaviours shown by people with this disorder was an associative splitting of the basic functions of personality As well believed the difficulty keeping a consistent train of thought, characteristic of all persons with this disorder, led to the many and diverse symptoms they displayed Cognitive impairments Thoughts deficits in the way they think oMany of K & Bs ideas are still with us SCHIZOPHRENIA: THE POSITIVE SYMPTOM CLUSTER The positive symptoms Active manifestations oThings like hallucinations, delusions oGenerally include the more active manifestations of abnormal behaviour, such as D and H Delusions oA belief that would be seen by most members of a society as a misinterpretation of reality is called a disorder of thought or a delusion oGross misrepresentations of reality (delusions of grandeur, paranoia, persecution, Capgras syndrome, or Cotards syndrome) Delusion of grandeur Believing they are someone famous or important people Ex. Arthurs belief that he could end starvation for all the worlds children is also a DOG Delusion of persecution Belief that others are out to get them can be the most disturbing Ex. biker Capgras belief that a person, someone I know, has been replaced by a double Cotards may believe a part of your body has changed in an impossible way Ex. Brain now is six times bigger than it should be thinks it explains why they are so smart Delusion of grandeur beliefs that are unrealistic Believing they are famous or important people Jesus Christ Ex. Arthurs belief that he could end starvation for all the worlds children Delusion of persecution belief that others are out to get them can be the most disturbing Ex. Biker who thought competitors were trying to sabotage her Capgras belief that a person, someone I know, has been replaced by a double Ex. man thought his wife and daughter had been replaced by imposters Cotards may believe a part of your body has changed in an impossible way Ex. Brain now is six times bigger than it should be thinks it explains why they are so smart oEvent-related brain potentials smaller N400 Why do delusions persist in the face of contradictory information? One possible explanation is that the new info is NOT PROPERLY INTEGRATED Investigated this possibility in a sample of patients with S using event-related brain potential (ERP) A magnitude of a particular brain wave (N400) has been proposed as an index of integration of new info that is inconsistent with expectation Certain parts of the EMG that is picked up called N400 Number of these potentials react to what is happening in the environment Asked to decide if a series of words belong to the category animal Showed the word tree produce MORE N400 than compared to when shown the word cat Deficit in establishing new information* oPersist because new information not properly integrated Ex. Women told teacher she died 100000 times last night this is IMPOSSIBLE but she could not integrate this in her mind claimed God resurrected her oROBERTS those currently delusional have a stronger sense of purpose, less depression Hallucinations: can involve 5 senses oExperience of sensory events without environmental input oPpl with S these perceptions are very real and occur on a regular basis Hear voices when no one is around oPpl experience hallucinations more when they are unoccupied or restricted from sensory input oAuditory hallucinations (MOST COMMON) DSMIV only need a few symptoms to diagnosis individual Brain scans (left primary auditory cortex & right middle- temporal gyrus, Brocas (speech production) area, not Wernickes (speech understanding) = misinterpretation of own inner speech as that from someone else One theory is that when people are hallucinating they are in fact not hearing the voices of others, but are listening to their own thoughts or their own voices and cannot recognize the difference Tested a woman with S using fMRI while she was experiencing her auditory hallucination and when she was listening to external speech; compared her results to those of a matched control participant tested under the same conditions found that the auditory hallucinations were associated with increased metabolic activity in the left primary auditory cortex and in the right middle temporal gyrus BROCAS AND WERNICKES AREAS
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