Psychopathology (PSYC 4240) Day 11
Psychopathology (PSYC 4240) Day 11 PSYC 4240
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This 3 page Class Notes was uploaded by Selin Odman on Tuesday May 31, 2016. The Class Notes belongs to PSYC 4240 at University of Georgia taught by Miller in Summer 2016. Since its upload, it has received 9 views. For similar materials see Psychopathology in Psychology (PSYC) at University of Georgia.
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Date Created: 05/31/16
Psychopathology (PSYC 4240) – Day 11 5/31/16 Schizophrenia and Other Psychotic Disorders Schizophrenia vs. Psychosis -Psychosis: broad team (i.e. hallucinations, delusions) -Schizophrenia: a type of psychosis -Psychosis and Schizophrenia are heterogeneous Lots of ways and reasons for psychosis and different “types” of schizophrenia **A lot of schizophrenics look different from each other, having different delusions and hallucinations -Disturbed thought, emotion, and behavior and major, global brain problems Nature of Schizophrenia and Psychosis: History and Current Thinking Historical Background Emil Kraepelin: used term dementia praecox (premature dementia) -Focused on subtypes of schizophrenia (paranoid; catatonic) Subtypes were in DSM until recently -Recognized it as a “disease of the brain” -Recognized that several distinct symptoms appeared to be a part of the broader syndrome -Differentiated “dementia praecox” from manic-depressive illness Eugen Bleuler: introduced the term “schizophrenia” -“splitting of the mind”; inability to keep a consistent train of thought -Described “positive” and “negative” symptoms which are still categorized as such today DSM-5 Criteria: Schizophrenia Characteristic symptoms: 2 or more of the following, each present for a significant portion of time during a 2-month period (of less if successfully treated) -Delusions -Hallucinations -Disorganized speech (frequent derailment or incoherence) -Grossly disorganized or catatonic behavior -Negative symptoms (***the most difficult to treat): affective flattening (unexpressive), alogia (decrease in speech), avolition (unable to do daily activities like brushing teeth) Social/occupational dysfunction Continuous signs of disturbance for at least 6 months Not schizoaffective or mood disorder: mixture of psychotic disorder and mood disorder Not due to substance use Schizophrenia: the “positive” symptom cluster (positive meaning you have excess, more than normal behavior) The Positive Symptoms -Active and obvious manifestations of abnormal behavior -Excess or distortion of normal behavior -Hallucinations, hearing voices… Delusions: Distortion in thought content -Erroneous beliefs that usually involve a misinterpretation of perception or experiences. Beliefs are typically held very strongly. ***Things like paranoid, grandiose delusions, thinking that you’re god-like and that someone is out to get you. -Gross misrepresentations of reality: *Persecutory (most common): The FBI is after me *Referential: “When Madonna waved to the audience, she was really signaling to me.” *Erotomanic: “Madonna is in love with me.” *Somatic: “My liver is dead and rotting inside me.” *Nihilistic: “The world is ending.” *Grandiose: “I am the President of the entire world.” *“Bizarre” delusions: thought insertion; thought withdrawal’ outside forces are controlling one’s body or actions “Someone is putting/taking these thoughts from my head.” Hallucinations -Experience of sensory events without environmental input (any of the senses) Auditory are most common -Can experience in any sensory mode (Auditory visual, olfactory, gustatory, tactile) -Auditory are the most common; usually in form of “voices”, familiar or not, that are heard as being distinct from own thoughts Scary form: “command” hallucinations Two or more voices conversing or one voice keeping a running commentary are considered highly characteristic of SZ Delusions and hallucinations may often have congruent theme – better to have a congruent theme than not; if not, more pathological brain functioning is possible i.e “I heard voices that are coming to get me.” Finding from SPECT studies: studies cerebral blood flow -During hallucinations, Broca’s area which produces speech is most active; Wernicke’s area which is speech reception is not activated -Listening to own thoughts Schizophrenia: The “Negative” Symptoms Cluster The Negative Symptoms -The absence of insufficiency of normal behavior Spectrum of Negative Symptoms -Avolitions (or apathy) – lack of initiation and persistence (i.e. lack of hygiene) -Alogia – relative absence of speech which may be due to a decrease in thought production; smaller, less active brains -Anhedonia – lack of pleasure, or indifference -Asociality – limited interest in social interactions -Affective flattening – little expressed emotion: face immobile and unresponsive; may not be indicated of experienced emotion; flat affect may appear before other symptoms Schizophrenia: The “Disorganized” Symptom Cluster The Disorganized Symptoms -Include severe and excess disruptions -Speech, behavior and emotion Nature of Disorganized Speech -Cognitive slippage: illogical and incoherent speech -Tangentiality: going off on a tangent -Loose associations: conversation in unrelated directions -Word salad; neologisms: makes up new words or mixes real words together Nature of Disorganized Affect -Inappropriate emotional behavior: behavior not consistent with context (i.e. smiling when talking about death) Nature of Disorganized Behavior -Include a variety of unusual behaviors (disheveled; odd appearance; inappropriate or unpredictable behavior) -Catatonia spectrum: wild agitation, waxy flexibility, immobility
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