Pitt PSY 1205 - Abnormal Psychology Chapter Thirteen Notes

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Abnormal Psychology Chapter Thirteen NotesSchizophrenia (page 453-455)- Schizophrenia characterized by an array of diverse symptoms, including extreme oddities in perception, thinking, action, sense of self, and manner of relating to others; hallmark of schizophrenia is psychosis a significant loss of contact with reality- Origins of the Schizophrenia Constructo Eugen Bleuler was the one who gave us the diagnostic term we still used today; “schizo” means to split or crack and “phren” refers to the mind – he believed the condition was characterized primarily by disorganization of thought processes, a lack of coherence between thought and emotion, and an inward orientation away (split off) from realityo No “split” in personalities, instead there is a split within the intellect and external reality - Epidemiologyo Lifetime risk is 0.7%o People with higher risk: if parent has schizophrenia, people whose fathers were 45-50 years old or older at the time of their birth, having a parent who works as a dry cleaner, and people of Afro-Caribbean origin living in the United Kingdomo Majority of cases begin in late adolescence and early adulthood (18 - 30 peak age)o Tends to begin earlier in men than in womeno Men tend to have more cases and more severe forms of schizophrenia (for every three men that develop it, only two women do)o Female sex hormones (estrogen) may help protect against schizophreniaClinical Picture (page 455-462)- Delusionso Delusion an erroneous belief that is fixed and firmly held despite clear contradictory evidenceo Delusions involve a disturbance in the content of thoughto 90% of schizophrenic patients have delusionso Prominent types of delusions: made feelings or impulses, thought broadcasting, thought insertion, and thought withdrawal- Hallucinationso Hallucinationa sensory experience that seems real to the person having it but occurs in the absence of any external perceptual stimulus o Auditory hallucinations are the most common type – 75% of patients; other hallucination types are visual (39%), olfactory, tactile, and gustatoryo Hallucinating patients show increased activity in the Broca’s areao Research findings suggest that auditory hallucinations occur when patients misinterpret their own self-generated and verbally mediated thoughts (inner speech or self-talk) as coming from another sourceo Auditory hallucinations are really a form of misperceived subvocal speech- Disorganized Speech and Behavior o Disorganized speech is the external manifestation of a disorder in thought formo Words and word combinations sound communicative but the listener is left with little or no understanding of the point the speaker is trying to make o Neologisms: completely new, made up words o Formal thought disorder: a term clinicians use to refer to problems in the way thatdisorganized thought is expressed in disorganized speecho Catatonia: patient shows a virtual absence of all movement and speech and may be in what is called a catatonic stupor- Positive and Negative Symptomso Disorganized symptoms bizarre behavior and disorganized speecho Positive symptoms reflect an excess or distortion in a normal repertoire of behavior and experience; exs: hallucinations and delusionso Negative symptoms reflect an absence or deficit of behaviors that are normallypresent; exs: flat affect (blunted emotional expressiveness), alogia (very little speech), avolition (the inability to initiate or persist in goal-directed activities), asociality, apathy, anhedoniao Preponderance of negative symptoms in the clinical picture is not a good sign for the patient’s futureo Even though patients with schizophrenia may sometimes not look very emotionally expressive, they are nonetheless experiencing plenty of emotion - Other Psychotic Disorderso Schizoaffective disorder hybrid because it is used to describe people with features of schizophrenia and severe mood disorder; person has psychotic symptoms that meet criteria for schizophrenia but also has marked changes in mood for a substantial amount of time (Two subtypes – bipolar and unipolar) Clinicians often do not agree about who meets the criteria for the diagnosis Long term outcome is much better when compared to patients with schizophrenia o Schizophreniform disorder schizophrenia-like psychoses that last at least a month but do not last for six months and so do not warrant a diagnosis of schizophrenia  Prognosis is much better when compared to patients with schizophrenia o Delusional disorderpatients hold beliefs that are considered false and absurd by those around them but may otherwise behave quite normally Subtype is erotomania: theme of delusion is great love for a person, usually of higher statuso Brief psychotic disorder involves the sudden onset of psychotic symptoms or grossly disorganized or catatonic behavior; great emotional turmoil but the episode usually lasts only a matter of days and then the person returns to his or her former level of functioning and may never have another episode again Often triggered by stresso Shared psychotic disorder a delusion that develops in someone who has a very close relationship with another person who is delusional Risk and Causal Factors (page 462-485)- Genetic Factorso Risk of developing schizophrenia increases as how genetically close you are to anindividual with ito Schizophrenia concordance rates for identical twins are routinely and consistently found to be significantly higher than those for fraternal twins or ordinary siblings (28 versus 6)o Finnish Adoptive Family Study has provided strong confirmation of the diathesis-stress model as it applies to the origins of schizophrenia (strong interaction between genetic vulnerability and unfavorable family environment) - Prenatal Exposures o Viral infections: more people with schizophrenia are born between January and March than would be expected by chance; risk of schizophrenia seems to be greatest when the mother gets the flu in the fourth to seventh month of gestation o Rhesus incompatibilityo Patients with schizophrenia are much more likely to have been born following a pregnancy or delivery that was complicated in some wayo Early nutritional deficiencyo Maternal stressTreatments and Outcomes (page 485-490)- Before the 1950’s when antipsychotics were introduced, there weren’t really any treatments and, instead, patients were put in institutions- Clinical Outcomeo 38% of people

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