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Schizophrenia Was called Dementia Praecox (early dementia) Then called schizophrenia (split mind) Fragmentation of thought processes Split between thought & emotions Withdrawal from reality NOT MPD Affects 1% - 1 1/2% of population Affects men & women about equally More frequently seen in lower socioeconomic classes More frequently seen in large cities vs. rural More frequent in divorced/separated 10-15% may commit suicide Among the most severe disorders Much heterogeneity in symptoms Symptoms of Schizophrenia Positive Symptoms Pathological additions to normal behavior Negative Symptoms Characteristics that are lacking or reduced Psychomotor Symptoms Odd gestures Excited movement Motionless stupor Positive Symptoms Delusions - beliefs contrary to reality Delusions of persecution others are out to get you, victimize you, slander you Delusions of reference attach special and personal meaning to things that happen or to the behavior of others Delusions of grandeur believe oneself to have special importance or power Delusions of control belief that others are controlling your thoughts, feelings, or behavior Disorganized Thinking or Speech Loose associations little apparent connection among thoughts Conceptual difficulties concrete thinking (i.e., difficulty thinking abstractly) Peculiar word usage Neologisms Word Salad Perseveration Clang associations Heightened Perceptions & Hallucinations Sensory flooding Difficulty distinguishing relevant from irrelevant sensory information Hallucinations perceptions contrary to reality most often auditory can be visual, tactile, somatic, gustatory, olfactory Inappropriate Affect Emotions unsuited to the situation smile or laugh when describing something serious sad or angry in some happy circumstance inappropriate shifts in mood inappropriately intense mood may represent a response to another positive symptom (e.g., an hallucination) Negative Symptoms Poverty of Speech A decrease in speech or speech content (alogia) little or no reply/meaning Blunted or Flat Affect blunted - less expression of feeling than most flat - virtually no emotion may reflect deficiency in experience of or expression of emotions Loss of Volition Avolition feel drained of energy or interest in normal goals unable to begin or follow through on activities Ambivalence Conflicted feelings about many things Social Withdrawal Social and emotional withdrawal from others Psychomotor Symptoms Reduced spontaneous movement Catatonia - extreme motor disturbance Catatonic stupor totally unresponsive (apparently unaware) remain motionless/speechless for extended time Catatonic rigidity & posturing remain rigid & upright for hours resist efforts to be moved may assume awkward posture waxy flexibility Catatonic Excitement extreme/uncontrolled hyperactivity Types of Schizophrenia Catatonic Schizophrenia Psychomotor Disturbance immobility excessive motor activity extreme negativism posturing repetition of speech or sounds Paranoid Schizophrenia Preoccupation with one or more delusions or frequent hallucinations (auditory) Absence of other schizophrenic symptoms Disorganized Schizophrenia Severe disintegration of personality Incoherent/disorganized speech or behavior Flat or inappropriate affect Undifferentiated Schizophrenia Meets criteria for schizophrenia, but not for any of the above sub-categories Residual Schizophrenia Been schizophrenic No longer active symptoms of schizophrenia Continuing evidence of symptoms Etiology of Schizophrenia Biological Factors Runs in families Strong genetic component Brain Anomalies enlarged ventricles reduced size of some areas Biochemical Abnormalities Neurotransmitters Dopamine » relationship to Parkinsons Disease/L-Dopa » maybe too many D-2 Dopamine Receptors » especially in Type I Serotonin especially in Type II Infectious Agents e.g., pre-natal exposure to influenza related to birth month pattern similar to stillbirths Psychosocial Factors Family Dysfunction Schizophrenogenic mother cold and domineering little empirical support Disturbed Family Communication Vague, unclear, disorganized communication Mixed support Cause/Effect not clear Expressed Emotion Family members express critical or overprotective emotions Predictive of relapse Diathesis - Stress Model Concordance rate is never more than 50% More than genetics involved Combination of physiological vulnerability and life stresses may be needed Physiological vulnerability may be non-genetic Birth complications or in-utero viral exposure Combination may be different for different schizophrenic presentations Positive vs.
Approximate Word count = 951
Approximate Pages = 3.8
(250 words per page double spaced)
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