Final Exam Study Guide Abnormal Psychology Psychosis inability to tell the difference between what is real and what is not Psychotic disorder when that inability is distressing and impairing Schizophrenia most common type of psychotic disorder Psychotic phenomenon Schizophrenia Positive symptoms characterized by the presence of unusual perceptions thoughts or behaviors positive refers to the fact that symptoms are salient added experiences and includes o Delusions ideas that a person believes are true but are highly unlikely or simply impossible ex voices in head aliens are contacting me radio told me to free the zoo animals DSM4 s definition involves phenomenon that one s culture would regard as implausible Types of delusions persecutory reference random events are directed at oneself grandiose great power talent or is famous powerful person guilt or sin unreasonably somatic altered perception of body being controlled thoughts feelings behaviors controlled by external force Delusions are different from normal thoughts in bizarreness preoccupation resistance Usually different types of delusions are woven together in a complex belief system o Hallucinations unreal perceptual experiences bizarre and extremely distressing impairing Cultural relativism applies when diagnosing delusions content differs across cultures Auditory hallucinations most common and more so in women than men and sometimes voices talk to each other can be aggressive threatening or give orders o Disorganized thoughts speech formal thought disorder loosening of associations or derailment word salad neologism o Disorganized catatonic behavior Disorganized unpredictable un triggered which explains disheveled appearance inappropriate hygiene clothing shouting swearing pacing Catatonia group of disorganized behaviors that resemble extreme lack of responsiveness Negative symptoms characterized by losses or deficits in certain domains negative refers to the absence of behaviors feelings and experience o Affective flattening diminished or absent emotional responses o Alogia inability to speak properly or at all o Avolition general lack of drive or motivation o Negative symptoms are less bizarre weird but they are associated with more impairment they areless responsive to medication Cognitive deficits deficits in working memory cognition and attention that may cause o Difficulty suppressing unwanted irrelevant information o Difficulty paying attention to relevant information o Overall difficulties in reasoning communication and problem solving Other symptoms o Inappropriate affect laughing at sad things crying at happy things o Anhedonia lack of interest in everything o Impaired social skills more of a result of a symptom than a symptom itself Phases of Schizophrenia o Prodromal phase symptoms present before full criteria is met o Acute active psychosis o Residual phase symptoms present after acute phase Schizophrenia criteria o At least 2 of the following for over a month Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behavior Negative symptoms o Social occupational dysfunction o Duration continuous signs of the disturbance for over 6 months Schizophrenia subtypes o Paranoid o Disorganized Most researched type Often do not have disorganized speech or behavior Prominent delusions and hallucinations Involves themes of persecution and grandiosity Very disorganized Do not have well formed delusions or hallucinations Odd stereotyped behavior Often unresponsive to treatment Most disabled by disorder Poor hygiene Early onset continuous course o Catatonic Excessive purposeless motor activity Extreme negativism Motoric immobility Odd voluntary movement Echolalia or Echopraxia o Undifferentiated Doesn t fit into another type Difficult to treat Early onset chronic o Residual Have had one acute episode of positive symptoms Do not have prominent positive symptoms currently Have negative symptoms and mild positive symptoms left Prevalence Chronic o 1 2 lifetime prevalence o 5 2 lifetime prevalence worldwide o More common in men Motor behaviors and way of speaking that suggests unresponsiveness to environment Clinical picture dominated by 2 or more of the following Prognosis course o Schizophrenia is debilitating o Life expectancy is 10 years shorter o High relapse 85 have residual and or active symptoms o Higher rates of infectious and circulatory diseases o 10 15 die by suicide Gender differences o Age of onset women late 20s to early 30s men around 21 years old o Course women have better prognosis o Cognitive deficits women show fewer cognitive deficits Other psychotic disorders o Schizoaffective o Schizophreniform o Brief psychotic disorder o Delusional disorder Biological theories o Genetics Higher concordance rate between MZ twins than DZ twins 50 likelihood to have schizophrenia if both parents have disorder o Structured brain abnormalities Enlarged ventricles Prefrontal cortex limbic system hippocampus Causes of abnormalities Birth complications perinatal hypoxia Prenatal virus exposure high rate associated with flu in 2nd trimester Neurotransmitters overactive DA in mesolimbic pathway underactive DA in prefrontal Psychosocial theories area o Schizophrenia associated with low SES o Social drift vs Urban birth social selection results in lower class relative to family stressful circumstances at birth o The schizophrenogenic mother bad parenting can cause schizophrenia in children o Communication problems double binds communicating conflicting messages o Expressed emotion The two hit hypothesis two different yet necessary malfunctions in the brain that cause schizophrenia The first happens while a baby is still inside the womb This could be from faulty genetics bad brain cells lack of oxygen during birth or even drugs or infections the mother might have in her body The second hit happens later in life due to the brain changing as it grows a major life stressor such as a young adult going to college or taking on a job after high school The brain must be faulty and unable to process stress correctly 1st hit so that when life stress happens 2nd hit schizophrenia symptoms begin to come out Biological treatments o Neuroleptics dopamine antagonist revolutionized treatment of schizophrenia o Prophylactic reduces positive symptoms ex thorazine haldol o Issues 25 of people don t respond at all More effective with positive than negative symtoms Discontinuation 78 relapse o Side effects Grogginess dry
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