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Chapter 14 - Schizophrenia (Whats The Stats? Who does it affect? What are…
Chapter 14 - Schizophrenia
What Is Psychosis?
Defined by loss of contact with reality
Symptoms?
What are the 3 categories?
Positive
Bizarre
Additions
to a person's behavior
Delusions
- Faulty interpretations of reality
Disordered thinking and speech
3 of them
Derailment
- cant recall and very loosely connected
Neologisms
- making up words
Perserveration
- repeat their words again and again and again
All about me type of references
Heightened perceptions
- overload of perception... maybe from the voices in their head
Hallucinations
- sensory perceptions that occur in the absence of external stimuli
What is most common?
Most common is auditory
Inappropriate affect
- emotions that are unsuited to the situation
Negative
Characteristics that are
lacking
in an individual
Poverty of speech
- Reduction of quantity of speech of speech content
Blunted and Flat affect
show less emotion
avoidance of eye contact
immobile face
monotonous voice
anhedonia - general lack of pleasure or enjoyment
Social withdrawa
l - withdraw from social environments and attend only to their own ideas and fantasies
Loss of volition (motivation)
- feeling drained of energy and interest in normal goals
Psychomotor Symptoms
Catatonia - 3 symptoms take an extreme form
include stupor, rigidity, psoturing
Awkward movements
Repeated grimaces
Odd gestures
How?
Substance-Induced
Brain injury
Whats The Stats?
Who does it affect?
What are the strains in reality?
Affects 1 in 100 people in the world
2.5 Million Americans have the disorder
Financial and emotional costs are enourmous
Most of the homeless are affected
Found in all socioeconomic groups
Although higher in lower levels
Appears earlier and more severe in males but less in older age
Appears less severe in females but greater frequency in older age
1/4 patients fully recover
3/4 continue to have problems for the rest of their lives
1/4 patients fully recover
3/4 continue to have Residual Problems
Theories?
Diathesis-Stress Relationship
Argue that the stress of poverty causes the disorder
Develop only if certain kinds of stressors or events are present
Downward drift theory
Biological
Genetic
Inherit a biological predisposition to schizophrenia
Family pedigree statistics
Twin studies
Received the most research support
Biochemical
Dopamine hypothesis
#
Dopamine fires to often, producing schiz
Abnormal Brain Structure
Enlarged ventricles which contain cerebrospinal fluid
Smaller temporal and frontal lobes
Smaller amount of grey matter
Abnormal blood flow to brain regions
Viral
Exposure to viruses before birth
Psychodynamic
World is hard... Retreat to earliest development (primary narcissism) and meet their own needs
Failed attempts to reestablish ego control... leads to furthur shiz symptoms
Theory of Schizpophrenogenic Mothers
Behavioral
Operant conditions
Not reinforced for their attentions to social cues
Responses become increasingly bizarre...yet rewarded with attention...likely to be repeated
Cognitive
Biological factors produce symptoms
Little research
Sociocultural
Multicultural factors
Social Labeling
Family dysfunction
Linked to greater family stress and dysfunction
Expressed Emotion ... express criticism and hostility and intrude
What is the course of Schizophrenia
When does it usually appear?
late teens and mid 30s
3 Phases
Prodromal
Beginning of deterioration; mild symptoms
Active
Symptoms become apparents
Residual
#
A return to prodromal-like levels
Diagnosis
Look at the DSM Checklist on PPT
Only after signs continue for 6 months or more
Type 1
Dominated by positive symptoms; later onset, better adjustment prior, henceforth ... greater likelihood of improvement
Type 1 is more closely tied to the
biochemical
abnormalities in the brain
Type 2
Dominated by negative symptoms
Tied to
structural
abnormalities in the brain
Treatment
Milieu Therapy
Based on humanistic principles
Token Economies
Based on behavioral principles
Antipsychotic Drugs
Reduce symptoms in 65%
Drugs most effective than any other approach
Side effects
Tardive Dyskinesia (TD) - tic-like involuntary movemesnts
Must continue medications for it to work
Psychosocial
Case management
Social Skills training
Coginitive-Behavioral therapy
Family Therapy
Self-Help Groups
There is evidence
against
Dopamine Hypothesis