1Schizophrenia Psychosis: inability to tell the difference between what is real and unreal. Schizophrenia: a psychotic disorder. They lose touch with reality, their thinking and speech are garbled, and they are unable to care for themselves. More than 90% of people with schizophrenia seek treatment in mental health or general medicine facility in any given year. 3% of nations’ health care budget is used in treating people with schizophrenia. Onset: late teenage or early adult yeas. They need continual services, including residential care, rehabilitative therapy, subsidized income, and the help of social workers to obtain needed resources--- they will need these services for the rest of the life because it is chronic. Within the U.S: 1 to 2% of the population will develop schizophrenia some time in their lives Symptoms, diagnosis, and course Three categories of symptoms: 1. Positive symptoms2. Negative symptoms3. Cognitive deficits. 1. Positive symptoms: delusions, hallucinations, disorganized thought and speech, and disorganized or catatonic behavior. Delusions: the ideas that an individual believes are true but are highly unlikely and often simply impossible. Difference b/w self-deceptions and delusions:o Self-deceptions are at least possible while delusions are not o People harboring self-deceptions may think about these beliefs occasionally, but people with delusions tend to be preoccupied with them o People holding self-deceptions typically acknowledge that their beliefs may be wrong, but people holding delusions are often highly resistant to arguments or compelling facts that contradict their delusions. Types of Delusions:o Persecutory delusions: they believe they are being watched or tormented by people they know or with authority with whom they have never had direct contact.2o Delusion of reference: in which people believe that random events or comments by others are directed at themo Grandiose delusions: are beliefs that one is a special being or possesses special powerso Delusions of thought insertion: beliefs that one’s thoughts are being controlled by outside forces. Hallucinations: unreal perceptual experiences o Auditory hallucination: hearing voices, music, and so on. The most common hallucination, and it is more common in women than in men The voices may seem to come either from insides the person’s head or from somewhere else They often have a negative quality, criticizing or threatening the individual to hurt themselves or others. o Visual hallucination: often accompanied by auditory hallucinations May be consistent with their delusionso Tactile hallucinations: involve the perception that something is happening to the outside of the person’s body. o Somatic hallucinations: the perception that something is happening inside the person’s body. Disorganized Thought and Speech o Formal thought disorder: the name commonly given to people with schizophrenia who suffer from disorganized thinking. Tendency to slip from one topic to a seemingly unrelated topic with little coherent transition May answer questions with unrelated comments. Word salad: the person’s speech is so disorganized as to be totally incoherent to the listener. Neologisms: make up works that only mean something to him Clangs: make association between words that are based on the sounds of the words rather than the content o Men with schizophrenia tend to show more severe deficient in language than do women with schizophrenia Language is controlled more bilaterally in women than in men. So women can use both sides thus can compensate for problems Disorganized or Catatonic Behavior o Catatonia: disorganized behavior that reflects unresponsiveness to the world. Catatonic excitement: the person becomes wildly agitated for no apparent reason3o May display unpredicted and apparently triggered agitation o Often have trouble organizing their daily routine because their attention and memory is impaired 2. Negative symptoms: involve losses, or deficits in certain domains. Three types of negative symptoms include: affective flattening, alogia, and avolition. Affective Flattening: or blunted affect is a severe reduction or absence of affective (emotional) responses to the environment. o The person’s face may remain immobile most of the time, and his or her body language may be unresponsive. o May reflect anhedonia: loss of interest in everything in lifeo May show no emotion but may be experiencing intense emotion they cant explain Alogia: poverty of speech, is a reduction in speaking. o Lack of speech may reflect a lack of thinking although it may be caused in part by lack of motivation to speak Avolition: inability to persist at common, goal-directed activities, including those at work, school, and home. o May have great trouble completing tasks, is disorganized and careless, and apparently is completely unmotivated. 3. Cognitive Deficits o Greater difficulty focusing and maintaining their attention at will o Show deficits in working memory: the ability to hold information in memory and manipulate it Makes it difficult to pay attention to relevant information and suppress unwanted or irrelevant information. Information and stimulation constantly flood their consciousness, and they are unable to filter out what is irrelevant or to determine the source of information. o Relatives of people with schizophrenia may show these cognitive deficits, even if they do not show the symptoms of schizophrenia. This may be an early marker for risk for schizophrenia and may contribute to the development of other symptoms Diagnosis o “Schizein” is a Greek work meaning “to split” and “phren” meaning “mind”4o Eugen Bleuler argued that the primary problem underlying the symptoms is the breaking of association among thought, language, memory and problem solving. o To be diagnosed a person must show some symptoms of the disorder for at least 6 months During these 6 months, there must be at least 1 month of acute symptoms during which two or more broad groups of symptoms are present and severe enough to impair the individual’s social or occupational functioning o Some seek treatment shorty after onset of symptoms, but most do not and may experience symptoms for months or years before seeking treatment. o Prodromal symptoms: are present before people go into the acute phase of
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