12/2/20101What do the voices in yourhead say?Chapter 9Schizophrenia and and the Related DisordersClass ObjectivesWhat is Schizophrenia?What are the features of Schizophrenia?Positive and NegativeWhat are the different types of Schizophrenia?Stop and Think…How would you describe Schizophrenia?How would you describe a person with this disorder?12/2/20102Who has Schizophrenia?A middle-aged man walks the streets of New York with aluminum foil under his hat, so the Martians can’t read his mind.A young woman sits in her college classroom and hears the voice of God telling her she is a vile and disgusting person.You try to strike up a conversation with the supermarket bagger, but he stares at you vacantly and will say only one or two words in a flat, monotone voice.They ALL do! Schizophrenia is classified as a psychotic disorder. These disorders are characterized by hallucinations and delusions, which involve a loss of contact with realityHow disruptive is this disorder?Schizophrenia is a devastating disorder that has a tremendous impact almost every area of functioning.This disorder is characterized by a broad spectrum of cognitive and emotional dysfunctions, including:‐ Hallucinations‐ Delusions‐ Disorganized speech & behavior‐ Inappropriate emotions12/2/20103HistorySchizophrenia comes from the Greek words for split mind, which reflected Bleuler’s (1908) belief that underlying all the unusual behaviors was an associative splitting of the basic functions of personality.This phrasing contributed to a large misconception about Schizophrenia. Cognition, emotion and perception are splintered, it is NOT multiple personality disorder!Society tends to devalue and dehumanizes those with schizophrenia.People with these severe mental disorders are twice as likely to be harassed in public as people without schizophrenia (Berzins et al., 2003).Are people with Schizophrenia accurately portrayed in our society?What preconceived images or ideas do you have about people with Schizophrenia?12/2/20104Characters on TV and in movies, as well as images in the media commonly depict this disorder inaccurately and often promote distorted images of schizophreniaMore than 70% of T.V characters in prime-time dramas with schizophrenia are presented as violent-More than 1/5 depicted as murders.Symptoms of schizophrenia are divided into 2 categories, positive and negative.Positive symptoms:-These are additions and the more obvious signs of psychosis- not to be confused with happy.Negative symptoms:‐ Indicate the absence of normal behavior.Positive symptomsDelusions are a false, unshakable belief. ‐ This symptom involves disorder of thought content and beliefs that are misrepresentations of reality.A person who believes the flickering street light is sending him messages from the aliens is delusional12/2/20105Hi, Jesus Christ. Nice to meet you.Delusions of Grandeur are the belief that you are more important than you are. ‐ For example when you believe that you are very special or have special powers or abilities.‐ “I’m Napoleon” “I can cure cancer with my powers”12/2/20106DelusionsA very common delusion effecting 1/3 of people with schizophrenia is the belief that others are “out to get them.” They believe they are being cheated, harassed, poisoned, or conspired against‐ These are called delusions of persecution(paranoid delusions) which can be the most disturbing for people with schizophrenia“I know what that means…”Delusions of reference involve a person having a belief or perception that irrelevant, unrelated or innocuous things in the world are referring to them directly or have special personal significance. While watching a re-run of the Cosby show, Dan recognizes that Bill Cosby is speaking directly to him. These “messages” are a sign from God that something bad is about to happen. He must run and get as far as possible!12/2/20107Delusions of Reference‐ They feel that people on television or radio are talking about, or talking directly to them. ‐ They believe the headlines or stories in newspapers are written especially for them ‐ believing that events (even world events) have been deliberately contrived for them, or have special personal significanceDid you hear that?!Hallucinations are also positive symptoms of schizophrenia that are evidence of perceptual disturbance.Hallucinations are false perceptions and inaccuracies that affect the senses. Causing people to hear, see, taste, touch or smell what others do not.Auditory hallucinations are the most common.12/2/20108Understanding Hallucinations Research found by using SPECT scan of the brain that the area of the brain most active during hallucinations was Broca’s area ‐ linked to speech production.This research suggests that people are not hearing the voices of others but they are listening to their own thoughts or voice and they can’t recognize the difference (Hoffman, 1999)In contrast to the presentation of new features with positive symptoms, negative features of schizophrenia indicate the absence of or insufficiency of “normal" behavior.They include emotional and social withdrawal, apathy, and poverty of thought and speech.• Avolition (Apathy), is the inability to initiate/persist in important activities.– People who are apathetic are uninterested in performing even the most basic day-to-day activities, like grooming/bathing.• Alogia is often referred to as poverty of speech. This is the relative absence of typical speech– A person with alogia may respond with brief answers to questions that have little content and may appear uninterested in the conversation.– Example- “Do you have children?” “Yes”12/2/20109Are they just unsocial people?This deficit in communication is believed to reflect a negative thought disorder, rather than inadequate communication skills.‐ Research suggests that people with alogia may have trouble finding the right words to formulate their thoughts (Alpert & Clark, 1994)Hey…Mom’s dead!Sometimes people with schizophrenia display inappropriate affect.-Behavior that does not fit the mood is sometimes displayed, such as laughing or crying at inappropriate times• Laughing at a funeral People with schizophrenia often lack insight (awareness) and have disorganized thoughts and speech.12/2/201010Disorganized ThoughtsThese are marked by looseness of associations, in which the patient rambles on from topic to topic in a