Slide 1Characteristic SymptomsCharacteristic SymptomsSlide 4Genetic factorsSlide 6Psychological Stress!!!Slide 8PsychotherapyPrognosisSchizophrenia“split mind”Symptoms, Etiology, and TreatmentCharacteristic SymptomsPositive Symptoms – excess of normal functioning, behavioral excessesDelusionsHallucinationsDisorganized Speech/ThinkingDisorganized Behavior Distortion in thought content, preoccupation, rigid thinking Sensory and perceptual distortionsDistortions in thought process; Incoherent communication Distortions in self-monitoring of behaviorParanoidGrandiose: Think you are bigger and grader that you actually are (ie magic powers/best athlete)Referential: Think everything is about you (ie all commercials are talking about you)Visual: SeeAuditory: Hear Tactile: Touch Olfactory: SmellTangential: Go from topic to topic without any flow or organization Word Salad: Just giving you words, no order to sentenceLoose Associations: Think answering questions, but no logical connectionsInactivity: Catatonic Childlike: (ie giggling, immature)Easily IrritableCharacteristic SymptomsNegative Symptoms – loss of normal functioning, behavioral deficitsAlogiaAffective Disturbance/Flattening Avolition Anhedonia Asociality- Poverty of speech production- Deficit of thinking or speech - Reduction of emotional intensity- Flattened Approach to Emotion -No goal-directed activityLoss of interest; decreased experience of pleasureImpaired social relationshipThought blocking(ie long break in speaking because they lost their thoughts)Limited Range of Affect Inappropriate AffectNo interest in daily activities (e.g, hobbies, work), poor hygieneWithdrawal from pleasurable activitiesPoor social skills, withdrawal, limited social supportEtiologyGenetic factorsGENETIC vulnerabilityNEUROTRANSMITTERSDopamine theory◦Excess dopamine?◦Dopamine receptorsExcess and hypersensation ◦Mesolimbic (cognitive/emotion) vs. Prefrontal cortex dopamine levels (organization of bx, motivation, attention)◦Excess dopamine in mesolimbic system, lower dopamine in the prefrontal cortexBRAIN FUNCTIONINGEnlarged ventriclesPrefrontal cortex◦SmallerWorking memory structures◦Decreased white matterPre-Natal DevelopmentPsychological Stress!!! Schizophrenia & SES◦Sociogenic HypothesisLow SES  Stress  Schizophrenia ◦Social Drift theoryStress  Schizophrenia  Low SESSES = Socioeconomic StatusFamily-related factors◦Communication ◦Expressed EmotionDIATHESIS-STRESS MODEL!!TreatmentPsychotropic MedicationsAnti-psychotic medications◦Side effectsExtrapyramidal; tardive dyskinesia diabetesMeds not sufficient (negative sxs)PsychotherapyCognitive Behavioral Therapy◦Reinforce adaptive behaviors; skills trainingFamily TherapyGOOD PROGNOSISOnset (sudden, later age)Good Social adjustment prior to onsetPositive vs. negative symptoms◦Few negative symptomsPreserved Cognitive functioningSocial supportCompliant Treatment