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Chapter Eleven.docx

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PSYC 3140
Joel Goldberg

Chapter Eleven  If you are unable to tell the difference between what is real and unreal, you are suffering from psychosis  Many disorders have psychosis as a primary feature  Schizophrenia is one of the most common psychotic disorders  Develops in late teens or early adult years- need constant care, it is a life-long disorder  0.5%-2% of Canadians diagnosed with schizophrenia spectrum disorder (i.e.: schizophrenia, schizoaffective disorder, delusional disorder)  It is a stigmatized disorder, so people hide away those with it  Many are in jails, homeless shelters, on the streets or in hospitals  Higher rate among immigrants  More common in men but women have better premorbid(predisorder) histories than men  More likely to have graduated high school or university, marries and have children and have good social skills due to it starting later in women (late 20’s and early 30’s)  Women also have fewer cognitive deficits, especially in verbal processing  Unknown why these gender differences exist  Men with schizophrenia show more brain abnormalities in structure and functioning than women  There are two categories of symptoms: 1. Positive symptoms (type I symptoms)  Symptoms present that shouldn’t be 2. Negative Symptoms (type II symptoms)  Behaviours absent that should be present  People with schizophrenia may also have depression, anxiety, substance abuse, inappropriate affect, anhedonia, and impaired social skills  Positive Symptoms Symptoms Definition Beliefs with little grounding in reality (e.g. one Delusions is being persecuted or is the Messiah) Unreal perceptual or sensory experience (e.g. Hallucinations hearing, seeing and feeling things not there) Grossly disorganized patterns of speech (e.g. Disorganized thought and speech complete incoherence, linking words based on sound instead of meaning) Behaviour that is highly unpredictable, bizarre Disorganized or catatonic behaviour and shows a lack of responsiveness to outside world (e.g. complete motionless for a while, sudden untriggered outburst)  People harbouring delusions are constantly preoccupied with them and hold their beliefs highly resistant to argument  Persecutory delusion: most common, they believe they are being watched or tormented by people they know or even government officials  Delusion of reference: also common, believe that random events or comments by others are directed towards them  Grandiose delusions: believe they are special or have special powers  Delusion of thought insertion: also common, one’s thoughts are being controlled by outside forces  Delusional beliefs are often complex and elaborate TABLE 11.3  Hallucinations: unreal perceptual experiences  Auditory hallucinations: most common type, more common in woman than men.  Visual hallucinations: often accompanied by auditory  Tactile hallucinations: that something is happening outside of one’s body, example, bugs are crawling on one’s back  Somatic hallucinations: something that is happening inside of one’s body, worms are eating your intestines  Disorganized thought and speech: often referred to as formal thought disorder usually slip from one topic to a unrelated topic known as loosening of associations or derailment  Word salad: very disorganized and incoherent sentence  Neologisms: making up words that only have a meaning to speaker, words are based on sound rather than content: clangs. (form sentence based on rhyme and sound)  Perseverate: repetition of the same word or statement  Also have deficit in smooth pursuit eye movement (eye tracking)  Also show deficits in working memory- capacity to hold information in memory and manipulate it; it can impair ability to learn and retrieve new information, and attention  Catatonia: group of disorganized behaviours that reflect an extreme lack of responsiveness to the outside world, one form is catatonic excitement in which the person becomes wildly agitated for not reason and is difficult to subdue, they may at this point articulate a number of delusions or hallucinations  Negative symptoms: Symptoms Definition Severe reduction or complete absence of Affective Flattening (blunted affect) affective (emotional) response to environment e.g: no facial expression in response to emotionally charged stimuli, no emotional expression in voice Severe reduction or complete absence of Alogia speech. e.g: complete mutism for wee
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