Chapter 12 Abnormal Psychology Notes 12 1 Perspectives in Schizophrenia Schizophrenia a devastating psychotic disorder that may involve characteristic disturbances in thinking delusions perception hallucinations speech emotions and behavior Complete recovery is rare Disease is costly Effects 1 of every 100 people at some point in their lives 12 1a Early Figures in Diagnosing Schizophrenia Demence loss of mind precoce early premature because the onset of the disorder is often during adolescence Catatonia a disorder of movement involving immobility or excited agitation Hebephrenia a silly and immature emotionality a characteristic of some types of schiznophrenia Paranoia people s irrational beliefs that they are especially important delusions of grandeur or that other people are seeking to do them harm Dementia Praecox the latin term meaning premature loss of mind an early label for what is now called schizophrenia emphasizing the disorder s frequent appearance during adolescence Kraepelin distinguished dementia praecoxc from manic depressive illness now called bipolar disorder Bleuler introduced the term schizophrenia Schizophrenia comes from the Greek words split skhizein and mind phren Associative splitting a separation among basic functions of human personality for example cognition emotion and perception seen by some as the defining characteristic of schizophrenia This concept emphasized the breaking of associative threads or the destruction of the forces that connect one function to the next 12 1b Identifying Symptoms Arthur and his schizophrenic episode 12 1 Clinical Description Symptoms and Subtypes Psychotic Behavior a severe psychological disorder category characterized by hallucinations and loss of contact with reality Schizophrenia is one of the disorders that involves psychotic behavior Schizophrenics are portrayed as violent but in reality you are more likely to see someone with substance abuse commit a violent crime then someone with schizophrenia Mental health workers typically distinguish between positive and negative symptoms of schizophrenia A third dimension disorganized symptoms also appears to be an important aspect of the disorder Positive symptoms generally more active manifestations of abnormal behavior or an excess distortion of normal behavior delusions and hallucinations Negative symptoms deficits in normal behavior in such areas as speech and motivation Disorganized symptoms rambling speech erratic behavior and inappropriate affect for example smiling when you are upset Schizophrenia requires that there are two or more positive negative or disorganized symptoms for at least 1 month Social Occupational Dysfunction Duration 1 month or more Schizoaffective and Mood Disorder exclusion ruled out because either no major depressive manic or mixed episodes have occurred or if mood episodes have occurred during active phase symptoms their total duration has been brief relative to the duration of the active and residual periods Substance general medication condition exclusion disturbance is not due to direct psychological effects of a substance Relationship to a Pervasive Developmental Disorder if there is a history of autistic disorder or another pervasive developmental disorder the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month or less if successfully treated 12 2a Positive Symptoms Positive Symtoms A more overt symptom such as a delusion or hallucination displayed by some people with schizophrenia Delusion a psychotic symptom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality Between 50 70 percent of people with schizophrenia experience hallucinations delusions or both Delusion the basic characteristic of madness Delusion of grandeur a mistaken belief that the person is famous or powerful Delusions of persecution a common delusion that others are out to get them Capgras Syndrome the person believes someone he or she knows has been replaced by a double Cotard s Syndrome the person believes he is dead Motivational View of Delusions look at these beliefs as attempts to deal with and relieve anxiety and stress Preoccupation with the delusions distracts the individual from the upsetting aspects of the world such as hallucinations Deficit View of Delusion beliefs resulting from brain dysfunction that creates these disordered cognitions or perceptions Hallucinations a psychotic symptom of perceptual disturbance in which something is seen heard or otherwise sensed although it is not actually present Auditory Hallucination the most common form experienced by people with schizophrenia Hears voices Metacognition examining your own thoughts The part of the brain most active during hallucinations was the Broca s area Broca s area is known to be involved in speech production rather than language comprehension Supports the idea that people who are hallucinating are not hearing the voices of others but are listening to their own thoughts or their own voices and cannot recognize the difference 12 2b Negative Symptoms Negative Symptom a less outgoing symptom such as flat affect or poverty of speech displayed by some people with schizophrenia Avolition an inability to initiate or persist in important activities Also known as apathy show little interest in performing even the most basic day to day functions including hygeine Alogia a deficiency in the amount or content of speech a disturbance often seen in people with schizophrenia May just have trouble finding the right words to express their thoughts Anhedonia an inability to experience pleasure associated with some mood and schizophrenic disorders e g eating sexual interactions social interactions Flat Affect an apparently emotionless demeanor including toneless speech and vacant gaze when a reaction would be expected Researchers showed that children who later went on to develop schizophrenia typically displayed less positive and more negative affect than those children who did not develop the disorder Emotional expression may be one of the ways to identify potential schizophrenia in children 12 2c Disorganized Symptoms least studied least understood People with schizophrenia often lack insight an awareness that they have a problem Cognitive slippage speech problems with schizophrenia sometimes they jump from topic to topic and other times they talk illogically Disorganized Speech a