PSYC 238: Abnormal Psychology Final Study Guide (8, 9, 5, 10, 11, 12, 14)- Chapter 8: Schizophrenia & Related Disorderso Symptoms: (3 different categories) Positive Symptoms: Things that are “normally absent in people, but are present in the individual- Delusions (more subjective)o Ideas that an individual believes are true but thatare highly unlikely and often impossible Cannot be shared by others e.g. religious beliefs don’t counto Can be “bizarre” or “non-bizarre”o 6 types listed in DSM-5 Persecutory (most common): False belief that oneself or one’s loved ones are being persecuted, watched, or conspired against by others. Referential: Belief that everyday events, objects, or other people have an unusual personal significance. Grandiose: False belief that one has greatpower, knowledge or talent or that one is a famous and powerful person. Erotomanic: The (false) belief that someone is in love with you. Nihilistic: The belief that a major catastrophe will occur Somatic: False belief that one’s appearance or part of one’s body is diseased or altered. The belief that one has serious health and/or organ problems.- Hallucinationso Unreal perceptual experienceso Heightened sensory (perceptual) experiences that are not due to external stimulio Experienced by 5 senses; most common, auditory Negative Symptoms (more stable):- Aspects of behavior and social relationships that are “normally” present, but are absent in the individual- Restricted Affect: Severe reduction in or absence of emotional expression (flat/blunted affect)- Avolition: Lack of will power, inability to initiate or persist at common, goal-directed activities- Alogia: Lack of spontaneous speech- Anhedonia: Decreased ability to experience pleasure- Asociality: Lack of interest in social interactions Disorganized Symptoms- Do not fit characteristics of positive or negative symptoms and reflect bizarre & thought disturbances- Disorganized Speech:o Going off on tangents, very difficult to follow o Not giving enough context to make speech meaningful (word salad)o Context maintenance- Grossly Disorganized/Bizarre Behaviorso Ranges from child-like silliness to unpredictable agitation- Catatonic Motor Behaviorso Unresponsiveness to the environment o Criteria for Schizophrenia A. In the ACTIVE phase, must have IMPAIRMENT in functioning+ TWO or more of the following (at least one must be 1, 2, or 3)during a one month period:- 1.Delusions, 2.hallucinations, 3.disorganized speech, 4.grossly disorganized or 5.catatonic behavior, negative symptoms B. During the PRODROMAL (before the acute phase) and RESIDUAL (after the acute phase) phases, may have only negative symptoms, or other symptoms in less severity (e.g. odd beliefs instead of delusions)o DSM 4 TO DSM 5 In DSM 4 there were subtypes of Schizophrenia (e.g. paranoid, disorganized, etc.?- These were dropped in DSM 5 due to:o Low diagnostic stability, reliability and validity In DSM 5, there is a severity dimensions that capture similar information- Clinicians rate each symptom type on a 5 point scale (0 to 4)o Not present to present and severeo Excluding Related Disorders Before a diagnosis of schizophrenia can be given, disorders with similar symptoms must be ruled out as a possibility- Depressive/Bipolar Disorders with Psychotic Symptoms- Schizoaffective Disorder- Schizophreniform Disorder- Brief Psychotic Disorder- Delusional Disorder Schizophrenia with Depressive/Manic Symptoms vs. Depressive/Bipolar Disorders with Psychotic Symptoms- Schizophrenia with Depressive/Manic Symptomso IF depression and mania symptoms are present, their duration must be brief in relation to the duration of active and residual schizophrenia symptoms.- Depressive/Bipolar Disorders with Psychotic Symptomso The psychotic symptoms only occur during a manic or depressive episode Schizophrenia vs. Schizoaffective Disorder- Schizophrenia with Depressive/manic Symptomso Length of time that depressive/manic symptoms are present is brief in comparison to the durationof psychotic disturbance- Schizoaffective Disordero Depressive/manic symptoms must be present fora substantial portion of the psychotic disturbanceo Delusions and hallucinations must be present forat least 2 weeks without prominent mood symptoms. Brief Psychotic Disorder vs. Schizophreniform Disorder vs. Schizophrenia- Delusional Disorder vs. Schizophrenia- Delusional Disordero Non-bizarre delusions are the prominent psychotic symptom.o Present for at least 1 montho Other schizophrenia symptoms, such as hallucinations, disorganized and negative symptoms are largely absent. So, what’s the difference?- Between Mood Disorders w/ Psychosis, Schizophrenia and Schizoaffective Disorder?o The duration of mood symptoms and psychotic symptoms- Between Schizophrenia, Schizophreniform Disorder & Brief Psychotic Disorder?o The duration of entire disturbance- Between Schizophrenia & Delusional Disorder?o Type of delusion and presence/absence of other symptomso Prevalence of Schizophrenia Rare but disabling Lifetime prevalence rate in general population is 0.3% to .7% High comorbidity with Substance Use Disorders- 60% have a substance abuse problem that is not related to tobacco The course of schizophrenia varies widely:- 1/3 of patients improve significantly- 1/3 of patients stay the same and/or relapse- 1/3 of patients become chronically and severely disabledo Distribution of Schizophrenia o Gender Differences in Schizophrenia Equally likely to be affected Age of onset:- Men = 18-25- Females = 26-45- Very rare in children Premorbid social functioning (better for women) Typical symptoms (men have more negative symptoms; women more hallucinations/paranoia and express more outward emotion) Course of illness & response to treatment men more chronic and poorer response to treatmento Epidemiology Suicide: 10-15% die by suicide Violence:- Rarely engage in violent behavior- Much more likely to be a victim of violence Culture- More common in urban areas and low socioeconomic status - African-Americans are twice as likely to develop schizophrenia than Whites and Latinos – could be due to social class and access to services Cultural Factors: Recovery in Different Countries- People in developing countries have higher recovery rates than industrialized countrieso Could be due to individualistic vs. collectivistic characteristics-