Unit 4 Learning Objectives Schizophrenia and Related Psychotic Disorders 1 What are the positive and negative symptoms of Schizophrenia Positive Negative characterized by the presence of unusual perceptions thoughts or behaviors positive refers to the fact that the symptoms are salient added experiences delusions hallucinations disorganized thought and speech disorganized or catatonic behavior characterized by losses or deficits in certain domains negative refers to the absence of behaviors feelings experiences etc 3 types are core negative symptoms affective flattening alogia avolition 2 Describe the characteristics of delusions hallucinations and catatonic behavior delusions ideas that an individual believes are true but are highly unlikely or simply impossible types persecutory being persecuted watched and conspired against reference random events are directed at oneself grandiose great power knowledge talent or is a famous powerful person guilt or sin committed a terrible act or responsible for a terrible event somatic appearance or part of a body is diseased altered delusions are different from thoughts we tell ourselves in at least 3 ways bizarreness preoccupation and resistance usually multiple different types of delusions are woven together in a complex belief system specific content of delusions differs across cultures and cohorts cultural relativism is important to consider when diagnosing delusions hallucinations unreal perceptual experiences hallucination in schizophrenia are bizarre and extremely distressing and impairing types auditory hallucinations most common more common in women than men voices talk to each other can be aggressive threatening and or give orders disorganized thought and speech and catatonic behavior formal thought disorder loosening of associations or derailment word salad neologisms disorganized unpredictable and untriggered this can explain disheveled appearances inappropriate hygiene clothing shouting swearing pacing catatonia group of disorganized behaviors that reflect extreme lack of responsiveness catatonic excitement wild agitation that is difficult to subdue 3 What are the cognitive deficits in Schizophrenia difficulty suppressing unwanted irrelevant information difficulty paying attention to relevant information overall difficulties in reasoning communication and problem solving 4 What are prodromal and residual symptoms prodromal phase symptoms present before full criteria is met residual phase symptoms present after acute phase after the symptoms have dissipated a lit tle but are still present 5 What are the subtypes of Schizophrenia and in what ways might these subtypes be problematic paranoid disorganized most researched type prominent delusions and hallucinations involved themes of persecution and grandiosity often do not have disorganized speech or behavior associated features anxiety anger argumentativeness tend to predispose people to suicidal or violent tendencies later onset do not have well formed delusions or hallucinations very disorganized odd stereotyped behaviors poor hygiene early onset continuous course often unresponsive to treatment most disabled by disorder these people tend to be the most disabled by schizophrenia catatonic motor behaviors and ways of speaking that suggest unresponsiveness to environment clinical picture dominated by 2 or more of the following motoric immobility excessive purposeless motor activity extreme negativism or mutism odd voluntary movement echolalia senseless repetition of words or echopraxia repetitive movement puts you at risk for malnutrition and self harm undifferentiated doesn t fit into any other type early onset chronic difficult to treat residual have to have had one acute episode of positive symptoms do not have prominent symptoms currently have negative symptoms and mild positive symptoms left chronic 6 Why might scientists consider Schizophrenia a heterogenous disorder 7 What are the similarities and differences among psychotic disorders schizoaffective criteria mixed of schizophrenia and mood disorder before or after mood dis order permits schizophreniform schizophrenic symptoms that last between one and six months all the same symptoms before the 6 months brief psychotic disorder sudden onset of delusions hallucinations positive symptoms very brief and can last from one day to a month delusional disorder person has delusions that last at least a month but they are not bizarre and might occur in real life they have no trouble in functioning and it is rare and usually a later onset in life than more psychotic disorders 8 What How do biological factors play a role in the development in of Schizophrenia Genetics 50 concordance rate monozygotic twins vs 14 dizygotic twins 50 likelihood of having schizophrenia if both parents have the disorder which means that 50 is also due to environmental influences Structured Brain Abnormalities enlarged ventricles prefrontal cortex limbic system hippocampus Causes of Abnormalities birth complications perinatal hypoxia prenatal virus exposure high rates of schizophrenia associated with the flu second trimester neurotransmitters overactive DA in mesolimbic pathway underactive DA in prefrontal areas 9 Describe the two hit hypothesis not just vulnerability and a stressor but two vulnerability factors or hits that lead to it genetic environmental influences that affect in uterus these problems will make the person more vulnerable to the second hit and the second part is a psychosocial stress or drug abuse that happens later in life 10 What type of family interaction patterns might play a role in Schizophrenia expressed emotion idea within family high conflict and over involvement in hostile and critical environments there is a high risk of relapse 11 How do psychosocial theories explain Schizophrenia schizophrenia is associated with low SES people with it tend to have a lower SeS than parents drift to lower status because of the symptoms social drift vs urban birth social selection results in lower class relative to family stressful circumstances at birth urban is associated with schizophrenia because there is stress and overcrowding which may make it easier to develop infectious disease and to transmit viruses schizophrenogenic mother early theories that place blame on mother for development and that mothers were over protective and had high conflict this is not supported by all research communication problems double blinds communicating
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